Abstract
A 64-year-old man examined for epigastralgia was found to have type 2 tumor at the lesser curvature of the gastric corpus on gastric endoscopy. Although biopsy specimens were negative for malignancy, total gastrectomy and D3 lymph node dissection were performed for advanced gastric cancer with multiple lymph node metastasis. Gastric small cell carcinoma was diagnosed on the basis of the pathological findings after operation. Despite adjuvant TS-1 chemotherapy, liver metastasis appeared 1 year after operation, and partial hepatectomy was performed. Hepatic arterial infusion (HAI) of low-dose 5-fluorouracil/cisplatin (FP) was administered once every 2 weeks after partial hepatectomy. Computed tomography (CT) performed during the course of HAI chemotherapy showed the recurrence of liver tumor twice. The chemotherapeutic regimen was continued for, few months later ; however, CT performed during this period did not reveal liver tumors. Recurrence was not observed, and the patient is alive for 5 years after first surgery.
Gastric small cell carcinoma is associated with a poor prognosis, and there is no established therapy to date. However, long-term survival has recently been reported in some cases. We suggest curative gastrectomy with extensive lymphadenectomy and long-term local control with hepatectomy and HAI for liver metastasis as a effective treatment of choice for gastric small cell carcinoma.
