Abstract
A 75-year-old woman developed advanced gastric cancer with multiple liver metastases (S2, S3). After docetaxel (DOC)/S-1 treatment, the liver metastases were reduced in size. Subsequently, in November 2011 the patient had a proximal gastrectomy, a left lateral segmentectomy, and a D2 dissection. On histopathology, no cancer was found in the resected stomach. The primary tumor biopsy tissue obtained before chemotherapy and the resected liver tissue were both positive for HER2 (IHC 2+, FISH positive). In March 2012, despite postoperative S-1 therapy, the woman's CEA and CA19-9 levels increased, and the abdominal CT showed liver metastasis (S7). Trastuzumab (Tmab) and paclitaxel (PTX) were added, the liver metastasis increased in size. Abdominal CT showed no new lesions ; therefore, a posterior segmentectomy was performed in September 2012. The resected lesion was negative for HER2 (IHC 0, FISH negative).
