Abstract
A 69-year-old woman was seen at our department because of an about one-month history of a right inguinal bulge. We confirmed a hard bulge with the size of a tip of the thumb on the foot side of the right inguinal ligament which could not be reduced by hand, and diagnosed it as incarcerated femoral hernia. On the next day radical repair of the femoral hernia was performed. Operative findings showed the content of the hernia to be the greater omentum, but there was a part of induration. The induration part was excised, of which histopathological study reported that omental metastasis of signet ring cell carcinoma was likely. Upper gastrointestinal endoscopy performed for exploration of primary lesion dislosed a type 3 lesion at the pyloric antrum. A biopsy of the lesion resulted in the same pathological findings as those of the omental node. Omental metastasis of gastric cancer was thus diagnosed. Gastric CT scan revealed multiple swollen lymph nodes around the stomach and multiple peritoneal disseminated lesions. The final diagnosis was gastric cancer, cT4aN2M1 and Stage IV. Thereafter chemotherapy with S-1+CDDP was conducted, but her symptoms were gradually aggravated. She died about 5 months after the operation.
We here report a case of peritoneal dissemination of gastric cancer presented with an incarcerated femoral hernia which is rare.
