Abstract
A 75-year-old man underwent total gastrectomy for gastric cancer invading the mesenterium with partial resection of the small intestine and transverse colon accompanied by splenectomy and cholecystectomy in February 2013. The disease was determined as Stage IIIC(T4a, N3, M0, P0, CY0, H0).
Postoperative adjuvant chemotherapy was administered for 6 months with TS-1 and docetaxel (DTX). Increase of the serum tumor marker levels was detected at 10 months after the surgery. Abdominal CT revealed findings suggestive of a right adrenal metastasis. Despite resumption of chemotherapy with TS-1 and DTX, the diameter of the adrenal metastasis increased to 36 mm by 17 months after the surgery. PET CT showed accumulation with an elevated standardized uptake value (SUV) only in the right adrenal metastasis. The patient was diagnosed as having isolated right adrenal metastasis, and laparoscopic right adrenalectomy was performed. Histological examination revealed findings consistent with adrenal metastasis from gastric cancer. The patient was followed up with CPT-11 treatment and did well without recurrence or metastasis. We report a rare case of laparoscopic adrenalectomy performed for solitary adrenal metastasis from gastric cancer.
