Abstract
The patient was 72-year-old man. He underwent laparotomy total gastrectomy for advanced cancer in the gastric body, with pancreatic body and tail and spleen resection. The pathological diagnosis was primary gastric neuroendocrine cancer. Adjuvant chemotherapy with S-1 was administered in the first postoperative year. A solitary lung metastasis was detected one and a half year after surgery, and thoracoscopy-assisted partial resection of the right lung was performed. The pathological findings were similar to those of the gastric cancer. Accordingly, the lung lesion was diagnosed as lung metastasis from gastric cancer. The patient was kept under observation with no treatment, but has been recurrence free for five years after the first surgery.
Although lung metastasis from gastric cancer is generally a poor prognostic factor, long-term survival could be achieved with resection in the case of a solitary lung metastasis, as in the present case. The primary gastric neuroendocrine tumor was easy to detect in the lymph node metastasis and liver metastasis based on the pathological features, so recurrence-free survival after lung metastasis resection, as in the present case, seems unusual.
