Abstract
A 69-year-old man who underwent upper GI endoscopy for an abnormality on gastric cancer (GC) screening was found to have type 2 GC of the gastric cardia and 0-II c GC of the gastric angle. A laparoscopic total gastrectomy and D2 lymph node (LN) resection were performed at our hospital. Histopathology showed a lesion depth of T2 in the cardia and T1a at the gastric angle, with no LN metastases. The diagnosis was stage I B GC.
One year 9 months postoperatively, the patient developed sudden dysarthria and a gait disturbance. Further evaluation showed a left cerebellar lesion, which was surgically resected, followed by whole-brain irradiation. Histopathology of the brain lesion showed adenocarcinoma, which was consistent with a brain metastasis from GC. However, systemic evaluation found no evidence of cancer recurrence other than in the brain. Subsequently, there was local recurrence in the brain, and the patient died 12 months after onset of brain metastasis. However, no metastatic lesions other than in the brain were ever found.
Brain metastases are rare in GC, occurring in only 0.5% of cases. However, a solitary brain metastasis without evidence of GC metastases in other organs is even rarer. This case of a solitary brain metastasis following GC surgery is reported, and the relevant literature is discussed.
