Long-term Survival of a Gastric Cancer Patient with a Synchronous Solitary Brain Metastasis—A Case Report—

Abstract

A case of a synchronous solitary brain metastasis of gastric cancer is described. An 81-year-old man was transferred to our hospital with a sudden loss of consciousness and subsequent seizure. Head computed tomography (CT) showed a 1-cm tumor with surrounding edema in the right frontal lobe of the brain. He was admitted with a diagnosis of symptomatic epilepsy caused by a brain tumor. Medical therapy did not control his seizures, and emergent brain tumorectomy was performed. The pathological diagnosis of the brain tumor was adenocarcinoma. To diagnose the primary lesion, upper gastrointestinal endoscopy and contrast-enhanced abdominal CT were performed, and a type 3 advanced gastric cancer with lymph node metastases was found in the lesser curvature of the lower gastric body. At the time of diagnosis, no other unresectable factors, such as peritoneal dissemination or liver metastases, were present. Then, distal gastrectomy with D2 lymph node dissection was performed. The pathological diagnosis was T3(SS), N3a. The patient's postoperative course was uneventful, and 4-year disease-free survival has been achieved so far. There are few reports of a synchronous solitary brain metastasis from gastric cancer. The present case was rare because long-term survival was achieved after concomitant resection of both primary and metastatic lesions.