Gastric Cancer with a Giant Lymph Node Metastasis—A Case Report—

Abstract

A 72-year-old man experiencing movement-related pain was admitted to our hospital. Abdominal computed tomography images revealed a floating tumor sized 8 cm. The tumor was believed to originate from the stomach, and hence, a gastrointestinal stromal tumor (GIST) was suspected. A few days later, the patient experienced hematemesis. Upon physical examination, rupturing of the tumor was expected ; thereafter, an emergency surgery was planned. The tumor had a smooth surface and was located near the greater curvature of stomach. We planned a wedge resection of the stomach. However, endoscopic examination of the stomach during the surgery revealed hemorrhagic gastric cancer. Therefore, we performed an emergency D2 distal gastrectomy. Pathologic examination revealed that the giant tumor was a gastric cancer that metastasized to the lymph node. We diagnosed gastric cancer, pT2(MP)N1M0, stage II A. The patient's recovery was uneventful, and there has been no sign of recurrence 20 months after surgery. In this study, we reported our experience of gastric cancer with a solitary large lymph node metastasis along with a literature review.