Late Recurrence to the Pleura 11 Years after Gastrectomy with Resection of Synchronous Peritoneal Dissemination—A Report of a Case—

Abstract

We present a rare case of late recurrence to the pleura after gastrectomy for gastric carcinoma and resection of synchronous peritoneal dissemination. A 70-year-old man underwent distal gastrectomy for advanced type 3 gastric cancer, when single small peritoneal metastasis, 1mm in diameter, was identified on the liver surface and resected at the surgery. Histologically it was peritoneal metastasis of gastric cancer. The patient was treated with S-1 chemotherapy for five years without any signs of recurrence and had closely been followed up after cession of the chemotherapy. Eleven years after the surgery, a CT scan revealed nodular deposits on the right diaphragm. We performed a video-assisted pleural biopsy, and pleural metastasis of gastric cancer was confirmed histologically. The number of longer survivors of synchronous peritoneal dissemination has increased, however, late solitary metastasis to the pleura without effusion is very rare.