Abstract
Combination chemotherapy with etoposide, epirubicin (adriamycin) and cisplatin (EAP chemotherapy) successfully provided a surgical resectability for advanced gastric cancer of Borrmann type 3 in a 19-year-old female. In the patient angiography revealed that the splenic and superior mesentric veins were obstructed by the cancer tumor, which was evaluated inoperable. EAP chemotherapy was started under intravenous hyperalimentation. Upper gastrointestinal series 2 weeks after chemotherapy revealed a remarkable decrease in the tumor size (decreasing rate: 94%). Elevated tumor markers on admission also decreased, when the tumor was judged as operable. On the 4th week after chemotherapy, total gastrectomy and splenectomy were performed. Macroscopically, it was of P0H0S2N3(+) in stage IV. Histopathologically it was a signet ring cell carcinoma. The efficacy of EAP chemotherapy was evaluated as grade 2 according to the histologic efficacy criteria. After additional postoperative EAP chemotherapy, the patient was discharged.
