Abstract
It is not uncommon with hepatic cancers to be associated with tumor embolus in the portal vein, but uncommon with gastric cancers. In this paper a case of advanced gastric cancer associating with tumor embolus in the portal vein is described.
A 61-year-old man visited a nearby hospital because of anemia and edema of the lower extremities. The patient was diagnosed as having a gastric cancer of Borrmann type 3 involving from the lower to upper part of the body of the stomach and was referred to the hospital. After the admission abdominal ultrasonography revealed a 2.5×4.5cm hyperrchoic mass in the portal vein and a metastatic lesion in the caudate lobe of the liver. Tumor embolus of the portal vein was suspected. Abdominal CT showed a tumor embolus in the main trunk of the portal vein and a hepatic metastasis. With abdominal angiography the main trunk of the portal vein was not visualized entirely and the vein along the common bile duct dilated like a varix as a collateral circulation. Operative procedures included total gastrectomy with excision of the pancreas and spleen and removal of the hepatic caudate lobe, followed by an attempt of enucleation of the embolus. The attempt, however, failed in complete enucleation.
