Abstract
We report a case of dissection of recurrent abdominal paraaortic lymph nodes in a 69-year-old man with gastric cancer. The patient had undergone curative surgery consisting of a distal gastrectomy with D2 lymph node dissection for advanced gastric cancer 16 months before. Histological findings showed mucinous adenocarcinoma and final findings were T3 (SE), N2, H0, P0, stage IIIb, and curability B. This time the patient was admitted to the hospital because of increases in tumor markers such as CEA and CA19-9. Metastasis to paraaortic lymph nodes was diagnosed by ultrasonography and CT scan and the recurrent nodes were dissected. Of 19 dissected nodes, metastasis was found in three in nos. 16 b1 (interaorticocaval, preaortic and lateroaortic), which showed the same mucinous adenocarcinoma as the primary tumor. After the re-operation, the patient has been well and disease-free for 3 years and 3 months. Some reports suggest that lymph nodes dissection can provide therapeutic effects if the number of involved nodes is small and we have few effective chemotherapy for No. 16 recurrence at present. Under these background factors, we think that operation can be recommended if no other distant metastases are present, and this case would offer a basis of performing operation.
