Abstract
A 61-year-old woman was referred to the hospital for close examination, because a type IIb lesion on the anterior wall of the lower body of stomach was pointed out on a gastric endoscopy at a medical checkup. She had no history of abdominal pain nor acute abdomen. She liked to eat raw fishes. An abdominal ultrasonography and a CT scan revealed no metastatic lesions. An operation was performed with a diagnosis of early gastric cancer. Abdominal exploration revealed two white nodules on the omentum, and a 12×8mm elastic hard nodule on the lesser curvature of the stomach. Disseminated metastasis and lymph node metastasis were suspected. A distal gastrectomy with lymph node dissection (D2) and an omentectomy including the tumors were performed. Intraoperative pathological examination was not performed. Postoperative pathological and parasitological examinations of the nodules indicated intraperitoneal granulomatosis due to ectopic parasitism by anisakis larvae. Ectopic anisakiasis is rare and morphologically gives the appearance of metastasis of cancer. Attention must be paid for the existence of the disease in performing surgery for a malignant tumor. We report this rare case together with some bibliographical comments.
