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A Case of Advanced Gastric Cancer with Para-Aortic Lymph Node Metastasis from Co-Occurring Prostate Cancer

  • Park, Miyeong (Department of Anesthesiology, Gyeongsang National University School of Medicine) ;
  • Jeong, Sang-Ho (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Lee, Young-Joon (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Park, Ji-Ho (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Choi, Sang-Kyung (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Hong, Soon-Chan (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Jung, Eun-Jung (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Ju, Young-tae (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Jeong, Chi-Young (Department of Surgery, Gyeongsang National University School of Medicine) ;
  • Lee, Jeong-Hee (Department of Pathology, Gyeongsang National University School of Medicine) ;
  • Ha, Woo-Song (Department of Surgery, Gyeongsang National University School of Medicine)
  • Received : 2016.10.10
  • Accepted : 2016.11.22
  • Published : 2017.03.31

Abstract

An 84-year-old man was diagnosed with two synchronous adenocarcinomas, a Borrmann type IV advanced gastric adenocarcinoma in his antrum and a well-differentiated Borrmann type I carcinoma on the anterior wall of the higher body of his stomach. Pre-operatively, computed tomography of the abdomen revealed the presence of advanced gastric cancer with peri-gastric and para-aortic lymph node (LN) metastasis. He planned for palliative total gastrectomy owing to the risk of obstruction by the antral lesion. We performed a frozen biopsy of a para-aortic LN during surgery and found that the origin of the para-aortic LN metastasis was from undiagnosed prostate cancer. Thus, we performed radical total gastrectomy and D2 LN dissection. Post-operatively, his total prostate-specific antigen levels were high (227 ng/mL) and he was discharged 8 days after surgery without any complications.

Keywords

References

  1. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010. Cancer Res Treat 2013;45:1-14. https://doi.org/10.4143/crt.2013.45.1.1
  2. Jeong O, Park YK. Clinicopathological features and surgical treatment of gastric cancer in South Korea: the results of 2009 nationwide survey on surgically treated gastric cancer patients. J Gastric Cancer 2011;11:69-77. https://doi.org/10.5230/jgc.2011.11.2.69
  3. Fujitani K, Yang HK, Mizusawa J, Kim YW, Terashima M, Han SU, et al.REGATTA study investigators. Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor (REGATTA): a phase 3, randomised controlled trial. Lancet Oncol 2016;17:309-318. https://doi.org/10.1016/S1470-2045(15)00553-7
  4. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017;20:1-19.
  5. Deng JY, Liang H. Clinical significance of lymph node metastasis in gastric cancer. World J Gastroenterol 2014;20:3967-3975. https://doi.org/10.3748/wjg.v20.i14.3967
  6. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-112. https://doi.org/10.1007/s10120-011-0041-5
  7. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al.MAGIC Trial Participants. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20. https://doi.org/10.1056/NEJMoa055531
  8. Cheng L, Rao Q, Huang WB. [Recent advance in staging of prostate cancer]. Zhonghua Bing Li Xue Za Zhi 2013;42:351-354.
  9. Loh KP, Mohile SG, Kessler E, Fung C. Treatment of metastatic prostate cancer in older adults. Curr Oncol Rep 2016;18:63. https://doi.org/10.1007/s11912-016-0548-3
  10. Kumar S, Podratz KC, Bakkum-Gamez JN, Dowdy SC, Weaver AL, McGree ME, et al. Prospective assessment of the prevalence of pelvic, paraaortic and high paraaortic lymph node metastasis in endometrial cancer. Gynecol Oncol 2014;132:38-43. https://doi.org/10.1016/j.ygyno.2013.10.002