<Clinical Studies>Two Case of Recurrent Pulmonary Metastasis Resected after Operation for Gastric Cancer

Abstract

It is said that the prognosis is poor in cases with recurrent pulmonary metastasis after operation for gastric cancer. In this article, 2 cases with nodular type of pulmonary metastasis resected after operation for gastric cancer and surviving well are reported by the authors. Case 1: 57year-old female. The patient underwent a total gastrectomy for the 3'type of cardiac cancer. As the serum levels of tumor markers increased and the chest X-ray examination revealed a mass lesion in the right lung (S_10), the operation for the lesion under the diagnosis of metastatic lung cancer was performed 1 year and 2 months after gastrectomy. The patient died of pulmonal and pleural metastasis 4 years and 7 months after the first operation. Case 2: 65-year-old male. The patient underwent a subtotal gastrectomy for the 5'type of gastric cancer. Chest X-ray examination for follow-up study revealed a mass lesion in the left lung (S_5). The patient underwent a left pulmonary superior lobe resection 2 years and 9 months after gastrectomy. The patient is still alive 6 years after the first operation. Surgical treatment must be actively considered for nodular type of metastatic lung cancer after operation for gastric cancer.

胃癌術後に肺転移をきたした症例の予後は不良とされている. 今回, 胃切除術後に結節型肺転移巣を切除し, 良好な結果を得た胃癌の2例を経験したので、報告する. 症例 1 は57歳, 女性. 噴門部 2'型胃癌の診断のもと, 胃全摘術を受けている. 腫瘍マーカーの上昇があり, 胸部X線写真で右肺 S_10 に腫瘤陰影を認めた. 胃癌術後1年2カ月目に肺部分切除術を施行した. 患者は胃癌切除後4年7カ月で肺転移および癌性胸膜炎のため死亡した. 症例2は65歳, 男性. 胃体部 5'型胃癌の診断のもと, 胃亜全摘を受けている. 術後経過観察中, 胸部X線写真で左肺 S_5 に腫瘤陰影を認め, 胃癌術後2年9カ月目に左肺上葉切除切除術を施行した. 患者は胃癌切除術後6年で健在である. 結節型の肺転移例に対しては積極的な外科手術を考慮すべきである.