Peritoneal Metastasis Detected 16 Years after Primary Operation for Gastric Neuroendocrine Tumor

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 51; no. 8; pp. 520 - 528
• Main Authors: Sasaki, Shozo, Kurata, Toru, Hagino, Shigeta, Shoji, Yasuhiro, Terada, Itsuro, Yoshikawa, Akemi, Kitagawa, Hirohisa, Fujimura, Takashi, Izumi, Ryohei, Saito, Katsuhiko
• Format: Journal Article
• Language: Japanese; English
• Published: The Japanese Society of Gastroenterological Surgery 01.08.2018
• Subjects: NET; neuroendocrine tumor; peritoneal recurrence
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.2017.0176

A 47-year-old woman underwent distal partial gastrectomy for gastric neuroendocrine tumor (NET) with serosal invasion in 1998. She received a CT scan for examination of eosinophilia in 2014, which revealed four tumors of the transverse mesocolon, right ovary, descending colon, and pelvic wall. The tumor of the transverse mesocolon was resected for diagnosis, and the pathological diagnosis was NET grade 2 (NET G2). We assumed the tumor was recurrence of gastric NET operated 16 years ago. The remaining other 3 tumors were also resected and diagnosed as NET G2. In the following year, CT scan revealed 2 recurrent tumors at the transverse mesocolon and pouch of Douglas. We excised them and diagnosed somatostatin analog for control of peritoneal metastasis. However, CT after 8 administrations of octoreotide acetate showed 2 peritoneal recurrences in the hepatorenal recess and pouch of Douglas. We terminated administration of octoreotide acetate and managed to observe the tumors at regular intervals because the growth rate of the tumors was very slow. We report a case of peritoneal recurrences of gastric NET G2, 16 years after primary operation.