복부에 거대 림프절 전이를 형성한 조기위암

• Published in: Annals of surgical treatment and research Vol. 63; no. 2; pp. 167 - 170
• Main Authors: 박종우(Jong Woo Park), 이상권(Sang Kuon Lee), 김원우(Won Woo Kim), 전해명(Hae Myung Jeon), 김응국(Eung Kook Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.08.2002
• Subjects: 일반외과학; EGC; 알파-태아단백; 림프절 전이; α-fetoprotein; 조기위암; lymph node metastasis
• ISSN: 2288-6575; 2288-6796

Lymph node metastasis is found in 10-15% of patients with early gastric cancer; however, metastatic nodes forming giant abdominal masses or distant metastases are extremely rare. A 51-year-old male, HBs Ag-positive patient presented with an incidentally found huge upper abdominal mass. Imaging studies showed a 7 cm-sized epigastric mass consistent with hepatocellular carcinoma. His serum α-fetoprotein level was also significantly elevated (330.6 ng/ml). Endoscopic studies revealed a suspicious early gastric carcinoma located on the lesser curvature and the anterior wall of the antrum. He was operated on with a preoperative diagnosis of hepatocellular carcinoma coexisting with an early gastric carcinoma. However, the actual abdominal tumor was a metastatic lymph node resulting from a gastric carcinoma which was located around the hepatic artery. Accordingly, he underwent a subtotal gastrectomy with the D2 lymph node dissection and the removal of the metastatic node. Postoperatively, he did well without any complications. His serum α-fetoprotein level decreased to 49.3 ng/ml one week after the surgery and was completely normalized 3 months later. To date, one year and 4 months after the operation, he is in good conditions without evidence of recurrence on endoscopic and imaging studies. (J Korean Surg Soc 2002;63:167-170) KCI Citation Count: 0