*Corresponding author:
Sun Hwi Hwang, Department of Surgery and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South KoreaReceived: June 19, 2018; Published: July 02, 2018
DOI: 10.26717/BJSTR.2018.06.001319
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Background :Adenocarcinoma is the commonest histological form of Gastric cancer. But several unusual presentations have been reported. Perigastric lymph nodes are involved very early and are of prognostic importance. However, carcinoma from other organs can also spread to this lymph node group.
Case Presentation :We report a case of 65 years old man who was found on routine Esophagogastroduodenoscopy to have gastric tumour. Histology revealed adenocarcinoma. Staging investigation with abdominal computed tomography (CT) and Positron emission tomography, fluorine-18 fluoro- 2-2deoxy-D-glucose (PET-CT: F-18 FDG) Torso (Skull base to thigh) confirmed gastric cancer of the antrum with lymph node enlargement at hepatoduodenal ligament. The patient underwent laparoscopic assisted distal gastrectomy with D2 lymphadenectomy. Pathology revealed intestinal type moderately differentiated tubular adenocarcinoma invading lamina propria (pT1a). Four positive lymph nodes out of 34 did not show metastatic adenocarcinoma but rather Squamous Cell Carcinoma (SCC) and were positive for p63 and CK5/6 on immune histo chemistary. Primary site of SCC was not found. He received adjuvant chemotherapy with TS-1 60mg. After two years of follow-up he is asymptomatic and repeated EGD and abdominal CT Scan were normal.
Keywords: Adenocarcinoma; Metastasis; Perigastric Lymph Node; Synchronous; Squamous cell Carcinoma
Abbreviations: GC: Gastric Cancer; LN: Lymph Nodes; CUP: Cancer Of Unknown Primary; SCC: Squamous Cell Carcinoma; EGD: Esophagogastroduodenoscopy; CT Scan: Computed Tomography Scan; PET-CTF-18 FDG: Positron Emission Tomography; Fluorine-18 Fluoro- 2-2deoxy-D-glucose; CK: Cytokeratin
Abstract| Introduction| Case Presentation| Discussion and Conclusion| Conclusion| References|