Gastric Cancer Recurrence in 12 Years after Surgical Resection

Ki Hwan Ku; Seun Ja Park; Jae Hyun Kim; Hye Jung Kwon; Hee Kyung Chang; Jung Gu Park

doi:10.4166/kjg.2017.70.6.296

Journal List > Korean J Gastroenterol > v.70(6) > 1007717

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Ku, Park, Kim, Kwon, Chang, and Park: Gastric Cancer Recurrence in 12 Years after Surgical Resection

Case Report

Korean J Gastroenterol 2017;70(6):296-300.

Published online: 4 October 2017

DOI: https://doi.org/10.4166/kjg.2017.70.6.296

Gastric Cancer Recurrence in 12 Years after Surgical Resection

Ki Hwan Ku, Seun Ja Park, Jae Hyun Kim, Hye Jung Kwon, Hee Kyung Chang¹, Jung Gu Park²

¹Department of Internal Medicine, Pathology, Kosin University Gospel Hospital, Busan, Korea

²Department of Internal Medicine, Radiology, Kosin University Gospel Hospital, Busan, Korea

Correspondence to: Seun Ja Park, Department of Internal Medicine, Kosin University Gospel Hospital, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea. Tel: +82-51-990-6103, Fax: +82-51-990-5055, E-mail: parksj6406@hanmail.net

Received 17 August 2017 Accepted 23 October 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Recurrence of gastric cancer after 10 years of surgical resection is highly rare. There are limited data on the surveillance of patients with gastric cancer after 10 years from gastrectomy. A 50-year-old man presented to the gastroenterology clinic at our hospital for the management of abnormal findings on a routine colonoscopic exam. He had undergone gastrectomy for advanced gastric cancer 12 years ago. At presentation, colonoscopic examination revealed asymmetrically edematous and hyperemic mucosal change with luminal narrowing on transverse colon. Abdominal computed tomography showed no evidence of distant metastasis, except for focal bowel wall thickening on transverse colon. He underwent a laparoscopic right-hemicolectomy, and the resected specimen revealed a recurrent and metastatic lesion. We report a case of recurrence of gastric cancer after 10 years from surgical resection with relevant literature review.

Keywords: Gastric cancer, Surveillance, Recurrence

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Fig. 1.

Initial endoscopic examination (before 12 years) revealed a 3 cm-sized, Borrmann type-3 tumor on the lesser curvature of midbody of the stomach.

Fig. 2.

Colonoscopic examination revealed asymmetrically edematous and hyperemic mucosal change with luminal narrowing on transverse colon.

Fig. 3.

Radiologic images. (A) Abdominal CT revealed irregular enhancing wall thickening on transverse colon (white arrow). (B) PET-CT showed localized segmental hypermetablism on transverse colon (black arrowhead). CT, computed tomography; PET, positron emission tomography.

Fig. 4.

Hematoxylin and eosin stain of colonic specimen. Tumor cells mainly located in submucosal layer and invaded into muscle layer and subserosal layer (black arrowheads) (A: ×40, B: ×100).

Fig. 5.

Immunohistochemistry. (A, B) Immunohistochemistry of gastric specimen (×200; A: CK 7, positive; B: CK 20, positive). (C-E) Immunohistochemistry of colonic specimen (×200; C: CDX2, negative; D: CK 7, weak positive; E: CK 20, positive). CK, cytokeratin.

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