Abstract
症例は46歳の女性で，心窩部痛のため当院を紹介受診した．上部消化管内視鏡検査で胃底部に腫瘍を認め，腹部CTで肝S6腫瘍を認めた．胃全摘術D2リンパ節郭清，肝右葉切除術を行った．胃上部前壁に7.5×4.5cm大の3型腫瘍を認め，肝右葉には6.5×4.0cm大の腫瘍を認めた．病理組織学的検査でwell-differentiated endocrine carcinoma（atypical carcinoid tumor）と診断した．核分裂像が多く，Ki-67指数は32％と高値であった．肝腫瘍は転移であった．リンパ節転移はなくpT3（SS）pN0 pM1 pStage IV（胃癌取扱い規約14版）と診断した．術後全身化学療法，肝動注など行い，10年間無再発生存中である．自験例は悪性度が高い胃カルチノイド腫瘍と考えられたが，胃全摘と同時肝切除により長期生存が得られているので文献的考察を加え報告する．
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