A CASE OF CARCINOID TUMOR OF THE STOMACH WITH MULTIPLE LIVER METASTASES

Abstract

A 66-year-old man was admitted to the hospital because of dysphagia. A tumor showing Borrmann 3 was found to be located in the lesser curvature of the upper gastric body with multiple metastases in the liver. Total gastorectomy, lateral segmentectomy of the liver, distal pancreatectomy and splenectomy were carried out. A resected tumor was 12×9 cm in size and histologically the tumor cells have specific argyrophilic granules in Grimelius staining, and a definite diagnosis was made of carcinoid tumor of the stomach. Hepatic arterial infusion chemotherapy with CDDP, 5FU, ADM and CPA was effective for decreasing in the size of the liver masses. He was died of lymph node metastasis on the eighth month after surgery, an autopsy revealed that most of the tumor cells in the liver had fallen in necrosis.In a review of 283 cases reported in the Japanese literature, the incidence of lymphnodal involvement or liver metastases was higher in gastric carcinoid cancers than that in gastric cancers, even with the tumors localizing within the submucosal layer of the stomach or with the size of the tumors being less than 2 cm in diameter.It is concluded that aggresive surgical resection and intraarterial infusion chemotherapy for carcinoid tumor of stomach with liver metastasis would improve the prognosis.