복부에 거대 림프절 전이를 형성한 조기위암
Early Gastric Cancer Accompanied with a Giant Metastatic Abdominal Lymph Node
박종우, 이상권, 김원우, 전해명, 김응국,
소속 상세정보
박종우 ( Park Jong-Woo )
가톨릭대학교 의과대학 외과학교실
이상권 ( Lee Sang-Kuon )
가톨릭대학교 의과대학 외과학교실
김원우 ( Kim Won-Woo )
가톨릭대학교 의과대학 외과학교실
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 외과학교실
김응국 ( Kim Eung-Kook )
가톨릭대학교 의과대학 외과학교실
KMID : 0371320020630020167
Abstract
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 ㎝-sized epigastric mass consistent with hepatocellular carcinoma. His serum α-fetoprotein level was also significantly elevated (330.6 ng/㎖). 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/㎖ 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.
키워드
조기위암; 림프절 전이; 알파-태아단백; EGC; lymph node metastasis; α-fetoprotein;
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