源自食管癌或胃癌的脑转移很少见,占日本登记的所有脑肿瘤的2.1-3.3%。对于脑转移没有既定的治疗措施,因此预后较差。我们在这里介绍一名患者,该患者在手术和伽玛刀治疗食管胃腺癌的小脑转移后存活了5年。原发性胃癌经全胃切除术开腹手术治疗,脾切除术,和D2淋巴结清扫术。被诊断为食管胃交界处SiewertII型肿瘤,类型3,tub1-2,pT3(SS),pN1,以及手术标本组织病理学检查的IIB期。术后五个月,发现了孤立的小脑转移并通过手术切除,随后接受20Gy伽玛刀立体定向放射外科治疗;患者未接受化疗等后续治疗.初次手术五年后,没有复发,患者生活质量良好。手术治疗食管胃结合部癌小脑转移后长期生存的病例报道很少。我们报告了我们的经验,并回顾了已发表的胃癌脑转移手术治疗的病例报告。
Brain metastases originating from esophageal or gastric cancer are rare, accounting for 2.1-3.3% of all brain tumors registered in Japan. There are no established therapeutic measures for brain metastases, which accordingly have a poor prognosis. We present here a patient who survived for 5 years after surgery and gamma knife treatment of a cerebellar metastasis from esophagogastric adenocarcinoma. The primary gastric cancer was treated by laparotomy with total gastrectomy, splenectomy, and D2 lymphadenectomy. It was diagnosed as a esophagogastric junction Siewert type II tumor, type 3, tub1-2, pT3 (SS), pN1, and stage IIB on histopathological examination of the surgical specimen. Five months postoperatively, a solitary cerebellar metastasis was identified and surgically removed, followed by 20 Gy administered by gamma knife stereotactic radiosurgery; the patient received no subsequent treatment such as chemotherapy. Five years after the primary surgery, there have been no recurrences and the patient has a good quality of life. There are very few
case reports of long-term survival after surgical treatment of cerebellar metastases from esophagogastric junction cancer. We report our experience and review published
case reports of surgical treatment of brain metastases from gastric cancer.