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Early-stage gastric cancer with solitary brain metastasis four years after curative surgery: a case report and literature review

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Abstract

Brain metastasis post-curative gastrectomy for early-stage gastric cancer is extremely rare. We present herein, a case of solitary brain metastasis that developed 4 years post-curative surgery for early-stage gastric cancer. A 60-year-old man had early-stage gastric cancer 4 years prior to presentation and underwent laparoscopy-assisted distal gastrectomy with lymph node dissection. The pathological TNM classification was T1b (submucosal) N0M0. He underwent scheduled examinations and had no recurrence. 4 years postoperatively, he presented to the emergency department with sudden onset of nausea, vomiting, and inability to speak clearly. Brain computed tomography revealed a 17-mm nodule in the right cerebral hemisphere and midline shift. The tumor could not be radically resected for anatomical reasons, and incisional biopsy was performed for histological examination. Histological examination confirmed the diagnosis of a poorly differentiated adenocarcinoma from the previous gastric cancer. Gamma knife radiosurgery and chemotherapy were scheduled. 28 months after brain metastasis, multiple liver and lung metastases appeared. The patient died 30 months after developing brain metastasis. Brain metastasis may occur during long-term follow-up even after curative resection of early-stage gastric cancer. In patients with a history of gastric cancer and neurological symptoms, brain metastasis should be considered.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

There are no sources of funding. There are no financial or non-financial interests.

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Authors and Affiliations

  1. Department of Gastroenterological and General Surgery, Kyorin University Faculty of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Atsuko Ohki, Tsuyuha Koba, Masanao Tsurumi, Yoshikazu Hashimoto, Gen Nagao, Hirohisa Takeuchi & Nobutsugu Abe

  2. Department of Medical Oncology, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Naohiro Okano

  3. Department of Pathology, Kyorin University Faculty of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Masachika Fujiwara & Junji Shibahara

Authors
  1. Atsuko Ohki
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  2. Tsuyuha Koba
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  3. Masanao Tsurumi
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  4. Yoshikazu Hashimoto
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  5. Gen Nagao
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  6. Hirohisa Takeuchi
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  7. Naohiro Okano
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  8. Masachika Fujiwara
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  9. Junji Shibahara
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  10. Nobutsugu Abe
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AO, TK and NA. The first draft of the manuscript was written by AO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Atsuko Ohki.

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Conflict of interest

Atsuko Ohki, Tsuyuha Koba, Masanao Tsurumi, Yoshikazu Hashimoto, Gen Nagao, Hirohisa Takeuchi, Naohiro Okano, Masachika Fujiwara, Junji Shibahara and Nobutsugu Abe declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Ohki, A., Koba, T., Tsurumi, M. et al. Early-stage gastric cancer with solitary brain metastasis four years after curative surgery: a case report and literature review. Clin J Gastroenterol 15, 90–94 (2022). https://doi.org/10.1007/s12328-021-01564-7

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  • DOI: https://doi.org/10.1007/s12328-021-01564-7

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