⑩化学療法により原発巣に癌組織を認めえなくなった肝転移胃癌の1剖検例

An Autopsy Case of Gastric Cancer with Multiple Liver Metastases in which the Primary Site Turned out Pathologically Negative after Chemotherapy

　最近，著名な肝転移を伴う進行胃癌に化学療法を行ったが，診断後16カ月で死亡し，剖検を行ったところ，原発巣と思われる胃には癌組織を認めず，原発巣跡に著明に断裂した筋線維がバラバラに残存する特異な像を呈した興味ある1例を経験したので報告する．

　A 57 years old woman with stomach cancer (Borrmann 2) diagnosed inoperable by scintigraphy and angiography for the presence of multiple liver metastases was treated successfully by MFC chemotherapy and local arterial infusion (MMC 10～30mg, given 3 times) followed by maintenance therapy of FT 207 p.o., 800～1200mg per day. An autopsy 16 months after diagnosns showed no cancer in the stomach (the primary lesion) even by serial tissue sections, only showing the presence of fragmentarily scattered muscle fibers at the primary site. Fiberscopic biopsy on July 31, 1978, revealed a well-differentiated tubullar adenocarcinoma. Disappearance of the primary cancer of the stomach by chemotherapy is not reported so far in autopsy cases to our knowledge. Concerning with this, the following factors are considered important. Firstly, the stomach cancer was cytologically a well-differentiated tubullar adenocarcinoma of Borrmann 2. Secondly FT 207 had been given for a long time (a total amount of 243g), and lastly local arterial infusion was done three times in the course. This case strongly suggests the difference of the sensitivity to the antitumor drugs between the primary and the metastatic cancers.