Skin Metastasis of Para-Aortic Lymph Node in MP Gastric Cancer

Abstract

The lymph node metastasis of gastric cancer has its own specific metastatic route to the regional lymph nodes. The skip metastases of gastric cancer defined as the presence of extraperigastric lymph node involvement without the detection of proximal lymph node metastasis. The skip metastasis was rarely found in early stage gastric cancer. A 78-year-old female admitted to treat a Type 1 cardiac gastric cancer. On preoperative diagnostic work up, the paraaortic lymph node swelling were pointed out by CT and it confirmed by PET. The total gastrectomy with standard D2 dissection of regional gastric lymph node was performed to treat the cardiac tumor and paraaortic lymph node sampling was also performed simultaneously. A total of 14 perigastric lymph nodes were dissected. The pathological examination revealed that all of the dis-sected perigastric regional lymph node was negative for metastasis whereas the paraaortic lymph node found a metastasis of the gastric cancer. As the result, present case explained as T2 (MP), N0, M1 (LYM) according to the 14 th edition of Japanese classification gastric carcinoma. The explanation of the skip metastasis is different from the 14 th edition and previous classification. We should be attention about this concern to compare the skip metastasis between previous and new cases.