A Case of Advanced Gastric Cancer Accompanied with Skip Lymph Node Metastasis in the Retro Portal Region

: We report a case of advanced gastric cancer accompanied with skip lymph node metastasis in the retro portal region only. An 81-year-old man was referred to our hospital because of epigastric pain. CT examination of the abdomen revealed a gastric tumor and a tumor of 3.5 cm in diameter behind the portal vein and pancreatic head, which had high concentrations of FDG(SUVmax=8.5)on PET-CT examination. Thus, we diagnosed lymph node metastasis of the gastric cancer. We performed distal gastrectomyand en bloc resection of regional lymph nodes(D2 plus retro portal and retro pancreatic head nodes). In pathological examinations, the gastric tumor was diagnosed as poorlydifferentiated adenocarcinoma(por1, T3, INF b, ly1, v0). There were no metastatic nodes in perigastric lymph nodes, but the only metastasis was observed in the bulky lymph node, which was indicated by preoperative examinations. Postoperative course was uneventful. The patient is living recurrence-free without adjuvant chemotherapyfor more than 6 years after the operation.