Carcinoma of the stomach with bilateral adrenal and liver metastasis
Vinay Kumar, Ruhi Dixit and Manoj Pandey
World Journal of Pathology 2013, 2:6
Metastatic failures are relatively common in patients who had undergone curative gastric resections. Metastasis commonly occurs to liver and lung, metastasis to other sites is relatively rare.
This is the first case report in literature of a 48 year male who had underwent radical gastrectomy followed by six cycles of adjuvant chemotherapy with docetaxel and carboplatin. After one and half year, he presented with metastatic disease in liver and bilateral adrenal glands. Capecitabine was started as a single agent. Time to disease progression was six months. On disease progression, erlotinib 150 mg was added to capecitabine. The patient has static disease for one year till he developed multiple liver secondaries and disease progression. The patient was started on weekly paclitaxel with three weekly pegylated adriamycin. After two cycle of chemotherapy the performance status of the patient deteriorated and active treatment was stopped. The patient succumbed to his illness after 3 years 2 months from the date of first diagnosis.
Docetaxel and carboplatin followed by capecitabine and erlotinib as a second line can be used to prolong the survival in case of advanced gastric cancer.