[A case of bilateral pulmonary metastasis from gastric cancer performed radical thoracoscopic lobectomy after neoadjuvant chemotherapy].

A 40s male was performed proximal gastrectomy with D1+alpha dissection and interposition reconstruction for type 1 esophago-gastric junctional cancer in January 2002. Pathological findings were as follows: pap, se, ly0, v0, n1 (#3, 1/9) stage IIIA, curability B. Adjuvant chemotherapy by 5'-DFUR (800 mg/day) was done for 1 year. Bilateral pulmonary metastasis was detected in left S6 (3.8 cm) and right S10 (3 cm) in February 2006. After S-1 (120 mg/day) was administered for 4 courses, right pulmonary metastasis had become scar, and the other was remained and growing. S-1 (100 mg/ day 1-21)+CPT-11 (120 mg div day 1, 15) was done for 6 courses. However, the tumor was growing. As no other lesions but left pulmonary metastasis in S10, radical thoracoscopic left lower lobectomy with ND1 lymph node dissection was performed. Pathological finding was pulmonary metastasis from gastric cancer with no lymph node metastasis. There were no recurrences observed in May 2009 since gastrectomy was done 7 years ago, and 3 years since pulmonary metastasis was detected.