Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4221-4229
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4221
Ex vivo liver resection followed by autotransplantation in radical resection of gastric cancer liver metastases: A case report
Hong Wang, Cheng-Cheng Zhang, Yan-Jiao Ou, Lei-Da Zhang
Hong Wang, Cheng-Cheng Zhang, Yan-Jiao Ou, Lei-Da Zhang, Southwest Hospital, Third Military Medical University (Army Medical University), Institute of Hepatobiliary Surgery, Chongqing 400038, China
Author contributions: Wang H wrote the manuscript; Zhang CC helped in writing the manuscript; all authors administered the daily medical treatments in this case; Zhang LD comprehensively supervised this study; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and accompanying images and clinical data.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei-Da Zhang, PhD, Professor, Southwest Hospital, Third Military Medical University (Army Medical University), Institute of Hepatobiliary Surgery, No. 30 Gaotanyan Street, Shapingba District, Chongqing 400038, China. 2518569931@qq.com
Received: October 21, 2020
Peer-review started: October 21, 2020
First decision: January 17, 2021
Revised: January 26, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: June 16, 2021
Processing time: 217 Days and 9.2 Hours
Abstract
BACKGROUND

Radical resection of gastric cancer liver metastases (GCLM) can increase the 5-year survival rate of GCLM patients. However, patients may lose the theoretical feasibility of surgery due to the critical location of liver metastasis in some cases.

CASE SUMMARY

A 29-year-old woman had a chief complaint of chronic abdominal pain for 1 year. Abdominal computed tomography and magnetic resonance imaging examinations suggested a mass of unknown pathological nature located between the first and second hila and the margin of the lower segment of the right lobe of the liver. The anterior wall of the gastric antrum was unevenly thickened. The diagnosis of (gastric antrum) intramucosal well-differentiated adenocarcinoma was histopathologically confirmed by puncture biopsy with gastroscopy guidance. She underwent radical resection (excision of both gastric tumors and ex vivo liver resection followed by autotransplantation simultaneously) followed by XELOX adjuvant chemotherapy. Without serious postoperative complications, the patient was successfully discharged on the 20th day after the operation. Pathological examination of the excised specimen indicated that gastrectomy with D2 lymph node dissection for primary gastric tumors and R0 resection for liver metastases were achieved. The resected mass was confirmed to be poorly differentiated gastric carcinoma (hepatoid adenocarcinoma with neuroendocrine differentiation) with liver metastases in segments VIII. No recurrence or metastasis within the liver was found during a 7.5-year follow-up review that began 1 mo after surgery.

CONCLUSION

Application of ex vivo liver resection followed by autotransplantation in radical resection for GCLM can help selected patients with intrahepatic metastases located in complex sites obtain a favorable clinical outcome.

Keywords: Ex vivo liver resection; Autotransplantation; Gastric cancer liver metastases; Critical location; Selected patients; Radical resection; Case report

Core Tip: Application of ex vivo liver resection followed by autotransplantation in radical resection for gastric cancer liver metastases can help selected patients with intrahepatic metastases located in complex sites obtain a favorable clinical outcome.