Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report
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We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapythat was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of mele-na. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4b-N1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-linetherapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which neces-sitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopyrevealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonicstenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.
Abstract
We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapythat was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of mele-na. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4b-N1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-linetherapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which neces-sitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopyrevealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonicstenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.
참고문헌 (15)
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