Advanced gastric cancer showing complete remission of metastatic lymph node after chemotherapy

A 69-year-old woman with dyspepsia and poor oral intake was diagnosed as advanced gastric cancer. Clinical staging was stage IV with inoperable status, and thus, three cycles of palliative chemotherapy with paclitaxel and cisplatin were performed. Follow up endoscopy and positron emission tomography with computed tomography (PET-CT) revealed marked decrease in the primary stomach lesion and metastatic lymph nodes. Distal gastrectomy and D2 lymph node dissection were performed with gastrojejunostomy. Later pathological examination demonstrated tumor invading submucosa. However, there was no pathologic evidence of lymph node metastasis. Only the necrotic areas without viable carcinoma cells were noted in regional lymph nodes located along the left gastric artery and common hepatic artery. Because of the excellent response to chemotherapy, R0 resection was carried out. Herein, we report a case of advanced gastric cancer showing complete remission of metastatic lymphadenopathy after palliative chemotherapy.