[Two Cases of Gastric Cancer with Hematogenous or Lymphatic Metastasis to Small Intestine]

Small intestinal metastasis from gastric cancer via hematogenous or lymphatic vessels has rarely been reported. We herein report 2 cases of these small intestinal metastasis from gastric cancer. Case 1 was diagnosed with Stage ⅣB advanced gastric cancer. We performed palliative distal gastrectomy and Roux-en-Y reconstruction. After performing chemotherapy, complete response was obtained and the chemotherapy was suspended. One day the patient presented to our hospital with vomiting. Under the diagnosis of adhesive ileus, conservative treatment was done, but not effective. We, therefore, performed surgery, revealing the small intestinal stricture by the tumor. Case 2 was also diagnosed with Stage ⅣB advanced gastric cancer. The patient subsequently underwent chemotherapy for several years. During the fifth-line of chemotherapy, the patient visited our hospital with the symptoms of abdominal pain. Under the diagnosis of perforated peritonitis, we performed emergent surgery, revealing small bowel perforation and stenosis by the tumor. In both cases, we performed partial resection of small intestine and pathological examination showed metastatic small intestinal tumor from gastric cancer via hematogenous or lymphatic invasion.