Backgroung Radical resection of gastric cancer liver metastases could increase the 5-year survival rate of GCLM patients. However, patients may lose the theoretical feasibility of surgery just due to the critical location of liver metastasis in some cases.
Case presentation A 29-year-old female with chief complaints of chronic abdominal pain for one year. Abdominal CT and MRI examination suggested a mass of unknown pathological nature located between first and second hilars and the margin of lower segment of the right lobe of liver. The anterior wall of the gastric antrum was unevenly thickened. The diagnosis of (gastric antrum) intramucosal well-differentiated adenocarcinomav was histopathologically confirmed by puncture biopsy with gastroscopy guidance. Pathological property of liver mass remains unclear before surgery. She accepted radical resection（excision of both gastric tumors and ELRA simultaneously）followed by XELOX adjuvant chemotherapy. Without serious postoperative complications, the patient was successfully discharged on the 20th day after operation. Pathological examination of excised specimen indicated that gastrectomy with D2 lymph node dissection for primary gastric tumor 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 of 6 and 8 segments. Follow-up review showed no recurrence and metastasis within liver. The mother of three children miraculously lived a happy life and worked like normal people.
Conclusions: Application of ELRA in radical resection of GCLM can help selected patients with intrahepatic metastases located in complex sites get a favourable clinical outcome.