Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 May-Jun;32(3):685-689.
doi: 10.21873/invivo.11294.

Superficial Spreading-type Gastric Cancer with Situs Inversus Totalis

Tsutomu Namikawa  1 , Sachi Tsuda  2 , Kazune Fujisawa  2 , Jun Iwabu  2 , Sunao Uemura  2 , Shigehiro Tsujii  2 , Hiromichi Maeda  3 , Hiroyuki Kitagawa  2 , Michiya Kobayashi  3   4 , Kazuhiro Hanazaki  2
Affiliations
Case Reports

Superficial Spreading-type Gastric Cancer with Situs Inversus Totalis

Tsutomu Namikawa et al. In Vivo. 2018 May-Jun.

Abstract

Situs inversus totalis (SIT) is a congenital anomaly characterized by a complete mirror-image transposition of the thoracic and abdominal viscera. We report on a rare case of superficial spreading gastric cancer associated with SIT in a 66-year-old woman referred to our hospital for examination of gastric cancer initially diagnosed by medical check-up. Esophagogastroduodenoscopy showed a slightly depressed lesion in the lesser curvature side of the stomach. Abdominal contrast-enhanced computed tomography showed complete transposition of the abdominal viscera, confirming SIT. The patient underwent total gastrectomy with regional lymph node dissection and Roux-en-Y reconstruction. Gross examination of the surgically resected specimen showed a slightly depressed lesion measuring 12×8 cm in diameter, and histopathology confirmed the diagnosis of signet-ring cell carcinoma, confined to the gastric mucosal layer without lymph node metastasis. The postoperative course was favorable, and the patient has been well without evidence of recurrence for 11 years following the operation. To the best of our knowledge, this is only the second case of a superficial spreading-type gastric cancer in a patient with SIT reported in the English literature.

Keywords: Situs inversus totalis; superficial spreading gastric cancer; total gastrectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Chest X-ray demonstrating dextrocardia and the right subphrenic gas pattern in the stomach
Figure 2
Figure 2. Esophagogastroduodenoscopy showing a superficial spreading-type tumor located in the middle third of the stomach.
Figure 3
Figure 3. Abdominal contrast-enhanced computed tomography showing complete transposition of the abdominal viscera.
Figure 4
Figure 4. A barium double-contrast examination showed a wall irregularity on the lesser curvature side of the gastric body (arrows).
Figure 5
Figure 5. Gross examination of the surgically resected specimen revealed a slightly depressed lesion, 12 mm in width and spreading from the upper to lower gastric body (arrows)
See this image and copyright information in PMC

References

    1. Haruki T, Maeta Y, Nakamura S, Sawata T, Shimizu T, Kishi K, Miyasaka S, Maeta H, Morimoto K, Taniguchi I. Advanced cancer with situs inversus totalis associated with KIF3 complex deficiency: report of two cases. Surg Today. 2010;40(2):162–166. - PubMed
    1. Namikawa T, Kitagawa H, Iwabu J, Okabayashi T, Sugimoto T, Kobayashi M, Hanazaki K. Clinicopathological properties of the superficial spreading type early gastric cancer. J Gastrointest Surg. 2010;14(1):52–57. - PubMed
    1. Brierley JD, Gospodarowicz MK, Wittekind C (eds) TNM classification of Malignant Tumours (8th Edition) New York John Wiley & Sons. 2017
    1. Yamaguchi S, Orita H, Yamaoka T, Mii S, Sakata H, Hashizume M. Laparoscope-assisted distal gastrectomy for early gastric cancer in a 76-year-old man with situs inversus totalis. Surg Endosc. 2003;17(2):352–353. - PubMed
    1. Benjellounel B, Zahid FE, Ousadden A, Mazaz K, Taleb KI. A case of gastric cancer associated with situs inversus totalis. Cases J. 2008;1(1):391. - PMC - PubMed

Publication types