Adult T-cell leukemia associated with gastric carcinoma: Report of a case

A 67-year-old man was admitted to our hospital with nausea and epigastralgi a, and a diagnosis of smoldering type adult T-cell leukemia (ATL) associate d with advanced gastric carcinoma was made. The gastric carcinoma had cause d pyloric stenosis, and investigations revealed regional lymph node metasta sis. The patient underwent total gastrectomy, splenectomy, cholecystectomy, and lymph node dissection with a Roux-en-Y anastomosis. Histological exami nation of the regional lymph nodes revealed not only metastases of gastric carcinoma, but also of ATL lymphoma, indicating a final diagnosis of advanc ed gastric carcinoma with locoregional lymph node due to both metastasis of the gastric carcinoma and the ATL lymphoma. Despite the administration of postoperative adjuvant chemotherapy comprised of cisplatin/adriamycin/5-flu orouracil in combination with oral etoposide and immunotherapy using ubenim ex, paraplegia suddenly developed caused by the metastasis of ATL to the ep idural space. Resection of this metastatic tumor for decompression of the s pinal cord resulted in resolution of the paraplegia; however, the patient d ied about 1 month later from rapid systemic tumor growth.