[A Case of Gastric Cancer Diagnosed from Adrenal Metastasis after Left Adrenal Tumor Resection and Treated with Robot-Assisted Distal Gastrectomy after Chemotherapy].

Adrenal metastasis from gastric cancer is often found as part of systemic metastasis, and is rarely an isolated tumor that requires resection.The patient was a 73-year-old man.Contrast CT scan performed to investigate anemia and positive stool for occult blood revealed a 5 cm mass in the left adrenal gland.Upper gastrointestinal endoscopy revealed gastric cancer in the lesser curvature of the gastric angle, and lower gastrointestinal endoscopy revealed rectal cancer.Laparoscopic left adrenalectomy was performed for the left adrenal mass, and a histopathological examination revealed that the tumor was adrenal metastasis from gastric cancer.After 3 courses of SOX therapy, robot-assisted distal gastrectomy, with D2 lymph node dissection, and Roux-en-Y reconstruction were performed.Postoperative pathological diagnosis was M, Less, ypType 4, 48×43 mm, por2>tub2>sig, ypT3(SS), INF c, Ly0, V0, ypPM0, ypDM0, ypN0, P0, CY0, H0, M1(ADR), ypStage Ⅳ.By appropriately combining systemic therapy(chemotherapy)and local therapy(surgical resection), it is expected that the prognosis can be improved even for isolated adrenal metastasis of gastric cancer.