Laparoscopic Total Gastrectomy with Adrenalectomy after Neoadjuvant Chemotherapy for Advanced Gastric Cancer with Solitary Adrenal Metastasis

A 66-year-old man was diagnosed with advanced gastric cancer (cT4a, N0, M1[ADR], cStage Ⅳ). He was treated with a triplet neoadjuvant chemotherapy regimen including docetaxel, cisplatin, and S-1, followed by totally laparoscopic total gastrectomy with D2+16a2lat lymph node dissection and adrenalectomy. He had an uncomplicated, good postoperative course and was discharged early from the hospital. S-1 plus cisplatin was started on POD42 as adjuvant chemotherapy. In such cases of solitary left adrenal metastasis from gastric cancer, multidisciplinary treatment comprising perioperative chemotherapy and radical surgery is required. In this report, we demonstrated that totally laparoscopic radical surgery with an uneventful postoperative course allowed the patient to initiate adjuvant chemotherapy in the early postoperative period.