Case Report of Gastric Cancer with Tumor Thrombus Extending into the Portal Vein

A 38-year-old man was admitted to Nipponkokan Hospital with a diagnosis of gastric cancer.At surgery we found a tumor thrombus extending from the superior mesenteric vein to the portal trunk along with gastric cancer. Metastatic lymph nodes in the subpyloric and prepancreatic area were adhering to the pancreas head.The mesocolon was also invaded by cancer.Therefore, pancreatoduodenectomy, resection of the transverse colon and resection of the portal vein were carried out.The resected portal vein was 8cm in length.End to end anastomosis of the stumps were performed without tension.The patient is alive without signs of recurrence 13 months after surgery.Thus far, 18 patients with gastric cancer with a tumor thrombus in the portal vein have been reported and 4 of them could undergo resection.With the development of imaging technics, this condition is likely to be diagnosed preoperatively.Surgeons should be aware of the possibility of treating such patients.