Gastric cancer with
protein-losing gastroenteropathy is relatively rare worldwide. The most important problem for the treatment of these patients is their low nutritional status and
protein level, which can cause severe postoperative complications. We report a 49-year-old Japanese female with a large gastric
tumor and
protein-losing gastroenteropathy successfully treated with neoadjuvant
TS-1 combined with CDDP
therapy. She had a type 5
tumor with partially cauliflower-like appearance. Her blood chemistry revealed low serum total
protein (3.3 g/dl) and low
albumin (1.7 g/dl). She was additionally diagnosed with
protein-losing gastroenteropathy based on (99m)Tc-human
serum albumin scintigraphy. Initial
neoadjuvant chemotherapy decreased the size of the
tumor and led to a marked improvement in her
serum protein levels. She then underwent a total
gastrectomy and
lymph node dissection (D2) with a combined resection of the spleen and gallbladder. Therefore,
neoadjuvant chemotherapy may provide a safe treatment before definitive surgery for
gastric cancer with
protein-losing gastroenteropathy.