부산대학교 도서관

The subject was a 52-year-old woman who underwent total gastrectomy for type 4 gastric cancer in October 2005 and received adjuvant S-1 chemotherapy for one year. In June 2007, a CT scan examination revealed a right hydronephrosis due to the retroperitoneal recurrence. After two courses of paclitaxel chemotherapy, the hydronephrosis disappeared. In October 2008, however, she suffered from pain and hardening of muscles in her lower limbs. In March 2009, a computed tomography (CT) scan examination revealed a low density area around the femoral arteries due to the progressing retroperitoneal recurrence. She underwent radiation therapy on each femoral area, however, the pain and hardening of her lower limbs became worse. An MRI examination revealed abnormal intensity of muscles in her back and lower limbs that suggested demyelinating disease or myositis. In November 2009, an incisional biopsy of the erector muscle was performed under local anesthesia. Pathological findings showed scattered atypical cells lying in the loose intestinal fibers replacing skeletal muscle fibers, and the final diagnosis was intramuscular metastasis from the primary gastric cancer. Intramuscular metastasis from gastric cancer is rare, moreover, there has been no report of a case of degenerating skeletal muscle.