A case of small cell carcinoma of the stomach

: We report a rare case of small cell carcinoma of the stomach with metastasis to the liver and invasion of the pancreas, which was associated with acute peritonitis due to perforation of the stomach. CPT-11/CDDP chemotherapy achieved a partial response. A 60-year-old man suddenly developed abdominal pain and visited the emergency room. We diagnosed acute peritonitis due to perforation of the digestive tract because CT scan showed free air in the abdominal cavity. An emergency operation was performed with an omental patch for closing the perforated hole in the stomach. Excisional biopsy was performed to the small liver nodule. Histological findings showed that the liver nodule was metastasis from small cell carcinoma. There was no finding from the thoracic CT scan, but gastroscopy revealed a giant tumor, which was diagnosed as small cell carcinoma in histology. Therefore, we diagnosed small cell carcinoma of the stomach with liver metastasis and invasion of the pancreas. After operation, one course of FP chemotherapy was performed, but the liver metastasis increased in size. Then we changed to CPT-11/CDDP chemotherapy as second-line therapy, and achieved partial remission (PR) of both the liver metastasis and gastric tumor.