Treatment of gastric cancer with situs invertsus totalis : A case report

Situs inversus totalis (SIT) is a relatively rare congenital anomaly with a reported incidence of 1 in 5,000 to 10,000 live births. Although some reports of SIT with malignancy have been published, there have been few reports on SIT with gastric cancer or on the potential complications of surgical intervention in such cases. We here report the case of a patient who underwent surgical treatment for gastric cancer with SIT. The patient was a 54-year-old male, who had been an outpatient with chronic hepatitis and diabetes mellitus. He received an upper endoscopic examination for follow-up of esophageal varices and type 2 ulcerative gastric cancer was found at the posterior wall of the lower stomach. Biopsy was performed and the patient was diagnosed with moderately differentiated gastric cancer. Distal gastrectomy was performed with precise preoperative anatomical analysis in order to confirm that there was no another anomaly, such as cardiovascular or congenital anatomical anomalies except for the inverted position of all of the viscera. Adequate anatomical examination and analysis of the inverted position of related vascular for surgical treatment could lead to safer interventional treatment for malignancies with SIT.