A case of early gastric cancer with cervical lymph nodes recurrence 5 years after a curative resection

A 61-year-old man exhibiting epigastric malaise on hunger was diagnosed with early gastric cancer by upper gastrointestinal endoscopy. Since no obvious metastasis was recognized by abdominal computed tomography(CT), he underwent distal gastrectomy with D1+ lymphadenectomy. Histopathological examination revealed a pStage IA lesion[pT1a (m), pN0]. He received no adjuvant chemotherapy, and he remained alive and in good health without recurrence for more than 5 years. At 5 years and 7 months after gastrectomy, he noticed cervical lymph node swelling and underwent further examination. He was diagnosed with recurrent gastric cancer in cervical lymph nodes, and treatment with S-1 (120 mg/ day) was initiated. He remained alive and free of progression for approximately 1 year on S-1 therapy, but he suddenly died from disseminated intravascular coagulation without an obvious cause. We report a rare case of late recurrence after curative resection in a patient treated for early gastric cancer.