Radical Subtotal Gastrectomy in Early Gastric Cancer Patient with Situs Inversus Totalis

ABSTRACT

Situs inversus totalis is a complete mirror image of the thoracic and abdominal viscera. There are many cases of malignant neoplasms being found in patients with situs inversus totalis. We report a case of situs inversus totalis with an early gastric cancer. The patient was a 50-year-old woman who presented with epigastric discomfort with a one-month duration. The chest X-ray showed dextrocardia and the abdomen CT revealed situs inversus totalis with wall thickening of the gastric antrum. The resected specimen showed a 2 cm sized eroded lesion in the antrum. Histologically, gastric cancer was diagnosed as a well differentiated tubular adenocarcinoma that was confined to the mucosal layer. The patient was treated successfully with a radical subtotal gastrectomy, even though situs inversus totalis was not familiar to the surgeon.