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A 44-year-old woman had undergone a laparoscopic low anterior resection and lymph node dissection for rectal cancer (pT4aN2aH0P0M0, pStage Ⅲc)in 20XX. Six months postoperatively, a CT scan revealed recurrent liver metastasis. She underwent surgery and adjuvant chemotherapy. Three years after the initial surgery, her liver metastasis recurred again, and the patient underwent another cycle of surgical treatment and adjuvant chemotherapy. Five years after the initial surgery, a lesion was found in a gastric lesser curvature lymph node. Gastric kyphosis lymph node dissection was performed under the suspicion of a solitary lymph node metastasis. The resected lymph node was diagnosed as a medium-differentiated adenocarcinoma, with findings consistent with a lymph node metastasis from the initial rectal cancer. Postoperative adjuvant chemotherapy was administered. No recurrence was noted 6 years and 6 months after the initial surgery. Rectal cancer rarely metastasizes to the gastric lymph nodes in a solitary fashion. We describe a case of a solitary gastric regional lymph node metastasis observed after the resolution of previous liver metastases.

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