A gastric cancer with myotonic dystrophy

Patients with myotonic dystrophy (MD) are susceptible to respiratory complications under general anesthesia. A 51- year-old woman who had been treated for MD developed appetite loss and visited a local clinic. Blood tests revealed anemia (Hb 8.0 g/dl), and respiratory function tests confirmed restrictive ventilation disorder (VC 0.93 l, %VC 37.8). We diagnosed Stage IIIA gastric cancer, and planned surgical treatment because of the anemia and appetite loss. The patient underwent total gastrectomy under total intravenous anesthesia combined with epidural anesthesia. Propofol was used for induction, and a muscle relaxant was used only once at induction. The patient was extubated at the end of surgery. On postoperative day (POD) 3, she started enteral nutrition, and on POD 5 she started to eat. The patient was discharged from hospital on POD 16. We presented a rare case of MD with concomitant gastric cancer requiring surgery under general anesthesia.