RESUMEN
A n 85-year-old woman presented with a mass in the left breast. A3 7mm lobulated mass including enhancement of a cyst of 37mm was detected by sonography. An axillary lymph node had increased to 16 mm. Atypical cells dyed by light green and orange G were identified by fine needle aspiration and cytology. She was diagnosed with left breast cancer(cT2N1M0, Stage II B), histologically suspected to be squamous cell carcinoma. She underwent a left-breast-conserving surgery and axillary lymph node dissection. On pathology, a cyst of 34×30mm was noted. The tumor grew from inside the cyst to the surround- ing tissue and it had a trend for keratinocytes. Lymph node metastases affected 1/11. By immunostaining, the tumor was found to be ER(+), PgR(-), HER2(-), CK5/6(+), p40(+), mammaglobin(-), and GCDFP15(-). There was no component of ductal carcinoma. She received radiotherapy to the left breast and tamoxifen as an adjuvant therapy. Squamous cell carcinoma of the breast is rare. We encountered a case of pure squamous cell carcinoma of the breast in an elderly woman. We report this case with a discussion of the relevant literature.
Asunto(s)
Neoplasias de la Mama/patología , Carcinoma de Células Escamosas , Anciano de 80 o más Años , Axila , Biopsia con Aguja Fina , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/cirugía , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirugía , Femenino , Humanos , Escisión del Ganglio Linfático , Ganglios Linfáticos/patología , Metástasis Linfática , Mastectomía SegmentariaRESUMEN
Fulvestrant is a novel endocrine therapy for breast cancer that exerts both anti-estrogenic and down-regulatory effects by binding to and degrading estrogen receptors (ERs). In the present study, the safety and effectiveness of 500 mg fulvestrant in 69 patients with advanced, recurrent, ER-positive postmenopausal breast cancer were investigated retrospectively. Outcomes were favorable for fulvestrant. The objective response rate was 24.6%, the clinical benefit rate was 49.2%, the median progression-free survival (PFS) was 203 days, and the median overall survival was 794 days. PFS tended to be longer in patients without a history of previous treatment or visceral metastasis. The main adverse events included injection site reactions and hot flushes; however, the majority of these events were mild to moderate. The present findings suggest that, among Japanese patients with advanced, recurrent, ER-positive postmenopausal breast cancer, 500 mg fulvestrant is effective and safe in those without metastasis and a minimal history of receipt of previous treatment regimens.
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Estradiol/análogos & derivados , Antagonistas de Estrógenos/uso terapéutico , Receptores de Estrógenos/antagonistas & inhibidores , Anciano , Anciano de 80 o más Años , Pueblo Asiatico , Neoplasias de la Mama/química , Regulación hacia Abajo , Estradiol/efectos adversos , Estradiol/uso terapéutico , Antagonistas de Estrógenos/efectos adversos , Femenino , Fulvestrant , Humanos , Persona de Mediana Edad , Posmenopausia , Receptores de Estrógenos/análisis , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
A 58-year-old woman presented to our hospital with a huge hepatic mass. A CT scan showed an enhanced mass lesion on the fundus of the gallbladder and an enhanced mass ring on the gallbladder bed. Since FDG-PET showed no evidence of metastasis, we performed cholecystectomy, hepatectomy of S4a/5, and regional lymph node dissection. The immunohistochemical study of the specimen was positive for CK7, CK20, chromogranin A, and synaptophysin. The Ki-67 labeling index was 50%, and the SSTR2 score was 2+. The patient was diagnosed with neuroendocrine carcinoma. Since she was in poor condition and on hemodialysis, we started administration of somatostatin analog at the time of recurrence, and soon her diarrhea improved but the tumor increased in size.
Asunto(s)
Carcinoma Neuroendocrino/cirugía , Neoplasias de la Vesícula Biliar/patología , Carcinoma Neuroendocrino/tratamiento farmacológico , Carcinoma Neuroendocrino/secundario , Colecistectomía , Femenino , Neoplasias de la Vesícula Biliar/tratamiento farmacológico , Neoplasias de la Vesícula Biliar/cirugía , Hepatectomía , Humanos , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Persona de Mediana Edad , Imagen Multimodal , Tomografía de Emisión de Positrones , Diálisis Renal , Tomografía Computarizada por Rayos XRESUMEN
The patient was an 86-year-old woman. She underwent right breast-conserving surgery and sentinel lymph node biopsy for breast cancer in August 2006. The pathological diagnosis was invasive ductal carcinoma, T1N0M0, Stage â , ER (+), PgR (-), HER2 (-). She was treated with tamoxifen for 5 years as adjuvant therapy and showed no signs of recurrence. In November 2014, CA15-3 was elevated and an accumulation of FDG in the right paracolic sulcus was observed on PET-CT. Peritoneal metastasis of breast cancer was suspected, and an operation was performed for a definitive diagnosis. During the operation, the tumor was seen on the paracolic sulcus, and laparoscopic-assisted right hemicolectomy was performed. A poorly differentiated adenocarcinoma was diagnosed by pathological examination, and immunostaining results were as follows: CK7(+), CK20(-), mammaglobin (-), GCDFP-15 (-), ER (-), PgR (-), and HER2 (-). Because there was no original lesion other than the breast cancer, the tumor was diagnosed as a metastasis of breast cancer. The frequency of peritoneal metastasis of breast cancer is low. In this case, pathological diagnosis was necessary for a definitive diagnosis. A change of subtype was also confirmed, and the treatment strategy was decided appropriately. Surgical resection should be considered for peritoneal metastasis of breast cancer when the operation can be performed safely.
Asunto(s)
Adenocarcinoma/cirugía , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Ductal/cirugía , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/cirugía , Anciano de 80 o más Años , Antineoplásicos Hormonales/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Carcinoma Ductal/tratamiento farmacológico , Colectomía , Femenino , Humanos , Laparoscopía , Recurrencia , Tamoxifeno/uso terapéutico , Tegafur/uso terapéutico , Uracilo/uso terapéuticoRESUMEN
A 71-year-old man was admitted to our hospital for epigastric pain. Upper gastrointestinal endoscopy revealed a type 2- like ulcerative lesion in the posterior wall of the upper and middle part of the stomach. Endoscopic biopsies showed malignant T-cell lymphoma histologically. A chest CT scan revealed a nodule in the apex of right lung, suggestive of primary lung cancer. A total gastrectomy with D2 lymphadenectomy and distal pancreatectomy with splenectomy was performed. Seventy-three days after surgery, the patient developed a lung abscess in the middle lobe of the right lung. A wedge-shaped resection of the upper lobe and total resection of the middle lobe of the right lung was performed. Histological examination revealed a primary pulmonary mucosa-associated lymphoid tissue lymphoma in the upper lobe of right lung and an abscess caused by Pseudomonas aeruginosa in the middle lobe of the right lung. Twelve months after surgery the man died of suffocation because of aspiration due to esophageal stenosis caused by progression of metastasis of the paraesophageal lymph node.
Asunto(s)
Neoplasias Pulmonares/patología , Linfoma de Células B de la Zona Marginal/diagnóstico , Linfoma no Hodgkin/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Gástricas/diagnóstico , Anciano , Gastrectomía , Humanos , Neoplasias Pulmonares/cirugía , Linfoma de Células B de la Zona Marginal/cirugía , Linfoma no Hodgkin/cirugía , Masculino , Neoplasias Primarias Múltiples/cirugía , Pancreatectomía , Neoplasias Gástricas/cirugíaRESUMEN
Laparoscopic surgery is less invasive and provides better cosmetic outcomes than conventional surgery. Laparoscopic liver resection has been covered by insurance since April 2010 and is increasingly performed in many hospitals. However, laparoscopic hepatectomy is sometimes difficult to perform safely in the case of HCC recurrence because adhesions restrict vision and manipulation of forceps. We report the results of laparoscopic hepatectomy for cases of HCC recurrence. From June 2010 through December 2014, 180 laparoscopic hepatectomy procedures for HCC were performed in our hospital; 33 were in patients with HCC recurrence. Of the 33 patients, 26 underwent pure laparoscopic partial hepatectomy. The median operative time was 242 min, the median bleeding amount was less than 5 g, and the median hospital stay after surgery was 12.0 days. In the group that underwent laparoscopic hepatectomy after open liver resection (12 patients), the median operative time was 303.5 min, the median bleeding amount was less than 5 g, and the median hospital stay after surgery was 9.0 days. Among the 21 patients that underwent laparoscopic hepatectomy after laparoscopic liver resection, the median operative time was 248 min (p=0.382), the median bleeding amount was less than 5 g (p=0.112), and the median hospital stay after surgery was 11.0 days (p=0.236). We could perform laparoscopic hepatectomy for cases of HCC recurrence. This procedure can be suitable for HCC recurrence, which sometimes requires poly-surgery.
Asunto(s)
Carcinoma Hepatocelular/cirugía , Laparoscopía , Neoplasias Hepáticas/cirugía , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica , Femenino , Hepatectomía , Humanos , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , RecurrenciaRESUMEN
Systemic chemotherapy based on 5-fluorouracil (5-FU) is a standard treatment for unresectable or recurrent colorectal cancer. Although hyperammonemia is known as one of the adverse side effects of 5-FU, a disturbance of consciousness caused by hyperammonemia is not a usual finding. We encountered a case of 5-FU-related consciousness disturbance with respiratory depression. A woman in her sixties was diagnosed with metastatic cecum cancer, involving peritoneal dissemination and hydronephrosis due to retroperitoneal invasion. After resection of the primary lesion, systemic chemotherapy, including capecitabine, irinotecan, bevacizumab and cetuximab, was administered for the metastatic lesions. As a third-line of treatment, the mFOLFOX6 plus bevacizumab regimen was administered. On the second day of the first course, the patient complained of nausea and vomiting. On third day, her consciousness level was deteriorating. The level of ammonia in the blood was abnormally high. Therefore, we diagnosed consciousness disturbance caused by hyperammonemia resulting from high-dose 5-FU infusion. The symptom improved immediately after mechanical ventilation and intravenous infusion. Renal dysfunction is considered a risk factor for hyperammonemia caused by 5-FU, and it is necessary to pay particular attention in patients with renal dysfunction who receive chemotherapy with 5-FU.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias del Apéndice/tratamiento farmacológico , Neoplasias del Apéndice/patología , Estado de Conciencia/efectos de los fármacos , Hiperamonemia/inducido químicamente , Neoplasias Peritoneales/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Apéndice/cirugía , Colectomía , Femenino , Fluorouracilo/efectos adversos , Fluorouracilo/uso terapéutico , Humanos , Hiperamonemia/tratamiento farmacológico , Leucovorina/efectos adversos , Leucovorina/uso terapéutico , Náusea/inducido químicamente , Compuestos Organoplatinos/efectos adversos , Compuestos Organoplatinos/uso terapéutico , Neoplasias Peritoneales/secundario , Neoplasias Peritoneales/cirugíaRESUMEN
Pancreatic adenocarcinoma is one of the leading causes of cancer-related deaths in Japan. oxaliplatin: L-OHP, irinotecan: CPT-11, fluorouracil: 5-FU, and Leucovorin: l-LV (FOLFIRINOX) combination chemotherapy provided significant improvements in overall and progression-free survival in a phase â ¢ trial in France and in a phase â ¡ trial in Japan. As a result, this combination therapy was approved for use in Japan. We evaluated the efficacy of FOLFIRINOX in metastatic or recurrent pancreatic cancer. Between October 2014 and July 2015, 10 patients received mFOLFIRINOX as follows: 2-hour infusion of LOHP at 85 mg/m2, 2-hour infusion of l-LV at 200 mg/m2 and infusion of CPT-11 over 90 min at 150 mg/m2, followed by continuous infusion of 5-FU over 46 hours at 2,400mg/m2. Prior to the treatment, a 5-hydroxytryptamine receptor antagonist, aprepitant, and dexamethasone were given. The treatment was repeated every 2 weeks until disease progression, unacceptable toxicity, discontinuation as decided by the investigators, or patient refusal. The mean age of the patients was 65.0 years (range, 59-75 years), and 4 out of 10 patients were men. Only 2 patients had no prior therapy. Nine patients had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0. Eight patients had metastasis and 2 had locally recurrent disease. The median number of treatment cycles was 5 (range, 1-14). The relative dose intensities of 5-FU, L-OHP and CPT-11 were 93.3% (range, 58.3-100%), 84.0% (range, 63.2-100%), and 76.0% (range, 44.4-83.3%), respectively. The major Grade 3 and 4 hematological toxicities were neutropenia (40%), leucopenia (30%), and thrombocytopenia(10%). The major Grade 2 and 3 non-hematological toxicities were diarrhea (30%), nausea (60%), and vomiting (10%). Serious adverse events occurred in 2 patients. Severe biliary tract infection causing sepsis was observed in 1 patient with a biliary stent. Overwhelming post-splenectomy infection was observed in 1 patient after distal pancreatectomy. No cases of interstitial lung disease were observed. The 6-month progression-free and overall survival rates were 59.3% and 61.7%, respectively. The overall response rate was 10%, and the disease control rate was 90%(complete response [CR], n=0; partial response [PR], n=1; stable disease [SD], n=8; progressive disease [PD], n=1). Although FOLFIRINOX is associated with increased treatment efficacy and survival outcomes, because of its severe toxicity it cannot be administered to all patients. FOLFIRINOX can be used as the standard treatment for patients with a good performance status.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/patología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Pancreatic ductal carcinoma is a highly aggressive cancer, with one of the highest mortality rates among gastrointestinal cancers. Nab-paclitaxel plus gemcitabine (GEM) significantly improved overall survival, progression-free survival, and response rate in a phase â ¢ trial in 151 community and academic centers in 11 countries. As a result, nab-paclitaxel plus GEM was approved for use in December 2014 in Japan. We report a case of a patient with pancreatic cancer who underwent this chemotherapy. A 47-year-old man was admitted to our hospital for evaluation of pancreatic lesions. Computed tomography revealed a hypoattenuating tumor in the body of the pancreas. After the patient underwent preoperative chemoradiotherapy under the diagnosis of cStage â £a cancer, we planned to perform distal pancreatectomy. However, this case was inoperable because we found 3 liver metastases during surgery. On postoperative day 14, we treated the patient with nab-paclitaxel plus GEM. Grade 2 toxicities included neutropenia, diarrhea, and peripheral neuropathy, but serious adverse events did not occur. The progression-free survival was 5 months. He remained alive for 7 months after the chemotherapy. In patients with metastatic pancreatic adenocarcinoma, nab-paclitaxel plus GEM can be considered as the standard treatment.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Pancreáticas/tratamiento farmacológico , Albúminas/administración & dosificación , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Humanos , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Paclitaxel/administración & dosificación , Neoplasias Pancreáticas/patología , Resultado del Tratamiento , GemcitabinaRESUMEN
In the EMBRACE trial, eribulin was reported to significantly increase overall survival compared to treatment of the physician 's choice when given to patients with recurrent or metastatic breast cancer who had received prior treatment, including an anthracycline and a taxane. In April 2011, eribulin was approved in Japan for the treatment of inoperable or recurrent breast cancer. In this article, we report on the efficacy and safety of eribulin in cases we encountered. Twenty patients with advanced and recurrent breast cancer were administered eribulin in our hospital during the period from August 2011 to December 2012. The median age was 62 years(range, 42-76 years); 16 patients had the estrogen receptor(ER)(+)/human epidermal growth factor receptor 2(HER2)(-)subtype, whereas 4 patients had the triple-negative subtype. Following recurrence, the median number of chemotherapy regimens was 3(range, 0-5). Regarding the antitumor effects of eribulin, no cases showed complete response(CR), 5 cases showed partial response(PR), and 10 cases showed stable disease(SD); therefore, the response rate(CR+PR)was 25% and the clinical benefit rate(CR+PR+B6-month SD)was 35%. Median progression free survival was 146 days, and median overall survival was 482 days. In terms of adverse events(AEs), observed cases of hematotoxicity were of neutropenia(75%), leucopenia(75%), and anemia(80%). Cases of Grade 3 hematotoxicity or higher were of neutropenia(40%), leucopenia(20%), and febrile neutropenia(1 case, 5%). The observed non-hematotoxic AEs were peripheral neuropathy(30%)and general malaise(35%), although none were of Grade 3 or higher. The therapeutic efficacy of eribulin in the present study was relatively better than that in previous reports(EMBRACE trial, Japan Domestic 221 trial). The frequency of Grade 3 or higher AEs was low, and the drug was well tolerated. We believe that eribulin is a novel drug that provides therapeutic efficacy while maintaining quality of life(QOL).
Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Furanos/uso terapéutico , Cetonas/uso terapéutico , Adulto , Anciano , Neoplasias de la Mama/patología , Furanos/efectos adversos , Humanos , Cetonas/efectos adversos , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia , Resultado del TratamientoRESUMEN
Primary colon carcinoma within an inguinal hernia sac is very rare and most reported cases were found at emergency open surgery for an incarcerated hernia. We report a case of incarcerated sigmoid colon carcinoma diagnosed preoperatively and treated with elective laparoscopic surgery. A 67-year-old man with a 2-year history of swelling of the scrotum and a breast lump was referred to us for surgical treatment of an irreducible left inguinal hernia and a right breast tumor. Blood examination results showed severe anemia. Computed tomography scan and endoscopic biopsy confirmed sigmoid colon carcinoma incarcerated in the left inguinal hernia. Thus, we performed definitive laparoscopic sigmoidectomy and conventional hernia repair for preoperatively diagnosed sigmoid colon carcinoma within an inguinal hernia.
Asunto(s)
Adenocarcinoma/complicaciones , Adenocarcinoma/cirugía , Colectomía/métodos , Procedimientos Quirúrgicos Electivos/métodos , Hernia Inguinal/complicaciones , Hernia Inguinal/cirugía , Laparoscopía/métodos , Neoplasias del Colon Sigmoide/complicaciones , Neoplasias del Colon Sigmoide/cirugía , Anciano , Neoplasias de la Mama Masculina/patología , Neoplasias de la Mama Masculina/cirugía , Carcinoma Ductal de Mama/secundario , Carcinoma Ductal de Mama/cirugía , Herniorrafia , Humanos , Escisión del Ganglio Linfático , Masculino , Mastectomía , Neoplasias Primarias Múltiples , Resultado del TratamientoRESUMEN
Laparoscopic hepatectomy has been reported as a safe and effective approach for the treatment of hepatocellular carcinoma ( HCC). However, few studies have reported survival outcomes after laparoscopic hepatectomy in HCC patients with cirrhosis. In the present study, we evaluated the surgical outcomes and disease-free survival in these cases. Between June 2010 and March 2013, 35 HCC patients with cirrhosis underwent laparoscopic hepatectomy. Operative variables for laparoscopic vs open hepatectomy were as follows: operative times, 268.3 vs 183.3 minutes (p=0.0043); blood loss volume, 151.0 vs 1,106.1 g (p<.001); 1-year disease-free survival rate, 73.1 vs 71.6%; and 2-year disease-free survival rate, 39.9% vs 28.6% (p=0.568), respectively. Laparoscopic hepatectomy is feasible and safe in selected patients with liver cirrhosis, with similar outcomes in disease-free survival when compared with open hepatectomy.
Asunto(s)
Carcinoma Hepatocelular/cirugía , Hepatectomía , Hepatitis B/complicaciones , Laparoscopía , Cirrosis Hepática/cirugía , Neoplasias Hepáticas/cirugía , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/etiología , Femenino , Humanos , Cirrosis Hepática/etiología , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Regorafenib is a novel, orally administered multi-kinase inhibitor that has recently been approved for the treatment of recurrent gastrointestinal stromal tumor (GIST). We report a case of successful treatment of recurrent duodenal GIST, which was found to be resistant to imatinib and sunitinib, with regorafenib. A 62-year-old woman underwent a pancreatoduodenectomy for duodenal GIST; after 2 years, a computed tomography (CT) scan detected liver metastases. The patient received imatinib for 6 years, and underwent 2 hepatectomies. Subsequently, she received sunitinib for 10 months; however, CT scans revealed the presence of multiple vertebral metastases. She underwent a laminectomy for the palliative treatment of the vertebral metastases. Upon immunohistochemical examination, the recurrent tumor stained positive for c-kit, confirming the diagnosis for GIST. Consequently, the patient received regorafenib; although the treatment controlled the liver metastases, the vertebral metastases were found to have progressed. She survived for 9 years and 5 months after the initial surgical resection. Regorafenib might be beneficial in the treatment of recurrent GISTs that prove to be resistant to imatinib and sunitinib.
Asunto(s)
Resistencia a Antineoplásicos , Neoplasias Duodenales/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Compuestos de Fenilurea/uso terapéutico , Piridinas/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Benzamidas/administración & dosificación , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Resultado Fatal , Femenino , Tumores del Estroma Gastrointestinal/cirugía , Hepatectomía , Humanos , Mesilato de Imatinib , Indoles/administración & dosificación , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Persona de Mediana Edad , Piperazinas/administración & dosificación , Pirimidinas/administración & dosificación , Pirroles/administración & dosificación , Recurrencia , Sunitinib , Resultado del TratamientoRESUMEN
Malignant bowel obstruction often causes oral intake difficulties and decreases quality of life. In Japan, gastroduodenal stenting for malignant gastric outlet obstruction has been covered by health insurance since 2010, while colon stenting has been covered since 2012. Both approaches are useful treatments for malignant bowel obstruction. Here we report the case of a woman with gastric outlet obstruction and rectal obstruction due to breast cancer metastases who was able to eat solid food after duodenal and colon stenting. When choosing whether to perform endoscopic stenting or surgical intervention such as gastrojejunostomy, ileostomy, and colostomy for treating malignant bowel obstruction, it is important to assess the patient's general condition and prognosis as well as the obstruction position.
Asunto(s)
Neoplasias de la Mama , Obstrucción Intestinal/terapia , Stents , Anciano , Neoplasias de la Mama/terapia , Colon , Duodeno , Resultado Fatal , Femenino , Humanos , Obstrucción Intestinal/etiología , Metástasis de la Neoplasia , Cuidados Paliativos , Calidad de Vida , EstómagoRESUMEN
A 53-year-old woman with recurrent abdominal pain was referred to our hospital. Based on the enhanced abdominal computed tomographic (CT) finding, she was diagnosed with intussusception of the sigmoid colon. Colonoscopy was performed to release the intussusception, and a lead point lesion was detected. An advanced cancer was found in the rectum, which could be pushed back into the sigmoid colon easily using pressurized air. A more-advanced colon cancer was also detected on the oral side of the lesion. The patient was diagnosed with double cancer of the sigmoid colon and was treated with laparoscopic sigmoidectomy with lymph node resection (D3). Preliminary reduction by colonoscopy prior to surgery is an effective option in cases of adult intussusception. Colonoscopy can be used to perform definitive and qualitative diagnoses.
Asunto(s)
Intususcepción/etiología , Neoplasias Primarias Múltiples/cirugía , Enfermedades del Sigmoide/cirugía , Neoplasias del Colon Sigmoide/cirugía , Colonoscopía , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Primarias Múltiples/complicaciones , Neoplasias del Colon Sigmoide/complicacionesRESUMEN
A 26-year-old man was admitted to hospital because of lower quadrant pain. Colonoscopy showed a polypoid lesion (0- Ip: protruded, pedunculated)in the cecum. Endoscopic biopsy revealed a tubular adenoma with severe atypia. Laparoscopy- assisted ileocecal resection was performed, as the diameter of the tumor made colonoscopic treatment difficult. Appendiceal intussusceptions were found in the excised specimen. The tumor was mucosal in origin. The patient remained cancer-free after the surgery.
Asunto(s)
Adenoma/cirugía , Neoplasias del Apéndice/cirugía , Enfermedades del Ciego/cirugía , Intususcepción/cirugía , Adenoma/complicaciones , Adulto , Neoplasias del Apéndice/complicaciones , Neoplasias del Apéndice/patología , Colonoscopía , Humanos , Intususcepción/etiología , Laparoscopía , MasculinoRESUMEN
An 80-year-old man was admitted to our hospital with fever and dizziness. He was diagnosed with splenic abscess and invasion of descending colon cancer by enhanced abdominal computed tomography. A type 2 colon cancer was also observed in the descending colon by colonoscopy. There was no distant metastasis. Therefore, he underwent left hemicolectomy with splenectomy. A histological diagnosis of mucinous adenocarcinoma was made. The pathological findings were pT4b, pN1, cM0, fStage IIIa. The patient was discharged on the ninth post-operative day without any complications. We herein report a rare case of splenic abscess due to invasion of colon cancer and review 8 previous case reports. An en block resection including lymph node resection is recommended in such cases for curative resection.
Asunto(s)
Absceso/etiología , Neoplasias del Colon/complicaciones , Enfermedades del Bazo/etiología , Anciano de 80 o más Años , Humanos , Masculino , Invasividad Neoplásica , Enfermedades del Bazo/patologíaRESUMEN
A-64-years-old woman with locally advanced rectal cancer, which had invaded the vagina, was referred to our hospital. She was administered neoadjuvant chemotherapy to reduce the tumor size. After 4 courses of chemotherapy consisting of folinic acid, fluorouracil, and oxaliplatin (mFOLFOX6), an enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) indicated marked tumor shrinkage. We performed a laparoscopically assisted low anterior resection, which included total mesorectal resection, resection of the vaginal posterior wall, and right lateral lymph node resection. The chemotherapy prevented us from having to create a permanent colostomy. The efficacy of the neoadjuvant chemotherapy was Grade 1b. We experienced a case of neoadjuvant chemotherapy followed by curative resection.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Neoadyuvante , Neoplasias del Recto/tratamiento farmacológico , Vagina/patología , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Humanos , Laparoscopía , Leucovorina/administración & dosificación , Persona de Mediana Edad , Invasividad Neoplásica , Compuestos Organoplatinos/administración & dosificación , Neoplasias del Recto/patología , Neoplasias del Recto/cirugía , Vagina/cirugíaRESUMEN
A 60-year-old man with unresectable colon cancer required treatment for hydronephrosis, acute cholecystitis, and obstructive jaundice before chemotherapy. His performance status (PS) gradually deteriorated to PS 4. Cetuximab monotherapy was initiated instead of intensive chemotherapy. His general condition improved and mFOLFOX7 therapy was then continued in addition to cetuximab. A computed tomography (CT) scan after 6 months of chemotherapy revealed a partial response (PR). Cetuximab monotherapy may contribute to the treatment of patients with a poor PS.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Colon/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Adenocarcinoma/secundario , Cetuximab , Neoplasias del Colon/patología , Humanos , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Resultado del TratamientoRESUMEN
In recent years, breast reconstruction is being increasingly performed. Axillary resection is the standard treatment for axillary recurrence after a negative sentinel node (SN) biopsy. Appropriate treatment in the event of a negative SN artifact poses a problem. Case 1: A3 9-year-old woman with right breast cancer underwent Bt+SN (negative)+TE, IMP. Approximately 8 years postoperatively, axillary lymph node recurrence was diagnosed. Axillary resection was performed, and the reconstructed breast was preserved. Case 2: A4 0-year-old woman with right breast cancer underwent Bt+SN (negative)+TE, IMP. Approximately 8 years postoperatively, axillary lymph node recurrence was diagnosed. Axillary resection was performed, and the reconstructed breast was preserved. Case 3: A5 7-year-old woman with right breast cancer underwent Bt+SN (negative)+ TE, IMP. Because the metastatic lymph node was near the reconstructed breast, axillary resection and removal of the reconstructed breast was performed. It is expected that the incidence of axillary lymph node recurrence after breast reconstruction will increase in the future. For axillary lymph node recurrence, surgical resection needs to be performed to achieve a complete recovery. Therefore, it may be necessary to perform surgery without preserving the reconstructed breast.