RESUMEN
Essential thrombocythemia(ET)is a rare myeloproliferative disorder characterized by thrombocytosis and a risk of thrombotic and hemorrhagic events. ET rarely occurs simultaneously with colorectal cancer. Including our case, only 5 cases of c o l orectal cancer with ET have been reported in Japan. Herein, we report a case of colon cancer in an ET patient who underwent laparoscopic right hemicolectomy. Our perioperative management avoided complications such as thrombosis or bleeding. An 81-year-old woman developed bloody stools. She was previously diagnosed with ET 9 years ago. Aspirin, cilostazol, and hydroxyurea(HU)were prescribed. Colonoscopy revealed a tumor at the ascending colon. Histopathological examination showed a well-differentiated tubular adenocarcinoma. Since the patient had anemia, aspirin and cilostazol were discontinued after diagnosis. HU was discontinued from the day before surgery to 2 days after surgery. Enoxaparin was subcutaneously administered for 1 to 3 days after surgery. Aspirin and cilostazol were resumed on the fourth day post-surgery. The patient could be discharged when her condition stabilizes with no thrombosis and bleeding after 8 days.
Asunto(s)
Neoplasias del Colon , Trombocitemia Esencial , Trombocitosis , Anciano de 80 o más Años , Colon Ascendente/cirugía , Neoplasias del Colon/complicaciones , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/cirugía , Femenino , Humanos , Japón , Trombocitemia Esencial/complicaciones , Trombocitemia Esencial/tratamiento farmacológicoRESUMEN
BACKGROUND: A gastric adenosquamous carcinoma (ASC) that produces granulocyte-colony stimulating factor (G-CSF) is an uncommon malignancy with a poor prognosis. Due to the rarity of this lesion, a standard treatment for the disease has not been established. CASE PRESENTATION: We describe a case of a 66-year-old male with a G-CSF-producing gastric ASC who presented with severe anemia and leukocytosis. A radical resection was performed, followed by a course of adjuvant chemotherapy. Histopathologic examination revealed that the tumor consisted of areas of both squamous cell carcinoma and adenocarcinoma. Immunohistochemical staining with an anti-G-CSF antibody was also positive. He was started on adjuvant capecitabine and oxaliplatin (CapeOX) 6 weeks after surgery. The patient stopped treatment after 3 months due to his own preference. Eight months following surgery, the patient was found to have diffuse lymph node, liver, and peritoneal metastases. CONCLUSIONS: G-CSF-producing gastric ASC is a rare and aggressive tumor. Because patients are usually diagnosed at an advanced stage, multidisciplinary evaluation and innovative treatments are needed. The rarity of this disease, with its aggressive features, poses a significant challenge in its treatment. In this brief case report, we summarize the management and outcomes of G-CSF-producing gastric ASC.
RESUMEN
A 63-year-old woman presented with abnormalities in liver enzyme levels on laboratory studies, which were detected during a routine medical check-up. She was diagnosed with carcinoma of the ampulla of Vater with a synchronous solitary liver metastasis (S7). She was treated with gemcitabine plus S-1. After 2 courses of the chemotherapy, computed tomography revealed that the primary and metastatic tumors had not changed in size, but new lesions had not appeared. A pylorus-preserving pancreaticoduodenectomy and partial resection of the liver (S7) were performed. She received gemcitabine monotherapy for 1 year and she remains alive and well with no evidence of disease 2 year 10 months after resection.
Asunto(s)
Ampolla Hepatopancreática/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Duodenales/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Combinación de Medicamentos , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Femenino , Hepatectomía , Humanos , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Persona de Mediana Edad , Ácido Oxónico/administración & dosificación , Pancreaticoduodenectomía , Tegafur/administración & dosificación , GemcitabinaRESUMEN
We report a case of esophageal perforation caused by an explosion, but which was not diagnosed until 3 days after the injury. A 53-year-old worker sustained superficial dermal burns to his trachea, face, neck, and legs during an explosion. The burns were treated conservatively at a local hospital, but he was transferred to our hospital 3 days after the injury, when mediastinal emphysema and bilateral pleural effusion became evident. An esophagogram followed by computed tomography showed an esophageal perforation caused by the blast injury, and we performed an esophagectomy with recontruction of the gastric tube. After the operation, an X-ray showed a foreign body in the lower abdomen, which we found in the upper thoracic esophagus on the day of injury. We surmised that the patient had inadvertently swallowed a foreign body, which had been heated and scattered by the explosion, and it had melted the upper thoracic esophagus.