RESUMEN
PURPOSE: To investigate the clinical features and prognoses of patients with diagnosed bone metastases from colorectal cancer (CRC). METHODS: This was a 16-year retrospective study of 32 patients with bone metastases secondary to CRC, who were seen at National Kokura Hospital between 1993 and 2008. The influence of clinical and pathologic variables on survival was assessed by univariate and multivariate analyses. RESULTS: The bone most commonly involved was the spinal column. The mean disease-free interval was 17.6 months and mean survival from the diagnosis of bone metastases was 9.3 months. On univariate analysis, the serum CEA level at the time of diagnosis of bone metastases (p = 0.020) and history of pulmonary metastases (p = 0.013) were significant. On multivariate analysis, a history of bone metastases in the ribs (hazard ratio 3.669, p = 0.025) and a history of pulmonary metastases (hazard ratio 3.854, p = 0.022) significantly affected survival. CONCLUSIONS: It is important to investigate for bone metastases in patients who complain of back pain and lumbago after CRC surgery.
Asunto(s)
Neoplasias Óseas/mortalidad , Neoplasias Óseas/secundario , Neoplasias Colorrectales/patología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Dolor de la Región Lumbar , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Factores de TiempoRESUMEN
We describe an operative case of a 64-year-old woman with hepatocellular carcinoma (HCC) associated with autoimmune hepatitis (AIH) during a 4.8-year follow-up. Sixty-seven cases of HCC with AIH have been previously reported as a sporadic complication of AIH. The survival rate after diagnosis with HCC showed the 5-year survival rate to be 10.4%, thus indicating the majority of patients to have either extensive HCC or severe liver dysfunction. Immunosuppressant therapy helped to postpone the hepatocarcinogenesis but it did not improve the prognosis of the patients demonstrating HCC with AIH. A univariate analysis of factors associated with prognosis disclosed that the histology of nontumorous lesion at diagnosis with HCC, tumor size, tumor number, and treatment for HCC were independent prognostic predictors. Patients with AIH were not recognized to be a high-risk group for developing HCC because HCC occasionally occurred even in patients with long-standing cirrhosis in the absence of hepatitis B virus and hepatitis C virus infection.
Asunto(s)
Carcinoma Hepatocelular/etiología , Hepatitis Autoinmune/complicaciones , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/cirugía , Femenino , Hepatitis Autoinmune/inmunología , Hepatitis Autoinmune/patología , Humanos , Persona de Mediana Edad , PronósticoRESUMEN
Mature cystic teratomas are found often in gonadal sites, but rarely in extragonadal sites, such as the retroperitoneum, mediastinum, central nerve system, lung, and liver. To our knowledge, only seven cases of pathologically benign mature cystic teratoma originating in the diaphragm have been reported. We report the case of a 45-year-old woman found to have a mature cystic teratoma below the left side of her diaphragm. She had undergone oophorectomy for a huge mature cystic teratoma in the left ovary 34 years earlier, followed 1 year later by excision of a tumor in the right side of the diaphragm. All sections of the pathological specimen showed evidence of a mature cystic teratoma and pathologically resembled the specimens obtained in the previous two operations. Although this tumor might have been a recurrence of the mature cystic teratoma in the left ovary, it is more likely that multicentric teratomatous foci metachronously developed in the gonadal and extragonadal sites.
Asunto(s)
Diafragma/patología , Neoplasias de los Músculos/patología , Neoplasias Primarias Secundarias , Neoplasias Ováricas/patología , Teratoma/patología , Diagnóstico Diferencial , Diafragma/diagnóstico por imagen , Femenino , Humanos , Laparotomía , Persona de Mediana Edad , Neoplasias de los Músculos/diagnóstico por imagen , Neoplasias de los Músculos/cirugía , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Ováricas/cirugía , Ovariectomía , Teratoma/diagnóstico por imagen , Teratoma/cirugía , Toracotomía , Tomografía Computarizada por Rayos XRESUMEN
In a 79-year-old man with ascending colon cancer, multiple liver metastases were detected by computer tomography. The patient underwent right hemicolectomy. Paraaortic lymph nodes metastases were found intraoperatively. After surgery, 5'-deoxy-5-fluorouridine (5'-DFUR) was administered orally at 600 mg daily. Abdominal CT showed disappearance of the liver metastases 6 months after operation. At a follow-up exam 24 months after the beginning of the chemotherapy, the patient remained in remission and reported no side effects. We consider oral administration of 5'-DFUR to be a useful treatment for advanced colon cancer.