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Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report
Tomoyuki Matsunaga,Hiroaki Saito,Kozo Miyatani,Seigo Takaya,Yoji Fukumoto,Tomohiro Osaki,Masahide Ikeguchi 대한위암학회 2014 Journal of gastric cancer Vol.14 No.3
The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. Incontrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man whopreviously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after theinitial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracicsurgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasizeto unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.
Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report
Matsunaga, Tomoyuki,Saito, Hiroaki,Miyatani, Kozo,Takaya, Seigo,Fukumoto, Yoji,Osaki, Tomohiro,Ikeguchi, Masahide The Korean Gastric Cancer Association 2014 Journal of gastric cancer Vol.14 No.3
The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. In contrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man who previously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after the initial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracic surgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasize to unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.
Harunobu Matsumoto,Mototsugu Shimokawa,Kaei Nasu,Ayumi Shikama,Takaya Shiozaki,Masayuki Futagami,Kentaro Kai,Hiroaki Nagano,Taisuke Mori,Mitsutake Yano,Norihiro Sugino,Etsuko Fujimoto,Norihito Yoshiok 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.6
Objective: We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease. Methods: At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease. Results: A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery. Conclusion: Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.
Shinya Sato,Kei Moriya,Masanori Furukawa,Soichiro Saikawa,Tadashi Namisaki,Mitsuteru Kitade,Hideto Kawaratani,Kosuke Kaji,Hiroaki Takaya,Naotaka Shimozato,Yasuhiko Sawada,Kenichiro Seki,Koh Kitagawa,T 대한간학회 2019 Clinical and Molecular Hepatology(대한간학회지) Vol.25 No.1
Background/Aims: L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease. Methods: A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires. Results: A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment. Conclusions: L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.
Masanori Furukawa,Akira Mitoro,Takahiro Ozutumi,Yukihisa Fujinaga,Keisuke Nakanishi,Koh Kitagawa,Soichiro Saikawa,Sinya Sato,Yasuhiko Sawada,Hiroaki Takaya,Kosuke Kaji,Hideto Kawaratani,Tadashi Namisa 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: Endoscopic resection (ER) for superficial non-ampullary duodenal epithelial tumors (SNADETs) is challenging. Conventional endoscopic mucosal resection (CEMR) is also problematic due to the anatomical features of the duodenum. Wecompared the safety and efficacy of underwater endoscopic mucosal resection (UEMR) with those of CEMR through a retrospectiveanalysis. Methods: Altogether, 44 consecutive patients with 46 SNADETs underwent ER (18 CEMR cases and 28 UEMR cases) betweenJanuary 2016 and October 2019. We investigated the proportions of en bloc resection, R0 resection, complications, resection time,and total procedure time and compared the outcomes of patients from the CEMR group with those of patients from the UEMRgroup. Results: The median tumor size was 8.0 mm (range, 2.0–20.0 mm). The UEMR group showed a higher proportion of en blocresection (96.4% vs. 72.2%, p<0.05) and significantly lower median resection time and total procedure time (4 min vs. 9.5 min,p<0.05 and 13 min vs. 19 min, p<0.05; respectively) than the CEMR group. No complications were observed. However, two patientstreated with piecemeal resection in the CEMR group had residual tumors. Conclusions: UEMR is a feasible therapeutic option for SNADETs. It can be recommended as a standard treatment.
Koh Kitagawa,Akira Mitoro,Takahiro Ozutsumi,Masanori Furukawa,Yukihisa Fujinaga,Kenichiro Seki,Norihisa Nishimura,Yasuhiko Sawada,Kosuke Kaji,Hideto Kawaratani,Hiroaki Takaya,Kei Moriya,Tadashi Namisa 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs)caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs. Methods: To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, andthe braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with differentanti-migration systems. Results: In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction(TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause ofstent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braided-type CMSs. Therewere no differences in the survival duration between the groups. Conclusions: The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cut-type. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.
Kei Moriya,Tadashi Namisaki,Shinya Sato,Masanori Furukawa,Akitoshi Douhara,Hideto Kawaratani,Kosuke Kaji,Naotaka Shimozato,Yasuhiko Sawada,Soichiro Saikawa,Hiroaki Takaya,Koh Kitagawa,Takemi Akahane,A 대한간학회 2019 Clinical and Molecular Hepatology(대한간학회지) Vol.25 No.4
Background/Aims: We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis. Methods: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed. Results: Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child- Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group. Conclusions: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.