Metachronous Sporadic Desmoid Tumors Arisen in the Stomach and the Cecum.

Desmoid-type fibromatosis (DF) is a rare soft-tissue tumor demonstrating fibroblastic to myofibroblastic differentiation, recognized as a biologically intermediate, locally aggressive tumor; however, it can be clinically lethal due to its infiltrative growth and risk of locoregional recurrence. Desmoid-type fibromatoses can arise from any part of the body, however, intra-abdominal DFs comprise only 8% of all DFs. We report a case of a male in his 60s who presented with the metachronous occurrence of DF: gastric DF followed by cecal DF with two years of clinical interval. The latter tumor (cecal DF) developed under scheduled postoperative surveillance of laparoscopic gastrectomy. Although a surgical wound is known to be an inductive factor for DFs, the cecal DF developed in a part that was not a surgical site in the previous operation. Curative resection is the first treatment option when the tumor shows progression in size. Following the curative resection, close observation should be provided because of the risk of locoregional recurrence.

[A Case of Liver Metastasis of Colorectal Cancer in a Hemodialysis Patient, Underwent Liver Resection and Chemotherapy after Colorectal Resection].

A 60 years old man has undergone hemodialysis due to chronic renal failure by diabetic nephropathy. A sigmoid colon cancer and multiple liver metastases(S2, S6)were found, and he had laparoscopic sigmoid colon resection first, it was local resection. The stage was pT3N2aH1, stage Ⅳ, and histopathological examination revealed that the tumor was well‒differentiated adenocarcinoma and RAS, BRAF mutation was negative. From the 4th week after surgery, mFOLFOX4 plus panitumumab( oxaliplatin 60 mg/m2[30% reduction]), continuous intravenous injection fluorouracil 600 mg/m2(regulated amount), rapid intravenous injection fluorouracil 400 mg/m2(regulated amount), Leucovorin 100 mg/m2(regulated amount), panitumumab 6 mg/kg(regulated amount)were given for 4 courses. Since partial response was obtained in both hepatic lesions, we underwent radiofrequency ablation for S6 lesion and laparoscopic partial hepatectomy for S2 lesion. Eight months have passed since the first visit, but no recurrence have been observed. The kidney is an organ that metabolizes many drugs, and it is necessary to adjust the drug volume and consider the timing of administration even in anticancer chemotherapy. We report that we experienced chemotherapy for colorectal cancer during hemodialysis with a review of the literature.

[Short-Term and Long-Term Outcomes as a Bridge to Surgery for Malignant Colonic Obstruction].

We investigated the efficacy of colonic stent as a bridge to surgery(BTS)for malignant colonic obstruction retrospectively. 25 patients were inserted self-expandable metallic colonic stent as BTS(S group), 16 patients were placed trans-anal ileus tube as BTS(I group)and in 15 patients(E group)emergent surgery were performed. These 3 groups were investigated as follows. Technical success for colonic stent placement was obtained in all S group patients but clinical success rate was 92.0%(23/25). One was not decompressed sufficiently due to 2 obstructed colonic cancers and another patient stent was migrated. 3-year overall survival was 79.7%(S group), 75.0%(I group), 73.3%(E group), respectively. 3-year progression- free survival was 47.1%, 56.3%, 53.3%, respectively. Overall survival rate for S group patients was equivalent compared with patients of non-obstructive colonic cancer(control group)in stage Ⅱ/Ⅲ for the same investigation periods. Colonic stent for BTS was indicated to be safe and effective strategy for obstructive colon cancer, and further investigation are needed to confirm long-term outcomes.