[Two cases of recurrent GIST successfully treated with imatinib mesylate at 100mg/day].

Case 1: Recurrent tumors from gastric GIST in the liver and the abdominal wall showed partial response with 200mg/day imatinib and maintained partial response at 100mg/day. Case 2: Metastatic liver tumors from the jejunal GIST showed partial response with 200mg/day imatinib. The tumors have been enlarged for interruption of imatinib administration, however, re- treatment with imatinib resulted in partial response again and kept partial response at 100mg/day of imatinib. The two cases seldom encountered adverse events at 100mg/day of imatinib. There are some cases successfully treated with low-dose imatinib mesylate for recurrent GIST.

Prognosis assessment of patients with refractory ascites treated with a peritoneovenous shunt.

BACKGROUND/AIMS: We investigated the postoperative outcome and risk factors for DIC and mortality in cases of implanted PVS. METHODOLOGY: We reviewed the cases of 65 patients implanted with PVS from 2000 to 2010. Of these patients, 32 were diagnosed with peritonitis carcinomatosa, 21 had liver cirrhosis with hepatocellular carcinoma (HCC), and 12 had liver cirrhosis without HCC. RESULTS: The postoperative morbidity rate was 18.8%, 76.2%, and 58.3% in cases of peritonitis carcinomatosa, liver cirrhosis with HCC, and liver cirrhosis without HCC, respectively. Early death (within 7 days of surgery) was 7.7% (5/65), and the cause of death in all cases was DIC. Underlying disease, low platelet count, prolongation of prothrombin time (PT), and hyperbilirubinemia were the risk factors for development of DIC, whereas underlying disease, prolongation of PT, hypoalbuminemia, and hyperbilirubinemia were risk factors for early death. Multivariate analysis showed that liver cirrhosis with HCC and prolonged PT were the risk factors for DIC. CONCLUSIONS: Patients with refractory ascites due to liver cirrhosis with HCC and those with prolonged PT should not be considered for PVS.

[A case of pancreatic cancer treated by gemcitabine with sequential radiotherapy].

A 65-year-old man suffering from acute pancreatitis underwent MRI scanning, which revealed a low signal on the T1 and T2 sequences, and hypovascularity in arterial phase in the head of the pancreas. This corresponded to the area showing the absence of the lower common bile duct. FDG-PET was highly suggestive of pancreatic cancer (T4N1M0, Stage IVa) with lymph node metastasis. He was treated with systemic chemotherapy using gemcitabine (GEM) followed by radiotherapy. His symptoms gradually improved with a reduction in size of the primary lesion. The patient has been receiving systemic chemotherapy using S-1 without recurrence.

[Case report of advanced esophageal cancer patient surviving for a long time after asynchronous chemoradiation].

We have present a case of advanced esophageal cancer(Stage IVb), that has survived for 7 years and 4 months after systemic hemotherapy followed by radiation therapy. The patient is a female, 63 years old. We diagnosed her with esophageal cancer Stage IVb with direct invasion to the main bronchus and the metastatic lesion to the right lobe of thyroid gland. Then we initiated low-dose FP therapy(5-FU 500 mg/day/body, day 1-7, CDDP 10 mg/day/body day 1-5), and then continued UFT+CDDP(UFT 400 mg/day, CDDP 10 mg/day). About 4 years and eight months after chemotherapy we detected swelling of a mediastinal lymph node, which was assessed as a recurrence. Then we started the radiation therapy. Since she has received UFT, we have not seen any recurrences.

Pancreatic schwannoma: report of a case.

Among pancreatic neoplasms, pancreatic schwannoma is quite rare. We report a case of solitary pancreatic schwannoma, plus a literature review of this tumor. A 71-year-old woman was diagnosed by abdominal ultrasonography as having a pancreatic tumor and was hospitalized in our department at Kumamoto University Hospital on January 26, 2006. Abdominal computed tomography, magnetic resonance imaging, and endoscopic ultrasonography all showed this tumor, which was located in the body of the pancreas, to have cystic and solid components, and with a septum in the cystic part of the lesion. The tumor, preoperatively identified as a mucinous cystic neoplasm, was clearly separated from the normal pancreatic parenchyma. We performed a spleen-preserving distal pancreatectomy with a lymph node dissection on February 7, 2006. A histopathological examination of the resected specimen by means of hematoxylin and eosin revealed the tumor to consist of two parts: one with a compact spindle cell pattern (Antoni type A), and the other showing degeneration of fat (Antoni type B). We also found positive results for immunohistochemical staining for S-100 and vimentin. These findings confirmed the tumor's classification as a pancreatic schwannoma.