[A Case of Lipoma Arising from the Mesentery Proper That Had Difficulty in Differential Diagnosis with Well-Differentiated Liposarcoma].

A 54-year-old male patient with a chief complaint of right lower abdominal pain and nausea visited the reporting hospital. Abdominal computed tomography was performed, which showed findings of a membrane-covered internally heterogeneous solid mass associated with a 11×10 cm well-circumscribed calcification, as well as ileus in the right lower abdomen. Based on the imaging findings, it was diagnosed with liposarcoma, and surgery was performed for both diagnosis and treatment. The mass was located in the mesentery of the terminal ileitis and could be removed without gross residue. Histopathological examination showed altered fat cells and fibrous partition, most of which were lipoma, but well-differentiated liposarcoma could also not be ruled out. It was diagnosed with lipoma mixed with well-differentiated liposarcoma. In particular, lipoma and liposarcoma from the mesentery proper is extremely rare. We encountered a case of lipoma arising from the mesentery proper that had difficulty in differential diagnosis with well-differentiated liposarcoma and here in report it with the addition of some literature consideration.

[Two Cases of Surgery Combined with Intraoperative Radiofrequency Ablation for Colorectal Cancer and Synchronous Liver Metastases].

The therapeutic management of simultaneous liver metastasis of colorectal cancer(SCRLM)remains controversial. Although hepatic metastasectomy is the first choice for resectable liver metastasis of colorectal cancer, radiofrequency ablation (RFA)is one of the least invasive application for patients who refuse more invasive treatment such as hepatectomy and longterm systemic chemotherapy or for whom such treatment is not suitable. We report 2 cases of SCRLM treated by surgery combined with intraoperative RFA and adjuvant chemotherapy, raising the possibility of local control in the liver for selected patients.

[Long-Term Disease-Free Survival after Chemoradiotherapy for Postoperative Local Recurrence of Rectal Cancer-A Case Report].

We report a case of a 63-year-old man with a perirectal abscess due to rectal cancer referred to us from another clinic. We performed 3 courses of preoperative chemotherapy using mFOLFOX6 and then performed a Miles operation plus D3 dissection followed by reconstruction of an artificial anus using the ileum. The pathological diagnosis was tub2, pAI(prostate), pN0 (0/12), ND(v+), and fStage Ⅲa. Dehiscence of the perineum wound area occurred 4 months after surgery, for which drainage was required. Local recurrence was then discovered by cytology. We administered mild 40 Gy radiation and chemotherapy using Bmab combined with mFOLFOX6. CT scans showed a significant reduction in the tumor and the tumor marker levels returned to within normal ranges. We then converted to Pmab plus FOLFIRI, which has been administered bimonthly for 3 years to date. The overall chemoradiotherapy duration has been about 5 years. Follow-up imaging findings continue to show sustained remission.