[Combined Modality Therapy for HER2-Positive Progressive Stomach Cancer Metastasis Achieving Treatment Response-A Case Report].

The patient was a 73-year-old man whose chief complaint was a 1-month history of anorexia and weight loss. Pyloric stenosis due to a circumferential type 2 lesion was detected on the pylorus ring from the gastric angle. Close inspection revealed a diagnosis of progressive stomach cancer cT3N+M0, stage Ⅲ. We judged that perioperative radical excision would be impossible and performed gastrojejunal bypass surgery. Postoperatively, the patient was treated with 2 courses of SOX plus trastuzumab and 7 courses of S-1. PR was identified, and a distal-side gastrectomy plus D2 lymph node dissection were performed as conversion surgery. The patient was discharged on postoperative day 9. For 1 year postoperative, no recurrence was noted. The prognosis of the unresectable gastric cancer is poor, but chemotherapy and conversion surgery in this case resulted in a favorable prognosis.

[A Case of Esophageal Malignant Melanoma during Follow-Up of Esophageal Melanosis Metastasis].

Man 62-years-old as for the case. In 2019, he was diagnosed with right hypopharyngeal cancer, and esophageal melanosis was noted on upper gastrointestinal endoscopy before treatment. We did a follow-up upper gastrointestinal endoscopy every year. At a follow-up upper gastrointestinal endoscopy performed in February 2021, he was histologically diagnosed with an esophageal primary malignant melanoma. Computed tomography showed no metastatic lesions. He underwent esophagectomy. He is currently being followed on an outpatient basis and has had no recurrence. Careful follow-up for esophageal melanocytosis is important for early diagnosis of esophageal primary malignant melanoma.

[Duodenal Stent Placement against Anastomotic Stenosis after Esophageal Cancer Resection-A Case Report].

A 53-year-old man was diagnosed as esophageal cancer, and esophagectomy was performed. Anastomotic stenosis was caused due to lymphorrhea and anastomotic leakage after surgery. Dilation was performed, though stenosis did not improved, we placed esophageal stent across the stenotic lesion. Pharyngitis occurred after indwelling esophageal stent, we hence removed the stent. Passage disorder was developed, we placed duodeneal stent which is more flexible. Stenosis is now palliated after placing duodeneal stent. Duodeneal stent could be an option for the tratment of anastomotic stenosis after esophageal surgery.