[Subtotal Esophagectomy for Mediastinal Lymph Node Oligo-Recurrence of ALK-Positive Lung Adenocarcinoma - A Case Report].

The patient was a 54-year-old woman with anaplastic lymphoma kinase-positive stage III B lung cancer. She received 4 courses of carboplatin(CBDCA)plus paclitaxel(PTX)plus bevacizumab(Bev)chemotherapy and crizotinib. Chemotherapy reduced the size of the primary site and mediastinal lymphadenopathy; however, the right supraclavicular and subcarinal lymph nodes were enlarged again during crizotinib treatment. Because it was an oligo-recurrence, we performed radiotherapy for these lymph nodes and changed systemic chemotherapy to alectinib. After 16 months, the patient exhibited esophageal stenosis due to subcarinal lymphadenopathy. We performed a subtotal esophagectomy, which improved the quality of life, and she was continued on an oral treatment of alectinib. Therefore, we suggest that an invasive surgical treatment is useful for oligo-recurrence cases.

[Advanced lung cancer with recurrence of liver and tracheal metastases responsive to multimodality therapy - a case report].

We report a case of advanced lung cancer with recurrence of liver and tracheal metastases that were responsive to multimodality therapy. The patient was a 77-year-old man who suffered from advanced lung cancer with chronic obstructive pulmonary disease (COPD) and alcohol-induced liver cirrhosis. The primary lung cancer was surgically resected. Eight months after resection of the primary lung cancer, a solitary liver tumor appeared and hepatic resection was performed. Histological findings showed that both the primary lung tumor and the solitary liver tumor were squamous cell carcinoma (SCC). Subsequently, he developed a recurrence in his trachea 8 months after hepatic resection. Radiotherapy, endobronchial argon plasma coagulation (APC), and systemic chemotherapy were administered. The tracheal tumor remained stable without any liver metastasis for 25 months.

[Advanced lung cancer with mediastinal lymph node metastasis and recurrence of brain metastasis completely responsive to combination chemotherapy and gamma knife radiosurgery--a case report].

We report a case in which advanced lung cancer with mediastinal lymph node metastasis and recurrence of brain metastasis was completely responsive to combination chemotherapy and gamma knife radiosurgery. The patient was a 61-year-old woman, who suffered from advanced lung cancer (SCC) with bilateral mediastinal lymph node metastasis and contralateral lung nodule. She was treated with CBDCA combined with PTX. Bilateral lung nodules were surgically resected. Seven months after resection, solitary brain metastasis appeared, and gamma knife radiosurgery was performed. Histological efficacy of both primary lung tumor (SCC) and metastatic brain tumor was evaluated as Ef 3 (pCR). She has had no recurrence for 3 years after radiosurgery.

[A case of relapsing polychondritis monitored by repeated measurements of flow-volume curve].

A 57-year-old man was admitted to our hospital with hoarseness, productive cough, and dyspnea. Chest CT revealed a thickening of the tracheal wall, and the flow-volume curve showed a constrictive upper airway flow pattern. Bronchoscopy revealed disappearance of cartilaginous rings and tracheal stenosis. Biopsy of the cricoid cartilage showed findings compatible with relapsing polychondritis and a diagnosis of relapsing polychondritis was made in accordance with Damiani's criteria. The flow-volume curve and symptoms were immediately improved by methylprednisolone pulse therapy, but on reduction of oral prednisorone, recurrence was identified by flow-volume curve and bronchoscopy. Administration of dapson and cyclophosphamide in addition to oral prednisolone after intravenous methylprednisolone and flow-volume curve resulted in improvement. In this case, monitoring of flow-volume curve was useful for the evaluation of airway complication in relapsing polychondritis.

Isolated unilateral proximal interruption of the pulmonary artery: findings of high-resolution computed tomography and three-dimensional volume rendering imaging of the pleura.

A unilateral proximal interruption of the pulmonary artery is a rare entity that is commonly associated with other congenital cardiovascular anomalies. However, less frequently, this condition may occur as an isolated finding, and some patients are completely asymptomatic. We report 2 cases of asymptomatic patients who had an isolated unilateral proximal interruption of the pulmonary artery. Herein, the radiological imaging findings are described with an emphasis on interlobular septal thickening of the affected lung demonstrated with high-resolution computed tomography. Three-dimensional volume rendering imaging clearly demonstrated reticular opacities on the surface of the affected side of the pleura.

[Clinical efficacy of TS-1 in refractory bone recurrence of a postoperative squamous lung cancer patient].

BACKGROUND: We need more effective treatments for refractory non-small cell lung cancer. CASE: A 61-year-old man had a recurrence in the left ninth rib invading the chestwall 4 years after resection of squamous cell lung cancer. The metastatic lesion grew larger even after 3 different regimens of systemic chemotherapy and local irradiation. Then he started to receive 120 mg of TS-1 daily for 28 days followed by 14 days of rest (1 course). A partial response was achieved after 2 courses of the treatment and continued for 6 weeks. Doses of oxycodone hydrochloride could be reduced to one-sixth of the initial dose according to tumor regression. CONCLUSION: This is the first report to show the effectiveness of TS-1 for a refractory recurrence of lung cancer to the bone.

Anaphylaxis due to intravenous levofloxacin with tolerance to garenoxacin.

Fluoroquinolones are widely used in the management of infectious diseases, and are generally safe and well tolerated. However, immediate hypersensitivity reactions, including anaphylactic reactions, have been reported. We present here a case of anaphylactic shock in a 26-year-old man following intravenous levofloxacin administration. Skin tests confirmed an immediate hypersensitivity reaction to levofloxacin. Subsequent oral challenge tests for garenoxacin, which showed negative skin test results, confirmed that garenoxacin was well tolerated. This is the first report of tolerance to full-dose garenoxacin in a patient who developed an immediate hypersensitivity reaction to levofloxacin.