[A Case of Successful CDDP plus CPT-11 Therapy for Recurrent Carcinomatous Lymphangiosis Occurring during Postoperative Adjuvant Therapy for Gastric Cancer].

The case involved a 67-year-old man. Type 2 gastric cancer in the body of stomach was discovered, and the patient was referred to this department, where distal gastrectomy with Roux-en-Y reconstruction was carried out. The pathological classification was pT2N2H0P0CY0M0, pStage II B, and S-1 administration was started as postoperative adjuvant therapy. After 10 months of administration, a chest computed tomography(CT)scan revealed fine nodular shadows and irregular thickening of the alveolar septa in both lungs, a finding that was judged to be carcinomatous lymphangiosis. CDDP plus CPT- 11 therapy was subsequently started. Chest CT scan after 2 courses of administration showed the disappearance of the carcinomatous lymphangiosis. However, peritoneal metastasis was noted immediately below the abdominal wall. After completing 6courses of administration, the recurrence of peritoneal metastasis disappeared, and the administration of chemotherapy was terminated. There was no subsequent recurrence, and the patient remains alive today, 6years after the surgery. In the present case, the CT scan did not show clear mediastinal or hilar lymph node enlargement, but nodular shadows were noted at the periphery of the lung field, which were thought to be carcinomatous lymphangiosis as a result of haematogenous or anterograde metastasis into the lungs.

[A Case of Locally Advanced Pancreatic Cancer Showing R0 Resection after Resection of the Portal Vein Following Preoperative Chemoradiotherapy].

We report a case of pancreatic cancer showing R0 resection after resection of the portal vein(PV)following preoperative chemoradiotherapy. A 71-year-old woman was admitted to our hospital with back pain. We diagnosed the patient with pancreatic cancer using computed tomography scan and fine-needle aspiration biopsy. Because the tumor directly invaded the PV, we diagnosed it as a borderline resectable locally advanced pancreatic cancer. Radiation therapy(40 Gy/20 Fr)was administered with S-1 monotherapy(120 mg/body/day on days 1-5 and days 8-12). After the treatment, the main tumor was stable without distant metastasis. Therefore, we performed pancreaticoduodenectomy with resection of the PV. Pathological examination confirmed negative margin status. The patient was healthy and showed no sign of recurrence eight months after surgery.