RESUMO
BACKGROUND: A small percentage of patients with foreign body ingestion develop complications, which have a variety of clinical presentations. Less than 1% of cases require surgical intervention. We present a patient with an abdominal wall abscess resulting from a fish bone that pierced the cecum. The patient was treated laparoscopically. CASE PRESENTATION: A 55-year-old Japanese man presented to our hospital with a complaint of right lower abdominal pain. A physical examination revealed tenderness, swelling, and redness at the right iliac fossa. Computed tomography showed a low-density area with rim enhancement in his right internal oblique muscle and a hyperdense 20 mm-long pointed object in the wall of the adjacent cecum. Based on the findings we suspected an abdominal wall abscess resulting from a migrating ingested fish bone. He was administered antibiotics as conservative treatment, and the abscess was not seen on subsequent computed tomography. Two months after the initial treatment, he presented with the same symptoms, and a computed tomography scan showed the foreign body in the same location as before with the same low-density area. We diagnosed the low-density area as recurrence of the abdominal wall abscess. He underwent laparoscopic surgery to remove the foreign body. His appendix, and part of his cecum and the parietal peritoneum that included the foreign body, were resected. He had an uneventful postoperative course, and at 1 year after the surgery, the abdominal wall abscess had not recurred. CONCLUSIONS: An abdominal wall abscess developed in association with the migration of an ingested fish bone. We suggest that a laparoscopic surgical resection of the portion of the bowel that includes the foreign body is a useful option for selected cases.
Assuntos
Abscesso Abdominal/patologia , Antibacterianos/uso terapêutico , Osso e Ossos , Corpos Estranhos , Migração de Corpo Estranho/patologia , Perfuração Intestinal/patologia , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/terapia , Dor Abdominal , Animais , Ingestão de Alimentos , Peixes , Migração de Corpo Estranho/complicações , Humanos , Perfuração Intestinal/diagnóstico por imagem , Laparoscopia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Hepatic carcinosarcoma (HCS) generally presents in advanced stages, demonstrates aggressive behavior, and has a poor prognosis. Other than curative primary resection, no effective treatment options exist. We present a case of resected HCS with four repeat resections for solitary lymph node recurrence followed by chemoradiotherapy with doxorubicin and ifosfamide. A 67-year-old Japanese man was admitted to our hospital for evaluation of an asymptomatic hepatic tumor. The patient underwent right hepatectomy with a presumptive preoperative diagnosis of atypical hepatocellular carcinoma. Based on histopathological and immunohistochemical findings, the tumor was diagnosed as HCS containing osteosarcoma and chondrosarcoma components. After the initial surgery, the patient underwent four additional resections for solitary lymph node HCS recurrence, and then underwent chemoradiotherapy with doxorubicin and ifosfamide for an unresectable lymph node recurrence. Chemotherapy was stopped after two cycles because of severe adverse events, although chemoradiotherapy markedly reduced the size of the lymph node recurrence and provided a progression-free survival of 12 months. Thirty-seven months after the initial surgery, the patient died of cardiac invasion of multiple mediastinal lymph node metastases. The clinical course outlined in this case report suggests that chemoradiotherapy with doxorubicin and ifosfamide for metastatic HCS may prolong survival in patients with unresectable lesions.
Assuntos
Carcinossarcoma/tratamento farmacológico , Carcinossarcoma/cirurgia , Terapia Combinada/métodos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Idoso , Antibióticos Antineoplásicos/uso terapêutico , Doxorrubicina/uso terapêutico , Humanos , Ifosfamida/uso terapêutico , Masculino , Recidiva Local de Neoplasia , Resultado do TratamentoRESUMO
Although several murine mAbs that have been humanized became useful therapeutic agents against a few malignancies, therapeutic Abs are not yet available for the majority of the human cancers because of our lack of knowledge of which antigens (Ags) can become useful targets. In the present study we established a procedure for comprehensive identification of such Ags through the extensive isolation of human mAbs that may become therapeutic. Using the phage-display Ab library we isolated a large number of human mAbs that bind to the surface of tumor cells. They were individually screened by immunostaining, and clones that preferentially and strongly stained the malignant cells were chosen. The Ags recognized by those clones were isolated by immunoprecipitation and identified by MS. We isolated 2,114 mAbs with unique sequences and identified 21 distinct Ags highly expressed on several carcinomas. Of those 2,114 mAbs 356 bound specifically to one of the 21 Ags. After preparing complete IgG(1) Abs the in vitro assay for Ab-dependent cell-mediated cytotoxicity (ADCC) and the in vivo assay in cancer-bearing athymic mice were performed to examine antitumor activity. The mAbs converted to IgG(1) revealed effective ADCC as well as antitumor activity in vivo. Because half of the 21 Ags showed distinct tumor-specific expression pattern and the mAbs isolated showed various characteristics with strong affinity to the Ag, it is likely that some of the Ags detected will become useful targets for the corresponding carcinoma therapy and that several mAbs will become therapeutic agents.
Assuntos
Anticorpos Monoclonais/química , Carcinoma/imunologia , Neoplasias/imunologia , Animais , Antígenos de Neoplasias/química , Antineoplásicos/farmacologia , Carcinoma/diagnóstico , Linhagem Celular Tumoral , Receptores ErbB/metabolismo , Humanos , Imunoglobulina G/metabolismo , Imunoterapia/instrumentação , Imunoterapia/métodos , Camundongos , Camundongos Nus , Modelos Biológicos , Neoplasias/diagnóstico , Biblioteca de PeptídeosAssuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Cutâneas/patologia , Idoso , Biópsia por Agulha , Carcinoma/patologia , Carcinoma de Células Escamosas/cirurgia , Epiderme/patologia , Feminino , Humanos , Imuno-Histoquímica , Sensibilidade e Especificidade , Neoplasias Cutâneas/cirurgiaAssuntos
Lipoma/patologia , Neoplasias de Tecidos Moles/patologia , Adulto , Biópsia por Agulha , Humanos , Imuno-Histoquímica , Lipoma/diagnóstico , Lipoma/cirurgia , Masculino , Prognóstico , Escápula , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Resultado do TratamentoRESUMO
Approximately 30 cases of carcinoid tumor of the kidney have been reported in the English literature, including three cases found as components of teratomas. Renal composite tumors associated with somatostatinoma have not been described. A 53-year-old female presented with an incidentally found right renal cystic lesion. Computed tomography demonstrated a cystic lesion associated with a solid nodule in the right kidney and postcontrast dynamic MRI revealed enhancement of the solid nodule. The patient underwent radical nephrectomy for the kidney lesion and is now well without recurrence 21 months after the operation. From the histopathological findings we diagnosed the cystic lesion as a composite tumor composed of mucinous cystadenoma and carcinoid tumor. Immunohistochemistry demonstrated the majority of cells of in carcinoid portion to be positive for antisomatostatin staining. The present case is the first documented composite tumor of mucinous cystadenoma and somatostatinoma of the kidney.
Assuntos
Cistadenoma Mucinoso/diagnóstico , Neoplasias Renais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Somatostatinoma/diagnóstico , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Neoplasias Renais/cirurgia , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/cirurgia , Nefrectomia , Somatostatinoma/cirurgia , Resultado do TratamentoRESUMO
We examined the modifying effects of heated garlic (Allium sativum L.) on N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG)-induced duodenal and jejunal carcinogenesis in mice. Heated garlic powder used in this study was prepared as follows: unpeeled garlic bulbs were blanched in boiling water for 6 min, and then peeled, the cloves being crushed, homogenized, and finally freeze-dried. The garlic powder had almost undetectable alliinase activity and was rich in alliin (the main sulfur compound of heated garlic; 22.1 &mgr;/g dry weight). Male C57BL/6 mice were given ENNG (100 &mgr;/l) in drinking water for the first 4 weeks, and then basal diet (Group 1), or 10% (Group 2), 3% (Group 3) or 1% (Group 4) heated garlic in the diet for 30 weeks. At the termination of the experiment, the incidences of duodenal tumors in Groups 1-3 were significantly lower than those in Group 1, and the multiplicities in Group 2 were significantly lower than those in Group 1. Additionally, the incidences and/or multiplicities of the jejunal tumors in Groups 2 and 4 were also significantly lower than those in Group 1. In this study, we also examined changes in erythrocyte polyamine levels. Values for Group 1 were significantly greater than those in the control group, and this elevation in Group 1 were significantly inhibited by dietary heated garlic (10% in the diet; Group 2). These results indicated that the post-initiation-stage feeding of heated garlic, especially at 10% in the diet, inhibits ENNG-induced duodenal and jejunal carcinogenesis in mice.
RESUMO
OBJECTIVE: To examine 10 cases with primary cutaneous CD30-positive anaplastic large cell lymphoma (ALCL), analyze their clinical manifestations and pathological and immunohistochemical features, and improve early diagnosis of this disease. METHODS: We studied the morphological characteristics of primary cutaneous CD30-positive ALCL using histopathological methods. Leukocyte common antigen (LCA), CD20, CD30, CD45RO, CD68, epithelial membrane antigen (EMA), cytokeratin (CK) and HMB45 antibodies were used to determine the expression of their respective antigens from routine paraffin samples of the patients. RESULTS: Ten patients (7 men and 3 women, aged 31 to 84 years) complained of subcutaneous masses or papular eruptions over their lower trunks and extremities. Histopathologically, the lesions were composed of numerous large round or oval pleomorphic cells. The cytoplasm was usually abundant, amphophilic or basophilic, and finely vacuolated. Nuclei were commonly eccentrically localized and lobated or horseshoed in shape, and multinucleated giant cells and Reed-Sternberg-like cells were seen. Nucleoli were generally multiple and large. Of the 10 patients, tumor cells displayed positive antigen expression of CD30 in all cases, positive CD45RO in 6 cases, positive CD20 in only 1 case, but negative CD45RO and CD20 expressions in 3 cases. Two patients died at 7 weeks and 3.4 years of follow-up, respectively. CONCLUSION: Our study highlights the importance of histopathologic features and positive CD30 staining for differentiation of this disease from other malignant skin tumors.
Assuntos
Linfoma Anaplásico de Células Grandes/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-1/análise , Antígenos Comuns de Leucócito/análise , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/imunologiaRESUMO
We examined the modifying effects of freeze-dried whole-leaf Aloe arborescens Miller var. natalensis Berger (designated as 'ALOE') on N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG)-induced duodenal tumorigenesis in C57BL/6 mice. Experiment 1: Male mice were given ENNG in drinking water for the first 4 weeks, and then 10% ALOE in basal diet for 16 weeks. Experiment 2: Female mice were given ENNG for 5 weeks, and then 5%, 1% or 0.2% ALOE in the diet were given for 15 weeks. In Experiment 1, the tumor incidence and tumor multiplicity (tumors per mouse) of the duodenum in the ENNG + 10% ALOE group were significantly decreased compared with that in the ENNG alone group. Erythrocyte polyamine levels in the ENNG + 10% ALOE group were also significantly decreased. In Experiment 2, the incidence of duodenal tumors in the ENNG + 5% ALOE group were significantly decreased compared with that in the ENNG alone group. These results indicated that ALOE, especially at 10% in the diet, inhibits ENNG-induced duodenal tumorigenesis in mice.