Colonic metastasis from breast carcinoma: a case report.

BACKGROUND: Colonic metastasis from breast carcinoma is very rare. Here, we report a case of colonic metastasis from breast carcinoma. CASE PRESENTATION: The patient was a 51-year-old woman. She had upper abdominal pain, vomiting, and diarrhea, repeatedly. We performed abdominal contrast-enhanced computed tomography (CT) to investigate these symptoms. The CT scan revealed a tumor in the ascending colon with contrast enhancement and showed an expanded small intestine. For further investigation of this tumor, we performed whole positron emission tomography-computed tomography (PET-CT). The PET-CT scan revealed fluorodeoxyglucose uptake in the ascending colon, mesentery, left breast, and left axillary region. Analysis of biopsy samples obtained during colonoscopy revealed signet ring cell-like carcinoma. Moreover, biopsy of the breast tumor revealed invasive lobular carcinoma. Therefore, the preoperative diagnosis was colonic metastasis from breast carcinoma. Open ileocecal resection was performed. The final diagnosis was multiple metastatic breast carcinomas, and the TNM classification was T2N1M1 Stage IV. CONCLUSIONS: We presented a rare case of colonic metastasis from breast carcinoma. PET-CT may be useful in the diagnosis of metastatic breast cancer. When analysis of biopsy samples obtained during colonoscopy reveals signet ring cell-like carcinoma, the possibility of breast cancer as the primary tumor should be considered.

Dendritic cell vaccines loaded with autologous tumor lysates for solid tumors.

Recently, immunotherapy has been utilized as a novel option for the treatment of various malignancies, however, it is necessary to develop immune cell therapy on the basis of the blockade of immune checkpoints, antigen presentation on dendritic cell (DC) vaccines and the high avidity tumor reactive T cells. Autologous tumor lysate-loaded DC vaccines could have a potency to elicit T cells immune response with both epitopes of neoantigen and com- mon antigen; however the innate immunity should be essential for the cross-presentation process. Furthermore, DC vaccines loaded with tumor lysates by electroporation system eli- cited both antigen-specific CD8 and CD4 T cells. In order to break the immunosuppression, the combined therapy of the tumor lysate-loaded DC vaccines and immune checkpoint inhib- itors should be investigated in the future.

[Examination of UGT1A1 polymorphisms and irinotecan-induced neutropenia in patients with Colorectal cancer].

Irinotecan is an effective drug in the treatment of colorectal cancer. However, there are reports of an association between certain UGT1A1 genetic polymorphisms and the development of adverse reactions(such as neutropenia)related to irinotecan metabolism. We retrospectively investigated UGT1A1 genetic polymorphisms and the occurrences of irinotecan-induced neutropenia in 25 patients of colorectal cancer at our hospital. Analysis of UGT1A1 genetic polymorphisms in these patients yielded the following classifications: a wild-type group( *1/*1)comprising 13 patients(52%), a heterozygous group(*1/ *28, *1/*6)of 10 patients(40%), and a homozygous group(*28/*28, *6/*6)of 2 patients(8%). The frequency of neutropenia was 15.4%(2/13)in the wild-type group, 30%(3/10)in the heterozygous group, and 100%(2/2)in the homozygous group. Grade 4 neutropenia only occurred in the homozygous group. These results suggest that a dose reduction of irinotecan should be considered for patients who fall into the homozygous group upon analysis of their UGT1A1 genetic polymorphisms, as such patients might be susceptible to grade 4 neutropenia.

[Case of esophageal cancer successfully performed in early response evaluation for preoperative chemotherapy by FDG-PET].

We present a case of esophageal cancer with multiple lymph node metastases successfully performed early response evaluation for preoperative chemotherapy by FDG-PET. The decrease of SUV from baseline to 11 days after initiation of low-dose FP chemotherapy were 32.8% in the primary lesion, 60.4% in the cervical lymph node and 13.5% in the abdominal lymph node. He underwent extended radical esophagectomy 4 weeks after the end of chemotherapy. The histopathologic response was Grade 1 in the primary lesion, Grade 3 in the cervical lymph node and Grade 0 in the abdominal lymph node. The early response evaluation by FDG-PET in each lesions were consistent with histopathologic response evaluation of after chemotherapy.

Neuroendocrine tumor of the small intestine diagnosed with trans-abdominal ultrasonography: A case report.

INTRODUCTION: Tumors of the small intestine are rare. In addition, clinical symptoms are nonspecific and neoplasm-related symptoms occur late. We report a case of neuroendocrine tumor (NET) of the small intestine that was diagnosed early with trans-abdominal ultrasonography (US). PRESENTATION OF CASE: The patient was a 61-year-old man. Abdominal contrast-enhanced computed tomography (CT) was performed because the patient complained of abdominal pain. The CT showed a tumor lesion in the mesentery. Trans-abdominal US was undertaken to evaluate this tumor lesion, and a tumor lesion of the small intestine was found nearby. A diagnosis of lymph-node metastasis of a small-intestine tumor was made as a preoperative diagnosis. A laparotomy was performed with partial resection of the ileum, together with the small-intestine mesentery including an enlarged lymph node. Histological examination revealed NET of the ileum and lymph-node metastasis. DISCUSSION: With the application of trans-abdominal US, we could diagnose lymph-node metastasis of a small-intestine tumor relatively early and before surgery. CONCLUSION: Trans-abdominal US is useful in the diagnosis of small-intestine NET.