RESUMO
A 79-year-old man was diagnosed with esophagogastric junction adenocarcinoma, cT3N3M0, cStage â ¢, including enlarged lymph node metastases(Bulky N)in the middle mediastinum and intraperitoneal. A total of 2 cycles of S-1 plus oxaliplatin(SOX)was administered. After neoadjuvant chemotherapy, the primary tumor and enlarged lymph nodes had greatly decreased in size. Subsequently, thoracoscopic subtotal esophagectomy and reconstruction with a gastric tube were performed. Histopathological examinations showed no residual cancer cells in the primary lesion and dissected lymph nodes (pathological complete response). Preoperative chemotherapy containing SOX could be a useful treatment strategy for patients with esophagogastric junction adenocarcinoma with enlarged lymph node metastasis.
Assuntos
Adenocarcinoma , Linfadenopatia , Masculino , Humanos , Idoso , Metástase Linfática , Terapia Neoadjuvante , Mediastino/cirurgia , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/cirurgia , Junção Esofagogástrica/cirurgiaRESUMO
We report here a case of postoperative recurrent adenosquamous carcinoma (ASC) of the esophagogastric junction (EGJ) treated with S-1 therapy. A 79-year-old woman was diagnosed with carcinoma of the EGJ. Thoracoscopic subtotal esophagectomy was performed, and pathological examination revealed advanced ASC with lymph node metastasis. Five months after surgery, multiple lung metastases and multiple lymph node metastases were observed, and the patient was treated with S-1 monotherapy, which showed partial response and may be effective for advanced ASC of the EGJ. On the other hand, immunohistological analysis of the tumors showed a relatively wide range of areas that could differentiate into both adenocarcinoma and squamous cell carcinoma, suggesting that tumor cells with multidifferentiation potential, or at least the ability to differentiate into both adeno-epithelial and squamous epithelial cells, were the likely source of the tumors.
Assuntos
Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Artéria Femoral/lesões , Fixação Intramedular de Fraturas/efeitos adversos , Acidentes por Quedas , Idoso , Falso Aneurisma/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Serviço Hospitalar de Emergência , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/cirurgia , Seguimentos , Fixação Intramedular de Fraturas/métodos , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Humanos , Doença Iatrogênica , Escala de Gravidade do Ferimento , Angiografia por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
We report an extremely rare case of inner head displacement from the stem of a bipolar hip prosthesis (BHP). An 88-year-old woman underwent BHP implantation for right femoral neck fracture. However, severe right hip joint pain occurred 12 days after surgery. A plain radiogram film revealed displacement of the inner head from the neck of the stem, accompanied by sinking of the stem. At reoperation, the inner head was disassembled from the stem, and Vancouver type A1 fracture was confirmed. Disassembly may have been caused by the pumping phenomenon or micromovement of the stem due to periprosthetic fracture. To our knowledge, this is the first report about disassembly of the BHP inner head, probably due to periprosthetic fracture.