RESUMEN
We report a CR case of advanced rectal cancer successfully treated with 39 courses of mFOLFOX6. The patient was a 29-year-old female with Stage IV rectal cancer. At first she was given IFL together with radiotherapy. It took effect for three months, and the therapeutic effect was PR, but interstitial pneumonia developed. Therefore, we shifted to mFOLFOX6, and she was treated with 39 courses. Grade 1 appeared several times for peripheral neuropathy, but recovered immediately. If we could control peripheral neuropathy with FOLFOX, it was thought that long-term survival could / be expected.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Recto/tratamiento farmacológico , Adulto , Biomarcadores de Tumor/sangre , Terapia Combinada , Femenino , Fluorouracilo/uso terapéutico , Humanos , Leucovorina/uso terapéutico , Estadificación de Neoplasias , Compuestos Organoplatinos/uso terapéutico , Proctoscopía , Neoplasias del Recto/sangre , Neoplasias del Recto/patología , Neoplasias del Recto/radioterapia , Inducción de Remisión , Tomografía Computarizada por Rayos XAsunto(s)
Adenocarcinoma Mucinoso/patología , Carcinoma Papilar/patología , Neoplasias Pancreáticas/patología , Pancreatitis/complicaciones , Seudomixoma Peritoneal/etiología , Adenocarcinoma Mucinoso/complicaciones , Carcinoma Papilar/complicaciones , Carcinoma Papilar/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/cirugía , Pancreatitis/etiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
A 57-yr-old female patient was referred to our hospital with a cystic lesion of the head of the pancreas that had been noted on abdominal computed tomography (CT). Endoscopic ultrasonography (EUS) showed a 3.0 cm rounded mass in the head of the pancreas. EUS images showed that the tumor had a solid component consisting of multiple microcysts separated by septae and a cystic component consisting of a macrocystic lesion. Thus, the tumor was suspected of being a serous cystadenoma (SCA). However, the histopathological diagnosis based on endoscopic ultrasound- guided fine-needle-aspiration biopsy (EUS-FNAB) was that of a pancreatic endocrine neoplasm (PEN). Surgical resection was performed. Despite having very similar macroscopic findings to SCA, microscopic examination revealed that the patient's tumor was definitely a PEN. This case suggests that it is very difficult to distinguish PENs from SCAs based solely on imaging methods. EUS-FNAB is essential for determining the appropriate therapeutic strategy, as it provides the histopathological diagnosis.
Asunto(s)
Cistadenoma Seroso/diagnóstico , Neoplasias de las Glándulas Endocrinas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Biopsia con Aguja , Diagnóstico Diferencial , Endosonografía , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
Carcinoma de Células Gigantes/patología , Conductos Pancreáticos , Neoplasias Pancreáticas/patología , Vena Porta , Carcinoma de Células Gigantes/diagnóstico por imagen , Carcinoma de Células Gigantes/cirugía , Endosonografía , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/cirugía , Vena Porta/diagnóstico por imagen , Vena Porta/patología , Ultrasonografía IntervencionalRESUMEN
This report concerns a patient with IgM AL amyloidosis due to a B cell lymphoproliferative disorder who was successfully treated with VAD and subsequent high-dose melphalan followed by autologous stem cell support. After this chemotherapeutic regimen, the patient showed complete hematological remission and improvement in nephrotic syndrome. These findings suggest that high-dose melphalan may also be effective for lymphoplasmacytoid cells producing monoclonal IgM which are phenotypically distinct from plasma cells. Myeloablative therapies, such as high-dose melphalan, should definitely be considered as a treatment option for AL amyloidosis, irrespective of the type of precursor immunoglobulin.
