ABSTRACT
We report the successful management of stage III colon cancer in an elderly patient who received an adjuvant chemotherapy regimen of capecitabine plus oxaliplatin (CAPOX) with the Japanese kampo medicine ninjin'yoeito (NYT). A 75-year-old woman with a medical history of hypertension presented at another institution with fecal occult blood, and a colonoscopy that showed a type II tumor in the sigmoid colon. She was referred to our hospital for tumor resection, where colonoscopy confirmed the location of the type II tumor in the sigmoid colon. Histopathology of the biopsy specimen indicated a moderately differentiated tubular adenocarcinoma. Enhanced computed tomography of the thorax and abdomen indicated thickening of the sigmoid colon wall. Regional lymph node metastasis was suspected, but distant metastasis was not indicated. A blood examination revealed an elevated carcinoembryonic antigen (CEA) concentration (32.7 ng/ml). Following a diagnosis of cancer of the sigmoid colon, clinical stage IIIb [cT4a, N1b, M0], a laparoscopic sigmoid colectomy was performed without complications. The postoperative histopathological examination revealed a moderately differentiated to mucinous adenocarcinoma. Three of 16 retrieved lymph nodes contained malignant cells. The final tumor classification was Stage IIIb [pT4a, pN1b, M0]. The patient recovered uneventfully, and was discharged 10 days after surgery with a recommendation for adjuvant chemotherapy with CAPOX starting 4 weeks after surgery. The patient also received 7.5 g of NYT daily throughout the adjuvant chemotherapy course. She did not report any loss of appetite, general fatigue, peripheral neuropathy, neutropenia, or febrile neutropenia. During a 1-year postoperative follow-up, she has not experienced any recurrence. We conclude that NYT might be useful for reducing the adverse effects of anticancer therapy, particularly in elderly patients.
ABSTRACT
An 81-year-old man underwent laparoscopic right hemicolectomy for ascending colon cancer. The postoperative diagnosis was tub1>tub2, pT4apN1bM0, pStage â ¢b, ascending colon cancer. At 1 year 4 months after operation, abdominal CT showed dissemination around anastomosis. The patient has been treated with first-line systematic chemotherapy(capecitabine, oxaliplatin and bevacizumab). Epigastralgia and grade 4 anemia were observed at 5 years 7 months after initiation of chemotherapy when he was treated with second-line chemotherapy(capecitabine, irinotecan and bevacizumab). As abdominal CT showed that the dissemination progressed rapidly in size 30 mm to 100 mm, we diagnosed tumor bleeding in the dissemination. Palliative radiotherapy(30 Gy/10 Fr)for the dissemination was performed. Hemostasis and tumor shrinkage were achieved, and epigastralgia improved after receiving the radiation therapy. The patient discharged our hospital on 31 days form admission. We believe that palliative radiotherapy is effective to recurrent colon cancer with tumor bleeding.
Subject(s)
Colon, Ascending , Colonic Neoplasms , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colon, Ascending/surgery , Colonic Neoplasms/drug therapy , Hemorrhage , Humans , Male , Neoplasm Recurrence, LocalABSTRACT
Desmoid tumor is one kind of fibromatosis, and much occurs the abdominal wall and outside the abdominal wall. Intra- abdominal desmoid tumor is rare at about 8%. We experienced a case of intra-abdominal desmoid tumors occurring 4 years after open radical prostatectomy with some literature review. A 72-year-old man had undergone open radical prostatectomy for prostate cancer. Four years after that resection, multiple intra-abdominal tumors measuring 56 mm in maximum diameter was identified on follow-up computed tomography, and he was referred to our department for management. We performed laparotomy and investigation of the biopsy. Immunohistochemistry of the resected specimen indicated the tumor cells were positive for vimentin and ß-catenin, and the diagnosis was desmoid. We performed partial resection of the small intestine and ileocecal resection. His postoperative course was uneventful and he was discharged on the 12th postoperative day. He has shown no sign of recurrence in the 4 months follow-up since surgery. In the past, an operation was the best treatment for intra-abdominal desmoid tumor. But it is reported that watchful waiting is also possible by the case which has no symptom and dysfunction in NCCN guidelines 2019. Further research is needed.
Subject(s)
Abdominal Wall , Fibromatosis, Abdominal , Fibromatosis, Aggressive , Aged , Fibromatosis, Abdominal/etiology , Fibromatosis, Abdominal/surgery , Fibromatosis, Aggressive/etiology , Fibromatosis, Aggressive/surgery , Humans , Male , Neoplasm Recurrence, Local , ProstatectomyABSTRACT
Hyperammonemia is a rare adverse event of 5-FU. Here, we report a case of hyperammonemia with disturbance of consciousness during 5-FU plus nedaplatin therapy for esophageal cancer and present a literature review. A 69-year-old man was diagnosed with cT2N2M0, cStage â ¢ esophageal cancer. He was administered with DCF therapy as the first-line neoadjuvant chemotherapy. After the first course, he showed renal dysfunction. Therefore, as the second-line neoadjuvant chemotherapy, he was administered with 5-FU plus nedaplatin. He vomited on treatment day 5 and suddenly presented with disturbance of consciousness on treatment day 6. Blood tests showed hyperammonemia(114 µg/dL). He was treated with rehydration and branched-chain amino acid solutions, resulting in a gradual improvement of symptoms. Hyperammonemia has been reported in patients with colorectal cancer but rarely in patients with esophageal cancer. A case of hyperammonemia during the 5-FU plus nedaplatin therapy has never been reported in Japan. We should be aware that 5-FU may cause hyperammonemia and resultant disturbance of consciousness during chemotherapy with 5-FU.
Subject(s)
Esophageal Neoplasms , Hyperammonemia , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Consciousness , Esophageal Neoplasms/complications , Esophageal Neoplasms/drug therapy , Fluorouracil/adverse effects , Humans , Hyperammonemia/chemically induced , Hyperammonemia/drug therapy , Japan , Male , Organoplatinum CompoundsABSTRACT
A 61-year-old male was referred to our department after decompression of the transanal ileus tube due to a rectal cancer obstruction. Colonoscopy revealed a circumferential type 2 tumor, 4 cm from the anal verge. The tumor was diagnosed as rectal cancer tub1-2, Group 5 on biopsy analysis. Longitudinal ulcers descending to the sigmoid colon were present and obstructive colitis was suspected. Enhanced computed tomography showed wall thickness in the Ra, Rb rectum and swelling of the mesorectum lymph node, but distant metastases were not identified. We diagnosed the patient with Ra, Rb rectal cancer cT4aN1aM0, cStage â ¢b. Because of the risk of anastomotic leakage with obstructive colitis, we planned neoadjuvant chemotherapy(SOX therapy)after laparoscopic transverse colostomy. After neoadjuvant chemotherapy, colonoscopy revealed improvements in the obstructive colitis. The tumor was reduced in size and the chemotherapy appeared effective. We performed laparoscopic rectal super low anterior resection with resection of the D3 lymph node. Histopathological examination revealed tub1, ypT3, ypN0, and the chemotherapeutic outcome was rated as Grade 1a. The final diagnosis was Ra, Rb rectal cancer with ypT3ypN0M0, ypStage â ¡a.
Subject(s)
Colitis , Proctectomy , Rectal Neoplasms , Anastomotic Leak , Colitis/drug therapy , Colitis/etiology , Humans , Male , Middle Aged , Neoadjuvant Therapy , Rectal Neoplasms/complications , Rectal Neoplasms/drug therapy , Rectal Neoplasms/surgeryABSTRACT
A 77-year-old man with rectal cancer was admitted to our hospital. After neoadjuvant chemotherapy, laparoscopic abdominoperineal resection of rectum with D3 dissection was performed. The pathological diagnosis was poorly differentiated carcinoma, pT3, N1a, M0, pStage â ¢a. Adjuvant chemotherapy was not performed. Fifteen months after operation, his chief complaint was fatigue. Thrombocytopenia and elevation of tumor maker was detected by blood test and disseminated intravascular coagulation(DIC)was suspected. He was admitted to our hospital and we started anti DIC therapy immediately. Bone scintigraphy revealed multiple bone metastases, then we diagnosed disseminated carcinomatosis of the bone marrow. He died 10 days after hospitalization. Disseminated carcinomatosis of the bone marrow with colon cancer is rare and prognosis is very poor. It is important to diagnose and start treatment as early as possible.
Subject(s)
Bone Marrow Neoplasms , Carcinoma , Disseminated Intravascular Coagulation , Peritoneal Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow , Bone Marrow Neoplasms/drug therapy , Carcinoma/drug therapy , Disseminated Intravascular Coagulation/etiology , Humans , Male , RectumABSTRACT
A 76-year-old man underwent laparoscopic left hemicolectomy D3(pStage â ¡b)for sigmoid colon cancer in 2015. Later, partial transverse colectomy D2(pStage â ¡b)was performed because transverse cancer was also detected. Recurrent peritoneal dissemination was found in 2018. In 2019, hematemesis/black stool, as well as prominent anemia(Hb 3.1 g/dL)and bleeding from recurrent gastric wall invasion of the lymph nodes on the lesser curvature side of the stomach, was observed. Although hemostasis was performed endoscopically, palliative irradiation(30 Gy in 10 fractions)was performed to control bleeding because the risk of rebleeding was high. After irradiation, endoscopy showed that the ulcer in the infiltrated area of the gastric wall had a tendency to improve. No bleeding or progression of anemia was observed, and oral intake became possible. However, the patient's general condition deteriorated, and he died 80 days after palliative irradiation. For palliative radiation therapy, alleviation of pain owing to bone metastasis, as well as alleviation of the narrowed airway and esophagus, is known. Palliative radiation therapy has recently been performed for symptom relief and prognosis extension against tumor bleeding. Palliative radiation therapy for controlling bleeding has limited hemostatic effect compared with surgical resection, and it takes some time before hemostasis is achieved, but it is less invasive and less adverse event and may be an effective treatment option.
Subject(s)
Radiation , Stomach Neoplasms , Aged , Hemostasis , Humans , Lymph Nodes , Male , Neoplasm Recurrence, Local , Stomach Neoplasms/radiotherapy , Stomach Neoplasms/surgeryABSTRACT
A67 -year-old man was diagnosed with ascending colon cancer and multiple liver metastases and underwent laparoscopic right hemicolectomy(D3 lymphadenectomy). Pathological examination indicated tubular adenocarcinoma(tub1, pT4apN2H2M1[HEP], pStage â £). After chemotherapy, he underwent hepatectomy. One year and 9 months after the first operation, obstructive jaundice appeared. Abdominal computed tomography revealed a tumor 2 cm in size in the head of the pancreas. After several detailed examinations, he was diagnosed with pancreatic metastasis of ascending colon cancer. After partial resection of the left lung metastasis, pancreaticoduodenectomy(SSPPD-â ¡ A-1, D1 lymphadenectomy)and low anterior resection(LAR)for early rectal cancer were performed. The tumor was positive for CDX2(+), resulting in a diagnosis of pancreatic metastasis. There has been no indication of recurrence 8 months after the pancreatic surgery. Resectable pancreatic metastasis from colon cancer is rare, and there are no clear indications for resection. Some cases of long-term survival have been reported; however, further studies are needed in order to establish a consensus.
Subject(s)
Colonic Neoplasms , Pancreatic Neoplasms , Pancreaticoduodenectomy , Aged , Colon, Ascending , Colonic Neoplasms/pathology , Humans , Male , Neoplasm Recurrence, Local , Pancreatic Neoplasms/secondary , Pancreatic Neoplasms/surgery , StomachABSTRACT
A 78-year-old man presented with anemia, with a hemoglobin level of 6.7 g/dL, during follow-up for angina pectoris and paroxysmal atrial fibrillation. Upper gastrointestinal endoscopy revealed type 2 advanced gastric cancer(por), and abdominal computed tomography(CT)showed multiple lymph node metastases. He was diagnosed with advanced gastric cancer, cStage â ¢(cT3N1M0). He received neoadjuvant chemotherapy in 3 courses of SOX(80mg/m / 2/day of S-1 on days 1-14 and 7 days of rest, and 100mg/m2 of oxaliplatin on day 1). Grade 1 thrombocytopenia was observed, but it resolved without any other major side effects. Upper gastrointestinal endoscopy revealed a marked reduction in the primary lesion, and abdominal CT showed a significant reduction in the metastatic lymph node. We performed laparoscopic distal gastrectomy(D2+No. 14v)for advanced gastric cancer ycT1N(+)M0, ycStage â ¡A. Histological assessment revealed no evidence of residual tumor cells in the primary tumor or lymph nodes, and the histologic response was classified as Grade 3, pathological complete response(pCR). We report a case in which pCR was obtained by SOX therapy administered as neoadjuvant chemotherapy for advanced gastric cancer.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoadjuvant Therapy , Stomach Neoplasms , Aged , Cisplatin , Drug Combinations , Gastrectomy , Humans , Male , Oxaliplatin , Oxonic Acid , Stomach Neoplasms/therapy , TegafurABSTRACT
A 47-year-old woman presented with a hard umbilical nodule that appeared red and was painful. A biopsy of the umbilical nodule revealed adenocarcinoma. As a result of general examinations, the patient was diagnosed with umbilical, hepatic, and ovarian metastases from transverse colon cancer. She was treated with S-1 and oxaliplatin(SOX)plus bevacizumab chemotherapy. After 4 courses of chemotherapy, CT revealed that the primary lesion and umbilical and hepatic metastases had reduced in size. We considered this to be a partial response and thus administered 4 additional courses of SOX plus bevacizumab chemotherapy. Finally, she remained well for 22 months and achieved relatively good prognosis. An umbilical metastasis from an internal malignancy is known as a Sister Mary Joseph's nodule, and it has very poor prognosis. Most studies show that the survival period from the time of diagnosis is within 1 year. However, our case suggests that novel anti-cancer drugs or molecular-targeted agents may improve survival.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colon, Transverse/pathology , Colonic Neoplasms/drug therapy , Sister Mary Joseph's Nodule/drug therapy , Adenocarcinoma/secondary , Bevacizumab/administration & dosage , Colonic Neoplasms/pathology , Drug Combinations , Female , Humans , Middle Aged , Oxaliplatin/administration & dosage , Oxonic Acid/administration & dosage , Sister Mary Joseph's Nodule/secondary , Tegafur/administration & dosageABSTRACT
PURPOSE: To analyze chemoradiotherapy results for locally advanced rectal cancers at a single institution. METHODS: The study cohort comprised 12 patients with clinically diagnosed T3/4, NX, M0 adenocarcinomas of the rectum who received preoperative chemoradiotherapy. RESULT: Pathological complete response(pCR)were observed in 2/12(16.7%)patients and pathological downstaging in 5/12(41.7%)patients, with generally mild adverse events. CONCLUSION: Preoperative che- moradiotherapy for clinical T3/4, NX rectal cancers significantly reduces local recurrences and improves prognoses.
Subject(s)
Chemoradiotherapy , Rectal Neoplasms/therapy , Aged , Female , Humans , Male , Neoplasm Metastasis , Preoperative Period , Rectal Neoplasms/pathology , Recurrence , Retrospective StudiesABSTRACT
A 52-year-old woman presented with sudden left lower abdominal pain, fever, and vomiting. As the symptom got improved immediately she went home then. She consulted our hospital with chief complaint of the left lower abdominal mass. Abdominal computed tomography revealed sigmoid colon cancer with abscess. She was diagnosed with sigmoid colon cancer via colonoscopy. Sigmoidectomy including partial resection of the abdominal wall was performed(D3 lymphadenectomy). Surgical specimen showed penetration of diverticulum on mucous membrane of the lesion which had been thought of a abdominal wall permeation and a tumor of I sp type at anal side. Pathological examination showed diverticulitis with penetration and the tumor was tubular adenocarcinoma(tub1, pT1bpN0, pStage I ). We had doubted penetration of sigmoid colon cancer most, but the cause of penetration turned out to be diverticulitis. We experienced a case in which we could performed surgery of sigmoid colon cancer and penetration of diverticulum at the same time.
Subject(s)
Adenocarcinoma/surgery , Diverticulum/etiology , Intestinal Perforation/surgery , Sigmoid Neoplasms/pathology , Sigmoid Neoplasms/surgery , Adenocarcinoma/complications , Adenocarcinoma/diagnostic imaging , Colonoscopy , Diverticulum/diagnostic imaging , Diverticulum/surgery , Female , Humans , Intestinal Perforation/etiology , Middle Aged , Sigmoid Neoplasms/complications , Sigmoid Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
A 76-year-old postmenopausal woman presented with a bloody attachment on the left nipple. She had a 3 cm-sized tumor in her left breast. Mammography showed a spiculated irregular mass. Ultrasonography showed a 38 mm, low echoic mass with an irregular border. Core needle biopsy examination indicated apocrine carcinoma of the breast, ER(-), PgR(-), and HER2(-). An overall examination showed no distant metastasis. We diagnosed her with apocrine carcinoma of the breast(T2N0M0, cStageâ ¡A). We performed total mastectomy with sentinel lymph node biopsy. The postoperative histopathological examination revealed apocrine carcinoma without lymph node metastasis. The patient recovered uneventfully and was discharged 8 days after the surgery. She has not experienced any recurrence for 1 year and 7 months after the surgery.
Subject(s)
Breast Neoplasms , Carcinoma , Aged , Breast , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/surgery , Carcinoma/diagnostic imaging , Carcinoma/surgery , Female , Humans , Mammography , Mastectomy , Neoplasm Recurrence, LocalABSTRACT
A 57-year-old woman was admitted to our hospital due to a suspected rectal tumor at previous doctor. Colonoscopy showed a submucosal tumor with 8mm yellowish protrusions and smooth surfaces in the rectum, 5 cm from the anal verge. Endoscopic ultrasonography showed the appearance of the internal portions of the tumor to be relatively uniform in low echoic imagery. The tumor was located in the second to third layer. Histopathological findings showed neuroendocrine tumor- G1. We performed transanal minimally invasive surgery with GelPOINT®Path. Under general anesthesia, complete fullthickness excision of the rectal lesion was performed. Primary closure was accomplished using a 3-0 braided absorbable suture. The operation duration was 24 min; blood loss was very little in this case. The patient recovered uneventfully and was discharged 2 days after the operation. There was no anorectal dysfunction and no local and distant recurrence during the postoperative follow-up of 1 year 3 months. Transanal minimally invasive surgery with GelPOINT®Path was an effective treatment for the safe removal of small rectal tumor indicated for local resection.
Subject(s)
Neuroendocrine Tumors , Rectal Neoplasms , Transanal Endoscopic Surgery , Anal Canal , Female , Humans , Middle Aged , Minimally Invasive Surgical Procedures , Neoplasm Recurrence, Local , Neuroendocrine Tumors/surgery , Rectal Neoplasms/surgery , RectumABSTRACT
A 79-year-old woman was admitted to the hospital because of continuous right lower abdominal pain lasting for 1 day. There was tenderness with signs of peritoneal irritation at the right lower abdomen along with a palpable mass. With the diagnosis of intussusception of the ileocecal region by CT examination, an emergency surgery was performed under general anesthesia. By laparoscopic ileocecal resection with lymph node dissection, the ileocecal region was found invaginated into the transverse colon, although this was easily reduced by Hutchinson's procedure. The histological diagnosis of the tumor was highly differentiated adenocarcinoma in Stage â ¢b. The postoperative course was uneventful and the patient remained in good health without any recurrence during a follow-up period of 12 months. When a patient has a sign of peritoneal irritation, such as in our case, and intestinal tract necrosis and perforation by intussusception cannot be excluded, it is necessary to perform an emergency surgery.
Subject(s)
Cecal Neoplasms , Intussusception , Aged , Cecal Neoplasms/complications , Cecal Neoplasms/surgery , Colon, Transverse/pathology , Colon, Transverse/surgery , Female , Humans , Intussusception/etiology , Neoplasm Recurrence, LocalABSTRACT
A 47-year-old man underwent hematopoietic stem cell transplantation for malignant lymphoma. He developed acute skin graft versus host disease(GVHD)and pneumomycosis which were treated with steroids. One hundred and fifteen days later, the patient had a diagnosis of free gas images in the abdominal cavity and streakly air collections in the bowel wall from the ascending colon to the sigmoid colon in the CT scan. He was asymptomatic and his physical examination was unrevealing. We diagnosed his condition as pneumatosis cystoides intestinalis(PCI). He was managed conservatively with the high concentration oxygen administration. The CT scan performed 3 days later revealed the marked improvement of intramural gas and disappearance of free gas. We considered image in the abdominal cavity that the occurrence of PCI was related to the damage of the bowel mucosa due to long term corticosteroid administration. In patients demonstrating PCI with free air in the abdominal cavity, it is important to evaluate not only the diagnostic date based on the physical, laboratory, and imaging findings, but also their medical history. Furthermore, it is important to make a correct diagnosis to avoid unnecessary surgery.
Subject(s)
Hematopoietic Stem Cell Transplantation/adverse effects , Lymphoma/therapy , Pneumatosis Cystoides Intestinalis/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fatal Outcome , Humans , Male , Middle AgedABSTRACT
The patient, 49-year-old woman, who was referred to our hospital in August 2016 because of left abdominal pain. The abdominal CT scan showed a large tumor, over 10 cm dimeter at splenic flexure of the transverse colon, and colonoscopy detected transvers colon cancer(por, cT4b, cN1, M0, cStage III A). There was no distant metastasis, although invasion to the retroperitoneum and the abdominal wall. Left hemicolectomy was successfully performed with D3 lymph node dissection. Pathological diagnosis was endocrine cell carcinoma, pT4a(SE), pN0, M0, pStage II . The Surgical margin was completely free of carcinoma(R0). The postoperative course was uneventful, and she has been in good health with no recurrence for 8 months after surgery. Neuroendocrine cell carcinoma is recommended for adjuvant treatment based on small cell lung cancer, but there are not effective clinical trials nor established treatment methods because it is rare disease.
Subject(s)
Carcinoma, Neuroendocrine/surgery , Colectomy , Colon, Transverse/surgery , Colonic Neoplasms/surgery , Colon, Transverse/pathology , Colonic Neoplasms/pathology , Female , Humans , Middle AgedABSTRACT
A 46-year old man presented with lower right quadrant abdominal pain caused by abdominal trauma. Abscess drainage was performed after the diagnosis of retroperitoneal abscess in the ileocecal portion of the colon. Type 2 advanced cancer was found in the cecum and ascending colon. Surgery was performed after improvement of inflammation. Considering the difficulty of curative resection for retroperitoneal invasion, we first performed ileo-transverse colon anastomosis. After surgery, the patient received FOLFOX with panitumumab(Pmab)as neoadjuvant chemotherapy. After 6 courses of this regimen, contrast enhanced computed tomography revealed shrinkage of the tumor. We performed a second surgery but the tumor was unresectable because of retroperitoneal invasion. After 47 courses of chemotherapy(5-FU plus LV with Pmab), the tumor was stable and we observed no distant metastasis. A third surgery was performed, and we were able to perform ileocecal resection including the retroperitoneum. The pathological diagnosis was pT4b(SI), pN1, ly2, V2, pPM0, pDM0, R0, pStage III a. On histological examination, the efficacy of chemotherapy was evaluated as Grade 1a. The patient received adjuvant chemotherapy with capecitabine and remains healthy without any evidence of recurrence more than 10 months after surgery.
Subject(s)
Abdomen/pathology , Abdominal Injuries , Colon, Ascending/surgery , Colonic Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colon, Ascending/pathology , Colonic Neoplasms/diagnostic imaging , Colonic Neoplasms/pathology , Colonic Neoplasms/surgery , Humans , Male , Middle Aged , Time FactorsABSTRACT
A 63-year-old man presented with abdominal pain in the lower right quadrant and high fever. An abdominal CT scan on admission revealed ileocecal wall thickening and inflammation of the terminal ileum. No foreign body was observed on CT scan. He received antibiotic therapy, but no improvement was noticed. Colonoscopy showed a sporadic type 0- I s+ II c lesion in the sigmoid colon. Histological examination showed well differentiated adenocarcinoma. We diagnosed the patient as having inflammation of the terminal ileum and sigmoid colon cancer. Laparoscopic surgery was performed. Inflammation was present in the terminal ileum, and local resection and sigmoidectomy were performed. A foreign body that appeared to be a fish bone was present in the resected specimen, and this led to the diagnosis of granulomatous inflammation of the ileum caused by fish bone. In the sigmoid colon, the pathological diagnosis was pT1b(sm), pN0, ly1, v1, pDM0, pPM0, R0, pStage I . He was discharged without any complication and has not shown any evidence of recurrence more than 1 year after surgery.
Subject(s)
Adenocarcinoma/surgery , Bone and Bones , Foreign Bodies/complications , Granuloma/etiology , Ileum/pathology , Sigmoid Neoplasms/pathology , Adenocarcinoma/complications , Animals , Fishes , Foreign Bodies/surgery , Granuloma/surgery , Humans , Ileum/surgery , Inflammation/etiology , Inflammation/surgery , Laparoscopy , Male , Middle Aged , Sigmoid Neoplasms/complications , Sigmoid Neoplasms/surgeryABSTRACT
A 65-year-old man presented with severe strictures from the esophagogastric junction to the body of the stomach and was histopathologically diagnosed with adenocarcinoma. Computed tomography showed multiple peritoneal metastases. A long, covered metallic stent was placed, and chemotherapy was started. Subsequent granulation from the oral side of the stent caused stricture formation, and a covered stent was also placed. After 8 months, granulation from the oral side of the stent caused recurrent stricture formation. We again placed a metallic stent. Successful chemotherapy for stomach cancer with long-term benefit is possible with new molecularly targeted drugs. Stenting may cause adverse events such as stenosis, but can enable oral intake and is minimally invasive. This report describes a case that required multiple stent placement and reviews the relevant literature.