False-positive 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) findings of bone metastasis from esophagogastric cancer: report of two cases.

We report two cases of (18)F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) fusion imaging showing false-positive findings of bone metastases from esophagogastric cancer. Although multiple bone metastases from esophagogastric cancer were suggested by several images, ultimately, degeneration of the bone marrow was diagnosed histologically. We discuss the value of imaging modalities and the importance of a comprehensive diagnosis based on a combination of physical examination, laboratory test results, and imaging studies.

[A case of recurrent esophageal cancer with lymph node and lung metastases, successfully treated with systemic chemotherapy and radiofrequency-ablation].

We report a case of recurrent esophageal cancer with lymph node and lung metastases, successfully treated with systemic chemotherapy and radiofrequency-ablation(RFA). A 45-year-old man was diagnosed with thoracic esophageal cancer.Radical esophagectomy with three-field lymphadenectomy was performed.After 6 months, mediastinal lymph node recurrence occurred.Although the size of the recurrent mediastinal lymph nodes were reduced after 10 courses of systemic chemotherapy, two new lung metastatic nodules appeared in the right segments 8 and 9.CT -guided percutaneous RFA was successfully achieved for the 2 lesions.However, 6 months after the RFA, a local recurrence at the RFA site of segment 9 occurred, and an additional RFA was performed for this tumor.Five years and four months after the first operation, the tumor marker level remained within a normal range, and the patient is doing very well without any signs of recurrence. RFA appears to be an effective and minimally invasive technique for controlling local recurrence of esophageal cancer when combined with systemic chemotherapy.

[Treatment for advanced gastric cancer with positive lavage cytology-systemic versus intraperitoneal chemotherapy].

The prognosis of advanced gastric cancer patients complicated with positive lavage cytology is poor, similar with that of peritoneal dissemination. For these diseases, we had reported the usefulness of intraperitoneal chemotherapy with cisplatin. Recently, systemic chemotherapy with S-1 and cisplatin is effective even for gastric cancer with peritoneal dissemination. Therefore, we compared the combination chemotherapy of S-1 and intraperitoneal cisplatin (IP group) with systemic S-1 plus cisplatin chemotherapy (IV group) for positive lavage cytology without peritoneal dissemination (P0CY1) gastric cancer. In this trial, 8 patients were enrolled after gastrectomy. Four were IP group and another 4 were IV group. The average chemotherapy courses for IV group and IP group are 3.5 times and 4.8 times, respectively. There was no difference in prognosis. Grade 3/4 events occurred for IV group and IP group were 3 patients and only 1 patient, respectively. The combination chemotherapy of S-1 and intraperitoneal cisplatin was found to be well tolerated and effective in patients with advanced gastric cancer with P0CY1.

[Observations on staging of advanced gastric cancer using contact rigid endoscopy].

A rigid contact scope is a recent development of optical instrument which allows observations of the superficial layers of the mucosai epithelium in gynecology and otorhinolaryngology. To assess the evaluation of 25 patients with advanced gastric cancer, whose lesions had been diagnosed to be more than T3 or suspected to have peritoneal deeding, we performed pre operative laparoscope with rigid contact scope. After inspecting a usual laparoscopic observation of the abdominal cavity, serosal exporsure and peritoneal seeding were confirmed. All the patients who had serosal exporsure and cancer cells showed an irregularity of cell distribution with the extent of heterogeneity of the cells with nuclei size and shape. Five patients had peritoneal seeding, and the findings with rigid contact scope showed a similar view to cancer cells which were observed in serosal exposure. The result suggests that this new endoscopic technique enabled a new diagnostic approach in advanced gastric cancer.

[A case report-the marked response to S-1 + CDDP chemotherapy for post-operative local recurrence of advanced gastric cancer].

A 55-year-old woman, underwent a total gastrectomy with super extended lymphadectmy for type 4 gastric cancer 4 years ago, suffered a locoregional recurrence at the esophagojejunostomy. She was given S-1 with cisplatin for a treatment against the recurrent site. Although grade 2 leucocytopenia and grade 3 anorexia were observed, consecutive twenty five courses of the regimen were carried out with a dose modification of anticancer drugs, and home parentenral nutrition system was used for severe anorexia. She has been alive for more than 3 years since the start of the treatment with a good control of locoregional recurrent lesion, and no other apparent metastatic sites were observed.

[A successful case of liver metastasis from gastric cancer treated with S-1 + induced hypertensive hepatic arterial infusion chemotherapy--a case report].

We have experienced a successful case of liver metastasis from gastric cancer treated with S-1 plus induced hypertensive hepatic arterial infusion chemotherapy. A 50-year-old man had undergone distal gastrectomy with extended lymphadenectomy for advanced gastric cancer. Although he was given 100 mg/day of S-1 for postoperative adjuvant therapy, an abdominal CT scan showed a liver metastasis at the hepatic segment 6 after 3 courses of adjuvant chemotherapy. Then, intra-arterial hepatic cannulation connecting to a subcutaneously implanted port system was indwelt via left subclavial artery. Mitomycin C (10 mg) was injected through out the induced hypertension with intravenously-administered angiotensin II once a month. After he received three courses of this combination chemotherapy, the liver metastasis has disappeared on CT scan and a complete response (CR) has been maintained.