RESUMO
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.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Retais/tratamento farmacológico , Adulto , Biomarcadores Tumorais/sangue , Terapia Combinada , Feminino , Fluoruracila/uso terapêutico , Humanos , Leucovorina/uso terapêutico , Estadiamento de Neoplasias , Compostos Organoplatínicos/uso terapêutico , Proctoscopia , Neoplasias Retais/sangue , Neoplasias Retais/patologia , Neoplasias Retais/radioterapia , Indução de Remissão , Tomografia Computadorizada por Raios XAssuntos
Adenocarcinoma Mucinoso/patologia , Carcinoma Papilar/patologia , Neoplasias Pancreáticas/patologia , Pancreatite/complicações , Pseudomixoma Peritoneal/etiologia , Adenocarcinoma Mucinoso/complicações , Carcinoma Papilar/complicações , Carcinoma Papilar/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/cirurgia , Pancreatite/etiologia , Fatores de Tempo , Resultado do TratamentoRESUMO
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.
Assuntos
Cistadenoma Seroso/diagnóstico , Neoplasias das Glândulas Endócrinas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Biópsia por Agulha , Diagnóstico Diferencial , Endossonografia , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Carcinoma de Células Gigantes/patologia , Ductos Pancreáticos , Neoplasias Pancreáticas/patologia , Veia Porta , Carcinoma de Células Gigantes/diagnóstico por imagem , Carcinoma de Células Gigantes/cirurgia , Endossonografia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/patologia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Veia Porta/diagnóstico por imagem , Veia Porta/patologia , Ultrassonografia de IntervençãoRESUMO
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.
