[A Case of Alcoholic Liver Disease Presenting as Prominent Accumulation of Ascites Associated with Liver Damage Due to CapeOX].

A 75-year-old man with rectal cancer had consumed an average of6 6 g of alcohol per day for 47 years. However, his liver function was within normal limits and his Child-Pugh classification was A before initiation of therapy. He underwent neoadjuvant chemoradiation and a low anterior resection. The patient then received CapeOX as an adjuvant therapy. During the fourth cycle of CapeOX, computed tomography(CT)showed massive ascites. The chemotherapy was discontinued and treatment including a diuretic agent was initiated. The ascites gradually decreased and 8 months after the discontinuation of CapeOX, CT showed neither the presence ofascites nor recurrence ofthe cancer or metastasis. When a patient has a history ofexcessive alcohol intake, even iftest results for liver function are within normal limits, we should be aware ofthe hepatic toxicity ofCapeOX.

[A Case of Squamous Cell Carcinoma of the Esophagus with Achalasia -- Conversion from Chemoradiotherapy to Surgery].

The patient was a 67-year-old woman with achalasia and squamous cell carcinoma(SCC)of the esophagus. She presented with a difficulty in swallowing. The cancer was on the surface of the esophagus. The patient initially received systemic chemotherapy with 5-FU and cisplatin, and radiation therapy. The difficulty in swallowing persisted due to insufficiency of radiation treatment caused by achalasia. Therefore, we shifted the treatment plan from chemoradiotherapy to surgery. Endoscopic examination performed before surgery showed that there was no obvious cancer in the esophagus. We resected the esophagus routinely. On the specimen, no cancer cells were detected upon macroscopic and microscopic examinations; metastasis was not detected in the lymph node. Achalasia is a recognized risk factor for esophageal SCC. In the treatment of superficial SCC, no difference of therapeutic effect was observed between surgery and chemoradiation. However, for the treatment of certain cases of SCC with achalasia, including the treatment of achalasia itself, surgery can be the preferred option of treatment.

A rare case of non-invasive ductal carcinoma of the breast coexisting with follicular lymphoma: A case report with a review of the literature.

The double presentation of breast cancer and follicular lymphoma is extremely rare, and only six cases have previously been reported in the literature. In the present study, a case of synchronous ductal carcinoma in situ (DCIS) of the breast and follicular lymphoma is reported. During an annual breast screening procedure, a 49-year-old female presented with a hard induration under the nipple of the right breast and swelling of a soft lymph node (LN) in the right axilla. Mammography and ultrasonography revealed two lesions in the right breast: One was a tumor with microcalcification, 1.0 cm in diameter, and the other was a large, crude calcification, 2.5 cm in diameter. In addition, computed tomography and positron emission tomography revealed swellings of the bilateral axillary (Ax) LN and intra-abdominal para-aortic LN. The patient underwent excisions of the large calcified mass, a micro-calcified tumor and the right AxLN. The pathological and immunohistochemical studies revealed fat necrosis and DCIS of the breast, which was positive for the estrogen receptor and the progesterone receptor, while human epidermal growth factor receptor II protein expression was evaluated as 2+ and stage was classified as pTis pN0 M0, stage 0. Furthermore, the Ax node was diagnosed as follicular lymphoma, which was positive for cluster of differentiation (CD)20, CD79a, CD10 and B-cell lymphoma (Bcl)-2 protein, but negative for Bcl-6 protein. The clinical stage was classified as stage III. The patient was administered chemotherapy followed by radiotherapy to the conserved breast. Two years have passed since the surgery, and the patient is disease-free.