[A case of anorectal malignant melanoma appearing 1 year after endoscopic mucosal resection of a rectal adenocarcinoma].

We present a case of a 61-year-old woman who underwent endoscopic mucosal resection (EMR) for early-stage colorectal cancer. However, because the condition of the horizontal margin of the resected tumor was unknown, she further underwent local transanal excision. Lower gastrointestinal endoscopy performed 1 year later showed protruding lesions both on the scar tissue and in the vicinity. Biopsy revealed malignant melanoma. She then underwent laparoscopic abdominoperineal resection and colostomy. This was an extremely rare case of adenocarcinoma complicated by malignant melanoma after resection.

[Curative resection for bulky gastrointestinal stromal tumor with conversion therapy by imatinib].

Imatinib is a standard treatment for unresectable gastrointestinal stromal tumor (GIST). We described the case of a 66- year-old woman with bulky GIST of which a diameter was 25 cm. Therefore, we decided the tumor was unresectable. After 2-year administration of imatinib, the diameter of tumor was reduced to 6 cm. After 3-year administration of imatinib, the diameter of tumor was increased to 8 cm. The patient did not have any distant metastasis. He underwent a resection of the tumor. The historical examination showed that c-kit and CD34 were positive. The number of mitosis was 12/50 HPF. Conversion chemotherapy for bulky GIST may contribute to a curative resection.

[A case report of internal hernia through an abnormal defect in the broad ligament of the uterus].

We report a rare case of internal hernia through an abnormal defect in the broad ligament of the uterus. A 49-year-old woman, without any previous surgery, was admitted because of vomiting and lower abdominal pain. Three days after admission a small amount of small intestinal gas was pointed out on her plain abdominal X-ray film. An enema examination by ileus tube revealed a pooling of gastrografin on the left side of the pelvic cavity, showing an obstruction of the ileum. Therefore, an emergency operation was performed, whereupon we found an abnormal defect in the left broad ligament of the uterus. This case describes an internal hernia through an abnormal defect in a female ileus patient without a history of surgery.

[Oral rehydration therapy with OS-1 for advanced and recurrent gastrointestinal cancer patients].

The aim of this study was to introduce an oral rehydration therapy with OS-1 for advanced and recurrent gastrointestinal cancer patients to reduce a hospital stay as well as having a good QOL. We targeted 10 advanced cancer patients. In this study, We recommended the OS-1 drinking amount to be 500 mL to 1, 000 mL whenever the following symptoms were observed:(1) the patient's meal consumption was decreased in half, (2) the volume of urine was decreased, and (3) the frequency of urine was decreased. Nine out of 10 patients were able to drink OS-1 in the range of 500 mL to 1, 000 mL. Most of the patients were taking the chemotherapy along with OS-1 therapy. We confirmed two distinct cases: The patients with OS- 1 short-term drinker at the time of appetite fall because of chemotherapy. Another case was the patients with OS-1 longterm drinkers due to the end of life stage which decreased in meal frequency. ORT with OS-1 may contribute to improve QOL of the terminal patient with chemotherapy.