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1.
Gan To Kagaku Ryoho ; 48(8): 1049-1051, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34404074

RESUMO

The rate of aging in Japan has currently exceeded 28.1%. Moreover, it is expected that the rate of aging will continue to increase in the future. Under these circumstances, the opportunities to treat breast cancer in the super-elderly individuals are elevating. Here, we summarized and examined the cases who were 85 years or above in age and diagnosed with breast cancer at our hospital during the last 10 years. There were 29 cases(30 breasts), who were all female, with an average age of 89.6 years. Dementia coexisted in 17 cases, and an enlarged mass was the trigger for the discovery in most cases. For breast cancer in super-elderly females, it is necessary to treat it in the right proportion. Moreover, it is considered that the treatment policy should be decided considering the presence or absence of dementia and comorbidities. Also, the treatment regime should be decided upon full consultation with the surroundings, such as family members and long-term care facilities.


Assuntos
Neoplasias da Mama , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Comorbidade , Feminino , Hospitais , Humanos , Japão/epidemiologia
2.
Gan To Kagaku Ryoho ; 48(7): 955-957, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267035

RESUMO

The case involved a 51-year-old woman who was diagnosed with Stage Ⅰ right breast cancer(cT1, N0, M0). Partial resection of the right breast and sentinel lymph node biopsy were performed. The histological type was found to be Stage Ⅰ triple-negative medullary carcinoma with pT1c, pN0(sn), and M0. A pituitary tumor was diagnosed after discharge. After removal of the pituitary tumor, whole-breast irradiation was performed. Subsequently, chemotherapy was started. Approximately 5 months after surgery, redness and swelling of the right breast were observed. Inflammatory breast cancer recurrence could not be ruled out by imaging, and skin biopsy was performed. No malignant findings were observed, and the symptoms were considered to indicate radiation recall dermatitis caused by chemotherapy. When chemotherapy was discontinued, the redness of the right breast improved.


Assuntos
Neoplasias da Mama , Neoplasias Inflamatórias Mamárias , Radiodermatite , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Radiodermatite/diagnóstico , Radiodermatite/etiologia , Biópsia de Linfonodo Sentinela
3.
Gan To Kagaku Ryoho ; 46(7): 1183-1186, 2019 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-31296827

RESUMO

The present study reports the case of a 49-year-old woman who was diagnosed with cancer of the left breast at the age of 43 years.Following chemotherapy, the patient had undergone partial mastectomy and axillary lymphadenectomy.Postoperatively, she underwent radiotherapy and hormone therapy.Five years and 4 months after the operation, the patient developed pain in the cervical vertebrae and was diagnosed with spinal metastasis.During the period, she began experiencing fatigue and hematological investigations indicated anemia, as well as thrombocytopenia, jaundice, and schistocytes.The patient was referred to our facility for further examination and treatment.On investigation, she was diagnosed with cancer-related thrombotic microangiopathy(TMA).The patient was advised to undergo chemotherapy due to which symptoms of TMA were relieved.She continued to receive chemotherapy for the following 3 years and 2 months until her death.


Assuntos
Anemia , Neoplasias da Mama , Microangiopatias Trombóticas , Neoplasias da Mama/complicações , Dor do Câncer , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Microangiopatias Trombóticas/etiologia
4.
Gan To Kagaku Ryoho ; 46(6): 1049-1051, 2019 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-31273173

RESUMO

According to previous reports in our country, histiocytoid breast carcinoma is a very rare case of its tissue type, accounting for only 0.3% of all breast cancer cases. We have neither established a diagnostic standard nor a general idea for these tumors. Previously, its inherited pathology was assumed to be a sub-form of invasive lobular carcinoma. However, some researchers indicate the presence of components that are assumed to originate from milk ducts or differentiation in the apocrine gland. In this way, origins of pathologies for these tumors seem to be complex. Previous reports suggest cases of relatively long survival times without spreading to distant sites. Recently, we encountered one case of histiocytoid breast carcinoma accompanied by multiple axillary lymph node metastases.


Assuntos
Neoplasias da Mama , Carcinoma Lobular , Axila , Humanos , Linfonodos , Metástase Linfática
5.
Gan To Kagaku Ryoho ; 46(6): 1081-1083, 2019 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-31273181

RESUMO

The present case involved a man aged about 70 years. He visited our hospital with the main complaint of abdominal pain. We diagnosed him with intestinal obstruction, and we decided to perform surgery. White knot sections were spread inside the abdominal cavity, and the small intestine appeared as a single block. This block was resected and examined for peritoneal mesothelioma. Peritoneal mesothelioma is thought to have incubation period of 20-25 years after exposure to asbestos, and the number of affected patients will increase in the future. In some cases, peritoneal mesothelioma occurs only in the peritoneum; therefore, diagnosis often becomes difficult. Once intestinal obstruction occurs, administering chemotherapy is difficult. Therefore, early diagnosis is thought to be very important.


Assuntos
Asbestos , Íleus , Mesotelioma , Neoplasias Peritoneais , Idoso , Humanos , Íleus/etiologia , Masculino , Mesotelioma/complicações , Neoplasias Peritoneais/complicações
6.
Oncol Lett ; 14(1): 397-403, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28693182

RESUMO

The meso-pancreatoduodenum is the primary site of tumor infiltration in patients with pancreatic head cancer, with numerous patients exhibiting lymph node metastases. Effective dissection of the regional lymphatic basin requires knowledge of the patterns of the arterial branches. The present study examined the patterns of the arteries feeding the pancreatic head and the distribution of the meso-pancreatoduodenum. The present study included 123 patients with pancreatic cancer who underwent contrast-enhanced preoperative 64-multidetector-computed tomography to determine the routes of the inferior pancreaticoduodenal and first jejunal arteries. Surgical specimens and cadavers were also evaluated histologically to clarify the distribution of the meso-pancreatoduodenum. The feeding arteries were divided into three types, with 64.2% of patients having type A, 28.4% having type B and 7.3% having type C branches. The branches emerged from the back or left side of the superior mesenteric artery and ran to the far side of the pancreatic head in an arc. Consequently, the meso-pancreatoduodenum had a roll-shaped appearance, surrounding the trunk arteries and extending to the left side of the superior mesenteric artery. Dissecting the right and left sides of the superior mesenteric artery during lymphadenectomy could improve the effectiveness of resection.

7.
Gan To Kagaku Ryoho ; 42(12): 1836-8, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805189

RESUMO

A 67-year-old man was treated for diabetes mellitus by his family doctor. A splenic tumor was suspected based on his pain in the left side of the abdomen. He was admitted to our hospital for close inspection and medical treatment. Abdominal CT and MRI scans showed a tumor, 10 cm in diameter, in the spleen. An opaque boundary with the diaphragm was also observed. On PET-CT, accumulations of FDG were observed in the left supraclavicular fossa and the left axilla. The serum levels of LDH and sIL-2R were elevated, and therefore a diagnosis of malignant lymphoma was suspected. Due to the risk of splenic rupture, a splenectomy was performed. After pathological examination, the patient was diagnosed with diffuse large B-cell malignant lymphoma. He is currently being treated with chemotherapy at another medical institute. Splenic rupture occurs in some cases of splenic malignant lymphoma, although the number of reported cases is low. In some of the cases, splenic rupture occurred during treatment of the malignant lymphoma. There is no specific way to measure the risk of splenic rupture; however, performing a prophylactic splenectomy is one option in cases where tumor cells have extended to the capsula lienis, similar to that in our patient.


Assuntos
Linfoma Difuso de Grandes Células B/diagnóstico , Esplenectomia , Neoplasias Esplênicas/patologia , Idoso , Diafragma/patologia , Humanos , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Invasividade Neoplásica , Ruptura Espontânea/prevenção & controle , Neoplasias Esplênicas/cirurgia , Resultado do Tratamento
8.
World J Gastroenterol ; 20(45): 17247-53, 2014 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-25493042

RESUMO

A lymphoepithelial cyst (LEC) of the pancreas is a rare benign lesion. Because patients with LEC of the pancreas have a good prognosis, it is important that these lesions are accurately differentiated from other more aggressive pancreatic neoplasms for an appropriate treatment strategy. Previous studies have reported that a definitive diagnosis of LEC often cannot be obtained based solely on the findings of preoperative imaging (e.g., Computed tomography or Magnetic resonance imaging). In this study, we reviewed four cases of pancreatic LECs to investigate the feature of LECs. We reviewed these cases with regard to symptoms, imaging findings, surgical procedures, and other clinical factors. We found that LEC was associated with unique characteristics on imaging findings. A preoperative diagnosis of LEC may be possible by comprehensively evaluating its clinical and imaging findings.


Assuntos
Diagnóstico por Imagem/métodos , Células Epiteliais , Tecido Linfoide , Cisto Pancreático/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Endossonografia , Células Epiteliais/diagnóstico por imagem , Células Epiteliais/patologia , Feminino , Humanos , Tecido Linfoide/diagnóstico por imagem , Tecido Linfoide/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cisto Pancreático/diagnóstico por imagem , Cisto Pancreático/patologia , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X
9.
Gan To Kagaku Ryoho ; 41(5): 645-8, 2014 May.
Artigo em Japonês | MEDLINE | ID: mdl-24917014

RESUMO

A 59-year-old man with gastric cancer underwent a total gastrectomy with splenectomy and D2 lymph node dissection. Pathological findings after the first operation were as follows: ML, AntLess, type 3, por, pT3, ly1, v0, and M, Post, 0-II c, tub1, pT1b2, ly0, v0, pN2M0P0H0, pStage IIIA. At 3 years and 6 months after the operation, multiple small nodules were noted on the skin of his face, neck, body, and arms. Biopsy of a skin lesion indicated that it was a metastatic skin cancer resulting from an adenocarcinoma. Thus, we diagnosed the lesions as skin metastases originating from an adenocarcinoma of the stomach. We also detected the presence of multiple metastases to the bone and lymph nodes, and we have treated the patient with chemotherapy. Metastases to the umbilicus from gastric cancer are termed as Sister Mary Joseph's nodules (SMJN). Although cases of SMJN are often reported, cases of multiple metastases from gastric cancer, without invasion to the umbilicus, are rare.


Assuntos
Adenocarcinoma/terapia , Neoplasias Cutâneas/terapia , Neoplasias Gástricas/terapia , Adenocarcinoma/secundário , Biópsia , Quimiorradioterapia , Gastrectomia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Neoplasias Cutâneas/secundário , Esplenectomia , Neoplasias Gástricas/patologia
10.
Gan To Kagaku Ryoho ; 41(4): 491-3, 2014 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-24743367

RESUMO

An 83-year-old woman was diagnosed as having advanced gastric cancer with multiple lymph node and hepatic metastases. Histopathological examination revealed that the tissue was human epidermal growth factor receptor 2(HER2)positive. The patient underwent gastrojejunostomy to improve stomach obstruction. Thereafter, S-1 and trastuzumab combination chemotherapy was administered as first-line treatment; irinotecan(CPT-11), cisplatin, and trastuzumab combination chemotherapy, as second-line treatment; and docetaxel plus trastuzumab combination chemotherapy, as third-line treatment. Although both primary and metastatic lesions decreased in size temporarily, their size increased again, and the patient died 1 year and 7 months later. The level of serum HER2-extracellular domain(ECD)was a valuable indicator of response to chemotherapy. Thus, serum HER2-ECD could be a useful biomarker for HER2-positive gastric cancer.


Assuntos
Biomarcadores Tumorais/sangue , Receptor ErbB-2/sangue , Neoplasias Gástricas/sangue , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Espaço Extracelular , Evolução Fatal , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Receptor ErbB-2/química , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia
11.
World J Surg ; 38(9): 2448-54, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24752361

RESUMO

BACKGROUND: Radical antegrade modular pancreatosplenectomy (RAMPS) has theoretical advantages for curative resection of adenocarcinomas of the left pancreas. The anterior renal fascia is a key structure, and resection planes should run posterior to this fascia. However, it is difficult to delineate this fascia and set a precise dissection plane. We modified RAMPS to achieve such a precise dissection plane with ease. METHODS: After clamping the splenic artery, the third duodenal portion was mobilized from the left to the right to locate the inferior vena cava, which was covered by the anterior renal fascia. Here, the anterior renal fascia was incised while approaching the dissection plane. Dissection then continued cephalad, with this plane along the inferior vena cava, and then turned along the left renal vein at the confluence of the left renal vein toward the renal hilum. At this point, dissection continued along the coronal plane to the superior edge of the pancreas. RESULTS: Between July 2007 and December 2012, a total of 24 pancreatic adenocarcinoma patients underwent modified RAMPS. Tumor extension beyond the pancreatic parenchyma (T3) and lymph node metastases was confirmed in 17 and 13 cases, respectively. Histologically clear surgical margins were achieved (R0 resection) in 21 patients (88 %). The 5-year overall survival rate was 53 %. Six patients survived for over 5 years without recurrence. CONCLUSIONS: This modification of RAMPS is advantageous for en bloc resection while actually including removal of the anterior renal fascia. It is associated with satisfactory survival rates for patients with distal pancreatic carcinomas.


Assuntos
Adenocarcinoma/cirurgia , Fasciotomia , Rim/cirurgia , Recidiva Local de Neoplasia/etiologia , Pancreatectomia/métodos , Neoplasias Pancreáticas/cirurgia , Esplenectomia/métodos , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Dissecação/efeitos adversos , Dissecação/métodos , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasia Residual , Pancreatectomia/efeitos adversos , Neoplasias Pancreáticas/patologia , Esplenectomia/efeitos adversos , Taxa de Sobrevida
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