ABSTRACT
Most cases of gastric subepithelial lesions follow a good clinical course; however, some lesions progress to malignant tumors, and treatment of tumors with a high risk of malignancy is essential. Surgical excision has been the primary treatment for tumors originating from the propria muscle layer, but it has the disadvantages of being invasive and causing postoperative functional abnormalities. With the development of endoscopic techniques and instruments, the role of endoscopic resection, which is a less invasive method for the removal of gastric subepithelial lesions, has been attracting attention. We performed an endoscopic full-thickness resection for 8 patients with gastric subepithelial lesions originating from the muscularis propria. No fatal complications occurred. Our findings suggest the need to develop various devices for resection and closure and to accumulate further experience through additional studies to prevent complications and specimen loss.
ABSTRACT
Signet ring cell carcinoma is a rare form of gallbladder cancer and has a worse prognosis. Since few cases have been reported, information regarding the behavior and prognosis of the gallbladder carcinoma is limited. About twenty four cases of gallbladder signet ring cell carcinoma have been reported so far. We present a rare case of primary signet ring cell carcinoma of the gallbladder. A 58-year-old male presented with epigastric pain. Abdominal computed tomography showed diffuse gallbladder wall thickening with enhancement, gallstones, and choledocholithiasis. After endoscopic treatment of choledocholithiasis, laparoscopic cholecystectomy was performed. Pathologic examination of the resected gallbladder revealed adenocarcinoma of signet ring cell type in the epithelium. Immunohistochemical stain for cytokeratin 7 was positive for tumor cells. The final pathologic diagnosis was primary signet ring cell carcinoma of the gallbladder. Lymph node metastasis was detected and he received chemotherapy and radiotherapy. After one year of follow-up, bone metastasis in the lumbar spine and malignant ascites were found. The patient is being provided with palliative care.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma , Ascites , Carcinoma, Signet Ring Cell , Cholangitis , Cholecystectomy, Laparoscopic , Cholecystitis , Cholecystitis, Acute , Choledocholithiasis , Diagnosis , Drug Therapy , Epithelium , Follow-Up Studies , Gallbladder Neoplasms , Gallbladder , Gallstones , Keratin-7 , Lymph Nodes , Neoplasm Metastasis , Palliative Care , Prognosis , Radiotherapy , SpineABSTRACT
A 46-year-old woman visited our hospital presenting throat pain and globus sensation. The symptoms occurred seven days after eating raw perch and mullet. An endoscopy under sedation showed a fluke―with an approximate length of 4.8 mm and width of 1.5 mm―on the left aryepiglottic fold, with active motility on the mucosa. It was extracted from the larynx using biopsy forceps and was identified as Clinostomum complanatum. To the best of our knowledge, this is the second reported case of human infection with Clinostomum complanatum diagnosed and treated by an endoscopy in Korea. Endoscopy is a useful tool in the diagnosis and treatment of patients at risk for parasitic infections complaining of throat pain.