Long-Term Survival in Stage IV Esophageal Adenocarcinoma with Chemoradiation and Serial Endoscopic Cryoablation

Esophageal cancer has a poor overall prognosis and is frequently diagnosed at a late stage. Conventional treatment for metastatic esophageal cancer involves chemotherapy and radiation. Local disease control plays a significant role in improving survival. Endoscopic spray cryotherapy is a novel modality that involves freezing and thawing to produce local ablation of malignant tissue via ischemic mechanisms. Spray cryotherapy has been shown to be effective, particularly for early T-stage, superficial esophageal adenocarcinomas. We present the case of a 72-year-old-male with locally recurrent stage IV esophageal adenocarcinoma and long-term survival of 7 years to date, with concurrent chemoradiation and serial cryoablation. He remains asymptomatic and continues to undergo chemotherapy and sequential cryoablation. The findings highlight the long-term safety and efficacy of cryotherapy in combination with chemoradiation, and suggest that cryoablation may have an additive role in the treatment of advanced stage esophageal adenocarcinoma.

Altered lipid profile in liver amoebiasis and its emendation with metronidazole treatment.

Liver amoebic abscess was produced by introducing 16,000 trophozoites of Entamoeba histolytica directly into the livers of growing hamsters. A group of the infected animals received orally 64 mg metronidazole/kg body weight for 5 days from the day of the infection. The treated group was autopsied 7 or 14 days after the treatment. Histologically, liquefaction of large parenchymal areas and biochemically, elevation in cholesterol, triglycerides, bile acids and decrease in phospholipids were observed in infected livers. The infected hamsters exhibited hyperlipidemia and hypocholesterolemia. With metronidazole treatment all the values tended to shift towards control levels. The magnitude of the shift was determined by the post-treatment period.