[Gastric Gastrointestinal Stromal Tumor Appearing Nine Years after Resection of a Duodenal Gastrointestinal Stromal Tumor-A Case Report].

Multiple sporadic gastrointestinal stromal tumor(GIST)are rare, except for those restricted to von Recklinghausen disease or hereditary conditions.We reported a case of a gastric GIST resected 9 years after the resection of a duodenal GIST.The patient was a 58-year-old male who had been followed-up with computed tomography scans after pancreatoduodenectomy for a duodenal GIST when he was 49-years-old.The patient was admitted to our hospital for anemia examination.A CT scan detected a tumor in the stomach, with a diameter of over 10 cm, and necrosis.Esophagogastroduodenoscopy revealed the presence of a delle on the gastric SMT.Due to suspected invasion of the spleen and left diaphragm by the tumor, we performed subtotal gastrectomy with splenectomy and left diaphragm segmental resection.In the pathological diagnosis, the tumor was diagnosed as a gastric GIST, because the cell type of the tumor was spindle and tested positive for c-kit.Based on the tumor size and mitotic count, the patient was diagnosed with high-risk GIST by the modified-Fletcher classification, and imatinib 400mg/day was administered.There have been no signs of recurrence for 2 years since the operation.

[Small cell carcinoma of the urinary bladder: a case report].

We report a case of primary small cell carcinoma of the urinary bladder. A 74-year-old woman was referred to our hospital because of pollakiuria. Cystoscopy showed a papillary tumor. We operated transurethral resection of the bladder tumor (TUR-Bt). Histopathological finding was transitional cell carcinoma (TCC), grade3, pT1 containing pTis. About six months later, tumor recurred to the bladder. Pathologic diagnosis was TCC in part and most was small cell carcinoma. Pelvic magnetic resonance imaging revealed a huge mass lesion with extravesical extension in the urinary bladder, and computed tomography scan showed external iliac lympho node metastasis. The rapid rise of a tumor maker NSE and pro-GRP were remarkable. It was diagnosed as a rapid advance of small cell carcinoma. We performed pelvic radiotherapy, and chemotherapy using carboplatin (CBDCA) and etoposide (VP-16). However 14 months after it had left hospital, computed tomography showed paraaortic lympho node metastasis. The patient died due to rapidly progressive disease.

[A case of mucinous cystadenocarcinoma of the appendix penetrating the urinary bladder].

The patient, an 81-year-old woman, had the chief complaint of macroscopic hematuria. Cystoscopy revealed a bladder tumor, which was determined by biopsy to be mucin-producing adenocarcinoma. Appendiceal carcinoma that invaded the bladder were diagnosed preoperatively by air-contract barium enema and magnetic resonance. She was treated with partial cystectomy and resection of the cecum. Sixteen cases of appendiceal carcinoma with invasion into the bladder have been reported in Japan.