[A Case of Thyroid Metastasis from Rectal Cancer].

The patient was a 68-year-old man who underwent Hartmann's procedure for a fistula due to rectal cancer in August 2012. The cancer was tub2>tub1, pSE, pN2, pH2, pM1(intrapulmonary metastasis), stage IV. The patient received 5 courses of FOLFOX and bevacizumab as adjuvant chemotherapy. In December 2012, the patient was seen by Otolaryngology for hoarseness. A neck examination revealed induration of the left lobe of the thyroid, and FNA biopsy strongly suggested metastasis of rectal cancer to the thyroid. FDG-PET was performed and revealed extensive accumulation of FDG at the same site. The patient was diagnosed with thyroid metastasis of rectal cancer and underwent a left thyroid lobectomy and lymph node dissection in January 2013. Histopathology confirmed the thyroid metastasis of rectal cancer. Thyroid metastasis of rectal cancer is extremely rare: there are 11 such cases in the Japanese literature, including the case encountered by the current authors. This case is reported here, along with a discussion of some of the literature.

[Intraperitoneal chemotherapy against peritoneal carcinomatosis of gastric cancer with activated carbon particles adsorbing mitomycin C for four patients].

Activated carbon particles adsorbing mitomycin C (MMC-CH) was administered to four patients with peritoneal carcinomatosis of gastric cancer into their abdominal cavities. Tumor markers of CEA, CA19-9, CA125, CA72-4 and STN were measured before and after the administration. The waist of each patient was also measured. After the administration of MMC-CH, tumor markers of three out of the four patients were decreased and a large amount of ascites of all patients had disappeared. The appetite of all four patients had increased and complaints such as nausea and vomiting had decreased. The mean survival of the four patients was 291.2 days (123-542 days). Our results suggested that MMC-CH had an anti-tumor effect of peritoneal carcinomatosis and improved the QOL of patients with a large amount of ascites.

[Complete response of gastric cancer with interaorticocaval lymph node recurrence to weekly administration of paclitaxel--a case report].

We report a case in which weekly administration of paclitaxel produced a complete response for gastric cancer with interaorticocaval lymph node recurrence. A 55-year-old man who underwent total gastrectomy for advanced gastric cancer had pathological findings of tub2, se, n2, ly2, v2, stage IIIB. As an outpatient, he was first treated with TS-1 (100 mg/day) for 5 cycles. CEA increased gradually however, and 7 months postoperatively he was found to have interaorticocaval lymph node swelling in upper abdominal CT and was diagnosed with a recurrence of gastric cancer. He underwent weekly administration of paclitaxel as second-line chemotherapy. Paclitaxel was administered by 1-hour intravenous infusion at a dose of 90 mg/body weekly after short premedication as an outpatient. This was continued for 3 weeks followed by 1 week of rest. CEA decreased gradually, and the swollen lymph node had responded completely after 10 cycles. The only toxic side effect was alopecia (grade 1). No major adverse effects such as hypersensitivity, leukopenia or peripheral neuropathy were observed.

An extrarenal malignant rhabdoid tumor suspected to originate from the mesentery in an adult: report of a case.

A malignant rhabdoid tumor is very rare and its prognosis is extremely poor. It was first described as a distinctive and highly malignant neoplasm of the infant kidney. Tumors with a similar appearance have been reported in various extrarenal sites. We herein report a case of a 41-year-old man who was admitted to our hospital complaining of a lower abdominal mass. After one series of examinations, the patient underwent a laparotomy. Most such tumors are situated in the mesentery and involve the small intestine, and thus we diagnosed it to originate from mesentery. This tumor could not be resected and only an excisional biopsy was done. It was histologically composed of a solid sheet arrangement with ovoid, round, and lateralized nuclei and mild acidophilic cytoplasm. Inclusion body-like structures were found in the cytoplasm. Immunohistochemically, the tumor cells were positive for cytokeratin, epithelial membrane antigen, vimentin, and CAM5.2. The patient died 2 weeks after operation due to multiple organ failure.

Acute peritonitis caused by intraperitoneal rupture of an infected urachal cyst: report of a case.

Embryologically, the urachus is the tubular structure that connects the dome of the bladder to the umbilicus. Incomplete obliteration of the urachal lumen results in several anomalies. The most common urachal abnormality is the urachal cyst and, while intraperitoneal rupture of an infected urachal cyst is very rare, acute peritonitis resulting from intraperitoneal rupture is the most dangerous of all complications associated with urachal anomalies. We report the case of an 80-year-old woman who underwent an emergency laparotomy for lower abdominal pain and signs of acute peritonitis, which revealed intraperitoneal rupture of an infected urachal cyst. Infected urachal cysts with intraperitoneal rupture are often misdiagnosed as a common acute abdomen and result in emergency exploratory laparotomy. These patients should be managed by complete excision of the urachal remnant to prevent any malignant change occurring, as malignant changes have been reported.