ABSTRACT
A 37-year-old woman diagnosed with ocular myasthenia gravis was referred to our department. Chest computed tomography (CT) showed anterior mediastinal tumor and right pleural dissemination. Extended thymectomy and right intraoperative-intrapleural perfusion hyperthermo-chemothrapy (IPHC) were performed. Pathological diagnosis was invasive thymoma type B2 and stage IVa based on Masaoka's classification. The post operative course was uneventful. The patient underwent 4 cycles of adjuvant chemotherapy with doxorubicin, cisplatin, vincristine, and cyclophosphamide (ADOC), and is free from recurrence at 12 months postoperatively.
Subject(s)
Antineoplastic Agents/administration & dosage , Cisplatin/administration & dosage , Hyperthermia, Induced/methods , Myasthenia Gravis/complications , Thymectomy/methods , Thymoma/therapy , Thymus Neoplasms/therapy , Adult , Combined Modality Therapy , Female , Humans , Intraoperative Period , Neoplasm Seeding , Pleura/pathologyABSTRACT
We report a case for whom negative pressure wound therapy (NPWT) was applied for empyema with bronchopleural fistula. The patient was a 64-year-old man with a history of gastric resection and diabetes visited our hospital with chief complaints of fever and respiratory failure. In spite of conservative treatment after being diagnosed as empyema, bronchopleural fistula developed. In order to manage the pyothorax, the bronchopleural fistula was closed with endobronchial Watanabe spigot, and fenestration was subsequently performed, however the infection control and obliteration of the empyema cavity could not be achieved. NPWT with continuous irrigation was therefore chosen, and the methicillin-resistant Staphylococcus aureus (MRSA) disappeared and a marked obliteration of the empyema cavity was observed in 3 weeks after initiation of NPWT. Although the patient died of another illness, NPWT with continuous irrigation was useful in treating empyema with bronchopleural fistula.
Subject(s)
Bronchial Fistula/complications , Empyema, Pleural/surgery , Negative-Pressure Wound Therapy , Pleural Diseases/complications , Respiratory Tract Fistula/complications , Empyema, Pleural/complications , Humans , Male , Middle AgedABSTRACT
A case of gastrointestinal stromal tumor (GIST) in stomach was presented. Serial barium meal x-ray examinations revealed an enlarging elevated lesion on the fornix of the stomach. Tumor volume doubling time was found to be 299 days. Microscopic and immunohistochemical studies of the resected tumor disclosed GIST, uncommitted type, low grade malignant/potentially malignant. A radiographic feature of this rare type of gastric submucosal tumor was demonstrated in this report.
Subject(s)
Stomach Neoplasms/diagnostic imaging , Female , Humans , Middle Aged , Radiography , Stomach Neoplasms/pathologyABSTRACT
A case of hepatocellular carcinoma (HCC) complicated by tumor thrombosis of the main trunk is presented. Four courses of hepatic arterial infusion therapy, via a subcutaneously implanted injection port, were performed using cisplatin (10 mg for 1 hour on days 1-5) and 5-fluorouracil (250 mg for 5 hours on days 1-5). After four courses of the chemotherapy, marked reduction in size of HCC and the tumor markers were noted. The esophageal varices and ascites were improved after the chemotherapy with a recanalization of the left branch of the portal vein. The patient was doing well with a survival period of 28 months after the chemotherapy. These encouraging results suggested that the present therapy, based on the biochemical modulation, was a useful option for advanced HCC with portal hypertension due to tumor thrombosis of the main portal vein.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Hypertension, Portal/etiology , Liver Neoplasms/drug therapy , Neoplastic Cells, Circulating , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carcinoma, Hepatocellular/complications , Cisplatin/administration & dosage , Female , Fluorouracil/administration & dosage , Humans , Infusion Pumps, Implantable , Infusions, Intra-Arterial , Liver Neoplasms/complicationsABSTRACT
This study was aimed at evaluating the tolerance to an intermittently administered oral UFT for hepatocellular carcinoma (HCC) with chronic liver disease (CLD). Ten patients who had received curative therapy for HCC with CLD (Child's classification A or B) were randomly assigned either an intermittent schedule (IS), oral administration of UFT (130 mg/m2/b.i.d.) with 2 days rest a week, or a continuous schedule (CS), consecutive administration of UFT with the same dose. On day 12, the serum concentration of 5-fluorouracil (5-FU) was measured. After 2 weeks rest, the patients were switched to the other schedule for 10 weeks and the concentration of 5-FU was measured on day 12. The median values of the area under the curve (AUC) and maximum concentration (Cmax) of 5-FU in IS and CS were 187.7 and 263.2 ng/ml/h, 57.1 and 93.0 ng/ml, respectively. Both the AUC and Cmax for IS were significantly lower than those for CS. One IS patient had tolerable diarrhea, while three of the CS patients had intolerable nausea and one had hemorrhagic gastritis. IS seemed to be a suitable measure for CLD.
