ABSTRACT
A 70-year-old man presented with septic shock and abdominal pain during treatment of pain caused by stage IV lung adenocarcinoma. CT revealed air collection from the retroperitoneum to the muscle around the thigh. Septic shock due to retroperitoneal penetration from the digestive tract was suspected. Despite treatment attempts, the patient died. The autopsy diagnosis was penetration of a sigmoid colon diverticulum under the serosa. When a diverticulum is located near the mesenterium and the size of penetration is small, the air collection rather than fecal matter is likely to extend retroperitoneally. Abdominal pain is little manifest in the penetration in contrast to perforation into abdominal cavity, and the attention is needed.
Subject(s)
Colon, Sigmoid , Diverticulum, Colon/pathology , Intestinal Perforation/pathology , Shock, Septic/etiology , Adenocarcinoma/physiopathology , Humans , Lung Neoplasms/physiopathology , Male , Middle Aged , Pain ManagementABSTRACT
For symptom alleviation, subcutaneous continuous injection of octreotide was administered to a patient with pancreatic neuroendocrine tumor (NET) accompanied by multiple hepatic metastases and ascites. The level of the tumor marker neuron-specific enolase decreased to the normal range and cystic necrosis of the tumors was confirmed. There have been some reports on the antineoplastic effects of octreotide on pancreatic NET; therefore, octreotide appears to be a valid option as a therapeutic agent in patients with highly advanced pancreatic NET, in whom administration of molecular targeted or anticancer agents is difficult because of a poor general status.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Biomarkers, Tumor/blood , Liver Neoplasms/drug therapy , Neuroendocrine Tumors/drug therapy , Octreotide/therapeutic use , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/pathology , Humans , Injections, Subcutaneous , Liver Neoplasms/secondary , Male , Middle Aged , Neuroendocrine Tumors/blood , Neuroendocrine Tumors/secondaryABSTRACT
This paper presents a woman in her 70's with G-CSF producing anaplastic carcinoma of the pancreas(Stage IVb)who underwent chemotherapy by S-1 alone. On FDG-PET after the first course, accumulation of FDG was impaired remarkably. After the second course, the patient died of carcinomatous pleuritis and peritonitis on the 88th day after initiation of treatment. G-CSF producing anaplastic carcinoma of the pancreas is extremely rare and there are no reports with regard to response evaluation by FDG-PET. Thus, this case has significant clinical value.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Carcinoma/diagnostic imaging , Oxonic Acid/therapeutic use , Pancreatic Neoplasms/diagnostic imaging , Positron-Emission Tomography , Tegafur/therapeutic use , Aged , Autopsy , Carcinoma/drug therapy , Carcinoma/metabolism , Drug Combinations , Fatal Outcome , Female , Fluorodeoxyglucose F18 , Granulocyte Colony-Stimulating Factor/biosynthesis , Humans , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/metabolism , Pleurisy/etiologyABSTRACT
A 37-year-old man underwent lobectomy of the right liver for granulocyte colony-stimulating factor (G-CSF) producing hepatocellular carcinoma accompanying type B hepatitis. Within two months after the surgery, lung metastases were revealed and administration of sorafenib was begun, however, the lung metastases continued to enlarge. Changing the patient's medication to tegafur-uracil provided remarkable reduction of the lung metastases. The patient is alive two years after diagnosis and receives outpatient chemotherapy. We concluded that this case is valuable with regard to the extreme rarity of G-CSF producing hepatocellular carcinoma and its successful treatment in this case.
