[Postprandial Abdominal Fullness after Pylorus-Preserving Gastrectomy for Early Gastric Cancer].

To clarify the basis for postprandial abdominal fullness(PAF)in patients after pylorus-preserving gastrectomy(PPG), the authors investigated the relationship of PAF with postgastrectomy disorder(PGD)and gastric emptying function(GEF)in PPG patients. A total of 22 patients(14 men and 8 women, average age 64.8 years)were divided into 2 groups[Group A, PAF-positive(n=12); Group B, PAF-negative(n=10)]at 1 year after PPG for early gastric cancer. The relationships of PAF with PGD and GEF were examined. Length of the antral cuff(LAC)was significantly shorter in group A than in group B(p< 0.05). Appetite and food consumption per meal were significantly greater in group B than in group A(p<0.05 and p<0.01, respectively). Symptomatic reflux esophagitis(RE), early dumping syndrome, decreased percent body weight before illness, endoscopic RE, and endoscopic gastritis in the remnant stomach were more common in group A than in group B. Gastric stasis in the remnant stomach was significantly more common in group A than in group B(p=0.0071). GEF for solid food [time to 50%residual rate in the remnant stomach(minutes)and residual rate at 120 minutes in the remnant stomach(%)] in group A was significantly delayed compared with that in group B(p<0.001). Patients with PAF showed shorter LAC, delayed GEF for solid food, and worse postoperative quality of life(QOL), compared with those without PAF.

[Primary Undifferentiated Pleomorphic Sarcoma of the Ileum-A Case Report].

Undifferentiated pleomorphic sarcoma(UPS)of the small intestine is extremely rare and has a poor prognosis. We encountered a case of primary UPS of the ileum without metastatic lesions. The patient was a 44-year-old man who presented with the chief complaint of lower abdominal pain for 9 months. He also presented with anemia, hypoproteinemia, and a lower abdominal tumor about 10 cm in size. Abdominal CT with cystography showed an irregular solid tumor with compression of the cystic bladder. Based on a presumptive diagnosis of the retroperitoneal tumor, he underwent laparotomy. An irregular tumor, 9×8×5 cm in size, was observed in the ileum approximately 60 cm from the terminal ileum. There were no lymph node, peritoneal, or liver metastases. Partial excision of 30 cm of the ileum from 50 cm to 80 cm at the terminal ileum was performed. The final histological diagnosis was primary UPS(storiform pattern with fibroblast-like spindle cells). The patient was not administered adjuvant chemotherapy and was discharged on postoperative day 10. He is currently well without any evidence of recurrence for 2 years after the surgery.

[A Case of Squamous Cell Carcinoma of the Right Breast].

Squamous cell carcinoma(SCC)of the breast is rare and its clinicopathological features have not been fully elucidated. We report a patient with SCC of the right breast who underwent surgical resection. A 51-year-old woman was admitted to our hospital because of a right breast tumor. A round tumor with an irregular surface measuring about 3.0×2.5 cm was palpable in the ACarea of the right breast. No abnormal data were observed on laboratory examination, including tumor markers such as carcinoembryonic antigen(CEA), cancer antigen 15-3(CA15-3), breast cancer antigen 225(BCA225), and SCC antigen. Mammography showed a mass with spiculation measuring 2.7×1.7 cm. Ultrasonography also demonstrated a hypoechoic solid tumor with an irregular surface, measuring 2.6×1.6 cm. The pathological diagnosis of a needle biopsy specimen was a mixed type of SCC. We performed a typical right mastectomy with axillary and supraclavicular lymph node dissection. The tumor size was 2.8×1.8 cm. SCC was histologically diagnosed. There was partial invasion to other tissues. The dissected lymph nodes were not involved by carcinoma. Hormone receptors(estrogen and progesterone)and HER2 results were negative. The pathological Stage was II A(T2, N0, M0). The patient refused chemotherapy. However, her condition remains satisfactory without recurrence 2 years after surgery.