ABSTRACT
A 73-year-old woman was referred to our hospital due to epigastralgia and jaundice. The radiological findings showed a stone-like tumor in the extrahepatic bile duct. The patient was initially thought to have adenocarcinoma of the bile duct based on the findings of a pathological examination of the bile duct biopsy specimen and underwent pancreaticoduodenectomy; the final diagnosis of the lesion was so-called carcinosarcoma of the extrahepatic bile duct. She died of liver metastasis six months after the surgery. This case suggests that surgical resection is not adequate for achieving a radical cure, and the optimal treatment for extrahepatic bile duct carcinosarcoma should be established immediately.
Subject(s)
Bile Duct Neoplasms/pathology , Bile Ducts, Extrahepatic/pathology , Carcinosarcoma/pathology , Aged , Bile Duct Neoplasms/surgery , Carcinosarcoma/surgery , Fatal Outcome , Female , Humans , PancreaticoduodenectomySubject(s)
Anticoagulants/adverse effects , Coronary Artery Bypass , Echocardiography , Hematoma/diagnosis , Magnetic Resonance Imaging , Mediastinal Diseases/diagnosis , Platelet Aggregation Inhibitors/adverse effects , Tomography, X-Ray Computed , Aged , Angina Pectoris/surgery , Female , Hematoma/etiology , Humans , Mediastinal Diseases/etiology , Time FactorsABSTRACT
A 71-year-old man underwent distal partial gastrectomy for gastric cancer. Four years after surgery, the tumor marker was elevated. Examinations by computed tomography (CT) revealed para-aortic lymphnode swelling and hydronephrosis. The patient treated oral administration of TS-1 (120 mg/day). After 3 courses of treatment of TS-1, progressive disease was observed. TS-1+CPT-11 (TS-1 120 mg/day day 1-14, CPT-11 100 mg/day day 1, 15) combination therapy was then chosen as second-line chemotherapy. After 5 courses of combination therapy, the tumor marker was decreased and para-aortic lymphnodes could not be detected by CT. Only grade 2 leukopenia was observed as an adverse event during the therapy. TS-1+CPT-11 combination therapy could be useful as the second-line chemotherapy for cases of TS-1 resistant recurrent gastric cancer.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Camptothecin/analogs & derivatives , Drug Resistance, Neoplasm/drug effects , Neoplasm Recurrence, Local/drug therapy , Stomach Neoplasms/drug therapy , Aged , Camptothecin/administration & dosage , Combined Modality Therapy , Drug Administration Schedule , Drug Combinations , Gastrectomy , Humans , Irinotecan , Male , Oxonic Acid/administration & dosage , Oxonic Acid/pharmacology , Pyridines/administration & dosage , Pyridines/pharmacology , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Tegafur/administration & dosage , Tegafur/pharmacologyABSTRACT
We describe a case of malignant endocrine tumor of the pancreas associated with von Recklinghausen's disease. A 66-year-old woman with familial von Recklinghausen's disease was admitted to our hospital with weight loss and lower abdominal pain. Endoscopy revealed a submucosal tumor in the second part of the duodenum. Contrast-enhanced computed tomography showed a heterogeneous low-density tumor, measuring 20 x 15 mm, in the head of the pancreas, and metastatic lymphadenopathy. Angiography showed faint tumor staining without encasement or apparent increase in vascularity. Pancreatoduodenectomy was performed. Macroscopically, there was a solid tumor, measuring 20 x 18 mm, in the head of the pancreas. Histologically, a malignant endocrine tumor was shown, with direct invasion to the duodenum, and lymph node metastases. This is the thirteenth case of pancreatic malignant tumor and the fourth case of pancreatic endocrine tumor associated with von Recklinghausen's disease reported in the world literature.
