ABSTRACT
Extragonadal germ cell tumors are relatively rare tumors, which usually occur in the mediastinum or retroperitoneum. In this report, we present a case of primary seminoma arising in the pelvic cavity. A 58-year-old man with urinary retention and abdominal distension was admitted to our hospital. Computed tomography and magnetic resonance imaging demonstrated a large mass in the pelvic cavity. Histological examination of the specimens obtained by open biopsy revealed seminomatous malignant cells. Immunohistochemical studies detected vimentin, placental alkaline phosphatase and c-kit. Taking these results together with the patient's other clinical manifestations, this case was diagnosed as extragonadal seminoma without c-kit-activating mutations, and chemotherapy followed by radiation therapy was successful. Primary seminoma in the pelvic cavity is extremely rare, but should be considered a cause of pelvic mass formation.
Subject(s)
Pelvic Neoplasms/diagnosis , Proto-Oncogene Proteins c-kit/isolation & purification , Seminoma/diagnosis , Alkaline Phosphatase/isolation & purification , Colostomy , Diagnosis, Differential , GPI-Linked Proteins/isolation & purification , Humans , Immunohistochemistry , Intestinal Obstruction/surgery , Isoenzymes/isolation & purification , Magnetic Resonance Imaging , Male , Middle Aged , Mutation , Pelvic Neoplasms/chemistry , Pelvic Neoplasms/complications , Pelvic Neoplasms/pathology , Proto-Oncogene Proteins c-kit/genetics , Seminoma/chemistry , Seminoma/complications , Seminoma/pathology , Treatment Outcome , Urinary Retention/etiology , Vimentin/isolation & purificationABSTRACT
A 55-year-old man underwent a pylorus-preserving pancreatoduodenectomy in August 2006 because of acinar cell carcinoma of the head of the pancreas. Since abdominal CT revealed multiple liver metastases, we started systemic chemotherapy with gemcitabine (1,400 mg/body, day 1, 8, 15/q4w) in October 2006. At the beginning of this treatment, it seemed to be a stable disease, but CT revealed tumor progression in January 2007. Despite the change to oral chemotherapy with S-1 (100 mg/body, day 1-14/q3w), tumors were markedly enlarged in March 2007. Therefore, we selected combination chemotherapy with oral S-1 and hepatic arterial infusion of CDDP (50 mg/body) as third-line. After 6 months of treatment, abdominal CT revealed marked shrinkage of tumors, accompanied by a decrease in AFP level. Though the patient died of hepatic failure in July 2009 (33 months after recurrence), he spent most of his time at home and worked as usual. We suggest that combination chemotherapy with oral S-1 and intra-arterial CDDP can be effective treatments for pancreatic acinar cell carcinoma.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Acinar Cell/drug therapy , Cisplatin/therapeutic use , Liver Neoplasms/drug therapy , Oxonic Acid/therapeutic use , Pancreatic Neoplasms/drug therapy , Tegafur/therapeutic use , Carcinoma, Acinar Cell/blood supply , Carcinoma, Acinar Cell/diagnostic imaging , Carcinoma, Acinar Cell/pathology , Cisplatin/administration & dosage , Drug Combinations , Fatal Outcome , Humans , Infusions, Intra-Arterial , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Male , Middle Aged , Oxonic Acid/administration & dosage , Pancreatic Neoplasms/blood supply , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Recurrence , Tegafur/administration & dosage , Tomography, X-Ray ComputedABSTRACT
PURPOSE: The aim of this study was to compare diffusion-weighted imaging (DWI) at 3.0 T and 1.5 T by evaluating the apparent diffusion coefficient (ADC) value and visibility of breast cancer in the same patients. MATERIALS AND METHODS: A total of 13 patients (16 lesions) with breast cancer underwent DWI at 3.0 T and 1.5 T. Tumors were classified into two groups based on the lesion size. The ADC values were measured, and visibility of the tumors was scored blindly. RESULTS: No significant difference was found for ADC values between 3.0 T and 1.5 T in either group (P > 0.05). All of the large lesions were visible clearly at both magnetic field strengths, and image scores were not different (P > 0.05). In contrast, small lesions were more clearly visible and had better image scores at 3.0 T than at 1.5 T (P < 0.001). CONCLUSION: Small cancers were more clearly visible on DWI at 3.0 T than 1.5 T.
