ABSTRACT
Primary gastric squamous cell carcinoma (SCC) is a rare histological subtype of gastric cancer. Here, we report the first case of primary gastric verrucous carcinoma (VC), a well-differentiated variant of SCC. Gastroscopy revealed a papillary polypoid lesion at the posterior wall of the upper gastric body and isolated squamous epithelium at the greater curvature of the fornix in a 78-year-old woman. Endoscopic submucosal dissection was performed. Microscopically, the lesion comprised very well-differentiated squamous epithelium with minimal atypia and exhibited coarse papillary structure and bulbous epithelial downgrowth with submucosal invasion. Conventional SCC or adenocarcinoma components were not included, and the lesion was surrounded by the metaplastic intestinal mucosa. Human papillomavirus infection was not detected. Although the pathogenesis of primary gastric SCC remains controversial, here, the disease is suggested as having originated from squamous epithelium. Knowledge of primary gastric VC and difficulty in diagnosing it using surface biopsy is necessary.
Subject(s)
Carcinoma, Squamous Cell/pathology , Carcinoma, Verrucous/pathology , Neoplasms, Complex and Mixed/pathology , Stomach Neoplasms/pathology , Aged , Biopsy , Carcinoma, Squamous Cell/surgery , Carcinoma, Verrucous/surgery , Endoscopic Mucosal Resection , Female , Gastroscopy , Humans , Neoplasms, Complex and Mixed/surgery , Stomach Neoplasms/surgeryABSTRACT
To obtain a good prognosis and preserve laryngeal function is one of the most important issues for patients with advanced cervical esophageal cancer. It is reported that induction chemotherapy (ICT) followed by concurrent chemoradiotherapy (CRT) is useful. We treated 8 consecutive patients with advanced cervical esophageal cancer by ICT and following CRT between 2003 and 2006. The regimen of ICT was FAP therapy (fluorouracil 1,000 mg/day and cisplatin 20mg/day on days 1-5, and doxorubicin 50mg/day on day 1) every 4 weeks. After 2-4 courses of FAP therapy, low-dose FP-CRT (fluorouracil 200mg/24 hours/day and cisplatin 5mg/day with radiation of 60-66 Gy, 2 Gy/day) were given. Effect of ICT was PR in 5 cases, SD in 1 case, and PD in 2 cases. Furthermore, the effect of ICT+CRT was CR in 5 cases and PD in 3 cases. The one-year survival rate was 62. 5%. Grade 3 hematological toxicity related to ICT was observed in 1 patient (12.5%). Grade 3 anorexia and esophagitis related to CRT were observed in 3 patients (37.5%) and 2 patients (25.0%), respectively. Radiation pneumonitis as a late toxicity occurred in 1 patient (12.5%). The therapeutic effect of ICT and CRT was suggested to be useful for patients with advanced cervical esophageal cancer because it was performed safely with no serious adverse effect and the outcome of ICT predicted the effect of the subsequent CRT.
Subject(s)
Esophageal Neoplasms/therapy , Aged , Antibiotics, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Combined Modality Therapy , Doxorubicin/administration & dosage , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/radiotherapy , Female , Fluorouracil/administration & dosage , Humans , Male , Middle AgedABSTRACT
The patient suffering from getting something lodged was admitted to our hospital in October 2008. He was diagnosed as hypopharyngeal cancer (cT2N1M0, cStage III) and cervical esophageal cancer (cT2N1M0, cStage III). Firstly he was administered 5-FU, DXR and CDDP as induction chemotherapy. The response evaluation was PR according to RECIST criteria. After the induction chemotherapy, he was treated with chemoradiotherapy (64.8 Gy/54 fr, concurrent with weekly DOC 10 mg/m2). Since cervical lymph node metastases were still remaining with complete response of the primary sites, we performed a neck lymph node dissection as salvage surgery in July 2009. There has been no evidence of recurrence after the salvage surgery.
Subject(s)
Carcinoma, Squamous Cell/therapy , Esophageal Neoplasms/therapy , Hypopharyngeal Neoplasms/therapy , Neoplasms, Multiple Primary/therapy , Salvage Therapy , Antibiotics, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/administration & dosage , Combined Modality Therapy , Doxorubicin/administration & dosage , Fluorouracil/administration & dosage , Humans , Lymph Node Excision , Male , Middle Aged , NeckABSTRACT
A 70-year-old man with dysphagia was diagnosed as advanced esophageal cancer by a primary doctor, and he was admitted to our hospital for treatment in February, 2004. The pretreatment diagnosis was basaloid squamous carcinoma, Mt area, T4 (aorta) , N2 (No. 107) , M1 (liver), Stage IVb performed systemic chemotherapy by FAP (5-fluorouracil ( 5-FU)+doxorubicin (DXR)+cisplatin (CDDP) ) from March, 2004. After 4 courses, the local tumor almost entirely disappeared, and the liver metastasis was obviously reduced. We continued chemotherapy afterwards. As of March 31, 2007, he had local lesion CR and metastatic lesion PR. It is very important to perform FAP repeatedly, for local and metastatic lesion of esophageal cancer while maintaining the patient's general condition and avoiding adverse events.
