[A Case of Adenoid Cystic Carcinoma of the Breast].

Primary adenoid cystic carcinoma(ACC)of the breast is a rare type of breast cancer. A 53-year-old woman with a right breast mass was examined at our institute. Ultrasonography showed 12.5×10.3×8.4 mm sized an ill-defined hypoechoic mass at zone C of the right breast. Pathological examination of core needle biopsy revealed atypical cells with solid and cribriform growth pattern. Computed tomography did not reveal lymph node metastases or distant metastases. The preoperative diagnosis was Stage ⅠA(cT1cN0M0, ER/PgR/HER2=-/-/1+)invasive ductal carcinoma or ACC. Surgery consisted of breast-conserving surgery and sentinel node biopsy. Pathological examination of the excised specimen revealed a so- called adenoid cystic pattern, so the final diagnosis was Stage ⅠA(pT1cN0M0, ER/PgR/HER2=-/-/1+)ACC. After 1 year of observation without adjuvant treatment, there has been no recurrence.

[A Case of Advanced Gastric Cancer with Extensive Lymph Node Metastasis That Showed pCR to Preoperative Chemotherapy Containing SP].

A 69-year-old woman, who complained of appetite loss, was diagnosed with Type 3 gastric cancer, and a biopsy resulted in the diagnosis of adenocarcinoma(tub2-por), Group 5. Abdominal computed tomography (CT) revealed bulky metastatic lymph nodes around the stomach and the aorta. The diagnosis was cT4a, cN2, cM1(LYM), cStage ⅣB, and SP therapy(a combination of S-1 and cisplatin) was immediately administered. On the completion of 3 courses of SP therapy, both the primary tumor and lymph nodes markedly decreased in size. Based on this finding, D2 total gastrectomy, No. 16 lymph node dissection, splenectomy, and right adrenal tumor resection were performed. Histopathology showed no residual tumor cells in the stomach or lymph nodes. Postoperatively, she received S-1 therapy, which was discontinued on completion of the first course due to its side effects. She survived for over 7 years postoperatively without receiving chemotherapy and showed no recurrence.

Meta-analysis of Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer.

BACKGROUND/AIM: A meta-analysis was conducted to evaluate and compare the short- and long-term outcomes of robot-assisted (RAS) and conventional laparoscopic surgery (LAS) for rectal cancer. MATERIALS AND METHODS: We searched MEDLINE for relevant papers published between 2010 and December 2017 by using specific search terms. We analyzed outcomes over short- and long-term periods. RESULTS: We identified 23 papers reporting results that compared RAS for rectal cancer with LAS. Our meta-analysis included 4,348 patients with rectal cancer; 2,068 had undergone RAS, and 2,280 had undergone LAS. In the short- and long-term period, 27 and 7 outcome variables were examined, respectively. RAS for rectal cancer was significantly associated with a greater operative time and a lower conversion rate to open surgery in the short-term, and results in almost similar outcomes in the long-term, compared to LAS. CONCLUSION: RAS may be an acceptable surgical treatment option compared to LAS for rectal cancer.

[A case of advanced gastric cancer responding to S-1/CDDP neoadjuvant chemotherapy, leading to a pathological complete response].

A 66-year-old man with cStage III B (cT4aN2H0P0M0) advanced gastric cancer in the cardia with esophageal invasion was treated with S-1/CDDP as neoadjuvant chemotherapy. After 3 courses of chemotherapy, a significant reduction in tumor burden was observed. Total gastrectomy and splenectomy with lymph node dissection (D2) were performed. Pathological specimens showed no cancer cells in the stomach and lymph nodes, indicating a pathological complete response.

[A case report of two-term surgery for focal progression of a huge liver metastasis and peritoneal dissemination from gastrointestinal stromal tumor during imatinib mesylate treatment].

We report a patient who underwent 2-term surgery to treat focal progression of a huge liver metastasis and peritoneal dissemination from a gastric gastrointestinal stromal tumor(GIST)during imatinib mesylate treatment. A 59-year-old man underwent an emergency surgery for perforative peritonitis caused by gastric GIST in June 2006 and a partial resection of the stomach in September 2006. Four years later, abdominal computed tomography(CT)detected a huge liver tumor that occupied the entire right lobe. We initiated imatinib mesylate treatment(400mg/day), and the patient maintained stable disease for several months. However, focal progression of the huge liver tumor and a peritoneal tumor at the splenic hilum were revealed by CT; therefore, an extended right hepatic resection was performed in August 2011 and a distal pancreatectomy, splenectomy, and partial resection of the stomach were performed in February 2012. The patient died of the primary disease at 16 months after the hepatic resection for focal progression.

[A case of rectal cancer with brain metastasis successfully treated with combined modality therapy - a case report].

The authors report their experience in a patient with brain metastasis from rectal cancer who has survived without recurrence after multidisciplinary treatment. A 60-year-old man presented to the Department of Neurosurgery with the primary complaint of spasm of the left side of the face. Examination revealed a tumor 2 cm in diameter in the right frontal lobe. The tumor was suspected to be metastatic, and brain metastasis from rectal cancer was diagnosed. The brain tumor was removed by a neurosurgeon, and the patient was transferred to the Department of Surgery. Removal of the primary lesion in the rectum was attempted, but only colostomy could be performed due to extensive anterior invasion. Postoperatively, 5 courses of capecitabine and oxaliplatin (XELOX) + bevacizumab were administered. The rectal tumor shrank in size, while another mass, suspected to be a lung metastasis, remained unchanged. Therefore, a second surgery on the rectum was scheduled, and abdominoperineal resection of the rectum and lateral lymphadenectomy were performed. Postoperatively, 4 courses of XE LOX therapy were administered. The patient is currently alive without recurrence at 1 year after surgery. Treatment (including timing) for brain metastasis from rectal cancer has not been established and prognosis is poor. However, multidisciplinary treatment may provide the possibility of cure.

Clinical significance of the expression of connexin26 in colorectal cancer.

BACKGROUND: Connexin26 (Cx26) is one of the connexins (Cxs) family members which form gap junction channels. Cx26 is considered to be a tumor suppressor gene. However, recent studies revealed that over expression of Cx26 is associated with a poor prognosis in several human cancers. This study investigated the correlation between Cx26 expression and the clinicopathological features and P53 expression in colorectal cancer. METHODS: One hundred and fifty-three patients who underwent a curative resection were studied. Tissue samples were investigated by immunohistochemical staining using antibodies for Cx26 and P53. Moreover, apoptotic cells were detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) staining. RESULTS: Cx26 expression was found in 83 cases (54.2%) and P53 expression in 71 cases (46.4%). A correlation was observed between the Cx26 expression and recurrence, histology, and p53 expression (P < 0.05). Cx26 positive tumors had significantly longer survival than Cx26 negative tumors (P < 0.05). A multivariate Cox analysis demonstrated that Cx26 expression was an independent prognostic factor (P < 0.05). However, no significant correlation was observed between Cx26 and AI. CONCLUSION: This study suggests that Cx26 expression is an independent prognostic factor in patients that undergo a curative resection of colorectal cancer.

[A case of primary gastric choriocarcinoma].

Primary gastric choriocarcinoma is an extremely rare and poor prognosis. A 73-year-old man who had appetite loss was admitted to our hospital in May 2006. Abdominal CT showed tumor measured 9x7 cm in size between residual stomach and pancreas. Gastrointestinal endoscopy revealed that gastric posterior wall was compressed and soft necrotic elevated tissue with coagulation. Endoscopic biopsy specimens showed poorly differentiated adenocarcinoma. Total gastrectomy with D2 lymphadenectomy, distal pancreatectomy, splenectomy, and partial resection of transverse colon were performed. Histological findings of resected specimens showed choriocarcinoma which demonstrated reactivity against anti-hCG antibody by immunohistochemical staining. Forty five days after the operation, skin metastasis appeared, and he died of this disease 60 days after the operation.

D-fructose detection based on the direct heterogeneous electron transfer reaction of fructose dehydrogenase adsorbed onto multi-walled carbon nanotubes synthesized on platinum electrode.

Multi-walled carbon nanotubes (MWCNTs) were synthesized on platinum plate electrodes by the chemical vapor deposition (CVD) method. From the results of X-ray photoelectron spectroscopy and voltammetric investigation, the iron nanoparticles used as a catalyst for the MWCNT synthesis were enclosed with MWCNTs. The MWCNTs synthesized on the Pt plate (MWCNTs/Pt) electrode were immediately immersed into solutions of d-fructose dehydrogenase (FDH) to immobilize the enzyme onto the MWCNTs/Pt electrode surfaces. After the FDH was immobilized onto the MWCNTs/Pt electrode, a well-defined catalytic oxidation current based on FDH was observed from ca. -0.15V (versus Ag/AgCl/sat'd KCl), which was close to the redox potential of heme c as a prosthetic group of FDH. From an analysis of a plot of the catalytic current versus substrate, the calibration range for the fructose concentration was up to ca. 40mmoldm(-3), and the apparent Michaelis-Menten constant was evaluated to be 11+/-1mmoldm(-3).

Gastric cancer with cervical lymph node metastasis as the first presentation: report of a case.

A 62-year-old man presented with a painful left lateral neck mass. Aspiration cytology revealed lymph node metastasis of undifferentiated carcinoma. A Borrmann type 3 tumor was detected in the body of the stomach on endoscopic examination. No visceral metastasis was found. Distal gastrectomy and radical neck dissection were performed. Pathological examination revealed that the histological features of the gastric lesion were identical to those of the cervical lymph node lesion. Regional lymph nodes of the stomach and Virchow's lymph nodes were not involved. Irradiation to the left supraclavicular and cervical region and an oral tegafur anticancer agent (TS-1) were started. Left axillary and right supraclavicular lymphadenopathies were detected 4 and 5 months after surgery, respectively. Rapid progression of hoarseness was observed, and weekly docetaxcel was started. However, he died of airway obstruction 8 months after surgery.

Size-tuneable and micro-patterned iron nanoparticles derived from biomolecules via microcontact printing SAM-modified substrates and controlled-potential electrolyses.

Site-selected and size-controlled iron nanoparticles were prepared on coplanar surfaces via microcontact printing of SAM-modified Au/mica electrodes and controlled-potential electrolytic reactions using ferritin biomolecules. Ferritin molecules packed like a full monolayer on 6-amino-1-hexanethiol (AHT)- and 11-amino-1-undecanethiol (AUT)-modified Au/mica surface via electrostatic interactions, which did not depend on the chain length of the amino terminal alkane thiols. After heat-treatment at 400 degrees C for 60 min, iron oxide nanoparticles (ca. 5 nm in diameter) derived from ferritin cores were observed at the Au/mica surface by atomic force microscopy (AFM). On the study on the electrochemistry of ferritin immobilized onto AHT- and AUT-modified Au/mica electrodes, the redox response of the ferritin immobilized AHT-modified electrode was clearly observed. On the other hand, no redox peak for ferritin was obtained at the AUT-modified electrode. The electron transfer between ferritin and the electrode through the AUT membrane could not take place. The difference in the electrochemical response of ferritin immobilized onto AHT- and AUT-modified Au/mica was caused by the chain length of the amino terminal alkane thiols. Uniform patterns of AHT and AUT on the Au/mica electrode surface were performed by use of a poly(dimethylsiloxane) (PDMS) stamp. After the immobilization of ferritin onto both AHT- and AUT-modified electrode surfaces, the modified electrode was applied to a -0.5 V potential for 30 min in a phosphate buffer solution. After this procedure, the PDMS stamp patterning image appeared by scanning electron microscopy (SEM) image. The SEM results induced by the size change of the ferritin core consisting of iron(III) by electrolysis.

[A case of gastric cancer with peritoneal recurrence which developed during adjuvant administration of TS-1 showing complete response by weekly docetaxel regimen].

A 62-year old man had undergone total gastrectomy for Borrmann type 4 gastric cancer. No peritoneal dissemination was observed at the laparotomy. Pathological examination revealed that the tumor involved the subserosal layer, and that the lymph node metastasis extended to the left gastric nodes. Vascular and lymphatic involvement was also observed. One hundred mg/body of TS-1, an oral 5-fluorouracil (5-FU) anticancer agent, which consisted of tegafur (a prodrug of 5-FU), and two modulators (gimeracil and oteracil potassium) was given from the 16th post-operative day. A course of TS-1 consisted of consecutive administration for 4 weeks followed by 2 weeks rest. The patient complained of abdominal fullness after administration of the second course of TS-1. Computed tomography (CT) revealed massive ascites. The serum carcinoembryonic antigen (CEA) titer was elevated to 13.5 ng/ml. From these findings, the occurrence of peritoneal dissemination was suspected. Weekly docetaxel of 30 mg/m2 (40 mg/body) was given for 3 weeks followed by a week cessation. At the start of the 6th course, the serum CEA was normalized, and CT scan detected the disappearance of ascites without any new lesion. Administration of docetaxel was continued until the 10th course then stopped without relapse of the disease. No dose reduction or postponement of administration were required. The patient has survived without disease one year after cessation of the treatment. Weekly docetaxel is a safe and effective regimen for gastric cancer worth using for a second-line therapy after failure of the 5-FU-based regimen.