A long-surviving patient with advanced esophageal basaloid squamous cell carcinoma treated only with radiotherapy: case report and literature review.

BACKGROUND: Esophageal basaloid squamous cell carcinoma (EBSCC) is a rare malignant disease. Advanced EBSCC (AEBSCC) has a poorer prognosis than the more common esophageal squamous cell carcinoma, but no treatment policy has yet been established. This is the first reported case with AEBSCC treated only with radiotherapy. Thus, our long-surviving patient merits consideration. We therefore reviewed cases with the same stage of AEBSCC for further investigation. CASE PRESENTATION: An 85-year-old man with a chief complaint of difficulty swallowing foods was diagnosed with AEBSCC, cT3N1M0, stage III, by thorough examination. The basaloid carcinoma extended from the upper thoracic esophagus to the middle thoracic esophagus based on imaging studies, endoscopy and biopsy. Morphologically, the tumor was an elevated ulcerative area. We conducted radiotherapy to relieve symptoms, as the patient and his family refused aggressive treatment. He has remained alive without recurrence for 2 years, to date, after completing radiotherapy. CONCLUSIONS: Basaloid carcinoma might be highly sensitive to radiotherapy. Thus, radiotherapy for local control might be beneficial for elderly patients with complications and those refusing aggressive treatment.

[Surgical Resection of Solitary Brain Metastasis from Breast Cancer].

BACKGROUND: Brain metastasis from breast cancer has a poor prognosis. For solitary cerebral metastases, surgical resection may contribute to the improvement of survival and QOL. We studied the prognosis and characteristics of solitary brain metastasis from breast cancer in patients undergoing surgical resection. METHODS: Seventeen patients had tumors metastatic to the brain at Kasukabe Municipal Hospital between June 2009 and May 2016, and 7 of them underwent craniotomy. Their treatment outcomes were analyzed retrospectively. RESULTS: The median age at diagnosis of brain metastasis was 56 years. The median survival duration was 19.6 months. With regard to radiation therapy after surgery, 3 patients received whole brain irradiation, 2 patients received stereotactic brain irradiation, and 2 patients received both. The site of brain metastasis was the cerebellum in 6 patients, and the occipital lobe in 1 patient. The number of HER2-positive breast cancer patients was 5, and lapatinib and capecitabine were administered to 4 out of these 5 patients. CONCLUSION: For solitary brain metastasis, the improvement in symptoms and the extension of the survival can be achieved using multidisciplinary treatment with surgery, radiation, and molecular targeting drugs.

Effective laparoscopic drainage for intra-abdominal abscess not amenable to percutaneous approach: report of two cases.

PURPOSE: The usefulness of the laparoscopic approach for massive intra-abdominal abscesses is controversial. We report two patients who underwent laparoscopic abscess drainage for massive intra-abdominal abscesses not amenable to the percutaneous approach that were suspected to be caused by acute appendicitis. METHODS: In both patients, four ports were placed at their abdominal walls under general anesthesia. Intra-abdominal abscess cavities were punched out, and the purulent exudates that spilled out from the cavities were aspirated completely. Copious irrigation was performed under direct vision. These procedures were completed laparoscopically. RESULTS: The postoperative clinical courses of the patients were uneventful. The intra-abdominal abscesses did not recur, and no wound complications were recognized. The patients were discharged from our hospital in excellent condition within two weeks. CONCLUSIONS: Laparoscopic drainage for massive intra-abdominal abscess is a minimally invasive and useful procedure compared with the open method or the percutaneous approach. It offers the advantage of being able to explore of the abdominal cavity without an unnecessary wide incision, and aspiration of a purulent exudate is possible under direct vision.