ABSTRACT
Case 1: Recurrent tumors from gastric GIST in the liver and the abdominal wall showed partial response with 200mg/day imatinib and maintained partial response at 100mg/day. Case 2: Metastatic liver tumors from the jejunal GIST showed partial response with 200mg/day imatinib. The tumors have been enlarged for interruption of imatinib administration, however, re- treatment with imatinib resulted in partial response again and kept partial response at 100mg/day of imatinib. The two cases seldom encountered adverse events at 100mg/day of imatinib. There are some cases successfully treated with low-dose imatinib mesylate for recurrent GIST.
Subject(s)
Antineoplastic Agents/therapeutic use , Benzamides/therapeutic use , Gastrointestinal Stromal Tumors/drug therapy , Ileal Neoplasms/drug therapy , Piperazines/therapeutic use , Pyrimidines/therapeutic use , Stomach Neoplasms/drug therapy , Abdominal Neoplasms/pathology , Abdominal Wall/pathology , Aged, 80 and over , Antineoplastic Agents/administration & dosage , Benzamides/administration & dosage , Combined Modality Therapy , Female , Gastrointestinal Stromal Tumors/pathology , Humans , Ileal Neoplasms/pathology , Imatinib Mesylate , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Middle Aged , Piperazines/administration & dosage , Pyrimidines/administration & dosage , Recurrence , Stomach Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: We investigated the postoperative outcome and risk factors for DIC and mortality in cases of implanted PVS. METHODOLOGY: We reviewed the cases of 65 patients implanted with PVS from 2000 to 2010. Of these patients, 32 were diagnosed with peritonitis carcinomatosa, 21 had liver cirrhosis with hepatocellular carcinoma (HCC), and 12 had liver cirrhosis without HCC. RESULTS: The postoperative morbidity rate was 18.8%, 76.2%, and 58.3% in cases of peritonitis carcinomatosa, liver cirrhosis with HCC, and liver cirrhosis without HCC, respectively. Early death (within 7 days of surgery) was 7.7% (5/65), and the cause of death in all cases was DIC. Underlying disease, low platelet count, prolongation of prothrombin time (PT), and hyperbilirubinemia were the risk factors for development of DIC, whereas underlying disease, prolongation of PT, hypoalbuminemia, and hyperbilirubinemia were risk factors for early death. Multivariate analysis showed that liver cirrhosis with HCC and prolonged PT were the risk factors for DIC. CONCLUSIONS: Patients with refractory ascites due to liver cirrhosis with HCC and those with prolonged PT should not be considered for PVS.
Subject(s)
Ascites/surgery , Disseminated Intravascular Coagulation/etiology , Peritoneovenous Shunt/adverse effects , Adult , Aged , Aged, 80 and over , Ascites/diagnosis , Ascites/etiology , Ascites/mortality , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/mortality , Disseminated Intravascular Coagulation/blood , Disseminated Intravascular Coagulation/mortality , Female , Humans , Liver Cirrhosis/complications , Liver Cirrhosis/mortality , Liver Neoplasms/complications , Liver Neoplasms/mortality , Logistic Models , Male , Middle Aged , Multivariate Analysis , Patient Selection , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/mortality , Peritoneovenous Shunt/mortality , Prothrombin Time , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
A 65-year-old man suffering from acute pancreatitis underwent MRI scanning, which revealed a low signal on the T1 and T2 sequences, and hypovascularity in arterial phase in the head of the pancreas. This corresponded to the area showing the absence of the lower common bile duct. FDG-PET was highly suggestive of pancreatic cancer (T4N1M0, Stage IVa) with lymph node metastasis. He was treated with systemic chemotherapy using gemcitabine (GEM) followed by radiotherapy. His symptoms gradually improved with a reduction in size of the primary lesion. The patient has been receiving systemic chemotherapy using S-1 without recurrence.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Deoxycytidine/analogs & derivatives , Pancreatic Neoplasms/drug therapy , Aged , Combined Modality Therapy , Deoxycytidine/therapeutic use , Drug Combinations , Humans , Magnetic Resonance Imaging , Male , Neoplasm Staging , Oxonic Acid/therapeutic use , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/radiotherapy , Remission Induction , Tegafur/therapeutic use , Tomography, X-Ray Computed , GemcitabineABSTRACT
We have present a case of advanced esophageal cancer(Stage IVb), that has survived for 7 years and 4 months after systemic hemotherapy followed by radiation therapy. The patient is a female, 63 years old. We diagnosed her with esophageal cancer Stage IVb with direct invasion to the main bronchus and the metastatic lesion to the right lobe of thyroid gland. Then we initiated low-dose FP therapy(5-FU 500 mg/day/body, day 1-7, CDDP 10 mg/day/body day 1-5), and then continued UFT+CDDP(UFT 400 mg/day, CDDP 10 mg/day). About 4 years and eight months after chemotherapy we detected swelling of a mediastinal lymph node, which was assessed as a recurrence. Then we started the radiation therapy. Since she has received UFT, we have not seen any recurrences.
Subject(s)
Antineoplastic Agents/therapeutic use , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/radiotherapy , Combined Modality Therapy , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/pathology , Female , Gastroscopy , Humans , Middle Aged , Neoplasm Staging , Time Factors , Tomography, X-Ray ComputedABSTRACT
Among pancreatic neoplasms, pancreatic schwannoma is quite rare. We report a case of solitary pancreatic schwannoma, plus a literature review of this tumor. A 71-year-old woman was diagnosed by abdominal ultrasonography as having a pancreatic tumor and was hospitalized in our department at Kumamoto University Hospital on January 26, 2006. Abdominal computed tomography, magnetic resonance imaging, and endoscopic ultrasonography all showed this tumor, which was located in the body of the pancreas, to have cystic and solid components, and with a septum in the cystic part of the lesion. The tumor, preoperatively identified as a mucinous cystic neoplasm, was clearly separated from the normal pancreatic parenchyma. We performed a spleen-preserving distal pancreatectomy with a lymph node dissection on February 7, 2006. A histopathological examination of the resected specimen by means of hematoxylin and eosin revealed the tumor to consist of two parts: one with a compact spindle cell pattern (Antoni type A), and the other showing degeneration of fat (Antoni type B). We also found positive results for immunohistochemical staining for S-100 and vimentin. These findings confirmed the tumor's classification as a pancreatic schwannoma.
