ABSTRACT
The case of a 58-year-old man with a large midthoracic oesophageal diverticulum and a left diaphragmatic relaxation who presented with night regurgitations, abdominal bloating, epigastric burning and a sensation of fullness after meals is reported. The patient underwent a successful thoracotomic diverticulectomy with left diaphragmatic plicature. The postoperative course was uneventful. To our knowledge this is the first reported case of an association between midthoracic oesophageal diverticulum and left diaphragmatic relaxation. Moreover, we hypothesised that the diverticulum was caused by a pulsion mechanism due to obstruction of the distal oesophagus secondary to diaphragmatic relaxation.
Subject(s)
Diaphragmatic Eventration/diagnostic imaging , Diverticulum, Esophageal/diagnosis , Diaphragmatic Eventration/complications , Diaphragmatic Eventration/surgery , Diverticulum, Esophageal/etiology , Diverticulum, Esophageal/surgery , Humans , Male , Middle Aged , Tomography, Spiral ComputedABSTRACT
The prognosis of patients affected by advanced gastric cancer who did not undergo non-curative resection is extremely poor. We report a case of a 26-year-old woman affected by gastric cancer with peritoneal carcinosis in whom surgical treatment was not considered. The patient was enrolled in the Italian phase II trial of cetuximab (Erbitux, Merck KGaA, Darmstadt, Germany), a monoclonal antibody, in combination with docetaxel and cisplatin chemotherapy. Restaging of the tumor showed progressive regression, so the patient underwent a total gastrectomy. The patient is alive, well and disease-free ten months after surgery. The good result achieved in this patient provides interesting prospects for chemotherapy combined with cetuximab, followed by surgery.
