ABSTRACT
A 73-year-old man, who was diagnosed as having advanced anorectal malignant melanoma (Stage IV), was treated with combination chemotherapy using dacarbazine, nimustine, cisplatin, and tamoxifen plus interferon-beta. After the first course of chemotherapy, rectal tumor was decreased in size with less anal pain and liver tumor was disappeared. Twenty-four months after the first treatment, the patient is survived. DAC-Tam IFN-beta therapy may improve the management of patients who have advanced MM of the anorectum.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Anus Neoplasms/drug therapy , Melanoma/drug therapy , Rectal Neoplasms/drug therapy , Aged , Anus Neoplasms/pathology , Cisplatin/administration & dosage , Dacarbazine/administration & dosage , Humans , Interferon-beta/administration & dosage , Liver Neoplasms/secondary , Male , Melanoma/pathology , Neoplasm Staging , Nimustine/administration & dosage , Tamoxifen/administration & dosage , Treatment OutcomeABSTRACT
BACKGROUND: Endoscopic mucosal resection with a cap-fitted panendoscope (EMRC) such as a soft prelooped hood is a useful, effective, and safe technique. One problem with this method is that the lesion cannot always be maintained in the center of the cap because the procedure is performed blindly after aspiration. OBJECTIVE: We developed a 2-channel prelooped hood that facilitates EMRC while simultaneously allowing both grip of the center in the lesion and irrigation of the aspiration site and evaluated the usefulness of this end hood for early gastric cancer. DESIGN: Retrospective study. SETTING: Between August 2003 and October 2004, patients underwent our novel EMR. PATIENTS: Twelve cases of early gastric cancer. INTERVENTIONS: Two side holes were fabricated by drilling in the cap portion of a conventional soft prelooped hood, and then the irrigation tube and the accessory channel tube were glued to the exterior surface of the holes. We placed the fabricated transparent hood at the tip of the endoscope and performed grasping forceps-assisted endoscopic aspiration mucosectomy. MAIN OUTCOME MEASUREMENTS: Accurate aspiration and the rate of en bloc resection. RESULTS: We obtained a satisfactory field of view and accurate aspiration in the center of the tumor in all lesions. The rate of en bloc resection was 91.7% (11/12). LIMITATIONS: Gastric intramucosal cancer. CONCLUSION: Grasping forceps-assisted endoscopic mucosal resection with a novel 2-channel prelooped hood is safe and useful for mucosal resection of intramucosal cancers less than 20 mm and may help center the lesion in the cap before resection.
