Multiple primary cancers in patients treated for squamous cell carcinoma of the esophagus.

Treatment of squamous cell carcinoma is associated with an increased risk of other primary malignancies, mainly within the head and neck, as well as in the oesophageal gastric graft. More frequent recognition of multiple primary cancers associated with esophageal cancer, both synchronous and metachronous, is associated with longer follow-up after radical cancer treatment for esophageal cancer and high quality diagnostic procedures, both before and after surgery. The paper reviews the available literature and describes the molecular basis of the formation of multiple primary tumors associated with squamous cell carcinoma of the esophagus.

Primary Adenocarcinoma in an Oesophageal Gastric Graft - Case Report.

Primary adenocarcinoma in the esophageal gastric graft is a rare complication diagnosed in patients with long-term survival. Most data concerning the diagnosis and treatment of patients with metachronic cancer in esophageal grafts is derived from Japan and South Korea. The diagnosis of cancer in esophageal gastric grafts in the European countries is rare. The study presented a case of a 66-year old male patient who, 30 months after an esophageal squamous cell cancer resection, was diagnosed with adenocarcinoma of the esophageal gastric graft. Despite control follow-up after the esophagectomy, cancer in the esophageal graft was detected during the stage that prevented performing radical surgery. The study presented the recommended diagnostic procedures and treatment options for esophageal gastric graft cancer, as well as review of available literature data.

Surgical treatment of pancreatic neuroendocrine tumours - clinical experience.

UNLABELLED: The aim of the work was the clinical characteristics and analysis of preliminary results for surgical treatment of pancreatic neuroendocrine tumors (PNETs), based on own material. MATERIAL AND METHODS. In the period from 2005 to 2009, in the Department of Gastrointestinal Surgery, Silesian Medical University in Katowice, there were 27 patients (15 males and 12 females) treated surgically for pancreatic neuroendocrine tumours, constituting 65.86% (27/41) of all gastroenteropancreatic neuroendocrine tumours. Prior to the surgery, the following diagnostic examinationswere performed: laboratory tests and imaging examinations (abdominal ultrasound and CT scan). The following tumour localisation was established: head of the pancreas - 14, body of the pancreas - 4, tail of the pancreas - 5, body and tail of the pancreas - 1, retroperitoneal space - 4. There were found 24 (88.89%) primary tumours and 3 (11.11%) recurrences. The following methods of surgical treatment were applied: pancreatoduodenectomy - 11, distal pancreatic resection with splenectomy - 6, middle segment resection with anastomosis between the pancreatic tail and jejunal loop: Roux-Y procedure - 1, pancreatic resection by Beger procedure - 1, pancreatic head and body resection with splenectomy - 1, tumour enucleation or local excision - 4, exploratory laparotomy with specimen collection - 3. RESULTS: The mean hospitalisation period was 25 days (4-78 days). The mean procedure duration was 4.2 hours (1.15-9.15 hours). Early post-operative complications were observed in 10 patients (37.04%). The following early complications were observed: intra-abdominal abscess - 2, wound suppuration - 2, pancreatic fistula - 1, acute pancreatitis - 1, pancreaticojejunal anastomosis leak - 1, peritoneal cavity haemorrhage - 1, acute cholangitis - 1, adhesion obstruction - 1, subobstruction - 1, portal vein thrombosis - 1, sepsis - 1, fluid in pleural cavity - 1, acute heart failure - 1. There were performed 2 (7.41%) repeat surgeries: one due to adhesion obstruction and one due to peritoneal cavity haemorrhage. Death of 1 patient (3.71%) was recorded in the post-operative period due to acute heart failure. CONCLUSIONS: Pancreatic neuroendocrine tumours constituted the majority of gastroenteropancreatic neuroendocrine tumours in the analysed patient group. Most commonly, PNETs were localised in the head of the pancreas. In the presented material, the mortality rate does not exceed 4%, similarly as in other renowned centres.