Lymphoepithelioma-Like Carcinoma of the Stomach with Epithelioid Granulomas.

An 83-year-old Japanese man was admitted to our hospital for gastric adenocarcinoma mimicking a submucosal tumor in the gastric body. Considering his general condition, partial resection of the stomach and dissection of regional lymph nodes were performed; a dome-shaped tumor that was largely covered by normal mucosa and having a shallow central stellate ulcer was removed. Histopathologically, the carcinoma cell nests were surrounded by prominent lymphoid stroma. Sarcoid-like epithelioid granulomas were noted both in the tumor stroma and in the regional lymph node with metastasis. Epstein-Barr virus (EBV)-encoded RNA (EBER) in situ hybridization showed an intense and diffuse positive reaction in the carcinoma cells and no reaction in the surrounding gastric and lymphoid tissues. While the presence of lymphoid stroma is a characteristic finding in EBV-associated lymphoepithelioma-like carcinoma, sarcoid-like epithelioid granulomas might be associated with latent EBV infection.

[A case of sigmoid colon cancer with peritoneal dissemination responding to third-line therapy employing bevacizumab combination therapy after failure of FOLFOX and FOLFIRI].

A58 -year-old man with sigmoid colon cancer with peritoneal dissemination was treated with bevacizumab (BV) plus mFOLFOX6 therapy as third-line chemotherapy after treatment failures with FOLFOX4 and FOLFIRI regimen. BV combination therapy resulted in a decrease in ascites and disappearance of the primary lesion. His ECOG performance status (PS) recovered from level 3 to level 1, and BV combination therapy improved his quality of life. This case suggested that BV in combination with chemotherapy could be a promising systemic chemotherapy for patients with colorectal cancer with peritoneal dissemination, and this regimen may be useful for patients progressing after receiving FOLFOX, FOLFIRI regimen.

Impaired liver regeneration after synchronous liver and colon resection in rats.

BACKGROUND/AIMS: Hepatectomy combined with colectomy is the preferred treatment for patients with synchronous colorectal cancer and hepatic metastasis. However, the effects on hepatic reserve function of combining colectomy with hepatectomy are unclear. The purpose of this study was to determine liver regeneration and functions after hepatectomy with and without colectomy. METHODOLOGY: 23 rats underwent 70% hepatectomy (Hx group) and 23 rats underwent 70% hepatectomy with ileocecal resection (HCx group), and 6 rats just after surgery (day 0) underwent simple celiotomy. On days 0, 1, 2, 3 and 7 after surgery, the remnant liver weight, DNA synthesis rate, malondialdehyde concentration, hepatic Adenosine monophosphate, ADP, ATP, serum hyaluronic acid concentration and endotoxin level in the portal blood were measured. RESULTS: In HCx group, the hepatic DNA synthesis rate on day 1 (p < 0.01) and the liver weight on day 7 (p < 0.05) were significantly lower, hepatic malondialdehyde concentration on days 1 and 2 (p < 0.05) was significantly higher and serum hyaluronic acid and portal endotoxin levels on day 1 were significantly higher (p < 0.01 and p < 0.05, respectively). CONCLUSION: Addition of colectomy to hepatectomy impairs regeneration and endothelial cell function of the remnant liver; the impairment is associated with increased levels of portal endotoxin and hepatic lipoperoxide.

[A long-term survivor case with good quality of life due to biliary bypass and gemcitabine for advanced pancreatic cancer].

A 54-year-old man was admitted to the hospital because of upper abdominal pain and anorexia. Physical examination revealed jaundice, and abdominal CT demonstrated a pancreatic mass and dilatation of bile duct. The patient was operated with the diagnosis of pancreatic cancer. However, the pancreatic cancer was unresectable because of invasion of the surrounding organs and metastasis to paraaortic lymph nodes, so a biliary bypass was performed. After operation, chemotherapy using gemcitabine was performed in the outpatient clinic. He survived for more than two years and eleven months without recurrence of jaundice. Combination of biliary bypass and gemcitabine is considered helpful for good quality of life and long-term survival of a patient with advanced pancreatic cancer.