[Gastric Gastrointestinal Stromal Tumor Appearing Nine Years after Resection of a Duodenal Gastrointestinal Stromal Tumor-A Case Report].

Multiple sporadic gastrointestinal stromal tumor(GIST)are rare, except for those restricted to von Recklinghausen disease or hereditary conditions.We reported a case of a gastric GIST resected 9 years after the resection of a duodenal GIST.The patient was a 58-year-old male who had been followed-up with computed tomography scans after pancreatoduodenectomy for a duodenal GIST when he was 49-years-old.The patient was admitted to our hospital for anemia examination.A CT scan detected a tumor in the stomach, with a diameter of over 10 cm, and necrosis.Esophagogastroduodenoscopy revealed the presence of a delle on the gastric SMT.Due to suspected invasion of the spleen and left diaphragm by the tumor, we performed subtotal gastrectomy with splenectomy and left diaphragm segmental resection.In the pathological diagnosis, the tumor was diagnosed as a gastric GIST, because the cell type of the tumor was spindle and tested positive for c-kit.Based on the tumor size and mitotic count, the patient was diagnosed with high-risk GIST by the modified-Fletcher classification, and imatinib 400mg/day was administered.There have been no signs of recurrence for 2 years since the operation.

[Two long-term survival cases of Stage IV colon cancer through multidisciplinary treatment].

We report the long-term survival in two cases of colon cancer through multidisciplinary treatment, including surgery. Case 1: A 67-year-old male patient underwent anterior rectal resection, partial hepatectomy(S4, S5, S5/8) and cholecystectomy for rectal cancer with liver metastasis in July 2006(pSS, pN0, sH1, sP0, sM0, Stage IV, Cur B). Liver metastasis, lung metastasis, and metastatic colon cancer occurred 5 times during the 59 months following the first operation. We performed surgery and adjuvant chemotherapy to treat each recurrence. Case 2: A 42-year-old male patient underwent sigmoidectomy for sigmoid colon cancer with multiple liver metastasis in May 2007 (pSS, pN0, sH2, sP0, sM0, Stage IV, Cur C). Recurrence occurred 7 times at the liver and lung during the 58 months after the first operation. We performed surgery and adjuvant chemotherapy to treat each recurrence.

[A resected case of signet-ring cell carcinoma of the rectum].

Here, we present the case of a 76-year-old woman who consulted us in April 2010, following a positive fecal occult blood test, and was diagnosed with lower rectal cancer. Signet-ring cell carcinoma was diagnosed by histology. Because hydronephrosis of both sides was considered the cause of dissemination of the tumor, only chemotherapy was performed. After the eighth course of XELOX+bevacizumab treatment, hydronephrosis of both sides improved and the tumor marker level became normal. An abdominoperineal rectal resection was performed in February 2011. The results of pathological examination of the resected specimen showed complete response. After the operation, the tumor marker level was elevated, and recurrence in the pelvic cavity and multiple bone metastases were detected by positron emission tomography/ computed tomography. Chemotherapy has now been resumed. Signet-ring cell carcinoma is rare in colorectal cancer. The frequency of multiple organ metastases is high, and the growth rate of the tumor is also high. Poor prognosis compared to the usual colorectal cancer has been reported.