[Bone Marrow Carcinomatosis with Disseminated Intravascular Coagulation in a Breast Cancer Patient Treated with Chemotherapy and CDK4/6 Inhibitor].

We report a case of a breast cancer patient with bone marrow carcinomatosis and disseminated intravascular coagulation who was treated with chemotherapy and a CDK4/6 inhibitor. The patients, a 68-year-old woman, presented to our hospital with anorexia and was found to have multiple liver metastases of breast cancer. Furthermore, she had anemia and thrombocytopenia, and a bone marrow biopsy showed bone metastasis of the breast cancer. Therefore, a diagnosis of bone marrow carcinomatosis and disseminated intravascular coagulation was made. Treatment was started with chemotherapy(epirubicin and cyclophosphamide)and subsequently changed to an aromatase inhibitor(letrozole)and a CDK4/4 inhibitor(abemaciclib) and was maintained without exacerbation of the patient's condition.

[A Case of Recurrent Breast Cancer with Complete Response to Eribulin Monotherapy after Bevacizumab plus Paclitaxel Combination Therapy].

A 65-year-old woman underwent mastectomy and dissection of a level I axillary lymph node in January 2002 for left breast cancer. The diagnosis was T1N0M0 scirrhous carcinoma that was estrogen receptor-positive, progesterone receptorpositive, and human epidermal growth factor receptor 2-negative. After 3 years 10 months, during which the patient underwent adjuvant therapy with oral aromatase inhibitors, she developed bilateral multiple lung metastases. These were treated with the anticancer agents anthracycline and taxane. Progressive disease(more and larger lung metastases)was diagnosed in April 2013, and bevacizumab plus paclitaxel combination therapy was started. After completion of 4 courses, a lung abscess appeared, which was conjectured to represent rapid tumor necrosis that had become infected. As several tumors remained solid even after the lung abscess improved, the patient received 18 courses of eribulin monotherapy. Computed tomography in April 2016 revealed only patches of linear or cord-like scarring in both lungs, with no metastatic or recurrent foci. In this case, a patient with recurrent breast cancer responded to the sequential administration of bevacizumab plus paclitaxel combination therapy followed by eribulin monotherapy.

An extremely rare case of pancreatic metastasis of esophageal squamous cell carcinoma.

We report a rare case of a 68-year-old male with metachronous pancreatic metastasis that was resected 2 years after salvage esophagectomy for local recurrence of esophageal squamous cell carcinoma (ESCC). Two years and 8 mo ago, he had undergone definitive chemoradiotherapy for the lower thoracic ESCC and achieved a complete response. Chemoradiotherapy used the protocol of the Japan Clinical Oncology Group trial 9906. Approximately 8 mo later, he developed a local recurrence of the ESCC and underwent thoracoscopic salvage esophagectomy followed by reconstruction with a conduit colon graft via a subcutaneous route. Recently, a tumor of the pancreatic body was found on routine follow-up computed tomography (CT). The tumor diameter was 15 mm on CT, and the maximum standardized uptake value of the lesion was 5.49 at 18F-2-fluoro-2-deoxy-D-glucose positron-emission tomography, strongly suggesting pancreatic cancer. In addition, all tumor markers were within the reference intervals. Therefore, distal pancreatectomy was performed with the resultant histological diagnosis being confirmed as pancreatic metastasis of the ESCC. He was treated with adjuvant chemotherapy, and there has been no evidence of recurrence 9 mo after the surgery. Resection of pancreatic metastasis offers a good prognosis and should be considered for solitary ESCC metastasis.