Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 108 , Issue 10
Showing 1-14 articles out of 14 articles from the selected issue
Review article
Monthly report; Adjuvant and neoadjuvant therapy for pancreatic carcinoma
Round-table discussion; Adjuvant and neoadjuvant therapy for pancreatic carcinoma
Case report
  • Yuka KOBAYASHI, Soichi SUGITANI, Koshi OSEKI, Takao IIRI
    2011 Volume 108 Issue 10 Pages 1696-1704
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    A 71-year-old man was admitted to our hospital in September 2009 because of severe headache due to meningeal carcinomatosis. In July 2007, subtotal gastrectomy was carried out for gastric cancer. Because intraabdominal cytodiagnosis was positive, he received systemic chemotherapy for 2 years. Recurrent signs were not found on chest or abdominal CT just before hospitalization. He was given NSAIDs and corticosteroid, but his symptom did not improve. Subsequent intrathecal chemotherapy with MTX and Ara-C improved clinical symptoms dramatically. He received care at home for 3 months before he passed away due to pleural and peritoneal recurrence. Recently, since the frequency of meningeal carcinomatosis is increasing, combination treatment of intrathecal chemotherapy and systemic chemotherapy should be considered not only for improvement of clinical manifestations, but also for prognostic improvement.
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  • Atsuyuki HIRANO, Kenji TSUCHIDA, Makoto NAKAMURA, Kazunori ADACHI, Yus ...
    2011 Volume 108 Issue 10 Pages 1705-1711
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    Extraskeletal neoplasms with osteoclast-like giant cells are very rare. These tumors are most frequently reported in the breast and pancreas, and but rarely in other sites. We report a case of duodenal malignant tumor with osteoclast-like giant cells. The patient was a 76-year-old man who presented with vomiting. Computed tomography, magnetic resonance imaging, and gastrointestinal endoscopy revealed a giant tumor in the ascending part of duodenum. Biopsy specimens showed an undifferentiated malignant tumor with benign multinucleated giant cells. Immunohistochemical staining indicated that the tumor cells were reactive with vimentin, but not with epithelial markers or the other mesenchymal markers, and the multinucleated giant cells were reactive with CD68. Thus, we diagnosed a malignant tumor of the ascending part of duodenum with osteoclast-like giant cells. To the best of our knowledge, this is the first case of duodenal malignant tumor with osteoclast-like giant cells in Japan.
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  • Takeshi OGURA, Masahiro TAJIKA, Yasumasa NIWA, Hiroki KAWAI, Shinya KO ...
    2011 Volume 108 Issue 10 Pages 1712-1719
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    We describe a 54-year old woman with oxaliplatin-induced autoimmune hemolytic anemia and review the clinical features of similar published cases. The present patient had metastatic colon cancer and was admitted to our hospital with a floating sensation and general malaise on day 4 after undergoing the last of 4 cycles of a 7th round of chemotherapy with XELOX. Laboratory data revealed 4.6g/dl hemoglobin and 8.77mg/dl creatinine. Direct and indirect Coombs tests of a blood sample for blood transfusion were both positive. We diagnosed immune hemolysis with acute renal failure based on the clinical course and blood samples showing haptoglobin <10mg/dl. We treated her with hemodialysis, plasmapheresis and immune suppression with prednisolone, which improved the anemia and renal failure.
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  • Takayoshi NAKAJIMA, Tadashi TSUKAMOTO, Yutaka HAMABE, Kenichi TANAKA, ...
    2011 Volume 108 Issue 10 Pages 1720-1725
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    A 50-year-old man was admitted to our hospital with a chief complaint of melena. An emergency upper gastrointestinal endoscopic study revealed arterial bleeding from a duodenal submucosal tumor, 1.5cm in diameter and about 2cm in an oral direction from the papilla of Vater. Because it was not possible to stop the bleeding, an emergency resection of the tumor was performed. Macroscopically, the ulcerated tumor was approximately 1.5cm in diameter. Histopathologically, the tumor was determined to be located in the accessory papilla of the duodenum. We report here a rare case of bleeding from the accessory duodenal papilla and discuss the literature.
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  • Keiichi HASHIGUCHI, Kazufumi YAMASAKI, Tatsuki ICHIKAWA, Fuminao TAKES ...
    2011 Volume 108 Issue 10 Pages 1726-1734
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    A 66-year-old woman with a history of alcoholic liver cirrhosis and hepatocellular carcinoma was repeatedly hospitalized for the treatment of encephalopathy. Computed tomography demonstrated a portosystemic venous shunt which continued from portal branch P7 to the right renal vein. Since pharmacotherapy for encephalopathy was ineffective, balloon-occluded retrograde transvenous obliteration (B-RTO) was performed to block the portal-renal flow. Hyperammonemia and encephalopathy improved remarkably after the procedure. Intrahepatic portosystemic venous shunt draining into the right renal vein is a rare condition. To the best of our knowledge, management of this type of shunt by B-RTO has not been previously described. We report this case accompanied by a short review of the related literature.
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  • Yoshifumi MORITA, Takanori SAKAGUCHI, Yasushi SHIBASAKI, Kosuke OISHI, ...
    2011 Volume 108 Issue 10 Pages 1735-1742
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    We report a case of primary hepatic actinomycosis showing elevation of serum protein induced by vitamin K absence or antagonist II (PIVKA-II). A 68-year-old man visited an affiliated hospital with a complaint of high fever and body weight loss. Hematological examination revealed severe inflammatory reactions and liver dysfunction. Abdominal CT showed a heterogeneous low density area composed of cystic and solid part. We suspected the cystic part with band-like enhancement to be a hepatic abscess and performed percutaneous transhepatic abscess drainage. Although inflammatory reactions decreased after the drainage, the solid part did not shrink and blood chemistry revealed elevation of PIVKA-II. Since we could not rule out the possibility of hepatoma, right hepatectomy was performed. Histological examination revealed actinomycetes. Although primary hepatic actinomycosis is a rare disease, it must be kept in mind in the differential diagnosis of the liver tumor.
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  • Makoto ABUE, Masaki SUZUKI, Takefumi MIYAZAKI, Eiki NOMURA, Kiyoshi UC ...
    2011 Volume 108 Issue 10 Pages 1743-1751
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    We reported a case of early cystic duct carcinoma concomitant with xanthogranulomatous cholecystitis (XGC). This case was a 72-year-old man in whom thickening of the gallbladder wall was pointed out an abdominal ultrasonography and elevation of the CA19-9 level was detected at a local clinic. Endoscopic ultrasonography and CT demonstrated a mass in the cystic duct. Mapping biopsy using peroral cholangioscopy (POCS) revealed a diagnosis of cystic carcinoma with superficial flat growth, therefore a pylorus-preserving pancreatoduodenectomy was performed. Histopathological diagnosis was well differentiated papillotubular adenocarcinoma with superficial flat spread and the thickening of the gallbladder wall was XGC. A case of early cystic duct carcinoma concomitant with XGC is extremely rare.
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  • Tomoki KOBAYASHI, Atsushi YAMAGUCHI, Sohei YAMAMOTO, Haruki KIMURA, Ke ...
    2011 Volume 108 Issue 10 Pages 1752-1760
    Published: 2011
    Released: October 05, 2011
    JOURNALS FREE ACCESS
    A 64-year-old man was found to have a 15-mm tumor in the pancreatic tail by CT angiography 1 year after resection of a left renal pelvic tumor. Clinically, the tumor was preoperatively suspected to be autoimmune pancreatitis. However, surgical resection was performed under a diagnosis of pancreatic ductal cancer, because atypical epithelial cells were detected by endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). Pathological examination of the tumor revealed a mass-forming autoimmune pancreatitis. Mass-forming autoimmune pancreatitis is often difficult to preoperatively differentiate from pancreatic carcinoma. Response to steroid treatment and the detection of extrapancreatic lesions may contribute to an accurate diagnosis, thereby avoiding unnecessary surgery.
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