We evaluated 214 patients (100 males and 114 females) with 223 lesions of basal cell carcinoma (BCC) who visited our department over the past 11 years (2005–2015). The diagnosis of BCC was confirmed by histopathology. Among the 223 lesions, the most frequent location was the face (64.1%), especially on the central part of the face. The most common histological subtype identified was nodular type (31.8%), and a tumor diameter of 20 mm or less accounted for 70% of the tumors. The average tumor size was significantly larger in the males than in the females. We also examined the period between the initial notice of the lesion and the first visit to the hospital. Females tended to visit the hospital earlier while the tumor was still small. Because surgery is the first-line therapy, it is important to educate people to visit the hospital when the tumor is still at an early stage.

We evaluated 680 patients (348 males and 332 females) with malignant skin tumors who visited our department over the past 11 years (2005-2015). The most common malignant skin tumor was basal cell carcinoma (214 cases), followed by Bowen’s disease (129 cases), squamous cell carcinoma (98 cases), actinic keratosis (91 cases), malignant melanoma (87 cases), and extramammary Paget’s disease (40 cases). We also compared our results with past statistical surveys from other facilities. The disease distribution in our hospital was similar to that of other designated regional cancer centers and hospitals. Because malignant melanoma requires multidisciplinary treatment, there were differences in the number of cases treated in each hospital. With the advent of immune checkpoint inhibitors, we think that medical institutions treating malignant melanoma will be further integrated in the future.

P-glycoprotein (P-gp) is a membrane protein present in the brain, liver, and kidney that has a major role in drug delivery. Escitalopram, a selective serotonin reuptake inhibitor, is transported as a substrate of P-gp. Digoxin, which is also a known substrate of P-gp, is used to evaluate the drug delivery function of P-gp.
Because previous investigations of P-gp have been mainly short-term studies, we examined the effect of the chronic administration of antidepressants on the function of P-gp. We administered oral escitalopram 10 mg/kg/day to C57BL/6 mice for 6 weeks. Digoxin 2 mg/kg was then administered intraperitoneally 2 hours before dissection. We examined the activation effect of P-gp on ATPase using a luciferase luminescent reaction. The P-gp activity in the mice that received a combination of escitalopram and verapamil showed an additive effect, whereas those receiving a combination of escitalopram and digoxin displayed a synergistic increase in P-gp activity. The concentration of digoxin in the brain significantly increased from 0.7125 ng/g at week 0 to 1.158 ng/g at week 6. We believe we are the first to report this synergistic effect between escitalopram and digoxin on the P-gp activity on ATPase. We hypothesize that chronic treatment with escitalopram inhibited the excretion of digoxin from the brain through P-gp, causing the concentration of digoxin to increase.
In conclusion, we observed an increase in digoxin concentration in the mouse brain mediated by the drug-drug interaction of escitalopram and digoxin.

A man in his 80s underwent examination for arteriosclerosis obliterans of the left common iliac artery in the Department of Cardiac Surgery at our hospital and was referred to our department because mass lesions were found in his stomach upon computed tomography (CT) examination. There were no obvious masses on palpation. Closer examination led to a diagnosis of advanced gastric cancer on the greater curvature of the gastric antrum accompanied by a gastric submucosal tumor on the greater curvature of the gastric angle. Because both lesions were considered resectable, open pyloric gastrectomy, D2 dissection, and a Billroth I procedure were performed. The results of postoperative pathological examination, led to a diagnosis of gastric cancer (pT3N0M0, fStage IIA) concomitant with primary gastrointestinal stromal tumor (GIST) of the stomach (Fletcher classification: low risk). The reported incidence rate of concomitant gastric epithelial tumor and gastric GIST is 0.29%, with only 30 cases reported in Japan. The present case of gastric cancer with primary GIST of the stomach incidentally detected on CT is reported herein along with some comments based on the literature.