A huge rectosigmoidal cancer which extended into the urinary bladder in a 64-year-old man is herein described. The tumor occupied the pelvic and lower abdominal cavities, while the rectosigmoid was ...totally obstructed. No hepatic or pulmonary metastasis was evident. The ventral and flank sides of the peritoneum in the right lower abdomen, right common iliac vessels, bilateral ureters, terminal ileum, cecum, ascending colon, and urinary bladder were all directly invaded by the tumor, but the aorta, sacrum, and lower rectum were free of cancer. Consequently, an anterior pelvic exenteration was carried out along with an ileal conduit and a right hemicolectomy. Immediately after the exenteration, intra-pelvic hyperthermochemotherapy was performed using a 46-47 degrees C perfusate containing 40 micrograms/ml of mitomycin C (MMC) and 200 micrograms/ml of cisplatin (CDDP), for 90 min, in an attempt to prevent any further local recurrence. A right hemicolectomy and a permanent colostomy were done simultaneously with the hyperthermia treatment. After an uneventful postoperative course, the patient was prescribed adjuvant chemotherapy, i.e., two administrations of 17 mg/m2 and 21 mg/m2 of MMC, and ten doses of 710 mg/m2 of 5-fluorouracil (5-FU) followed by five doses of 535 mg/m2 of 5-FU. At the time of this writing, the patient is still alive without recurrence at 21 months after surgery.
A 24-year-old man was hospitalized with the chief complaints of jaundice and splenomegaly. He was diagnosed as having congenital hemolytic anemia at 6 years of age. The laboratory data on admission ...were hemoglobin 10.7g/dl, reticulocytes 19.3%, indirect bilirubin 9.5mg/dl, and haptoglobin less than 10 mg/dl. Gallstone was detected in plain abdominal X-ray film and ultrasonic scan. No spherocytes were present in his peripheral blood smear. Sixteen red blood cell enzymes were maintained at resonable levels. The diagnosis of congenital nonspherocytic heamolytic anemia with cholecystolithiasis was confirmed. Splenctomy with cholecystectomy was performed. Although hemolysis was improved, splenectomy was not effective in improving anemia.
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