A CASE OF PANCREATIC METASTASIS FROM LUNG CANCER YOSHIDA, Naomasa; SUMI, Yasuhiro; MURASE, Katsutoshi ...
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association),
2003, Volume:
64, Issue:
5
Journal Article
Open access
A 52-year-old woman was admitted to the hospital because of persisting back pain. She had undergone a radical modified mastectomy for right breast cancer at 49 years old and a left upper lobectomy ...for lung cancer at 51 years old. Abdominal computed tomography revealed each one tumor about 20mm in diameter in the pancreas head and tail. Endoscopic retrograde cholangiopancreatography revealed stenosis of the main pancreatic duct in the head and dilatation in the body and tail. The tumors were suggestive of malignancy by a cytology of pancreas juice. We diagnosed the case as multiple pancreas metastasis from breast or lung caner and performed a distal pancreatomy and a splenectomy. Histologically the excised tumors consisted of well differentiated squamous cell carcinoma and partially differentiation to adenocarcinoma. Compared with previous pathological findings of lung cancer, these pancreatic tumors were compatible with pancreas metastasis from lung cancer. After the operation her back pain disappeared, and she has remained well with other recurrence as of 1 year and 3 months. Although pancreas metastasis had poor prognosis, we should consider aggressive surgery that might prolong prognosis and improve quality of life in some cases.
We report a case of pancreatic injury that underwent an operation on 3 months after trauma. A 17-year-old man bruised his abdomen in an accident on April 10, 2001. He referred to a doctor and ...diagnosed with traumatic pancreatic injury. Despite conservative therapy, his serum amylase remained high. He was referred to another hospital and diagnosed in abdominal computed tomography (CT) and other studies with obstruction of the main pancreatic duct. He was referred to us for surgery, conducted on July 11. The pancreatic body and tail were very hard due to obstructive inflammation, necessiting pancreatojejunostomy. His postoperative course was uneventful and he was discharged on postoperative day 19.
We report a case of hepatocellular carcinoma (HCC) with tumor emboli in the inferior vena cava (IVC). A 51-year-old man suffering from HCC due to HBV cirrhosis since 3 years previously and undergoing ...TAE and percutaneous ethanol injection (PEI) several times was referred to our hospital for surgery for recurrent HCC. Abdominal CT in July 2000 showed a 3 cm tumor in segment 7 that extended to the IVC through the middle right hepatic vein (MRHV). The tumor continuously formed 4.0 cm emboli in the IVC in August 2000. Right hepatic lobectomy and tumor emboli removal were conducted by total hepatic vasculr exclusion (THVE). His postoperative course was uneventful and he was discharged on postoperative day 24. THVE is useful in HCC embolectomy, which extended to the IVC, provides a survival benefit for patients. We recommend the operation for HCC with tumor emboli into the IVC because of the improved quality of life (QOL).
A 52-year-old man admitted for palpitation and exertional dyspnea was found by our internal medicine department to have anemia and sigmoid colon carcinoma. The patient had situs inversus (Kartagener ...syndrome), and preoperative diagnosis of complicated anomalies were right-sided heart, two-lobe lung, multiple spleens, IVC defect and intestinal malrotation. Surgical findings were left-sided liver, right-sided stomach, total situs inversus, and nonrotational intestinal malrotation in which the cecum was on the median. Since sigmoid colon carcinoma inveded the cecum we conducted sigmoidectomy with ileocecal resection. The man was discharged on postoperative day 18. Situs inversus is a rare congenital disease and often has several complicated anomalies. Although this case involved sigmoid colon carcinoma with some complicated anomalies, no severe problems occurred during surgery.
We report a case of early gastric cancer resembling submucosal tumor due to marked venous infiltration. A 68-year-old man was pointed out an abnormality of the stomach in a medical checkup. ...Radiological findings revealed a submucosal tumor-like lesion measuring about 1.5cm with central concavity in the body of the stomach. We diagnosed the case as early gastric cancer and performed a segmental gastrectomy. Histologically the tumor was diagnosed as poorly differentiated adenocarcinoma {porl, pT1 (SM), med, INF α, ly0, v3, and pNO}. The submucosal tumor-like appearance was due to marked venous infiltration in the submucosa. The postoperative course was uneventful. The patient is living and well as of 10months after the operation.
A CASE OF CHOLANGIOCELLULAR CARCINOMA IN THE YOUNG KANEKO, Tadashi; SAWADA, Suguru; SUMI, Yasuhiro ...
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association),
2002, Volume:
63, Issue:
11
Journal Article
Open access
We report a young patient with cholangiocellular carcinoma. A 30-year-old man with icterus was diagnosed with cholangiocellular carcinoma of the left hepatic lobe with invasion to the right hepatic ...duct and the right anterior branch of the portal vein. Left hepatic trisegmentectomy, caudate lobectomy, and resection and reconstruction of the bile duct and portal vein were done. His postoperative course was uneventful and he was discharged on postoperative day (POD) 19. Five months after surgery, portal hypertension due to recurrence at the portal anastomosis was noted, but he died 14 months after initial surgery despite additional treatment and follow-up. The rarity of cholangiocellular carcinoma in the young prompted us to report this case.
Radical pancreatoduodenectomy was performed for a 69-year-old female with cancer of the pancreas head accompanied with atherosclerotic stenosis of the superior mesenteric artery (SMA). The patient ...was asymptomatic. On abdominal computed tomography, percutaneous cholangiography and endoscopic retrograde pancreatography, the common bile duct and main pancreatic duct of the body and tail were dilated. Preoperative angiography revealed that the SMA trunk had atherosclerotic stenosis and the blood flow of the SMA was supplied via the pancreatoduodenal arcades. Pylorus preserving pancreatoduodenectomy and thrombectomy of the SMA were performed. Pathologically, the pancreatic tumor was well differentiated adenocarcinoma. Adequate blood flow of the SMA was demonstrated angiographically on the 26th postoperative day. The postoperative course was uneventful and the patient was discharged on the 52nd postoperative day. The patient is cancer free and asymptomatic for atherosclerotic stenosis of the SMA at 1-year-9-months after the operation.
A 49-year-old man with anemia was found in endoscopic examination to have a subpedunculated polypoid tumor in the descending colon. The top of the tumor was white, lustrous, and movable with almost ...normal mucosa. We suspected it as a cancer of the descending colon and conducted left hemicolectomy. Macroscopically, the tumor was 22×18 mm and elastically soft. Microscopically, it showed proliferation of uniform atypical lymphocytes with hyperchromatic unclei in the superficial layer of the tumor head. Singularly, the tumor had hyalinofibrous connective tissue in the center of the head and peduncle. Immunohistochemically, tumor cells were positive to T-cell markers (CD3, MT1) and negative to B-cell markers (L26, MB1). The tumor had invaded the submucosal layer without lymph node metastasis and was diagnosed as non-Hodgkin's lymphoma, diffuse medium cell, T-cell in LSG. This case case was extremely rare, since it involved the descending colon, was subpedunculated, was early lymphoma, and was T-cell.
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