1/54. Intracranial hemorrhage due to cerebral metastasis of lung cancer - a case report.lung cancer often metastasizes to brain. However, hemorrhage of the metastatic lesions is uncommon. We report a case of a 68-year old man with lung cancer who underwent right upper lobectomy of the lung and presented in 15 months with a cerebral hemorrhage from a metastatic lesion of the brain.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/54. lung adenocarcinoma in lymphocytic interstitial pneumonitis associated with primary sjogren's syndrome.We experienced a rare case of lung adenocarcinoma associated with lymphocytic interstitial pneumonitis caused by primary sjogren's syndrome. A 78-year-old woman was referred to our hospital because of progressive sicca syndrome and nodular opacities in the right lower lobe on chest radiograph. This patient was diagnosed as primary sjogren's syndrome by a labial gland biopsy and classical clinical features including xerophthalmia, xerostomia and immunoserological findings. Pathological findings including immunohistochemical studies in a surgically resected lung revealed adenocarcinoma in lymphocytic interstitial pneumonitis associated with primary sjogren's syndrome. There was no evidence of malignant lymphoma in the lymph nodes or resected lung tissue. Pulmonary involvement of sjogren's syndrome is now regarded both clinically and histopathologically as a wide spectrum of lymphoproliferative disorders ranging from benign to malignant. However, lung cancer associated with primary Sjogren's syndrome, as in our case, has apparently not been reported previously.- - - - - - - - - - ranking = 0.89027054042959keywords = chest (Clic here for more details about this article) |
3/54. Successful resection of endotracheal papillary adenocarcinoma by endoscopic electrosurgery using a new snare: report of a case.We report herein the rare case of a patient with endotracheal papillary adenocarcinoma of the goblet cell type. The tumor existed in the upper trachea, obstructing 95% of the airway, and prompt palliation was required. Endotracheal polypectomy was successfully performed in this patient using electrosurgery with a new snare designed for the respiratory tract. The procedure took only a few minutes and the dyspnea was relieved promptly without any complications. The alternative techniques for palliation of bronchial stenosis are also discussed.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/54. Sigmoid colon carcinoma metastatic to the myometrium.Metastases to the uterus from extragenital cancers are significantly rarer than metastases to the ovaries. Of the approximately 200 cases of metastases to the uterus from extragenital cancers that have been reported in the literature, more than half are cases of metastases from breast carcinoma and only 16 are cases of metastases from colorectal carcinoma. A case of isolated metastases restricted to the myometrium of the right uterine comu from sigmoid colon carcinoma, without involvement of the ovaries, is described. The patient who six months previously had surgery for sigmoid colon carcinoma presented with right lower abdominal pain and a palpable mass in the region of the right uterine cornu. The diagnosis of isolated metastases restricted to the myometrium of the right uterine cornu was confirmed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. This case illustrates that a growing uterine mass in a patient with a history of primary extragenital cancer, regardless of whether abnormal uterine bleeding is present or absent, should alert the physician to consider the possibility of uterine metastases.- - - - - - - - - - ranking = 8.9487472568001keywords = abdominal pain (Clic here for more details about this article) |
5/54. A case of pulmonary adenocarcinoma with overexpression of multidrug resistance-associated protein and p53 aberration.A 66-year-old female patient underwent left upper lobectomy and dissection of the mediastinal lymph nodes. The pathological diagnosis was well-differentiated papillary adenocarcinoma of the lung with metastasis to the mediastinal lymph nodes, p-T2N2MO, stage IIIA. After the operation, she was treated by chemotherapy including lipophilic anticancer compounds (carboplatin and VP-16). The patient unexpectedly showed long survival for 6 years and 2 months without obvious recurrence or metastasis of the cancer. The anticancer compounds were not effective on the recurrent lesions and then she died due to respiratory failure 8 months after recurrence. The autopsy revealed pleural dissemination and intrapulmonary metastasis. Immunohistochemical analysis showed increased multidrug resistance-associated protein (MRP)-positive tumor cells in the recurrent and metastatic lesions, while few MRP-positive cells were apparent in the primary lesion. The MRP-positive cells were accompanied by p53 nuclear accumulation in the carcinoma. This was a case of pulmonary adenocarcinoma with acquired multidrug resistance caused by MRP overexpression and aberrant p53 after chemotherapy.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
6/54. adenocarcinoma of the ileum producing carbohydrate antigen 19-9: report of a case.We report herein the case of an 81-year-old woman found to have small intestinal carcinoma producing carbohydrate antigen (CA)19-9, in whom recurrence on the abdominal wall was strongly suspected 4 months after resection. She presented to our hospital with acute abdominal pain with severe anemia. Marked serum elevation of CA19-9 to 164.8 U/ml suggested a progression to malignancy. A fluorography using an ileus tube revealed an abnormal mucosal pattern. An exploratory laparotomy showed an incomplete annular constrictive Borrmann type 2 tumor, located approximately 190 cm from Treitz's ligament, without any signs of peritoneal or hepatic metastases. Histological examination confirmed a diagnosis of papillotubular adenocarcinoma without metastases of the regional lymph nodes. CA19-9 antigenicity was detected in the cytoplasm and on the surface of the cancer cells, using the monoclonal CA19-9 antibody, NS19-9. In this report, we demonstrate the CA19-9 productivity and distribution of the cancer tissues in relation to their prognosis.- - - - - - - - - - ranking = 8.9487472568001keywords = abdominal pain (Clic here for more details about this article) |
7/54. Double cancer of gallbladder and bile duct associated with anomalous junction of the pancreaticobiliary ductal system.We report a case of double cancer of the gallbladder and the common bile duct associated with anomalous junction of the pancreaticobiliary ductal system, and review the literature of similar case reports. A 66-year-old woman was admitted to an associated hospital complaining of upper abdominal pain, and was diagnosed as having pancreatitis. Abdominal imaging revealed an irregularly protruding mass at the body of the gallbladder and an intraluminal protrusion at the lower third of the common bile duct. Endoscopic retrograde cholangiopancreatography also revealed anomalous junction of the pancreaticobiliary ductal system with congenital biliary dilatation of 14 mm in the largest diameter. She underwent surgical resection of the gallbladder, the extrahepatic bile duct and the gallbladder bed of the liver with a dissection of the regional lymph nodes for double cancer of the gallbladder and the bile duct associated with anomalous junction of the pancreaticobiliary ductal system. She is still alive 33 months after surgery without any signs of recurrence. There were 12 patients (including our case) reported in the literature who had double cancer of the gallbladder and the extrahepatic bile duct associated with anomalous junction of the pancreaticobiliary ductal system. Only 33% of these 12 patients had jaundice. Tumors of the 12 patients were commonly early-stage cancer both in the gallbladder (36%) and in the extrahepatic bile duct (73%). Therefore, we concluded that precise preoperative imaging of the total biliary tract should be required in order to detect early-stage cancer in patients with anomalous junction of the pancreaticobiliary ductal system before planning surgical procedures, and consideration should be given to the possibility of multiple occurrences of biliary tract cancers.- - - - - - - - - - ranking = 9.9487472568001keywords = abdominal pain, upper (Clic here for more details about this article) |
8/54. Intraductal papillary cholangiocarcinoma with aneurismal dilation: a case of the mimicking abscess.A case of cystic intraductal papillary cholangiocarcinoma is presented. A 58-year-old male patient presented with fever, chills, epigastric and right upper quadrant pain for 15 days. Clinically and radiologically, he was diagnosed as having liver abscess. After ultrasonography and abdominal computed tomography were taken, percutaneous drainage was performed and pus was drained. Computed tomography revealed a huge, multiloculated, septated cystic lesion in the right lobe of the liver. On the pathologic exam, the cystic lesion was an aneurismally dilated tumor, which spread diffusely and contiguously along the intrahepatic bile duct and microscopically the lesion was composed of a single layer of tall columnar tumor cells with short intraluminal papillary projections. We present the unusual case of intraductal papillary cholangiocarcinoma with aneurismal dilation and with superimposed infection.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
9/54. Combined bilateral lung resections and off-pump coronary artery bypass grafting.We report herein a 74 year old man with angina who had an abnormal chest roentgenogram. Computed tomography of the chest showed a solitary 1.0-cm peripheral, noncalcified lesion in the apical segment of the left lower lobe and a 1.5-cm peripheral lesion in the posterior basal segment of the right lower lobe. coronary angiography revealed the left anterior descending coronary artery to have a long 90% stenosis. We report here a case of a combined bilateral lung resection and off-pump coronary surgery though a midline sternotomy in a compromised lung function patient with both severe coronary artery disease and bilateral synchronous primary lung cancer.- - - - - - - - - - ranking = 1.7805410808592keywords = chest (Clic here for more details about this article) |
10/54. Invasive carcinoma of the pancreas derived from intraductal papillary adenocarcinoma without mucin hypersecretion but with changes in the pancreatic duct on pancreatography.We present a case of invasive carcinoma of the pancreas derived from intraductal papillary adenocarcinoma without mucin hypersecretion in a 65-year-old man with a 45-year history of alcohol abuse and a 2-year follow-up of chronic pancreatitis. Two years previously, in May 1998, he was admitted for investigation of abdominal pain. Computed tomography (CT) showed diffuse dilation of the main pancreatic duct with atrophy of the pancreatic parenchyma. Endoscopic retrograde pancreatography (ERP) showed a diffusely dilated main pancreatic duct with irregular side branches in the head of the pancreas. Chronic alcoholic pancreatitis was diagnosed on the basis of the pancreatography findings. The patient was readmitted for investigation of progressive weight loss in August 2000. serum CA19-9 levels were markedly elevated (750 U/ml) and CT showed enlargement of the head and body of the pancreas. ERP showed irregularity of the main pancreatic duct in the head of the pancreas, and the distal main pancreatic duct (which was dilated on initial ERP examination) was interrupted in the body of the pancreas. Suspected pancreatic carcinoma was diagnosed, and pylorus-preserving pancreatoduodenectomy was performed. Frozen section examination of the cut end of the pancreas revealed ductal carcinoma, and total pancreatoduodenectomy with portal vein resection was performed. Histologically, the resected tumor was diagnosed as an invasive carcinoma derived from intraductal papillary adenocarcinoma without mucin hypersecretion. We recommend observing changes in the pancreatic duct on pancreatography to diagnose invasive carcinoma of the pancreas derived from intraductal papillary adenocarcinoma in a resectable state.- - - - - - - - - - ranking = 8.9487472568001keywords = abdominal pain (Clic here for more details about this article) |
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