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1.
Neuronal Na+/K+ ATPase is an autoantibody target in paraneoplastic neurologic syndrome.
Scharf, M, Miske, R, Heidenreich, F, Giess, R, Landwehr, P, Blöcker, IM, Begemann, N, Denno, Y, Tiede, S, Dähnrich, C, et al
Neurology. 2015;(16):1673-9
Abstract
OBJECTIVES To identify an autoreactivity in a 66-year-old woman who presented with combined brainstem and cerebellar syndrome including vertical gaze palsy, severe progressive ataxia, and spastic tetraparesis, an acute deterioration of vision, dysarthria, and dysphagia with concurrent diagnosis of a colon adenocarcinoma. METHODS Patient's serum and CSF underwent comprehensive autoantibody screening by indirect immunofluorescence assay and immunoblot. For autoantigen purification, a histo-immunoprecipitation technique was developed followed by mass spectrometrical analysis. Recombinant candidate antigens were expressed in HEK293 and used to verify the identification. RESULTS Indirect immunofluorescence assay screening revealed strong immunoglobulin G reactivity with neural tissues in serum and CSF, but not with a panel of 28 recombinantly expressed established neural autoantigens. The hitherto unknown target antigen was identified as the neuronal Na(+)/K(+) ATPase. Epitope mapping and competitive inhibition experiments showed that the autoantibodies were directed against the membrane-spanning alpha 3 subunit (ATP1A3) of the enzyme but did not bind to extracellular epitopes. Immunohistochemical analysis revealed overexpression of this subunit in the patient's tumor. CONCLUSIONS We describe a case of an anti-ATP1A3-associated neurologic disorder. Mutations in the gene encoding this neuronal surface protein have already been recognized as the cause of infantile alternating hemiplegia, rapid-onset dystonia parkinsonism, and CAPOS syndrome. Although the autoantibodies are unlikely to be pathogenic, they are likely to be rare biomarkers for the apparently paraneoplastic neurologic syndrome or for the tumor itself.
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2.
[A case of carcinoma arising in a diverticulum of the transverse colon].
Nomi, M, Umemoto, S, Kikutake, T, Hosaka, S, Mase, T, Kawamoto, S, Yoshida, T
Gan to kagaku ryoho. Cancer & chemotherapy. 2014;(12):1680-2
Abstract
A 64 year-old woman presented with advanced, transverse colon cancer arising in the diverticulum. Tumor invasion extended beyond the serosa to the anal side of the colon. Anemia and fatigue progressed after 6 months of iron administration. The hemoglobin value was 5.3 g/dL and carcinoembryonic antigen (CEA) level was elevated to 44.2 ng/mL. A palpable and tender fist-sized mass was found in the right upper abdomen. Computed tomography (CT) revealed a low-density mass in the transverse colon invading beyond the serosa to the anal side of the colon. Right hemi-colectomy with lymph node dissection was performed. The resected specimen contained multiple diverticula including the one from which the tumor arose. Histological examination revealed a well-differentiated, tubular adenocarcinoma (UICC TNM T4bN0M0) arising in a transverse colon diverticulum. There has been no recurrence for 2 years. Colon cancer arising in a diverticulum may expand to the extra-serosa and easily invade to the adjacent organ. In such cases, malignancy should be considered.
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3.
Seminal vesicle-rectal fistula secondary to anastomotic leakage after low anterior resection for rectal cancer: a case report and brief literature review.
Kitazawa, M, Hiraguri, M, Maeda, C, Yoshiki, M, Horigome, N, Kaneko, G
International surgery. 2014;(1):23-7
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Abstract
We report a case of a patient with seminal vesicle-rectal fistula, an extremely rare complication of low anterior resection of the rectum. A 53-year-old man with rectal adenocarcinoma underwent low anterior resection in our hospital. The patient experienced diarrhea, pneumaturia, and low-grade fever on postoperative day 13. A computed tomography scan showed emphysema in the right seminal vesicle. We concluded that anastomotic leakage induced a seminal vesicle-rectal fistula. The patient underwent conservative therapy with total parenteral nutrition and oral intake of metronidazole. Diarrhea and pneumaturia rapidly improved after metronidazole administration and the patient was successfully cured without invasive therapy such as colostomy or surgical drainage. A seminal vesicle-rectal fistula is a rare complication of low anterior resection, and therapeutic strategies for this condition remain elusive. Our report provides valuable information on the successful conservative treatment of a secondary seminal vesicle-rectal fistula that developed after low anterior resection of the rectum in a patient.
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4.
Non-familial double malignancy of the colon and ampulla of Vater: a case report and review of literature.
Rajalingam, R, Javed, A, Gondal, R, Arora, A, Nag, HH, Agarwal, AK
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. 2012;(2):143-5
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Abstract
Apart from their association in familial and hereditary cancer syndromes, sporadic double malignancies of the gastrointestinal tract involving the ampulla of Vater and colon are extremely rare. Although synchronous resection of the two by adding a colectomy to a pancreaticoduodenctomy can be accomplished with minimal increase in the surgical morbidity, a few patients, however, are best managed by a staged resection. We report a case of sporadic double malignancy of the ampulla of Vater and right colon who despite the best attempts continued to bleed and remained malnourished and was successfully managed by staged right hemicolectomy followed by a pancreaticoduodenectomy.
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5.
[Renal metastasis from prostatic adenocarcinoma : a case report].
Sakata, R, Iwasaki, A, Kobayashi, M, Osaka, K, Fujikawa, A, Tsuchiya, F, Ishizuka, E
Hinyokika kiyo. Acta urologica Japonica. 2011;(12):683-7
Abstract
We report a case of renal metastases from prostate cancer to show that the possibility of tumor metastasis, although rare, should be considered in the differential diagnosis of renal mass. A 67-year-old man was found to have a renal mass on computed tomographic scan incidentally. He had had total androgen blockage (bicalutamide + leuprolerin) and chemotherapy (docetaxel hydrate ) for treatment of prostate cancer discovered 33 months ago. On the basis of the clinical features and radiologic results, the patient was thought to have a second malignant tumor, and we performed left nephrectomy. The pathological finding of this case was renal metastasis from prostatic adenocarcinoma. He died 18 months postnephrectomy.
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[Five cases of advanced gastroesophageal junction adenocarcinoma successfully treated with chemoradiotherapy followed by curative resection].
Takahashi, M, Koeda, K, Fujiwara, H, Chiba, T, Sasaki, A, Wakabayashi, G
Gan to kagaku ryoho. Cancer & chemotherapy. 2010;(11):2169-71
Abstract
We reviewed five patients with advanced gastroesophageal cancer who were successfully treated with chemoradiotherapy followed by a curative resection. Patients with histologically-documented adenocarcinoma of the gastroesophageal junction were eligible. Direct tumor extension into the stomach (cT3 or cT4), and involvement of lymph nodes were observed. The patients stopped receiving orally administered carcinostatic drugs due to digestive stenosis or tumor bleeding. They received 25 mg/m2 of cisplatin and 60 mg/m2 of paclitaxel once a week on days 1, 8, 15 and 22. Radiation was administered concurrently at a total dose of 45 Gy in 1.8 Gy fractions for over 25 treatments. Effectiveness of the therapy was evaluated 4 weeks after the chemoradiotherapy. All patients with clinical partial responses underwent gastrectomy (n=4) or esophagogastrectomy (n=1). Curative resection was performed in 5 patients (resection A/B 4/1), and no patient suffered from major postoperative complications. Four patients were downstaged according to the pathological findings. The histologically effective responses of all patients were Grade 2. The obvious chemotherapeutic efficacy of the present regimen suggested that it may be a good treatment option for advanced gastroesophageal cancers. Further studies including randomized controlled trials are needed to evaluate the significance of preoperative chemoradiotherapy.
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[Two cases of the primary small intestine cancer successfully treated with S-1 and UFT/LV therapy].
Lee, T, Noda, E, Maeda, K, Inoue, T, Nagahara, H, Amano, R, Kubo, N, Tanaka, H, Muguruma, K, Takashima, T, et al
Gan to kagaku ryoho. Cancer & chemotherapy. 2010;(12):2789-91
Abstract
The primary small intestinal cancer is rare in gastrointestinal cancer, and there are much advanced/recurrent cases. However, there were a few case reports about chemotherapy for advanced or recurrent small intestinal cancer, and a treatment resume was inconsistent. We reported that S-1 and UFT/LV therapy was effective with the two cases as an oral chemotherapy for the primary small intestinal cancer.
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Capecitabine cardiotoxicity--case reports and literature review.
Manojlovic, N, Babic, D, Stojanovic, S, Filipovic, I, Radoje, D
Hepato-gastroenterology. 2008;(85):1249-56
Abstract
This study presents 3 case reports of patients who experienced anginous pain during treatment with capecitabine. The interruption of capecitabine and sublingual or intravenous nitroglycerine treatment lead to recovery. Rechallenge of capecitabine with dose reduction of 30% lead to repeated anginous pain in 2 patients. Treatment with capecitabine had been replaced with weekly bolus 5FU-LV, without further cardiotoxicity. The literature contains data from about 50 patients who experienced cardiotoxicity during capecitabine treatment. The most frequent manifestations of capecitabine cardiotoxicity included: anginous pain in 38/53 (71.7%), arrhythmia in 6/53 (11.3%), myocardial infarction in 6/53 (11.3%). Cardiotoxicity of capecitabine lead to death in 6/53 (11.3%) patients. Risk factors for cardiotoxicity are associated with the grade 4 and the fatal outcome of cardiotoxicity (p = 0.035, p = 0.015), but not with the symptom recurrence upon capecitabine rechallenge (p = 0.18). The combination chemotherapy regimens are associated with the grade 4 of cardiotoxicity (p = 0.048), but not with the fatal outcome (p = 0.3). Rechallenge of capecitabine lead to symptoms recurrence in 10/16 patients. Neither the dose reduction of capecitabine (p = 0.18) nor the additional medical prophylaxis (p = 0.37) were important for the outcome of capecitabine rechallenge.
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Synchronous occurrence of a primary colon adenocarcinoma and a gastric stromal tumor. A case report.
Tzilves, D, Moschos, J, Paikos, D, Tagarakis, G, Pilpilidis, I, Soufleris, K, Kadis, S, Tarpagos, A, Katsos, I
Minerva gastroenterologica e dietologica. 2008;(1):101-3
Abstract
Gastrointestinal stromal tumors are currently the object of a great clinical and experimental interest. We are presenting the case of a 69-year-old patient, who was presented with lower gastrointestinal bleeding and dyspeptic symptoms over the last six months. The colonoscopy showed a large tumor of the sigmoid and the gastroscopy a large gastric tumor of the antrum, which were histologically diagnosed as colonic adenocarcinoma and gastric stromal tumor respectively. The patient underwent a sigmoidectomy and a partial gastrectomy. Six months after surgery were the clinical condition, abdominal CT, gastroscopy and colonoscopy without pathological findings. To our best knowledge, this is the second report of a synchronous gastric stromal tumor and a colonic adenocarcinoma in medical literature.
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10.
[Cancer of an ectopic pancreas in the duodenal wall].
Abakar-Mahamat, A, Rahili, A, Saint-Paul, MC, Chevallier, P, Peroux, JL, Schneider, SM, Benchimol, D, Hébuterne, X
Gastroenterologie clinique et biologique. 2005;(2):201-3
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Abstract
Ectopic pancreas is defined as pancreatic tissue outside the normal location of the pancreas. It can be affected by the same complications as the orthotopic pancreas, such as adenocarcinoma. This extremely rare complication (only 14 published cases) may have a better prognosis that adenocarcinoma of an orthotopic pancreas. Endoscopic ultrasonography may be useful in the diagnosis of this disease. We report a case of malignancy of the duodenal wall originating in aberrant pancreatic tissue, and review the literature.