-
1.
Removal of Nasogastric Tube Accidentally Stitched to Roux-en-Y Oesophagojejunostomy Following a Radical Gastrectomy for Stomach Cancer: Case report and review of the literature.
Azzam, AZ, Azzam, KA, Amin, T
Sultan Qaboos University medical journal. 2018;(1):e110-e111
Abstract
Nasogastric tubes (NGTs) are important for feeding, stenting and decompression after gastrointestinal surgeries, particularly in the upper gastrointestinal tract. Resistance in the removal of a NGT is a rare surgical complication and may be due to a knot in the tube or a stitch anchoring the tube to an anastomosis. We report a 41-year-old male patient who was admitted to the King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia, in 2015 with stomach cancer. He underwent a radical total gastrectomy with a Roux-en-Y oesophagojejunostomy. One week after the surgery, removal of the NGT was attempted; however, this was very difficult and the proximal end of the tube was cut off as a temporary measure. Six weeks later, an upper gastrointestinal tract endoscopy revealed that the distal end of the NGT had been accidentally stitched to the Roux-en-Y oesophagojejunostomy. The stitch was removed and the rest of the NGT was successfully extracted using a snare.
-
2.
[Good Controlled Chylothorax in Gastric Carcinoma].
Tsuji, H, Hara, S, Urano, J, Samukawa, T, Makio, T, Sugiyama, Y, Hosoi, K, Ogiyama, H, Murayama, Y, Min, KY
Gan to kagaku ryoho. Cancer & chemotherapy. 2018;(10):1449-1451
Abstract
Chylothorax has been reported to be caused by accidental injuries in half of all cases in Japan, and < 10% of these cases have been associated with malignant tumors, including lymphoma. Chylothorax is a rare complication of gastric carcinoma. We successfully treated a 58-year-old man with gastric carcinoma, chylothorax, and ascites using a combination of talc pleurodesis and a lipid-limited diet. Case: A 58-year-old man with advanced stage of poorly differentiated gastric adenocarcinoma presented to our hospital with complaints of shortness of breath. Whole-body computerized tomographic images suggested massive pleural effusion and ascites. Examination of pleural fluid and ascites revealed elevated serum triacylglycerol levels of up to 913mg/dL with numerous free-floating cancer cells. Malignant chylothorax was diagnosed. A lipid-limited diet and octreotide were started, followed by talc pleurodesis for pleural effusion. The patient with controlled pleurisy died of gastric cancer on day 55 after pleurodesis.
-
3.
Localized amyloidosis of the stomach mimicking a superficial gastric cancer.
Kagawa, M, Fujino, Y, Muguruma, N, Murayama, N, Okamoto, K, Kitamura, S, Kimura, T, Kishi, K, Miyamoto, H, Uehara, H, et al
Clinical journal of gastroenterology. 2016;(3):109-13
Abstract
A 73-year-old man was referred to our hospital for further examination of a depressed lesion in the stomach found by cancer screening gastroscopy. A barium upper gastrointestinal series showed an area of irregular mucosa measuring 15 mm on the anterior wall of the gastric body. Esophagogastroduodenoscopy revealed a 15 mm depressed lesion on the anterior wall of the lower gastric body. We suspected an undifferentiated adenocarcinoma from the appearance and took some biopsies. However, histology of the specimens revealed amyloidal deposits in the submucosal layer without malignant findings. Congo red staining was positive for amyloidal protein and green birefringence was observed under polarized light microscopy. Congo red staining with prior potassium permanganate incubation confirmed the light chain (AL) amyloid type. There were no amyloid deposits in the colon or duodenum. Computed tomography of the chest, abdomen, and pelvis showed no remarkable findings. Thus, this case was diagnosed as a localized gastric amyloidosis characterized by AL type amyloid deposition in the mucosal or submucosal layer. As the clinical outcome of gastric AL amyloidosis seems favorable, this case is scheduled for periodic examination to recognize potential disease progression and has been stable for 2 years.
-
4.
Cronkhite-Canada syndrome: a rare case report and literature review.
Zhao, R, Huang, M, Banafea, O, Zhao, J, Cheng, L, Zou, K, Zhu, L
BMC gastroenterology. 2016;:23
Abstract
BACKGROUND Cronkhite-Canada Syndrome (CCS) is a rare non-inherited disease characterized by gastrointestinal polyposis and ectodermal abnormalities, the estimated incidence is about one per million. Recognizing and curing the disorder face great challenge. CASE PRESENTATION This report refers to a Chinese 52 year old man with gastrointestinal symptoms and ectodermal abnormalities. Gastrointestinal symptoms occurred without obvious cause, followed by ectodermal abnormalities after two months. In several hospitals, endoscopy examinations found numerous polypoid lesions in various sizes spreading over the stomach and the entire colon and rectum, histopathological examinations showed inflammatory and adenomatous polyp. In our hospital, both endoscopy and the contrast-enhanced computed tomography (CT) of small intestine showed gastrointestinal polyposis. Gastric antrum and the colon biopsy samples suggested hyperplastic and inflammatory polyp respectively. Endoscopic ultrasonography (EUS) suggested gastric wall thickening. Fujinnon intelligent color enhancement (FICE) revealed that the size of gastric glands pit varied, and vessels were visible. Confocal endoscope showed increased glandular epithelium layers. Magnifying narrow-band imaging endoscopy (ME-NBI) detected that pit pattern in the mucous of the polyp were regular and type III-IV of microvessels were seen. Biochemical investigations showed anemia, hypoalbuminemia and electrolyte disturbance. IgG, IgA and C3 decreased. Anti-ribosomal phosphoprotein is weak positive. The patient was given nutritional support treatment. Gstrointestinal symptoms and hyperpigmentation improved gradually. CONCLUSION The patient was ever hospitalized in four hospitals and was diagnosed with CCS after 8 months of gastrointestinal symptoms. So when encountering the patient with gastrointestinal polyposis and ectodermal abnormalities, try to take CCS into consideration. Due to its low incidence, no standard therapy regimen has been established so far. However, nutritional support treatment is of great significance.
-
5.
Intrahepatic bile duct adenoma mimicking hepatic metastasis: case report and review of the literature.
Takumi, K, Fukukura, Y, Nagasato, K, Nakajo, M, Natsugoe, S, Higashi, M
Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine. 2013;(2):141-5
Abstract
We present a case of bile duct adenoma that mimicked hepatic metastasis from gastric cancer. The adenoma exhibited prolonged enhancement on dynamic computed tomography, hyperintensity on diffusion-weighted imaging, and diminished uptake of superparamagnetic iron oxide and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid on magnetic resonance imaging, resembling those of adenocarcinomas. Knowledge of the imaging findings of this rare entity may aid correct diagnosis.
-
6.
[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.
-
7.
[Histological complete response in a case of advanced gastric endocrine carcinoma treated by irinotecan plus cisplatin].
Kirishima, T, Yoshinami, N, Marui, A, Matsuda, S, Takai, K, Motoyoshi, T, Yamashita, Y, Takaaki, J, Shintani, H, Mizumoto, M, et al
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology. 2009;(11):1616-24
Abstract
A 65-year-old man was admitted because of epigastralgia and body weight loss. A 50-mm tumor found at the lesser curvature of the gastric antrum was histologically diagnosed as endocrine carcinoma. A computed tomography (CT) scan showed liver metastasis and multiple lymph node metastasis. We started chemotherapy with irinotecan and cisplatin every 4 week. After three courses of treatment, the primary lesion was estimated PR, the metastasis CR, and the synthesis PR. Then we performed distal gastrectomy with lymph node dissection. Histological findings revealed no cancer cells.
-
8.
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.
-
9.
[Bone marrow infiltration as an early sign of gastric cancer].
Guerrero-Hernández, I, Hernández-Calleros, J, Weimersheimer-Sandoval, M, Montaño-Loza, A
Revista de gastroenterologia de Mexico. 2007;(3):236-9
Abstract
The symptomatic infiltration to bone marrow by gastric carcinoma is an extremely infrequent condition even so as an early manifestation. Very few reports exist in the worldwide literature about it. In this paper we report a case of a 47 years woman who was attended in our Institute because of the presence of thrombocytopenia, anaemia, fever involuntary weight loss and linfadenopathy, and also dyspepsia. Through her diagnostic evaluation the diagnosis of an occult gastric cancer was established. The aim of this report is to present the clinical, radiological and pathological characteristics of this unusual presentation of gastric cancer; and also we present a brief literature review of the cases that had been reported and their clinical implication.
-
10.
Metastatic head and neck carcinoma to a percutaneous endoscopic gastrostomy site.
Adelson, RT, Ducic, Y
Head & neck. 2005;(4):339-43
Abstract
BACKGROUND Percutaneous endoscopic gastrostomy (PEG) tube placement is a safe and widely accepted alternate route for enteral alimentation in the head and neck cancer patient population. Cancer metastatic to a PEG tube exit site is a rare but serious complication of this procedure. We sought to determine the route of spread responsible for PEG site metastases such that we may prevent further occurrences of this highly morbid condition. We also report a case of PEG site metastasis at our institution. METHODS We performed a MEDLINE search for the years 1962 to 2002 and conducted a review of the literature. In the case at our institution, a 63-year-old man was referred to our institution with recurrent squamous cell carcinoma of the right base of tongue; he also had a 1.5-cm left apical lung nodule. He underwent PEG tube placement at the time of staging panendoscopy. Six months after the original tube placement, he had an ulcerated mass develop at the PEG site; biopsy of the mass revealed squamous cell carcinoma histologically identical to the base of tongue tumor. He also had recurrent lung cancer and four hepatic lesions develop. RESULTS In our MEDLINE search, of the five patients diagnosed with PEG site disease >10 months after PEG placement, all five (100%) had synchronous distant metastatic disease. In the group of patients diagnosed with PEG site metastases < or =10 months after PEG placement, only four (24%) of 17 had synchronous distant metastatic disease. All patients underwent PEG placement by means of the "pull" technique. Direct implantation with a variable-sized initial tumor burden can explain all cases of PEG site metastasis. The presence of distant metastases is representative of the natural history of advanced head and neck malignancies. Smaller initial tumor implants present later than would larger initial tumor burdens, when the patient is more likely to have distant metastatic disease. In the case at our institution, the patient did not respond to treatment for his hepatic and PEG site metastases and his lung cancer, and he died 4 months after detection of the PEG site metastasis. CONCLUSIONS PEG site metastases are iatrogenic complications of PEG tube placement in patients with squamous cell carcinoma of the upper aerodigestive tract. The use of laparoscopic, open, or the "push" technique of PEG tube placement in patients with head and neck cancer may prevent direct implantation of malignant cells into an enteral access site.