Journal of gastrointestinal oncology最新文献

Background: Epstein-Barr virus-positive (EBV⁺) inflammatory follicular dendritic cell sarcoma (IFDCS) is a rare stroma-derived neoplasm of lymphoid tissues. It typically involves the spleen and liver, and is often associated with the presence of EBV. Because of its nonspecific clinical and imaging findings, making a correct diagnosis at the time of initial diagnosis is challenging. Therefore, we report this misdiagnosis case in order to help decrease the rate of making wrong diagnoses in the future.

Case description: We report a case of 71-year-old woman in whom a splenic space-occupying lesion was incidentally found during a chest computed tomography (CT) scan. After laparoscopic partial splenectomy and histopathological examination, the lesion was diagnosed as splenic EBV⁺ IFDCS.

Conclusions: EBV⁺ IFDCS is an extremely uncommon tumor. To date, there are no well-recognized imaging features for EBV⁺ IFDCS. We report a case of EBV⁺ IFDCS and focus on its imaging characteristics. The magnetic resonance imaging (MRI) of the lesion in this case report shows nodular enhancement in the arterial and portal phase and reversal enhancement in the delayed phase. This is a new enhancement pattern that has not been previously reported. Nonetheless, at present, the definitive diagnosis still relies on histopathological and immunohistochemical staining. By sharing this case, we aim to improve awareness of this rare entity and its imaging manifestations, which may aid in earlier and more accurate diagnosis.

Background: Metastasis of non-gastrointestinal (non-GI) cancers to the upper GI tract is a rare occurrence, with limited cases reported in the literature. Recognising this type of metastasis is crucial, as it presents unique diagnostic and therapeutic challenges. This case series adds to the literature by discussing seven rare cases of non-GI cancer metastasising to the upper GI tract, emphasising the complications and clinical manifestations. These cases highlight the importance of early recognition and interdisciplinary management to optimise patient outcomes.

Case description: This retrospective series spans from 2016 to 2024 and includes seven consecutive patients from a tertiary hospital. The primary cancers include renal clear cell carcinoma, non-small cell lung cancer, prostate cancer, and melanoma. Each patient presented with unique patterns of metastasis to the GI tract, manifesting as complications such as upper GI bleeding, melaena, bowel perforation, abdominal pain and weight loss. Interventions ranged from gastroscopy and biopsy to surgical resection, and outcomes varied from disease control to progression with palliative interventions and fatality in some cases, despite targeted treatments. Follow-up of some of the cases highlights the difficulties in managing recurrent bleeding and perforation in these patients.

Conclusions: Metastasis of non-GI primary tumours to the upper GI tract-although rare, requires clinicians to maintain a high index of suspicion when encountering unexplained GI symptoms in patients with a history of malignancy. This case series highlights the diverse presentations and complications of upper GI metastasis from non-GI cancers and underscores the need for personalised management strategies. Early recognition and tailored interventions can improve patient outcomes and reduce morbidity.

Background: Tumor deposits (TDs) can impact proper staging of cancer, which is crucial for discussing prognosis and determining the appropriate treatment plan. Our study aimed to correlate how TDs influence prognosis of resected colorectal cancer (CRC) and how to optimize tumor-node-metastasis (TNM) staging with respect to TDs for clinical decision-making.

Methods: A retrospective analysis was performed on 611 patients with CRC treated in Jiangsu Cancer Hospital from January 1, 2010 to December 31, 2020 among whom 197 had TDs. The influence and distribution characteristics of TDs on the median overall survival (mOS) of patients with CRC were quantitatively and qualitatively analyzed, and the differences in mOS between different subgroups were also analyzed.

Results: Patients with TDs had a shorter mOS (only 60.3±3.9 months) than did patients without TDs. TDs had a more significant association with the survival of M0 patients, and there were significant differences in the prognosis of M0 patients with stage pN0 and pN1c or stage pN0, pN1, and pN2. The combination of lymph node metastases (LNMs) and TDs was associated with mOS. The proportion of rectal cancer, papillary tissue type, and nerve invasion was higher in the TD-positive group, and proportion of metastasis to the brain, spleen, lung, and bone in this groups was also higher. Subgroup analysis showed that the degree of tumor differentiation, the depth of tumor invasion, vascular invasion, nerve invasion, liver metastasis, lung metastasis, bone metastasis, peritoneal metastasis, ovarian metastasis, pelvic and abdominal metastasis, and the number of distant metastases were associated with the prognosis of patients with CRC.

Conclusions: TDs were closely correlated with the poor prognosis of patients with CRC. Greater attention should be paid to improving the quality of pathological reports in clinical decision-making and the comprehensive assessment of patients' baseline characteristics so that accurate prognosis and corresponding treatment plan can be properly communicated with patients.

[This corrects the article DOI: 10.21037/jgo-20-474.].

Background: Colorectal metastasis from gastric cancer is very rare, with existing literature limited to only a few case reports. This study was designed to investigate the clinicopathological features and prognosis of colorectal metastasis arising from gastric cancer.

Methods: Patients with colorectal metastasis from gastric cancer who underwent surgical intervention at a single tertiary hospital between January 2010 and June 2023 were included, and their clinicopathological characteristics and oncologic outcomes were analyzed.

Results: A total of 13 patients were identified and analyzed. The majority (92.3%) experienced metachronous metastasis, with a median disease-free interval of 34.5 months (range, 16-92 months). Surgical resection was performed in 10 patients (76.9%), while the remaining 3 (23.1%) underwent diverting enterostomy. Histopathology revealed that the metastatic colorectal tumors were poorly differentiated adenocarcinoma (76.9%) or signet ring cell carcinoma (23.1%). Among the 10 patients undergoing surgical resection, 5 (50.0%) achieved R0 resection, while the others had R2 resection. After a median follow-up of 11 months (range, 0-158 months), the 2-year overall survival (OS) was 18.5%. Postoperative chemotherapy was significantly associated with improved 2-year OS (26.7% vs. 0.0%, P=0.008), and R0 resection trended toward improved 2-year OS (37.5% vs. 12.5%, P=0.17). Notably, one patient who received R0 resection and chemotherapy survived for 158 months.

Conclusions: Colorectal metastasis from gastric cancer demonstrated unfavorable histological features and a poor OS. Nonetheless, the pursuit of R0 resection and postoperative chemotherapy appears to hold significance, suggesting a potential avenue for improved outcomes.