Japanese Journal of Cancer and Chemotherapy最新文献

Esophageal metastasis from breast cancer is rare and seldom diagnosed before death, with no established standard treatment. We report 3 cases managed at our institution. Case 1:A 78-year-old woman previously underwent surgery for invasive ductal carcinoma(ER+, PgR+, HER2-)at the age of 65. Eight years postoperatively, the first recurrence occurred, followed by progressive dysphagia 5 years later, leading to the diagnosis of esophageal metastasis. Case 2:A 63-year-old woman had surgery at age 48 for invasive ductal carcinoma(ER+, PgR+, HER2-). Fourteen years postoperatively, she experienced a recurrence, and 1 month later, rapidly progressive dysphagia developed, resulting in the diagnosis of esophageal metastasis. Case 3:An 81-year-old woman was diagnosed with stage Ⅳ(bone)invasive ductal carcinoma(ER+, PgR+, HER2-)at age 73. After 8 years of systemic treatment, esophageal metastasis was diagnosed. In Cases 1 and 3, radiation therapy was selected, leading to symptomatic improvement and maintenance of oral intake until death. In contrast, Case 2, complicated by interstitial pneumonia, was treated with chemotherapy, but symptoms did not improve, and the patient remained unable to take food orally until death.

A woman in her seventies presented with mucous hematochezia. Colonoscopy revealed a poorly differentiated adenocarcinoma in the upper rectum. Immunohistochemical staining showed CK7 positivity and CK20/CDX2 negativity, findings atypical for primary colorectal carcinoma. Contrast-enhanced CT and pelvic MRI demonstrated circumferential thickening of the rectal wall with an adjacent multilocular cystic lesion, raising suspicion of an endometriosis-associated intestinal tumor (EAIT). Laparoscopic low anterior resection with D3 lymphadenectomy was performed along with total hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination revealed submucosal adenocarcinoma with CD10-positive endometrial stromal cells surrounding the tumor, consistent with EAIT. The patient received 6 courses of adjuvant chemotherapy with docetaxel and carboplatin. No recurrence has been detected during 3 years and 9 months of postoperative follow-up. This case may provide valuable insight into the diagnosis and multidisciplinary management of this uncommon disease.

Gastric metastasis of breast cancer is clinically rare and its diagnosis is often delayed because of the difficulty in differentiating it from primary gastric cancer. Here, we report a case of gastric metastasis identified 12 years after surgery for left-sided breast cancer. Gastrointestinal symptoms prompted an upper gastrointestinal endoscopy, which revealed an elevated gastric lesion. Immunohistochemical staining of the lesion showed positivity for CK7, GATA-3, mammaglobin, and GCDFP-15, and negativity for CK20, leading to the diagnosis of gastric metastasis from breast cancer. When gastrointestinal symptoms occur in patients with a history of breast cancer, it is important to consider gastric metastasis in the differential diagnosis and perform a thorough evaluation, including immunohistochemical analysis.

Aging is one of the most significant risk factors for various diseases, including cancer, cardiovascular diseases, and neurological disorders. Cellular senescence, one of the factors regulating aging, is induced by DNA damage and oxidative stress, and is characterized by irreversible cell cycle arrest and excessive secretion of pro-inflammatory cytokines. The secretion of inflammatory factors induces chronic inflammation in the microenvironment of tissues and organs, potentially leading to the development of various geriatric diseases and age-related functional deterioration of organs. In this context,"senolysis," the selective elimination of senescent or other inflammation-inducing cells, has emerged as a promising strategy to suppress chronic inflammation. Additionally,"senomorphics,"which aim to suppress inflammatory factors secreted by these cells, are also under investigation. These approaches are expected to help prevent the onset of age-related diseases and extend healthy lifespan. However, several challenges remain, including the heterogeneity of inflammation-inducing cells and the potential disruption of beneficial processes such as tissue repair. Therefore, the stratification of target inflammation-inducing cell populations is a key issue for future research.

A 70s-year-old woman was diagnosed with advanced transverse colon cancer with an invasion of the duodenum, pancreas and liver. Pre-operative diagnosis was cT4b(the duodenum, pancreas and liver), N1b, M0, cStage Ⅲc. Neoadjuvant chemotherapy was performed for R0 resection. Since the tumor shrank, radical resection(R0)was performed. The standard treatment for resectable advanced colon cancer is surgical therapy in JSCCR Guidelines 2024 for the Treatment of Colorectal Cancer. On the other hand, neoadjuvant chemotherapy for locally advanced colon cancer is reported to contribute to prolong prognosis by increasing the proportion of R0 resection. Our hospital has a policy of neoadjuvant chemotherapy followed by surgical treatment for T4b cases, and the same policy was applied to this case. A successful case of R0 resection after neoadjuvant chemotherapy for advanced transverse colon cancer with invasion of the duodenum, pancreas and liver is reported.

We report here for the first time a case of laparoscopic completion gastrectomy for pouch dysfunction after proximal gastrectomy. The patient was a man in his 60s. Ten years ago, he underwent a proximal gastrectomy and jejunal pouch interposition for gastric cancer. Although there had been no recurrence, a health check revealed malnutrition, and he was referred to our hospital with a diagnosis of ileus due to jejunal pouch dysfunction. He had a functional obstruction due to the dilation of the jejunal pouch and food retention and also had reflux esophagitis(LA classification:Gr D). As he had severe nutritional disorders(BMI 13.2, ALB 2.1 g/dL), he underwent laparoscopic enterostomy, and nutritional therapy for approximately 6 months. After which, he underwent laparoscopic completion gastrectomy and jejunal pouch resection. A Roux-en- Y reconstruction was performed, and a jejuno-jejunal anastomosis was performed by preserving part of the interposed jejunum. He was discharged on the 13th day after surgery with oral intake. Five years after surgery, the patient's BMI had increased to 19.7, and reflux esophagitis had improved to Gr M. In patients expected to survive long-term after gastrectomy, the occurrence of jejunal pouch dysfunction must be considered.

A 60's man was admitted with melena. A colonoscopy was detected lower rectal cancer, and a enhanced CT scan revealed invasion of the prostate and enlarged left lateral lymph node. Total neoadjuvant therapy(TNT)considered of preoperative 7 courses of CAPOX followed by 5 Gy×5 short course RT, after treatment PET-MRI showed shrinkage of the tumor and left lateral lymph node, but invasion of the prostate was remained, preoperative diagnosis was ycT4b(AI:prostate) N3M0, ycStage Ⅲc. In collaboration with urologists, robot-assisted abdominoperineal resection with en bloc prostatec t omy and left lateral lymph dissection was performed. He exhibited a good post operative course and was discharged on the 17th postoperative day. Pathological examination revealed no tumor invasion into prostate and any lymph node metastasis, ypT3N0M0, ypStage Ⅱa.

Background: Primary intraosseous carcinoma(IOC)is a rare malignancy originating from the epithelial lining of odontogenic cysts. We present a case of IOC arising from an odontogenic cyst in the mandible.

Case: A 51-year-old man presented to a general hospital with limited mouth opening. Initial anti-inflammatory treatment was administered for a presumed secondary infected mandibular odontogenic cyst;however, symptoms persisted. Subsequent biopsy revealed squamous cell carcinoma, prompting referred to our department for multidisciplinary management. Various examinations were performed, and the patient was diagnosed with a primary intraosseous carcinoma arising from a mandibular odontogenic cyst. Chemoradiotherapy was planned for this patient with unresectable locally advanced cancer. Three courses of induction chemotherapy were administered, followed by radiation therapy to the primary tumor and bilateral cervical areas(total 72 Gy)with cetuximab(Cmab). Cmab was continued post-radiation;however, the patient failed to respond to treatment and died 1 year and 2 months post-treatment initiation.

Discussion: Primary IOCs are challenging to distinguish from odontogenic cysts. This highlights the importance of definitive diagnosis and early intervention.

We report a rare case of subcutaneous local recurrence of cecal cancer with subcutaneous abscess formation, successfully managed by additional resection. An 86-year-old woman underwent ileocecal resection with partial peritoneal resection for cecal adenocarcinoma complicated by a subcutaneous abscess. Postoperative chemotherapy was administered, and the patient was followed up regularly. Five months later, a painful subcutaneous mass appeared in the right lower quadrant. Imaging studies, including CT and PET-CT, indicated subcutaneous local recurrence. Surgical excision was performed due to symptom progression. Histopathological and immunohistochemical findings confirmed recurrent adenocarcinoma of cecal origin. The patient has remained recurrence-free for 17 months.

We reported a case of sigmoid colon cancer with rectal intussusception. An 82-year-old woman had anal prolapse. Results of the examination, it was a diagnosis of sigmoid colon cancer with rectal intussusception. The tumor was then repositioned. Based on the above, robotic sigmoidectomy with D3 dissection of lymph nodes was performed. The histopathological diagnosis demonstrated double sigmoid colon cancers and no ischemic change of colon. She has not recurred 16 months later after operation.