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Skull metastasis from hepatocellular carcinoma with chronic hepatitis B

World Journal of Gastrointestinal Oncology 2010年第3期2卷 165-168页

作者： Takashi Goto Takahiro Dohmen Kouichi Miura Shigetoshi Ohshima kazuo yoneyama Tomomi Shibuya Ei Kataoka Daisuke Segawa Wataru Sato Yumiko Anezaki Hajime Ishii Daigo Kon Ikuhiro Yamada Kentaro Kamada Hirohide Ohnishi Department of Gastroenterology Akita University School of Medicine

A 56-year-old male visited our hospital for evaluation of an occipital *** computed tomography showed hypervascular enhancement with osteolytic change in the skull and a huge enhanced mass in the *** resonance imaging showed bone metastasis in the thoracic *** for hepatitis B surface antigen and hepatitis B core antibody were positive and his liver condition was Child-Pugh grade *** diagnosis was hepatocellular carcinoma(HCC) with skull and vertebrae metastases on chronic hepatitis *** was treated with radiation therapy for bone metastases and transcatheter arterial chemoembolization for *** he developed acute respiratory failure because of aspiration pneumonia,congestion and oedema with haemorrhage of the lungs and *** showed HCC with multiple bone *** liver tumor was categorized as well-differentiated HCC,Edmondson classification Ⅰ,trabecular type and pseudoglandular *** the liver mild infiltration of lymphocytes was seen in Glisson's capsules which were signif icantly enlarged with well preserved limiting *** necrosis was not *** fibrosis was *** 8 cm × 7 cm × 3 cm metastatic lesion had formed in the left occipitotemporal part of the cranial *** lesion was osteolytic and showed invasion into the dura *** the subdural cavity nor the brain showed involvement from the metastatic ***,skull metastasis from HCC is very rare and it affects the patient's prognosis and the quality of ***,it is very important to make an early diagnosis and carry out proper management of skull metastasis from HCC.

关键词： Hepatocellular carcinoma Skull metastasis Bone metastasis Osteolytic change Chronic hepatitis B

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Unresectable esophageal cancer treated with multiple chemotherapies in combination with chemoradiotherapy:A case report

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World Journal of Clinical Cases 2021年第12期9卷 2801-2810页

作者： Masahiro Yura kazuo Koyanagi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu yoneyama Yoshifumi Tamai Reiko Dehari Motohito Nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Radiology Hiratsuka City HospitalKanagawa 2540065Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Definitive chemoradiotherapy(dCRT)using cisplatin plus 5fluorouracil(CF)with radiation is considered the standard treatment for unresectable locally advanced T4 esophageal squamous cell carcinoma(ESCC).Recently,induction chemotherapy has received attention as an effective treatment *** SUMMARY We report a successful case of a 59-year-old female with unresectable locally advanced T4 ESCC treated by two additional courses of chemotherapy with CF after induction chemotherapy with docetaxel,cisplatin and fluorouracil(DCF)followed by *** esophagogastroduodenoscopy(EGD)detected a type 2 advanced lesion located on the middle part of the esophagus,with *** tomography detected the primary tumor with suspected invasion of the left bronchus and 90°of direct contact with the aorta,and upper mediastinal lymph node *** findings from biopsy revealed squamous cell *** initially performed induction chemotherapy using three courses of DCF,but the lesion was still evaluated unresectable after DCF ***,we subsequently performed dCRT treatment(CF and radiation).After dCRT,prominent reduction of the primary tumor was recognized but a residual tumor with ulceration was detected by *** the patient had some surgical risk,we performed two additional courses of CF and achieved a clinically complete *** 14 mo from last administration of CF chemotherapy,recurrence has not been detected by computed tomography and EGD,and biopsy from the scar formation has revealed no cancer *** We report successful case with tumor remnants even after DCF and subsequent dCRT,for whom a complete response was finally achieved with two additional courses of CF *** CF chemotherapy could be one radical treatment option for residual ESCC after treatment with induction DCF followed by dCRT to avoid salvage surgery,especially for high-risk patients.

关键词： Unresectable esophageal cancer Induction docetaxel,cisplatin and fluorouracil Chemoradiotherapy Complete response Additional chemotherapy Case report

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Pancreaticoduodenectomy after neoadjuvant chemotherapy for gastric cancer invading the pancreatic head:A case report

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World Journal of Gastroenterology 2021年第6期27卷 534-544页

作者： Masahiro Yura Kiminori Takano Kiyohiko Adachi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Yoichiro Ikoma Hiroto Fujisaki Akira Hirata Kumiko Hongo Kikuo Yo Kimiyasu yoneyama Reiko Dehari kazuo Koyanagi Motohito Nakagawa Department of Surgery Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Surgical Pathology Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 259193KanagawaJapan

BACKGROUND Pancreaticoduodenectomy(PD)for advanced gastric cancer is rarely performed because of the high morbidity and mortality rates and low survival ***,neoadjuvant chemotherapy for advanced gastric cancer has improved,and chemotherapy combined with trastuzumab may have a preoperative tumorreducing effect,especially for human epidermal growth factor receptor 2(HER2)-positive *** SUMMARY We report a case of successful radical resection with PD after neoadjuvant S-1 plus oxaliplatin(SOX)and trastuzumab in a patient(66-year-old male)with advanced gastric cancer invading the pancreatic *** esophagogastroduodenoscopy detected a type 3 advanced lesion located on the lower part of the stomach obstructing the pyloric *** tomography detected lymph node metastasis and tumor invasion to the pancreatic head without distant *** findings revealed adenocarcinoma and HER2 positivity(immunohistochemical score of 3+).We performed staging laparoscopy and confirmed no liver metastasis,no dissemination,negative lavage cytological findings,and immobility of the distal side of the stomach due to invasion to the *** gastrojejunostomy was performed at that *** course of SOX and three courses of SOX plus trastuzumab were *** computed tomography showed partial response;therefore,PD was performed after neoadjuvant chemotherapy,and pathological radical resection was *** We suggest that radical resection with PD after neoadjuvant chemotherapy plus trastuzumab is an option for locally advanced HER2-positive gastric cancer invading the pancreatic head in the absence of non-curative factors.

关键词： Pancreaticoduodenectomy Gastric cancer Neoadjuvant chemotherapy Trastuzumab Human epidermal growth factor receptor 2 Case report

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Distal gastric tube resection with vascular preservation for gastric tube cancer:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2020年第9期12卷 397-406页

作者： Masahiro Yura kazuo Koyanagi Kiyohiko Adachi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu yoneyama Reiko Dehari Motohito Nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Survival rates in patients with esophageal cancer undergoing esophagectomy have improved,but the prevalence of gastric tube cancer(GTC)has also *** resection of the gastric tube with lymph node dissection is considered a radical treatment,but GTC surgery is more invasive and involves a higher risk of severe complications or death,particularly in elderly *** SUMMARY We report an elderly patient with early GTC that had invaded the duodenum who was successfully treated with resection of the distal gastric tube and Roux-en-Y(R-Y)*** tumor was a type 0-IIc lesion with ulcer scars surrounding the pyloric *** submucosal resection was not indicated because the primary lesion was submucosally invasive,was undifferentiated type,surrounded the pyloric ring,and had invaded the *** of distal gastric tube with R-Y reconstruction was safely performed,with preservation of the right gastroepiploic artery(RGEA)and right gastric artery(RGA).CONCLUSION Distal resection of the gastric tube with preservation of the RGEA and RGA is a good treatment option for elderly patients with cT1bN0 GTC in the lower part of the gastric tube.

关键词： Gastric tube cancer Distal resection Preservation of right gastroepiploic artery and right gastric artery Elderly patients Duodenal invasion Case report Posterior mediastinal reconstruction

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