Letrozole is a drug used in the treatment of postmenopausal women with breast and ovarian tumours. There is no evidence in the literature indicating its use in treating gastric cancer. We present a 68 year old lady admitted from the emergency department with weight loss, malaise and anaemia. Investigations confirmed the presence of two different primary tumours in the left breast and the stomach. Following that this patient with oestrogen receptor positive breast cancer and oestrogen receptor negative gastric cancer was treated with letrozole for her breast cancer followed by a gastric resection. Independent histology by two pathologists pre-operatively diagnosed gastric adenocarcinoma. Post-operatively, independent analysis of the resected stomach, omentum and lymph nodes revealed no evidence of gastric cancer. Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer. Further studies are needed.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Emergencies ; Female ; Humans ; Lymph Nodes ; Nitriles ; Omentum ; Remission, Spontaneous ; Stomach ; Stomach Neoplasms ; Triazoles ; Weight Loss

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block.In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following nonrecurrent inguinal herniorrhaphy.

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block.In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following nonrecurrent inguinal herniorrhaphy.