Thrombocytopenia is frequently seen in patients with multiple myeloma when most often the etiology is either chemotherapy induced marrow suppression or bone marrow replacement by myeloma cells. But immune thrombocytopenia has only rarely been documented in patients with multiple myeloma. Also ascites caused by peritoneal infiltration with myeloma cell rarely develops in patients with multiple myeloma. We report a patient with nonsecretory multiple myeloma associated with immune thrombocytopenia and complicated by malignant ascites and periumbilical nodules.
Ascites* ; Bone Marrow ; Drug Therapy ; Humans ; Multiple Myeloma* ; Thrombocytopenia*

Humans ; Tolvaptan/therapeutic use* ; Ascites/drug therapy* ; Receptors, Vasopressin ; Liver Cirrhosis/drug therapy* ; Sodium

Chylous effusion is an unusual complication of malignant neoplasm, usually lymphoma. In cases with cancer, the tumor was usually extensive, and the prognosis was invariably poor with a one year mortality rate of 80%. It was also reported that chylous effusion could also result from liver cirrhosis. The incidence of this complication was reported to be 0.5% in patients with liver cirrhosis and ascites. Here we report a case of 62 year old male with chronic alcoholism history who presented with abdom-inal distension and right cervical mass. He was subsequently diagnosed as non-Hodgkin's lymphoma and chylous ascites with liver cirrhosis and treated with chemotherapy. In spite of treatment, lymphoma progressed and the patient expired.
Alcoholism ; Ascites ; Chylous Ascites* ; Drug Therapy ; Humans ; Incidence ; Liver Cirrhosis* ; Liver* ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Male ; Middle Aged ; Mortality ; Prognosis

OBJECTIVE: The purpose of this study was to determine the significance of preoperative serum CA-125 level of primary epithelial ovarian carcinoma with respect to prognostic factors (histologic grade, tumor stage, success of cytoreductive operation) and to assess the relationship between the changes of serum CA-125 level and 5-year survival rate after the cytoreductive operation and chemotherapy. METHODS: We retrospectively investigated the results of 101 patients with primary epithelial ovarian cancer staged over IC, who had been diagnosed and treated at Kyung-Hee University Medical Center from January 1991 to April 2003. They were managed with cytoreductive operation and chemotherpy. They were monitored by serum CA-125 level serially during treatments. RESULTS: There were significant differences of preoperative serum CA-125 level in histologic types, histologic grades, presence of ascites, presence of lymph node involvement, success of cytoreduction and success of 5-year survival (P<0.05). But no difference was found in FIGO stage (P>0.05). There were significant differences of 5-year survival rate in groups divided by pre- and postoperation serum CA-125 level (P<0.05). And significant differences were shown between serum CA-125 values and 5-year survival rate in three cycles of chemotherapy (P<0.05). CONCLUSION: Serum CA-125 level is a valid tumor marker in predicting the responsiveness of cytoreduction and combined chemotherapy in epithelial ovarian cancer. Measurement of serum CA-125 levels during treatment might permit an early change to optimal forms of therapeutic management or alternatives.
Academic Medical Centers ; Ascites ; Drug Therapy ; Humans ; Lymph Nodes ; Ovarian Neoplasms* ; Retrospective Studies ; Survival Rate

Endometrial stromal sarcoma (ESS) that arises from extrauterine endometriosis is a rare form of malignancy. We report the case of a 37-year-old ESS patient with extrauterine endometriosis who was treated with ifosfamide/cisplatin chemotherapy. A woman presented with epigastric pain and abdominal distension. Computed tomography imaging revealed a profuse amount of ascites, including a 12.4x12.3 cm sized posterior cul-de-sac mass composed of solid and cystic components. Cytoreductive surgery was performed to remove the mass and the histopathologic findings indicated ESS associated with extrauterine endometriosis. Six cycles of combination chemotherapy [ifosfamide (5 g/m(2)) with mesna (1 g/m(2)) and cisplatin (50 mg/m(2)) (IP)] were administered. After a six-month of disease-free interval, recurrent ESS developed in the pelvic cavity and in both lung fields. Megace medication decreased tumor marker CA-125 for six weeks. However, the patient expired sixteen months after the cytoreductive surgery. ESS associated with extrauterine endometriosis showed response to IP chemotherapy and megace.
Adult ; Ascites ; Cisplatin ; Drug Therapy, Combination ; Endometriosis ; Female ; Humans ; Lung ; Megestrol Acetate ; Mesna ; Sarcoma, Endometrial Stromal

OBJECTIVE: The purpose of this study was to compare the survival of patients with pseudomyxoma peritonei (PMP) according to the modalities of treatment and find out the prognostic factors by evaluating clinical variables. METHODS: Thirty one patients were treated at Seoul National University Hospital between May 1995 and May 2005. The clinical data were collected retrospectively and all charts were reviewed. Kaplan-Meier survival analyses with low-rank test were performed for the comparison of survival according to clinical variables, and univariate and multivariate Cox regression analyses were performed for finding out the prognostic factors of PMP. RESULTS: The mean age at diagnosis was 60.9 years and the mean survival (MS) was 25 months. The recurrence rate was 46.7 % and the disease free survival (DFS) till recurrence was 22.6 months. The prognostic factors affecting DFS were histology, FIGO stage, ascites, CA 125, residual disease in 1st and last operations by univariate analyses, but only FIGO stage was the statistically significant prognostic factor by multivariate analysis. Surgical treatment combined with chemotherapy (intraperitoneal or adjuvant) improved MS more than surgical treatment alone by univariate analysis. CONCLUSION: FIGO stage is a prognostic factor that can predict the DFS in patients with PMP. Histology, CA 125, ascites, residual disease may be probably prognostic factors associated with DFS. Surgical treatment combined with chemotherapy is more effective than surgical treatment alone for the treatment of PMP.
Ascites ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Humans ; Multivariate Analysis ; Pseudomyxoma Peritonei* ; Recurrence ; Retrospective Studies ; Seoul

OBJECTIVE: The purpose of this study was to compare the survival of patients with pseudomyxoma peritonei (PMP) according to the modalities of treatment and find out the prognostic factors by evaluating clinical variables. METHODS: Thirty one patients were treated at Seoul National University Hospital between May 1995 and May 2005. The clinical data were collected retrospectively and all charts were reviewed. Kaplan-Meier survival analyses with low-rank test were performed for the comparison of survival according to clinical variables, and univariate and multivariate Cox regression analyses were performed for finding out the prognostic factors of PMP. RESULTS: The mean age at diagnosis was 60.9 years and the mean survival (MS) was 25 months. The recurrence rate was 46.7 % and the disease free survival (DFS) till recurrence was 22.6 months. The prognostic factors affecting DFS were histology, FIGO stage, ascites, CA 125, residual disease in 1st and last operations by univariate analyses, but only FIGO stage was the statistically significant prognostic factor by multivariate analysis. Surgical treatment combined with chemotherapy (intraperitoneal or adjuvant) improved MS more than surgical treatment alone by univariate analysis. CONCLUSION: FIGO stage is a prognostic factor that can predict the DFS in patients with PMP. Histology, CA 125, ascites, residual disease may be probably prognostic factors associated with DFS. Surgical treatment combined with chemotherapy is more effective than surgical treatment alone for the treatment of PMP.
Ascites ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Humans ; Multivariate Analysis ; Pseudomyxoma Peritonei* ; Recurrence ; Retrospective Studies ; Seoul

PURPOSE: More than half the Korean gastric cancer patients are diagnosed at a late stage. An understanding of the clinicopathological characteristics of advanced cases is warranted, especially in order to give tailor-made treatments. METHODS: Ninety-five Borrmann type 4 gastric cancer patients, who received surgical treatment at the Department of Surgery, Hanyang University Hospital during the period between June 1992 and December 2001, were enrolled in this study. Several clinicopathological profiles of these Borrmann type 4 gastric cancers were compared to those of Borrmann types 1, 2, and 3. Thereafter, univariate and multivariate survival analyses on the type 4 were performed. RESULTS: Compared to the other macroscopic types, Borrmann type 4 gastric cancer patients showed several significant features: as for clinicopathological factors; there was a prominence of female, young-aged patients, a larger tumor size, higher rates of entire stomach cancer and late stage cases, and as for treatment-related factors; there was a higher rate of non-resection cases, combined organ resections, positive marginal state, non-curatively treated case, and more postoperative complications. The prognosis of Borrmann type 4 gastric cancer was found to differ according to the type of operation, depth of invasion, nodal status, distant metastasis, and curability (P=0.0000) from the univariate survival analysis. No independent prognostic factor was found from the multivariate survival analysis. CONCLUSION: The majority of Borrmann type 4 gastric cancer are diagnosed at a late stage, which results in a poor prognosis. To improve the curability of the operation, combined organ resection should be considered, when feasible. There were no long-term survivors in the cases with peritoneal seeding or malignant ascites. It is for these cases that we have to exert our efforts, in order to improve their QOL, but not from over-surgery or intensive chemotherapy.
Ascites ; Drug Therapy ; Female ; Humans ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Stomach Neoplasms* ; Survivors

This study aims to explore the effects of chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar on the diversity of gut microbiota in the rat model of malignant ascites, identify the key differential microbial taxa, and reveal the biological mechanism of water-expelling effect of the two chemical ingredient groups. The rat model of malignant ascites induced by Walker-256 cells was established, and phenolphthalein was used as the positive drug. The rats were orally administrated with corresponding agents for consecutive 7 days. On day 6, fresh feces samples were collected from the rats, and 16 S rDNA high-throughput sequencing and GC-MS were employed to determine the composition of gut microbiota and the content of short-chain fatty acids, respectively. On day 7, serum and intestinal tissue samples were collected for the determination of related indicators. Compared with the control group, the model group showed decreased feces volume and urine volume(P<0.01), increased volume of ascites and levels of Na~+, K~+, and Cl~- in urine(P<0.01), down-regulated mRNA and protein levels of intestinal AQP8(P<0.01), lowered abundance of beneficial Lactobacillus(P<0.01) while risen abundance of potential pathogenic Lachnospiraceae and Anaeroplasma(P<0.01), and reduced content of short-chain fatty acids(P<0.01). Compared with the model group, administration with chemical ingredient groups B and C alleviated all the above indicators(P<0.01). In conclusion, chemical ingredient groups B and C in Kansui Radix stir-fried with vinegar could alleviate the disordered gut microbiota in rats with malignant ascites to expel water through increasing the abundance of beneficial Lactobacillus and reducing the abundance of harmful Lachnospiraceae and Anaeroplasma. This study can provide a reference for the reasonable clinical application of Kansui Radix stir-fried with vinegar.
Acetic Acid/chemistry* ; Animals ; Ascites/drug therapy* ; Euphorbia/chemistry* ; Gastrointestinal Microbiome ; Plant Roots/chemistry* ; Rats

Adult ; Aged ; Ascites ; drug therapy ; etiology ; therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; complications