Photodynamic therapy is a promising modality for the palliation of advanced upper gastrointestinal cancer and for the eradication of early neoplastic and pre-neoplastic lesions. It is based on the combination of a photosensitizer that is selectively localized in the target tissue and illumination of the lesion with visible light, resulting in photodamage and subsequent cell death. For early esophageal cancer, esophagectomy has been a standard modality of curative intent. However, accumulated data supports the possibility of PDT replacing surgery as a curative modality. We experienced a case of early esophageal cancer that recurred after esophagectomy. The patient was successfully treated with photodynamic therapy using porfimer sodium as a photosensitizer.
Endoscopy, Gastrointestinal ; Esophageal Neoplasms/*drug therapy/pathology/surgery ; *Esophagectomy ; Humans ; Male ; Middle Aged ; *Photochemotherapy ; Photosensitizing Agents/administration & dosage/*therapeutic use

Melanosis ilei is an extremely rare condition in which black pigment, consisted of aluminum, magnesium, or silicon, accumulate in the terminal ileal mucosa. Medical treatment with charcoal enhances the neutralization of the toxic material and elimination of many drugs. In addition, it has been used as a traditional remedy in some oriental countries to relieve chronic diarrhea, abdominal pain, or acute enterocolitis, which is made up carbon, oxygen, aluminum, magnesium, silicon, calcium, and palladium. Two patients taking the charcoal for a long time underwent a colonoscopy to evaluate chronic diarrhea or abdominal pain. The colonoscopy revealed a normal colonic mucosa and multiple geographic black-pigmented mucosal changes at the terminal ileum. Therefore, it was assumed that melanosis ilei can develop in patients with long-standing charcoal ingestion. To the best of our knowledge, this is the first case of melanosis ilei associated with the ingestion of charcoal.
Abdominal Pain ; Aluminum ; Calcium ; Carbon ; Charcoal ; Colon ; Colonoscopy ; Diarrhea ; Eating ; Enterocolitis ; Humans ; Ileum ; Magnesium ; Melanosis ; Mucous Membrane ; Oxygen ; Palladium