We report the case of a patient with gastric adenocarcinoma with multiple liver metastases. This patient showed complete remission for more than 68 months after S-1/cisplatin combination chemotherapy and radical total gastrectomy. The patient, a 63-year-old man, presented with dyspepsia and difficulty in swallowing. Endoscopic findings showed a huge ulcero-infiltrative mass at the lesser curvature of the mid-body, extending to the distal esophagus. Biopsy revealed a poorly differentiated tubular adenocarcinoma. An abdominal computed tomography scan demonstrated multiple hepatic metastases. S-1/cisplatin combination chemotherapy was initiated, and following completion of six cycles of chemotherapy, the gastric masses and hepatic metastatic lesions had disappeared on abdominal computed tomography. Radical total gastrectomy and D2 lymphadenectomy combined with splenectomy were performed. The patient underwent three cycles of S-1/cisplatin combination chemotherapy followed by tegafur-uracil therapy for 1 year. He remained in complete remission for more than 68 months after surgery.
Adenocarcinoma* ; Biopsy ; Cisplatin ; Deglutition ; Drug Therapy ; Drug Therapy, Combination ; Dyspepsia ; Esophagus ; Gastrectomy ; Humans ; Liver* ; Lymph Node Excision ; Middle Aged ; Neoplasm Metastasis* ; Splenectomy ; Stomach Neoplasms

Neuroendocrine carcinoma of colon is a rare disease entity that is histologically poorly differentiated and immunochemically synaptophysin positive, enabling it to be confirmed by an immunohistochemical stain. Neuroendocrine carcinomas, in almost all cases, have poor prognosis due to a tendency of early metastasis and lack of standardized treatment. The concurrent diagnosis of neuroendocrine carcinoma and adenocarcinoma is extremely rare. The relation of these two disease entities is not understood. We experienced a patient with a colonic neuroendocrine carcinoma concurrent with adenocarcinoma. A 65-year-old male presented with abdominal pain. Emergent computed tomography suggested a malignant tumor of the ascending colon. Colonoscopy showed an infiltrative lesion in the ascending colon with a luminal narrowing, a large pedunculated lesion at the splenic flexure, and multiple small polyps in the descending colon. The patient underwent a right hemicolectomy including the pedunculated lesion. The pathology confirmed advanced neuroendocrine carcinoma in the ascending colon, adenocarcinoma in proximal descending colon, and multiple metastatic lymph nodes of neuroendocrine carcinomas on abdomen. The patient underwent the postoperative chemotherapy but did not tolerate it well and expired a year after diagnosis. We report this rare case with a review of the literature.
Abdomen ; Abdominal Pain ; Adenocarcinoma ; Carcinoma, Neuroendocrine ; Colon ; Colon, Ascending ; Colon, Descending ; Colon, Transverse ; Colonic Neoplasms ; Colonoscopy ; Humans ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Phenobarbital ; Polyps ; Prognosis ; Rare Diseases ; Synaptophysin

Primary low-grade lymphoma of the mucosa-associated lymphoid tissue (MALT) type lymphoma of the bladder is rare. A relationship between MALT lymphoma of the urinary bladder and chronic cystitis has been proposed by some reports. Additionally a relationship between MALT lymphoma of the urinary bladder and Helicobacter pylori has been reported. Here we present a case of regression of urinary bladder MALT lymphoma after antibiotic therapy, using H. pylori eradication protocol in an elderly patient, who had a high risk of treatment related mortality in curative systemic chemotherapy. The patient is a 74-year-old woman who had a history of chronic cystitis. She was diagnosed with stage IIA primary MALT lymphoma of the urinary bladder and was treated with H. pylori eradication triple therapy for 2 weeks. After 2 months, there was a marked regression of the bladder MALT lymphoma lesion in a computed tomography scan of the abdomen.
Abdomen ; Aged* ; Cystitis ; Drug Therapy ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Mortality ; Urinary Bladder*