Long-term Survival of a Case of Rectal Neuroendocrine Carcinoma with Liver Metastasis

Colorectal neuroendocrine carcinoma（NEC）is extremely rare and has a dismal prognosis. However, no standardized treatment strategy has been established for this lesion. For patients with NEC and distant metastasis, disease stabilization is difficult even after treatment with multidisciplinary strategies including chemotherapy. Here we describe a case of rectal NEC that presented as multiple liver metastases; a favorable prognosis was obtained after treatment with a multidisciplinary strategy that included surgery, irradiation, and chemotherapy. A 66-year-old male presented with diarrhea and constipation. Colonoscopy and a computed tomography（CT）scan revealed a rectal mass involving all of the luminal circumference, after which a diagnosis of NEC was confirmed by pathological examination. A CT scan also revealed several liver metastases in S5, S6, and S8. Abdominoperineal resection with total mesenteric excision and lymphadenectomy, including the lateral area, was performed. After resection, we administered radiation for local disease control in the lateral area. We also administered chemotherapy consisting of cisplatin and irinotecan for the liver metastases because only the endocrine cell component constituted this tumor. After chemotherapy, a CT scan was performed to confirm that the liver metastasis in S5 and S6 had disappeared, and it was shown that the other lesion in S8 had shrunk substantially（it eventually disappeared）. Then, 48 months after resection, all metastatic liver tumors were under good control, and no other recurrent lesion was recognized. In conclusion, a multidisciplinary strategy including optimal chemotherapy seems to be important to achieve a favorable prognosis of NEC of the colorectum with distant metastasis

放射線誘発肉腫の1例

This report describes a nine-year-old girl with postradiation sarcoma. The patient was found to have rhabdomyosarcoma in the right hip when she was one year and eleven months old, and received surgery. In addition to chemotherapy, the lesion was irradiated with 3300 rad of 10 Me V electron beam. Six years and eight months after irradiation, postradiation sarcoma arised from the right iliac bone in the irradiated field. Postradiation sarcoma is considered to be an important disease because of its rare occurrence and generally unfavorable prognosis. Therefore, this case report is presented

Recent interdecadal changes in the interannual variability of precipitation and atmospheric circulation over northern Eurasia

This study investigated the interannual variability and trends in precipitation and atmospheric circulation patterns over northern Eurasia using long-term Precipitation REConstruction over Land and atmospheric Japanese 55-year Reanalysis data (JRA-55) from 1958 to 2012. Special emphasis was placed on the recent increase in summer (June, July and August) precipitation around the Lena river basin in eastern Siberia. We found interdecadal modulation in the relationships between interannual variability in summer precipitation and atmospheric circulation patterns among the three major Siberian river basins (Lena, Yenisei, and Ob). The interannual variations in summer precipitation over the Ob and Lena river basins were negatively correlated from the mid-1970s to the mid-1990s. However, after the mid-1990s, this negative correlation became insignificant. In contrast, a significant positive correlation was apparent between the Yenisei and Lena river basins. We also found that there has been a significant increasing (positive) trend in geopotential height in the low-level troposphere since the mid-1980s over Mongolia and European Russia, resulting in an increasing trend of westerly moisture flux into the Yenisei and Lena river basins. Summer precipitation in both basins was continuously high from 2005 to 2008 under a trough that broadly extended from the Yenisei and Lena river basins, which has been a typical pattern of interannual variation since the mid-1990s. This trough increased the meridional pressure gradient between Mongolia and eastern Siberia in combination with the trend pattern. This further enhanced the eastward moisture flux towards the Lena river basin and its convergence over the basin, resulting in high summer precipitation from 2005 to 2008