Parietal Bone Metastasis of Rectal Adenocarcinoma as an Initial Diagnosis of Recurrence: Case Report CASE REPORT Open Access

Colorectal cancer (CRC) is a most common and lethal disease of the gastrointestinal tract [1]. CRC can usually spread by lymphatic and hematogenous routes. The most common metastatic sites are the regional lymph nodes, liver, lungs, and peritoneum [1]. Uncommon metastasis of CRC were described such as skin, muscles, skull and thyroid [2][3] A 44-year old man had diagnosed with adenocarcinoma of the rectum as a result of colonoscopic biopsy in July 2009. Fluoropyrimidine-based neoadjuvant chemoradiotherapy had performed. "Low Anterior Resection" was held in September 2009 and after surgery 4 cycles adjuvant chemotherapy had admitted. The patient was followed in remission until February 2012. He had presented with a mass approximately 6 cm in diameter located his temporoparietal region in February 2012. The mass had grown rapidly in 4 or 5 months. Because of tumour diameter and pain, he had applied to Neurosurgery Department. Magnetic resonance imaging (MRI) showed a 6.0x4.0 cm mass, extending from bottom of scalp and epidural space Parietal Bone Metastasis of Rectal Adenocarcinoma as an Initial Abstract Keywords: Skull metastasis; Parietal bone metastasis; Metastatic colorectal cance

Impact of adjuvant treatment modalities on survival outcomes in curatively resected pancreatic and periampullary adenocarcinoma.

BACKGROUND: We examined the impact of adjuvant modalities on resected pancreatic and periampullary adenocarcinoma (PAC). METHODS: A total of 563 patients who were curatively resected for PAC were retrospectively analyzed between 2003 and 2013. RESULTS: Of 563 patients, 472 received adjuvant chemotherapy (CT) alone, chemoradiotherapy (CRT) alone, and chemoradiotherapy plus chemotherapy (CRT-CT) were analyzed. Of the 472 patients, 231 were given CRT-CT, 26 were given CRT, and 215 were given CT. The median recurrence-free survival (RFS) and overall survival (OS) were 12 and 19 months, respectively. When CT and CRT-CT groups were compared, there was no significant difference with respect to both RFS and OS, and also there was no difference in RFS and OS among CRT-CT, CT and CRT groups. To further investigate the impact of radiation on subgroups, patients were stratified according to lymph node status and resection margins. In node-positive patients, both RFS and OS were significantly longer in CRT-CT than CT. In contrast, there was no significant difference between groups when patients with node-negative disease or patients with or without positive surgical margins were considered. CONCLUSIONS: Addition of radiation to CT has a survival benefit in patients with node-positive disease following pancreatic resection