Long-term recurrence-free survivor after laparoscopic removal of solitary adrenal metastasis from endometrial adenocarcinoma

Solitary adrenal metastasis from endometrial adenocarcinoma is extremely rare. We report herein the case of a laparoscopically resected solitary adrenal metastasis originating from endometrial adenocarcinoma. The patient was a 55-year-old woman who had undergone total abdominal hysterectomy for stage IIIc endometrial carcinoma, followed by 7 courses of adjuvant chemotherapy comprising carboplatin and paclitaxel. However, the patient developed an isolated right adrenal metastasis 15 months postoperatively. The solitary adrenal metastasis (diameter, 5.7 cm) was removed laparoscopically. The patient has now been in good health without recurrence for 5 years and 7 months after laparoscopic surgery. To the best of our knowledge, this is the first case of solitary adrenal metastasis originating from endometrial adenocarcinoma that is controlled for the long term by successful laparoscopic resection

コキュウ コンナン オ ケイキ ニ ハッケンサレ シュウガクテキ チリョウ ニヨリ カンカイ シタ シンコウ セイソウ ガン ノ 1レイ

A 30-year-old man was referred to our hospital for examination and treatment of dyspnea.Clinical examination revealed multiple lung tumor masses with marked elevation -HCG and -fetoprotein. CT showed not only multiple lung tumors but also retroperitoneal tumor mass. Apercutaneous needle biopsy of lung tumor was performed and pathological findings suggestedchoriocarcinoma. Although testicular swelling was not detected, ultrasonography revealed a righttesticular mass lesion. Therefore we diagnosed multiple lung metastases from right testicularcancer with retroperitoneal lymph node metastasis. The induction chemotherapy with bleomycin,etoposide, cisplatin（BEP） for 3 cycles was performed. Subsequently second line chemotherapywith paclitaxel, ifosfamide, nedaplatin（TIN）for 8 cycles followed. After the tumor markers werenormalized, resection of residual lung metastases by video-assisted thoracic surgery（VATS）andright high orchiectomy were performed. Histologically no viable cells were detected. One cyclechemotherapy with TIN was given after first surgery. Secondly, retroperitoneal lymph nodedissection was performed, and pathologically the small amount of viable cancer was detected in theresected specimen. Then post operative chemotherapy with TIN for 2 cycles were performed.The patient is alive without any recurrence 3 years after combined modality therapy

Prognostic significance of serum hepatocyte growth factor in clear cell renal cell carcinoma : comparison with serum vascular endothelial growth factor

No adequate serum predictive biomarker currently exists, which can identify the activity of renal cell carcinoma (RCC). We investigate the association of serum hepatocyte growth factor (HGF) and serum vascular endothelial growth factor (VEGF) levels with clinicopathologic parameters in untreated clear cell RCC patients. We measured serum levels of HGF and VEGF in 45 patients with untreated clear cell RCC and 45 healthy controls using an enzyme-linked immunosorbent assay (ELISA). Patients with clear cell RCC had significantly higher serum HGF and VEGF concentrations than healthy subjects : median, 1070.7 versus 728.3 pg/ml (p1150 pg/ml) was significantly reduced compared to patients with low serum HGF concentrations (p=0.0044). In patients with nuclear grade 2 or high stage RCC, the higher serum HGF group exhibited significantly lower cause-specific survival (p= 0.0087 and p<0.05, respectively). No significant difference was observed between serum VEGF levels and cause-specific survival rate. Serum HGF might be a diagnostic and prognostic indicator in clear cell RCC, especially for patients with grade 2 or high stage RCC

性索の巨大平滑筋肉腫の1例

A 56-year-old man was diagnosed with a right testicular tumor. Orchiectomy with high ligation of the spermatic cord was performed. Histological examination revealed leiomyosarcoma of the spermatic cord. Distant metastases were not found. The patient was treated with adjuvant radiation therapy to control the disease, since a high incidence of local recurrence has been reported. The patient had no evidence of disease 24 months postoperatively.患者は56歳, 男性で, 右精巣癌と診断された。右高位精巣摘除術を施行し, 病理結果は精索の平滑筋肉腫だった。遠隔転移はなかった。局所再発が高率にみられると報告されていることより局所のコントロールとして追加の放射線療法を施行した。術後18ヵ月の現在, 再発の所見はない。(著者抄録