Metastatic carcinoma of the colon similar to Crohn's disease: a case report.

A 68-year-old Japanese man with a history of linitis plastica carcinoma of the stomach and subsequent gastrectomy 8 years previously presented with lower abdominal pain. Radiological and endoscopic examinations showed multiple submucosal nodular lesions similar to Crohn's disease in the ileocecal area. A firm diagnosis could not be made after initial multiple biopsies. Finally, a submucosal biopsy revealed adenocarcinoma. The ileocecal lesion was diagnosed as a recurrence because of the histological findings, which included mucosal preservation, a similarity with the histologic type of stomach carcinoma, and atypical immunoreactivity for primary colon carcinoma; the lesion was negative for both cytokeratin 7 and cytokeratin 20. In cases where metastatic carcinoma of the colon is suspected, we recommend early consideration of a submucosal biopsy.</p

Real-Time Evaluation of the Effectiveness of Microwave Coagulation Therapy for Hepatocellular Carcinoma Using Color Doppler Imaging

Percutaneous microwave coagulation therapy (PMCT) is a new technique for the treatment of hepatocellular carcinoma (HCC). However, it is difficult to distinguish those lesions in which necrosis has been induced from the viable residual lesions during the procedure, because the margin of the tumor becomes unclear during PMCT. We determined the area of necrotic lesions during the procedure using color Doppler imaging. PMCT was performed on 10 patients (17 lesions) with recurrent HCC. The electrode of the microwave delivery system was moved around the tumor and the surrounding area until color mosaic images disappeared from the entire area of the tumor. The areas in which necrotic tissue was indicated by color Doppler imaging were later confirmed by other modalities such as angiography or contrast-enhanced computed tomography. This leads us to believe that real-time, effective evaluation of PMCT is possible with color Doppler imaging.</p

A Case of Catamenial Pneumothorax Treated by Video-Assisted Thoracoscopic Surgery

This is a case of a 47-year-old female who had a medical history of right pneumothorax for the second time. The pneumothorax, accompanying the start of menstruation, recurred and the patient was hospitalized. From the medical history, a catamenial pneumothorax was suspected. As for intraoperative findings, many small fenestrations of 1 mm or 3 mm were present in the border region with the muscle bundle of the central tendon of the diaphragm. The lesion site of the diaphragm and the apex area as a biopsy were partially excised under video-assisted thoracoscopic surgery. Although a postoperative Gn-RH agonist was started for endometriosis, it was stopped because side effects appeared. Because the right pneumothorax recurred in accordance with the start of menstruation, the treatment was changed to danazol. To date, the pneumothorax has not recurred

Intraluminal implantation of rectal carcinoma successfully resected by endoscopy.

A 55-year-old Japanese woman presented at our hospital complaining of hematochezia 4 months after surgery for a rectal carcinoma. A proctoscopy revealed 2 protuberant lesions in the rectum, 5 mm anally from the anastomotic suture line. The diagnosis of adenocarcinoma was confirmed by biopsy. It was considered that these lesions were caused by intraluminal implantation from the primary rectal carcinoma. The patient underwent an endoscopic resection for these recurrent lesions and has remained stable, with neither recurrence nor metastasis, in the 7 years since the resection. For rectal carcinoma, we propose early follow-up by proctoscopy, namely within 4 months after surgery.</p

Effect of immunosuppressive substance against the potency of natural human tumor necrosis factor as biological response modifier

TNF is a cytokine with the activity of a BRM (biological response modifier). TNF-α and TNF-β enhanced NK activity of peripheral blood mononucleocytes of a normal donor, but not in a cancer patient. ISS, a glocoprotein extracted from the ascitic fluid of a colon cancer patient with immunosuppressive properties, ia also detected in large quantities in the serum of cancer patients. NK activity of a normal donor which was in an immunosuppressive state by the administration of ISS was not affected by treatment of TNF-α or TNF-β, but the suppressed NK activity was improved by the combination of TNF with IFN-α or IFN-γ. On the other hand, NK activity of a cancer patient treated with anti-IS antiserum which was obtained from serum of rabbit immunized by ISS was enhanced by both TNFs. These findings suggest that ISS suppresses the effect of TNFs on NK activity. Furthermore, the effect of TNF as a BRM is inhibited in cancer patients due to the high dose of ISS in the serum, and that the combination of TNF with other cytokines, such as IFN, is more effective than the single use of TNF, clinically

Dynamic PET evaluation of elevated FLT level after sorafenib treatment in mice bearing human renal cell carcinoma xenograft

Background: Sorafenib, an oral multikinase inhibitor, has anti-proliferative and anti-angiogenic activities and is therapeutically effective against renal cell carcinoma (RCC). Recently, we have evaluated the tumor responses to sorafenib treatment in a RCC xenograft using [Methyl-3H(N)]-3'-fluoro-3'-deoxythythymidine ([3H]FLT). Contrary to our expectation, the FLT level in the tumor significantly increased after the treatment. In this study, to clarify the reason for the elevated FLT level, dynamic 3'-[18F]fluoro-3'-deoxythymidine ([18F]FLT) positron emission tomography (PET) and kinetic studies were performed in mice bearing a RCC xenograft (A498). The A498 xenograft was established in nude mice, and the mice were assigned to the control (n = 5) and treatment (n = 5) groups. The mice in the treatment group were orally given sorafenib (20 mg/kg/day p.o.) once daily for 3 days. Twenty-four hours after the treatment, dynamic [18F]FLT PET was performed by small-animal PET. Three-dimensional regions of interest (ROIs) were manually defined for the tumors. A three-compartment model fitting was carried out to estimate four rate constants using the time activity curve (TAC) in the tumor and the blood clearance rate of [18F]FLT. Results: The dynamic pattern of [18F]FLT levels in the tumor significantly changed after the treatment. The rate constant of [18F]FLT phosphorylation (k3) was significantly higher in the treatment group (0.111 ± 0.027 [1/min]) than in the control group (0.082 ± 0.009 [1/min]). No significant changes were observed in the distribution volume, the ratio of [18F]FLT forward transport (K1) to reverse transport (k2), between the two groups (0.556 ± 0.073 and 0.641 ± 0.052 [mL/g] in the control group). Conclusions: Our dynamic PET studies indicated that the increase in FLT level may be caused by the phosphorylation of FLT in the tumor after the sorafenib treatment in the mice bearing a RCC xenograft. Dynamic PET studies with kinetic modeling could provide improved understanding of the biochemical processes involved in tumor responses to therapy