Mucoepidermoid Carcinoma of the Breast Found during Treatment of Lymphoma

A 71-year-old woman, previously treated for malignant lymphoma, was admitted to our hospital with a tumor in the right breast. The tumor size was 2.0 cm in diameter, and the borderline was unclear. The core needle biopsy material revealed an invasive adenocarcinoma with metaplastic change. Right mastectomy and sentinel lymph node biopsy was performed. Histologically, the tumor was composed of mucus-secreting, epidermoid, and intermediate cells. These findings confirmed the diagnosis as mucoepidermoid carcinoma (MEC) of the breast. MEC is more frequently observed in the salivary glands and occurs rarely in the breast, with an incidence of approximately 0.3% of all breast cancers. Because of the rarity of the disease, the clinicopathological features and clinical outcome have not been fully investigated. The relationship between MEC of the breast and lymphoma are unclear. Here we report a rare case of MEC of the breast

Endoscopic submucosal dissection followed by chemoradiotherapy for superficial esophageal cancer: choice of new approach

Abstract Background The standard treatment for superficial esophageal cancer (SEC) involving muscularis mucosal (T1a-MM) or submucosal (T1b) invasion has been the surgical resection of the esophagus. However, esophagectomy with extended lymph node dissection is highly invasive. Recent reports have shown that endoscopic submucosal dissection (ESD) followed by chemoradiotherapy (CRT) has promising results and might become a new therapeutic approach. This retrospective study aimed to elucidate the efficacy and safety of this new treatment. Methods Patients with clinical stage T1b tumor without apparent metastasis treated with ESD followed by CRT from 2014 to 2017 (the CRT group) were included. The outcomes on disease-free survival (DFS) of this group were compared with those of consecutive patients in a historical control group who underwent ESD followed by esophagectomy (the esophagectomy group) between 2008 and 2015. Results Of 32 patients analyzed, 16 were in the CRT group and 16 with similar stage cancer were in the esophagectomy group. Radiotherapy was completed in all patients, and the incidence of grade ≥ 3 nonhematologic adverse events was 6%. The 2-year overall survival rates were 100%, and locoregional control was achieved in all patients in the CRT group, and the 2-year DFS rates were 88 and 100% for the CRT and esophagectomy groups, respectively, without significant differences. Conclusions Our data confirmed our new approach as being safe and effective for locoregional control and may provide a nonsurgical treatment option for patients with clinical stage T1b tumors

ステントグラフトに工夫を要した高度屈曲かつ大口径ネックを伴う腹部大動脈瘤の一例

This report presents the case of an abdominal aortic aneurysm (AAA), in which the aortic neck was severely angulated. Furthermore, there was moderate stenosis and a severe angle with calcification of the suprarenal aorta. EVAR was performed with a commercial Zenith stent-graft, with a slight modification, because an open aneurysm repair was risky in general condition. No complications occurred during the follow-up period.症例は86歳，女性．腎動脈下に55mm，紡錘状の腹部大動脈瘤を認めた．高齢，冠動脈ステント後かつ慢性心不全のため開腹人工血管置換術は，周術期合併症や手術死亡の危険性が高いと判断した．動脈瘤の中枢頸部は径30mm，長さ15mm，屈曲高度を伴い，かつ腎動脈直上は高度屈曲，石灰化狭窄を認め，解剖学的にはステントグラフトの適応外であった．大口径のステントグラフト(ゼニス36mm)を用いれば，中枢頸部の圧着は可能であるが，腎動脈直上の高度屈曲，石灰化狭窄のため腎動脈上ステントが展開しない恐れがあった．そこで我々は，バックテーブルでステントグラフトを展開し，腎動脈上ステントを除去した後に，ステントグラフトをシース内に再格納し，腎動脈上ステントを除去したステントグラフトを腎動脈直下に展開することによって，動脈瘤治療の技術的成功を得た．現在までステントグラフトの脱落やエンドリークは認めず，術後経過は良好であった．ステントグラフトを工夫することにより，開腹人工血管置換術のハイリスク症例かつ屈曲高度を伴う解剖学的ステントグラフト適応外症例において，一つの治療オプションとなる可能性がある

A Case of Fitz-Hugh-Curtis Syndrome Representing Hepatic Capsular Enhancement

We present CT findings of a 22-year-old woman diagnosed as Fitz-Hugh-Curtis syndrome. The patient was admitted to our hospital with right upper abdominal pain. Abdominal enhanced CT showed hepatic capsular enhancement over the medial segment and the right lobe on the early phase. This capsular enhancement completely disappeared after treatment. Abdominal enhanced CT may serve as a non-invasive modality for the diagnosis of Fitz-Hugh-Curtis syndrome