• Title/Summary/Keyword: Carcinomatosis

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A Case of Advanced Gastric Cancer with Multiple Leptomeningeal Metastasis (진행성 위암의 추적 관찰 도중 다발성 수막내 전이가 발견된 환자 1례)

  • Hae Jin Shin;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.122-126
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    • 2016
  • Leptomeningeal carcinomatosis occurs in approximately 5% of patients with cancer. The most common cancers involving the leptomeninges are breast, lung cancer and melanoma. However, gastric adenocarcinoma has been rarely reported with leptomeningeal carcinomatosis. The presenting manifestations are usually headache, visual disturbances and seizures. We report a case of leptomeningeal metastasis that presented as a gastric cancer. A 75-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IA (cT1N0M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as recurrence was suspected. After receiving chemotherapy in the order of DP (Cisplatin + Docetaxel), FOLFIRI (5-FU + Leucovorin + Irinotecan), an abdominal CT response assessment showed complete response. Since decreased mentality maintained throughout the follow up period based on outpatient clinic, brain MRI was performed and revealed multiple leptomeningeal metastasis. The Patient died 2 days after the diagnosis.

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The Role and Efficacy of Diagnostic Laparoscopy to Detect the Peritoneal Recurrence of Gastric Cancer (복막 전이가 의심되는 위암 환자에서 진단적 복강경 검사의 의의와 역할)

  • Song, Sun-Choon;Lee, Sang-Lim;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.51-56
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    • 2009
  • Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

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Difference in F-18 FDG Uptake According to the Patterns of CT-Based Diagnosed Pulmonary Lymphangitic Carcinomatosis in Patients with Lung Cancer (폐암환자에 있어 CT상으로 진단된 폐림프관성암종증의 형태에 따른 F-18 FDG 섭취의 차이)

  • Jun, Sung-Min;Kim, Yong-Ki;Kim, In-Ju;Kim, Seong-Jang;Nam, Hyun-Yeol;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.292-300
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    • 2008
  • Purpose: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and Methods: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). Results: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: $2.9{\pm}1.4$, group 2: $1.5{\pm}0.6$). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. Conclusion: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.

Pleural Metastasis of Atypical Bronchial Carcinoid

  • Zinchenko, Eugeniy Igorevich;Maslak, Olga Sergeevna;Pischik, Vadim Grigorievich;Obornev, Aleksandr Dmitrievich;Kovalenko, Aleksandr Igorevich
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.317-320
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    • 2020
  • Pulmonary carcinoids are relatively rare tumors with low metastatic potential. Pleural carcinomatosis of a bronchial carcinoid has only been reported in 4 cases. Due to the rarity of this condition, there are no guidelines for its treatment or management. We report a case of atypical carcinoid with local recurrence and pleural metastases treated by video-assisted thoracoscopic surgery lobectomy and total pleurectomy with photodynamic therapy after non-radical wedge resection.

Perforated Afferent Loop Syndrome in a Patient with Recurrent Gastric Cancer: Non-Surgical Treatment with Percutaneous Transhepatic Duodenal Drainage and Endoscopic Stent (재발된 위암 환자에서 발생한 천공성 수입각 증후군의 비수술적 치료)

  • Song Kyo Young;Son Chang Hee;Park Cho Hyun;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.176-179
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    • 2004
  • Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

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Paragonimiasis in the Abdominal Cavity and Subcutaneous Tissue: Report of 3 Cases

  • Lee, Chang Ho;Kim, Jong Hun;Moon, Woo Sung;Lee, Min Ro
    • Parasites, Hosts and Diseases
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    • v.50 no.4
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    • pp.345-347
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    • 2012
  • Paragonimiasis is a parasitic disease caused by the lung fluke, Paragonimus spp. Lung flukes may be found in various organs, such as the brain, peritoneum, subcutaneous tissues, and retroperitoneum, other than the lungs. Abdominal paragonimiasis raises a considerable diagnostic challenge to clinicians, because it is uncommon and may be confused with other abdominopelvic inflammatory diseases, particularly peritoneal tuberculosis, and peritoneal carcinomatosis. Also, subcutaneous paragonimiasis does not easily bring up clinical suspicion, due to its rarity. We herein report 2 cases of abdominal paragonimiasis and 1 case of subcutaneous paragonimiasis in Korea.

Inferior Mesenteric Plexus Block Performed in the Lateral Position (측와위에서 시행한 하 장간막 신경총차단)

  • Kim, Chun-Sook;Cha, Young-Deog
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.144-148
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    • 1995
  • Inferior mesenteric plexus block(IMPB) sa useful nerve block for the relief of intractable lower abdominal and pelvic pain caused by a lower abdominal visceral or a pelvic malignancy. IMPB has been performed in the prone position. But there are many patients who can't lie in the prone position, because ascites is frequently noticed in cancer patients and they also frequently received abdominal operations. We performed IMPB in the lateral position on two patients with lower abdominal pain, Case 1: A 77 year old female who had a right ovarian cancer with metastatic cancer of descending colon and rectum, experienced complete pain relief. Case 2: A 72 year old female who had a far advance pancreatic cancer with intestinal obstruction due to carcinomatosis received right and left celiac plexus block and right and left IMPB. The patient was satisfied with the result of these pain blocks. Conclusion; IMAPB performed in the lateral position on two patients with lower abdominal pain and their results were excellent for pain relief.

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The Celiac Plexus Block and the Lumbar Sympathetic Ganglion block for the Upper and Lower Abdominal Cancer Pain -7 cases- (상하복부 암성통증에 대한 복강신경총 및 요부교감신경절 차단 -7예 보고-)

  • Gill, Hyun-Jue;Yoon, Duck-Mi;Oh, Hung-Kun;Ree, Ye-Chul
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.171-176
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    • 1988
  • It is well known that the celiac plexus block is specially useful for relieve intractable upper abdominal pain caused by upper abdominal visceral malignancy or upper abdominal metastasis from distant organs. But in cases of lower abdominal or pelvic metastasis from upper abdominal malignancy, the lower abdominal intractable pain is remained after the successful celiac plexus block. We have reported 7 cases of celiac plexus block combined with lumbar sympathetic ganglion block, among the 305 cases of the celiac plexus block from 1968 to Nov. 1987, performed in patients with lower abdominal or back pain due to carcinomatosis of lower abdominal metastatic malignancy, that their results were excellent for pain relief.

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Recent Update on the Treatment of Colorectal Peritoneal Metastasis: A Surgical Perspective

  • Hye Jung Cho;Woo Ram Kim
    • Journal of Digestive Cancer Research
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    • v.10 no.2
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    • pp.74-81
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    • 2022
  • Colorectal peritoneal metastasis has been an incurable disease for centuries. However, since the new millennium, recent advancements in therapies are achieved with modern chemotherapeutic agents, target agents, and immune checkpoint blockade introduction. Modern chemotherapies, from a nearly nonexistent median survival if untreated, have raised the duration to 16 months with target agents. Experts have once again surpassed its limit by introducing intraperitoneal chemotherapy and cytoreductive surgery (CRS). Numerous clinical trials regarding CRS and hyperthermic intraperitoneal chemotherapy have now opened new doors in peritoneal carcinomatosis treatment, even securing complete remission. In addition, up-to-date modalities, such as pressurized intraperitoneal aerosol chemotherapy and immunotherapies, showed promising results at an early stage.

Imaging of Mesentery and Omentum (장간막과 대망의 영상 소견)

  • Woo Kyoung Jeong
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.335-346
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    • 2021
  • Although primary tumors in the mesentery and omentum are relatively rare, it is often necessary to distinguish them from other non-tumorous diseases. Since the omentum and mesentery are major routes for the spread of various abdominal diseases, the anatomy, type, and pattern of the diseases affecting these organs should be known in detail for accurate differential diagnosis. In addition, it is important to detect and promptly treat hidden lesions in the mesentery and omentum. Therefore, careful observation of the area where the lesion occur should be emphasized when assessing mesentery and omentum in abdominal CT.