• The Korean Journal of Cytopathology
• /
• v.2 no.2
• /
• pp.105-110
• /
• 1991

We report a case of hepatoma with duodenal metastasis in a 53 year-old male patient. Hepatoma was confirmed by fine needle aspiration cytology technique, and duodenal metastasis by gastrofiberscopic biopsy. Duodenal metastasis of hepatoma is rare. We briefly review the role of fine needle aspiration cytology technique in diagnosis of hepatoma.

• Journal of Digestive Cancer Research
• /
• v.11 no.1
• /
• pp.49-54
• /
• 2023

Colorectal cancers often invade adjacent organs; however, direct duodenal invasion is rare. Adenocarcinoma is the most common type of colorectal cancer, but an undifferentiated carcinoma type is unusual. Herein, we present a case of undifferentiated carcinoma of the colon that directly invaded the duodenum and metastasized to distant lymph nodes. An 85-year-old female patient was admitted with a 7-cm-sized colonic mass invading the duodenum, detected by computed tomography. Positron emission tomography revealed fluorodeoxyglucose uptake in the colon, duodenum, and aortocaval lymph nodes. A large encircling mass in the ascending colon and an ulcerated mass in the duodenum were revealed by colonoscopy and esophagogastroduodenoscopy, respectively. Pathologic examinations of the colon and the duodenum revealed nonglandular, diffusely infiltrating atypical round cells, confirming undifferentiated carcinoma of the colon. The histologic type of this tumor was distinguished using immunohistochemical (IHC) markers. Finally, microscopic characteristics and IHC markers aided in identifying the histologic type of colorectal cancer.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.1
• /
• pp.114-119
• /
• 2023

A 51-year-old male patient had four times of massive hematochezia episode three days before arrival. Carbohydrate antigen (CA) 19-9 level was extremely elevated. Computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography identified 5.7 cm sized periampullary duodenal cancer with regional metastatic lymph nodes and vascular invasion to aberrant right hepatic artery, main portal vein, and superior mesenteric vein. Diagnosed as duodenal adenocarcinoma through endoscopic biopsy, 16 times of FOLFIRI (5-fluorouracil, leucovorin, irinotecan) was conducted. The regimen changed to XELOX (capecitabine, oxaliplatine), four times of administration was done, and the CA19-9 level dramatically decreased. The tumor decreased to 2.1 cm. After R0 laparoscopic pylorus preserving pancreatoduodenectomy, no adjuvant therapy was given. No sign of recurrence or metastasis was reported, and the patient reached complete remission after five years. We reported a case where neoadjuvant chemotherapy for locally advanced duodenal adenocarcinoma was shown to be effective.

• Tuberculosis and Respiratory Diseases
• /
• v.63 no.3
• /
• pp.283-288
• /
• 2007

A gastrointestinal metastasis from lung cancer is rare and is quite often found during an autopsy. A 58-year-old man was admitted with left upper back pain and a mass in the left upper lobe on the chest radiograph. The transbronchial lung biopsy revealed an adenocarcinoma of the lung. A gastroduodenoscopy was carried out to evaluate the indigestion and epigastric discomfort. The duodenofibroscopy revealed bulging mucosa on the minor papilla of the duodenum. A metastasis to the duodenum from an adenocarcinoma of the lung was diagnosed by a duodenofibroscopic biopsy of the bulging lesion. We report this rare case of an adenocarcinoma of lung with a metastasis to the duodenum.

• Advances in pediatric surgery
• /
• v.11 no.2
• /
• pp.186-191
• /
• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.12
• /
• pp.4873-4880
• /
• 2015

Purpose: To describe the clinicopathological features of gastrointestinal stromal tumors (GIST) diagnosed in our section and to perform risk stratification of our cases by assigning them to specific risk categories and groups for disease progression based on proposals by Fletcher et al and Miettinen and Lasota. Materials and Results: We retrieved 255 cases of GIST diagnosed between 2003 and 2014. Over 59% were male. The age range was 16 to 83 years with a mean of 51 years. Over 70% occurred between 40 and 70 years of age. Average diameter of tumors was 10 cms. The stomach was the most common site accounting for about 40%. EGISTs constituted about 16%. On histologic examination, spindle cell morphology was seen in almost of 85% cases. CD117 was the most useful immunohistochemical antibody, positive in 98%. Risk stratification was possible for 220 cases. Based on Fletcher's consensus proposal, 62.3 gastric, 81.8% duodenal, 68% small intestinal, 72% colorectal and 89% EGISTs were assigned to the high risk category; while based on Miettinen and Lasota's algorithm, about 48% gastric, 100% duodenal, 76% small intestinal, 100% colorectal and 100% EGISTs in our study were associated with high risk for disease progression, tumor metastasis and tumor related death. Follow up was available in 95 patients; 26 were dead and 69 alive at follow up. Most of the patients who died had high risk disease and on average death occurred just a few months to a maximum of one to two years after initial surgical resection. Conclusions: Epidemiological and morphologic findings in our study were similar to international published data. The majority of cases in our study belonged to the high risk category.

• Radiation Oncology Journal
• /
• v.16 no.1
• /
• pp.17-25
• /
• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.