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Neoadjuvant chemotherapy followed by D2 gastrectomy and esophagojejunal Roux-en-Y anastomosis in gastric small cell carcinoma: A case report.

Xin K, Wei J, Wang H, Guan W, Liu B - Oncol Lett (2014)

Bottom Line: A biopsy was performed under an electronic gastroscope and the pathological analysis resulted in the diagnosis of gastric small cell carcinoma (GSCC).The mass had invaded the liver and the pancreas according to an enhanced computed tomography scan, thus current surgical methods were considered to be of high risk and highly challenging.The patient experienced survival without progression in the 8-month follow-up.

View Article: PubMed Central - PubMed

Affiliation: The Comprehensive Cancer Center of Nanjing Drum-Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China.

ABSTRACT
A 60-year-old male was referred to Nanjing Drum-Tower Hospital (Nanjing, Jiangsu, China) due to the presence of gastric carcinoma. A biopsy was performed under an electronic gastroscope and the pathological analysis resulted in the diagnosis of gastric small cell carcinoma (GSCC). The mass had invaded the liver and the pancreas according to an enhanced computed tomography scan, thus current surgical methods were considered to be of high risk and highly challenging. Following four cycles of neoadjuvant chemotherapy with irinotecan (200 mg, days 1, 21, 41 and 61) and oxaliplatin (120 mg, days, 1, 21, 41 and 61) the patient underwent a D2 gastrectomy and an esophagojejunal Roux-en-Y anastomosis, followed by adjuvant chemotherapy. The patient experienced survival without progression in the 8-month follow-up. To the best of our knowledge, this is one of few cases of GSCC treated with the combination of neoadjuvant chemotherapy, surgery and adjuvant chemotherapy.

No MeSH data available.


Related in: MedlinePlus

Enhanced computed tomography prior to the neoadjuvant chemotherapy. (A) A mass (arrow) in the gastric wall. (B) The mass (arrow) invading the liver and pancreas. (C) A nodular shadow (arrow) of low density, with mild enhancement.
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f1-ol-08-06-2549: Enhanced computed tomography prior to the neoadjuvant chemotherapy. (A) A mass (arrow) in the gastric wall. (B) The mass (arrow) invading the liver and pancreas. (C) A nodular shadow (arrow) of low density, with mild enhancement.

Mentions: A 60-year-old male presented to the Nanjing Drum-Tower Hospital (Nanjing, Jiangsu, China) with a one-year history of epigastric distress. No other symptoms, including acid regurgitation, eructation, nausea, emesis, diarrhea or melena, were described. The patient had no history of hypertension or diabetes mellitus and suffered from no infectious diseases, such as hepatitis or tuberculosis. The patient had smoked one pack of cigarettes per day for the past 30 years and had consumed alcohol for ~20 years, but had no significant drug use or history of malignancy in first-degree relatives. There was no evident histological abnormality upon physical examination. An electronic endoscopy revealed irregular tumor-like lesions in the cardia, lesser curvature of the stomach and angular notch. A separate, large, ulcerated mass with friable mucosa was observed in the gastric cardia. Multiple biopsy specimens were obtained. The hematoxylin and eosin-stained sections revealed densely-packed sheets of small basophilic cells. Immunostaining was positive for cytokeratin and the tumor was focally positive for synaptophysin and chromogranin A. The immunohistochemical profile supported the histological diagnosis of an SCC. No abnormality was detected on chest radiography. A routine blood examination, liver function test and electrocardiogram were performed. Among all the tumor markers, the level of carbohydrate antigen (CA)-125 was 69.80 U/ml, slightly higher than the normal range of 0–35 U/ml. Computed tomography (CT) revealed a thickening of the gastric wall and a mass (Fig. 1A), mainly in the lesser curvature of stomach. A thickening left gastric artery entered the mass. The mass invaded the liver and the pancreas (Fig. 1B), and the enhanced CT scan revealed a nodular shadow of low density, with mild enhancement (Fig. 1C).


Neoadjuvant chemotherapy followed by D2 gastrectomy and esophagojejunal Roux-en-Y anastomosis in gastric small cell carcinoma: A case report.

Xin K, Wei J, Wang H, Guan W, Liu B - Oncol Lett (2014)

Enhanced computed tomography prior to the neoadjuvant chemotherapy. (A) A mass (arrow) in the gastric wall. (B) The mass (arrow) invading the liver and pancreas. (C) A nodular shadow (arrow) of low density, with mild enhancement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214484&req=5

f1-ol-08-06-2549: Enhanced computed tomography prior to the neoadjuvant chemotherapy. (A) A mass (arrow) in the gastric wall. (B) The mass (arrow) invading the liver and pancreas. (C) A nodular shadow (arrow) of low density, with mild enhancement.
Mentions: A 60-year-old male presented to the Nanjing Drum-Tower Hospital (Nanjing, Jiangsu, China) with a one-year history of epigastric distress. No other symptoms, including acid regurgitation, eructation, nausea, emesis, diarrhea or melena, were described. The patient had no history of hypertension or diabetes mellitus and suffered from no infectious diseases, such as hepatitis or tuberculosis. The patient had smoked one pack of cigarettes per day for the past 30 years and had consumed alcohol for ~20 years, but had no significant drug use or history of malignancy in first-degree relatives. There was no evident histological abnormality upon physical examination. An electronic endoscopy revealed irregular tumor-like lesions in the cardia, lesser curvature of the stomach and angular notch. A separate, large, ulcerated mass with friable mucosa was observed in the gastric cardia. Multiple biopsy specimens were obtained. The hematoxylin and eosin-stained sections revealed densely-packed sheets of small basophilic cells. Immunostaining was positive for cytokeratin and the tumor was focally positive for synaptophysin and chromogranin A. The immunohistochemical profile supported the histological diagnosis of an SCC. No abnormality was detected on chest radiography. A routine blood examination, liver function test and electrocardiogram were performed. Among all the tumor markers, the level of carbohydrate antigen (CA)-125 was 69.80 U/ml, slightly higher than the normal range of 0–35 U/ml. Computed tomography (CT) revealed a thickening of the gastric wall and a mass (Fig. 1A), mainly in the lesser curvature of stomach. A thickening left gastric artery entered the mass. The mass invaded the liver and the pancreas (Fig. 1B), and the enhanced CT scan revealed a nodular shadow of low density, with mild enhancement (Fig. 1C).

Bottom Line: A biopsy was performed under an electronic gastroscope and the pathological analysis resulted in the diagnosis of gastric small cell carcinoma (GSCC).The mass had invaded the liver and the pancreas according to an enhanced computed tomography scan, thus current surgical methods were considered to be of high risk and highly challenging.The patient experienced survival without progression in the 8-month follow-up.

View Article: PubMed Central - PubMed

Affiliation: The Comprehensive Cancer Center of Nanjing Drum-Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China.

ABSTRACT
A 60-year-old male was referred to Nanjing Drum-Tower Hospital (Nanjing, Jiangsu, China) due to the presence of gastric carcinoma. A biopsy was performed under an electronic gastroscope and the pathological analysis resulted in the diagnosis of gastric small cell carcinoma (GSCC). The mass had invaded the liver and the pancreas according to an enhanced computed tomography scan, thus current surgical methods were considered to be of high risk and highly challenging. Following four cycles of neoadjuvant chemotherapy with irinotecan (200 mg, days 1, 21, 41 and 61) and oxaliplatin (120 mg, days, 1, 21, 41 and 61) the patient underwent a D2 gastrectomy and an esophagojejunal Roux-en-Y anastomosis, followed by adjuvant chemotherapy. The patient experienced survival without progression in the 8-month follow-up. To the best of our knowledge, this is one of few cases of GSCC treated with the combination of neoadjuvant chemotherapy, surgery and adjuvant chemotherapy.

No MeSH data available.


Related in: MedlinePlus