Kaku Egami

Comparative Study between DNA Copy Number Aberrations Determined by Quantitative Microsatellite Analysis and Clinical Outcome in Patients with Stomach Cancer

Purpose: We detected the relative DNA copy numbers (RCNs) at target loci in patients with stomach cancer with quantitative microsatellite analysis. We additionally clarified the relationship between DNA copy number aberrations and the clinical outcome of the patients. Experimental Design: Fresh frozen samples were obtained from 30 patients who had undergone surgery for stomach cancer. Seven microsatellite loci in chromosomes 8q, 16q, and 20q and one gene-specific locus (ZNF217) were selected as the target loci. The DNA copy number was obtained relatively to a pooled reference consisting of six microsatellite primer sets selected from the regions where few aberrations have been reported in comparative genomic hybridization analysis. On the basis of the TaqMan PCR system, the internal probes used were carrying donor (6-carboxyfluorescein) and acceptor (6-carboxytetramethylrhodamine) fluorescent molecules complementary to CA repeats in the microsatellite markers and to one gene-specific oligomer in the gene-specific marker. Results: Chromosome 8q gain, 20q gain, and 16q loss were detected in 18 (60.0%), 8 (26.7%), and 13 (43.3%) cases, respectively. Gains in the RCNs of D8S1801 and D8S1724 were most frequently found (36.7%). There was a significant correlation between the loss of D16S3026 and reduced survival duration (P = 0.0158), and the simultaneous aberrations of D8S1801 gain and D16S3026 loss (double marker positive) was significantly associated with reduced survival duration (P = 0.0008). According to Cox proportional hazards model, the double marker positive was a significant and independent factor indicating an unfavorable prognostic factor (relative risk, 17.176; 95% confidence interval, 2.782–106.026; P = 0.0022). Conclusion: RCN aberrations in tumor tissues determined by quantitative microsatellite analysis enable identification of the prognostic factors that correlate with clinical outcome of the patients with stomach cancer.

Treatment of symptomatic hepatic cyst by injection of minocycline hydrochloride

We treated two patients with symptomatic hepatic cyst with minocycline hydrochloride (MINO) injections. Patient 1 was a 72-year-old woman who experienced upper abdominal discomfort brought on by a large hepatic cyst, 12 cm in diameter. MINO (200 mg) was injected daily for 8 days with a continuous drainage catheter. After the treatment, the size of the cyst decreased markedly and the symptoms disappeared. There has been no recurrence in a 55-month follow-up. Patient 2 was a 52-year-old man who experienced abdominal fullness and exhibited hepatomegaly. Investigations revealed many large hepatic cysts. Three continuous drainage catheters were inserted into the three largest cysts for the injection of MINO; a total of 5600 mg was injected over a period of 27 days. The cysts decreased in size and symptoms abated.

Primary leiomyoma of the pancreas.

SummaryWe report the first documented case of a primary leiomyoma of the pancreas. A 72-yr-old female patient was admitted to our hospital for the follow-up of a pancreatic tumor detected 2 yr previously at a different hospital. Diagnostic images revealed the presence of a tumor located in the head of the pancreas. The tumor was characterized by a clear margin, hypervascularity, and was a homogenous mass. Moreover, the tumor had not changed in size or characteristics since a previous computed tomography (CT) scan performed 2 yr previously. The tumor was preoperatively diagnosed as a nonfunctional islet-cell tumor or papillary cystic tumor. During the operation, the tumor was found to be encapsulated and showed no signs of direct invasion to neighboring structure. Tumorous lesions of the liver or swellings of the neighboring lymph nodes suggesting metastasis were not found. Instead of a pancreatoduodenectomy, the tumor was enucleated. Microscopically, immunohistochemical studies of a resected specimen indicated a myogenic origin, and neither mitotic activity nor hemorrhagic and necrotic findings were recognized. No signs of recurrence have been seen since its excision. Accordingly, the tumor was diagnosed as a primary leiomyoma of the pancreas.

Complete Cure of Malignant Lymphoma of the Stomach with a Huge Adrenal Lesion Achieved by Preoperative Chemotherapy and Surgery: Report of a Case

Abstract We report herein the case of a 53-year-old woman with malignant lymphoma of the stomach who was successfully treated by preoperative chemotherapy and surgery. The patient consulted our hospital with the chief complaint of upper abdominal pain. Endoscopy demonstrated a protruding lesion at the antral posterior wall of the stomach, and a post-biopsy pathological diagnosis of diffuse large cell type B-cell lymphoma was established. Moreover, abdominal ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a tumor measuring approximately 10 cm in diameter in the left adrenal gland. A total of three courses of chemotherapy using the CHOP regimen were given preoperatively. The CHOP regimen consisted of 100 mg of prednisolone administered for 8 days together with 1.9 mg of vincristine, 1 000 mg of cyclophosphamide, and 60 mg of epirubicin administered intravenously on the first day. This resulted in tumor shrinkage, and a distal gastrectomy, lymph node dissection, and left adrenalectomy were subsequently performed. Since the pathological findings of the resected tissue specimen demonstrated complete elimination of the malignant lymphoma, this combination of procedures was defined as having resulted in a complete response. The postoperative course of this patient was uneventful. She is still alive without any sign of tumor recurrence 6 years after her operation, and is being followed up at the outpatient clinic.

A Case of Malignant Hemangiopericytoma of the Retroperitoneum Successfully Treated by Combined Modality Therapy.

症例は17歳の男性. 主訴は腹部膨満感, 右下肢の疼痛としびれ感. Computed tomography, magnetic resonance imagingなどにより右後腹膜に巨大腫瘤を認め, 開腹生検にてmalignant hemangiopericytomaと診断した. Linac照射, Cisplatinにより腫瘍の著明な縮小がみられたため, いったん退院. 腫瘍はその後5か月間増大傾向なく, 再入院となった. 出血予防の目的で第III, IV, V腰動脈などを塞栓した後, 摘出を行った. 術後Vincristin, Farmombicin, Cisplatinを投与し, 退院となる. 初回化学療法より13か月現在, 外来において経過観察中であるが, 再発, 転移は認めていない.後腹膜の本悪性腫瘍はまれで, 本邦では自験例を含めて14例にすぎず, 2年以上の長期生存例はない. 今回, 集学的治療が有効であったmalignant hemangiopericytomaの1例を経験したので報告する.