Toshihiko Matsumoto

A Case of Lymphangioma Coexistent with Tubular Adenoma in the Descending Colon and a Review of the Literature

Abstract: We recently encountered a case of lymphangioma of the colon which coexisted with a tubular adenoma. The patient was a 71‐year‐old male who was admitted for physical therapy for lumbago caused by osteoarthritis. He had no evident abdominal symptoms and no weight loss. Although mild anemia and hypoproteinenia were observed, his stool occult blood test was negative and tumor markers revealed no significant changes. A barium enema revealed two elevated lesions in the descending colon. The proximal lesion appeared to be semipedunculated and its form changed following postural changes. The distal lesion was pedunculated. When the patient changed his posture, the head and stalk of the lesion were identified, Both lesions were removed by endoscopic polypectomy. The proximal lesion was histologically diagnosed as being a cavernous lymphangioma, while the distal one was found to be a tubular adenoma.

P3-055Oxaliplatin reintroduction for colorectal cancer patients who were refractory or intolerant to oxaliplatin

Results: 14 patients received oxaliplatin containing chemotherapy reintroduction. Median age was 70 years old(range:46-76 years old).10 patients were male, PS over 1 were 4 patients.10 patients were left side colon cancer, 4 patients were right side colon cancer. 6 patients were RAS mutant. All patients were refractory to fluoropyrimidines, bevacizumab and inotecan. In RAS wild patients, 7 patients(88%) were refractory to anti EGFR rntibodies.TAS-102 and regorafenib was administrated only one patient. 5 patients were refractory to first administration of oxaliplatin, 9 patients discontinued by other reason. Median oxaliplatin free time was 11.9 months(range:3.0-36.9 months).Median progression free survival was 5.2months(95% CI: 1.2-7months), and median overall survival was 13.8months (95% CI: 6.6-16.2 months).In patients who had measurable lesion, response rate was 7% and disease control rate was 50%.

A Case of Boerhaave's Syndrome —Evaluation of Diagnostic Value of Endoscopy—

Abstract: We experienced a case of Boerhaaves syndrome. The patient, a 47‐year‐old male, vomited after drinking a large quantity of alcohol and thereafter, complained of epigastralgia, back pain, and dyspnea. Leukocytosis, positive CRP, fever, tenderness of the upper abdomen and muscular defense were noted on admission. Endoscopy revealed an ulcer at the lower esophagus. Since a chest X‐P and CT showed thoracic effusion and subcutaneous and mediastinal emphysema, rupture of the esophageal ulcer was suspected. The diagnosis of Boerhaaves syndrome was established by esophagography. A rupture along the longitudinal axis of about 3cm was found at the left posterior wall 3cm above the E‐G junction, and was surgically sutured.