Yoshiaki Sekishita

Laparoscopic two-stage surgery for goblet cell carcinoid of the appendix: report of a case and review of the Japanese literature.

Goblet cell carcinoid of the appendix is a rare clinical entity exhibiting features of both carcinoid and adenocarcinoma. Here, we present the first report of laparoscopic 2-stage surgery for goblet cell carcinoid with a review of the Japanese literature. A 49-year-old man underwent laparoscopic appendectomy under the diagnosis of acute appendicitis. A pathologic diagnosis of goblet cell carcinoid, accompanied by the aggressive proliferation, with acute appendicitis was made. Subsequent laparoscopic ileocecal resection was performed, and it was verified that there were neither residual tumor nor lymph node metastases. The postoperative course was uneventful. Because goblet cell carcinoid may be difficult to clinically distinguish from acute appendicitis, pathologic examination is essential. Depending upon the grade of tumor proliferation, additional resection should be considered, and our experience with this case suggests that laparoscopic 2-stage surgery is feasible for the adequate treatment of goblet cell carcinoid without complications.

Positive response to oral chemoendocrine combination therapy using 5"-deoxy-5-fluorouridine for locally advanced breast cancer with carcinomatous pleurisy: report of a case.

A 60-year-old postmenopausal woman presented with an ulcerating and bleeding tumor in her right breast. On physical examination, the tumor was found mainly in the D area of the right breast, and was associated with ulceration and thoracic rigidity. Chest X-ray showed a pleural effusion in her right chest and a computed tomography scan after thoracentesis showed multiple bilateral pleural nodules. Thus, a diagnosis of unresectable advanced breast cancer (T4cN2M1b, PLE) was made. She was given oral 5″-deoxy-5-fluorouridine (5″-DFUR) with medroxyprogesterone acetate, followed by tamoxifen, without any severe adverse reactions, and was subsequently followed up as an outpatient. Her tumor gradually decreased in size, the thoracic rigidity disappeared, and the pleural dissemination and effusion resolved. Thereafter, a radical mastectomy was performed and histologically, the tumor was Grade 1a. She had no signs of recurrence or metastasis 14 months postoperatively. Therefore, oral chemoendocrine combination therapy with 5″-DFUR resulted in a favorable quality of life, there were no severe adverse reactions, and the patient was able to be managed as an outpatient.