A case of endometrioid adenocarcinoma supposedly arising from endometriosis of the rectum is reported. Malignant transformation is uncommon but a well-known complication of endometriosis. In the present case, it was proved by histopathological findings and immunophenotype such as cytokeratin7+/cytokeratin20-/estrogen receptor+. The cause of rectal endometriosis in this case might have been related with previously received hormone replacement therapy for ovarian endometriosis. Following surgical removal of the lesion, this patient underwent adjuvant chemotherapy with paclitaxel and carboplatin, although this kind of therapy is still controversial as to its effectiveness.
We herein present the case of a-58-year-old female with a metastasis of breast cancer to the appendix, which caused acute appendicitis. She had undergone a bilateral partial mastectomy with sentinel lymph node biopsy ten years earlier at another hospital. She had subsequently received radiation therapy, chemotherapy and endocrine therapy. There had been no sign of recurrence for five years after the surgical procedure. She was admitted to our hospital because of abdominal pain lately. Abdominal computed tomography showed a dilated and thickened wall of the appendix. She was diagnosed with acute appendicitis and underwent appendectomy. A histopathological examination revealed metastatic breast cancer of the appendix, and the patient received endocrine therapy using an aromatase inhibitor. Metastatic involvement of the appendix should be suspected in any patient with a previous history of breast cancer presenting with acute appendicitis, even if many years have passed after initial therapy.
The patient was a 74-year-old man suffering from tuberculotic chronic pyothorax. He had hematemesis in January 2006. Hb was 6.1 g/dl. A type 2 tumor 3 cm in diameter was found in the vaulted region on the greater curvature side. It was diagnosed as a malignant lymphoma. WBC and differential count were normal, and the patient tested negative for HTVL-1 antibody. sIL2-R was elevated to 1,500 U/ml. The superficial lymph nodes were not palpable. CT examination was not remarkable for the liver and spleen. There was no generalized lymph node enlargement. Based on these findings, a diagnosis of malignant lymphoma of gastric origin was made. As the patient had respiratory disorders, too, wedge-shaped gastrectomy was performed to inhibit invasion. Pathological examination revealed CD3 positive large atypical lymphocytes diffusely, EBV positive, HP negative. As a result, a diagnosis of non-Hodgkin T-cell lymphoma was made. The tumor did not return for 1 year and 8 months after surgery, but the patient died of sudden aggravation of respiratory disorders in September 2007. Pathological anatomy was performed. The gastric remnant was left with lymphoma, and the bone marrow and systemic lymph nodes were negative for a malignant lymphoma. The possibility of stomach metastasis from the preoperative pyothorax-related malignant lymphoma was considered, but was ruled out because the lungs were devoid of a malignant lymphoma. We report a case of an extremely rare malignant T-cell lymphoma of gastric origin.
The patient was a 58-year-old man. A recent complete work-up was done to find the cause of epigastric pain and revealed a nodule about 4 cm in diameter in the upper right abdomen on CT scans. Laparoscopic resection was performed to allow for a definitive diagnosis to be made and to treat the lesion. The tumor was located in the transverse mesocolon, and there was no communication between the lesion and the ascending or transverse colon. Spindle-shaped tumor cells were arranged in palisades. The number of mitotic figures was only 1/50 HPF. The tumor was weakly positive for KIT and negative for CD34. From these findings, a diagnosis of extra-gastrointestinal stromal tumor originating in the transverse mesocolon was made.
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