The Japanese Society for the Study of Postoperative Morbidity after Gastrectomy conducted a nationwide questionnaire survey to clarify the current status of reconstruction after gastrectomy. One hundred and forty-five institutions (66%) responded to the survey. The questionnaire dealt with the reconstruction after a distal gastrectomy, pylorus-preserving gastrectomy (PPG), total gastrectomy, and proximal gastrectomy. The most common method of reconstruction after distal gastrectomy was Billroth I in 112 institutions (74%), and Roux-en-Y (RY) in 30 (21%). Seventy-seven institutions (53%) responded to the PPG questions. The lengths of the antral cuff were widely distributed among the institutions. Segmental gastrectomy was performed by 23 institutions for limited cases. The most common method of reconstruction after total gastrectomy was RY in 138 institutions (95%). Reconstruction with a pouch after total gastrectomy was done in 26 institutions (18%). The most common reconstructions after proximal gastrectomy were esophagogastrostomy in 69 institutions (48%), jejunal interposition in 41 (28%), double tract in 19 (13%) and pouch reconstruction in 6 (7%). Although most Japanese surgeons are concerned about the revised methods of reconstruction and quality of life after gastrectomy, surgeons have not yet reached a full consensus on these issues.

HighlightsA very rare case of large retroperitoneal mucinous cystadenocarcinoma and little-known clinical course of the disease is reported.The disease took unexpectedly aggressive progression despite the small portion of adenocarcinoma for the multiple and large cysts.Informative findings in imaging of primary retroperitoneal mucinous cyst adenocarcinoma, and impressive imaging after recurrence are presented.

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A Peutz-Jeghers P-J type polyp is a hamartomatous polyp that occurs in patients with P-J syndrome, but is rarely found as a solitary polyp in non-P-J syndrome patients 1 . There have been some reports of polyposis and cancerous transformation in patients with P-J syndrome, but few reports of solitary P-J type polyps containing cancer foci 2, 3 . We report here a rare case of a colorectal P-J type polyp showing the hamartoma-adenoma-carcinoma sequence in a non-Peutz-Jeghers syndrome patient. Case ReportA 48-year-old woman was admitted to our hospital for medical examination. Colonoscopy Abstract : Peutz-Jeghers P-J syndrome is an inherited disorder characterized by multiple hamartomatous gastrointestinal polyps, mucocutaneous pigmentation, and an increased risk of both digestive tract and non-digestive tract cancers. P-J type polyps are characteristic of P-J syndrome but rarely present as solitary polyps. Though cancerous lesions frequently develop from polyposis in P-J syndrome, reports of malignancy in solitary colorectal P-J type polyps are rare ; our literature search identi ed only two examples. This report describes a non-Peutz-Jeghers syndrome patient with a solitary P-J type polyp showing the hamartoma-adenoma-carcinoma sequence.

IntroductionOnly 30 cases of non-invasive intra-capsular carcinoma ex pleomorphic adenoma have been reported in the English language literature [1][2][3][4][5] . Here, we report three cases of noninvasive carcinoma ex pleomorphic adenoma and we have carried out a literature survey. Table 1-1, 1-2 Case Reports Case 1A 61-year-old man was admitted to hospital, presenting with a mass in the parotid gland. The prognosis and therapeutic appoach will depend on evidence of capsular invasion. HER-2/neu is a useful marker in the differential diagnosis of pleomorphic adenoma versus noninvasive carcinoma ex pleomorphic adenoma.