Successful Treatment of Gastric Adenocarcinoma in a Meckel's Diverticulum with Pemetrexed Plus Carboplatin

Muto, Osamu; Munakata, Masaki; Iino, Chikara; Sakata, Yuh

doi:10.1093/jjco/hyq092

Cited by 10 publications

(6 citation statements)

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“…Johnson in 1973 reported the total number in the world literature as 18 [7], and recently, Kusumoto et al reported 30 cases [1]. A review of the literature of cases of adenocarcinoma of MD is shown in Table 1 [8][9][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the adenocarcinoma is thought to arise from heterotopic mucosa, and as such, gastric and intestinal types predominate, though another type like pancreas-type adenocarcinoma has been reported [8]. The common modes of presentation are abdominal pain and obstruction and most are detected in a metastatic setting [9]. Treatment of MD adenocarcinoma in the resectable stage includes resection and anastomosis of the small intestine with dissection of regional nodes.…”

Section: Discussionmentioning

confidence: 99%

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A case of primary adenocarcinoma of Meckel’s diverticulum presenting as ovarian mass and literature review

Gupta¹,

Inderdeep²,

Haldar³

et al. 2021

Indian J Case Reports

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Meckel’s diverticulum (MD) is the most common congenital anomaly affecting the gastrointestinal tract. It is located on the anti-mesenteric border of the small intestine and occurs due to incomplete obliteration of the omphalomesenteric duct during embryogenesis. Tumors, particularly cancers, are rare complications of MD. Carcinoids are the most common malignancies in this site. Adenocarcinomas are extremely rare and carry a poor prognosis. Here, we present the case of adenocarcinoma of MD presenting as Krukenberg tumor in a 42-year-old lady and causing a diagnostic dilemma. Pelviabdominal examination revealed large bilateral adnexal masses along with ascites and computed tomography-guided fine-needle aspiration cytology from the right adnexal mass was suggestive of adenocarcinoma. At exploratory laparotomy, a MD was found with hard intramural growth palpable at the tip of MD adnexal deposits and omental caking. Immunohistochemistry revealed CK 7- and CK 20+ve and also CDX2 positive. The rarity of presentation of bilateral adnexal mass due to primary adenocarcinoma of MD urges us to report this case.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case of primary adenocarcinoma of Meckel’s diverticulum presenting as ovarian mass and literature review

Gupta¹,

Inderdeep²,

Haldar³

et al. 2021

Indian J Case Reports

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“…Although activity of pemetrexed against several breast, gastric, pancreatic and colorectal adenocarcinoma cell lines has been reported [7], only a limited number of phase I or II studies involving chemotherapy including pemetrexed have been carried out in patients with gastric cancer; response rates ranged from 23% to 36% [8,9]. In Japan, there is only one case report demonstrating the efficacy of carboplatin plus pemetrexed in patients with gastric cancer [10]. Our case showed the efficacy of docetaxel or irinotecan monotherapy in non-squamous NSCLC, but not in gastric adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Synchronous lung and gastric cancers successfully treated with carboplatin and pemetrexed: a case report

et al. 2012

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IntroductionLung and gastric cancers are the first and second leading causes of death from cancer worldwide, and are especially prevalent in Eastern Asia. Relatively few reports are available in relation to the treatment and outcome of synchronous lung and gastric cancers, although there are increasing numbers of patients with these cancers. Efforts to develop more effective drugs for the treatment of synchronous cancers, without serious adverse effects, have been intensifying. Pemetrexed, a multi-targeted antifolate enzyme inhibitor, was approved by the United States Food and Drug Administration as a first-line chemotherapy for advanced non-squamous non-small cell lung cancer in 2007. Although clinical activity against several tumor types of adenocarcinoma, including gastric cancer, has been demonstrated, the efficacy of pemetrexed for gastric cancer remains to be fully evaluated.Case presentationWe report a case involving a 62-year-old Japanese woman with synchronous locally-advanced poorly-differentiated lung adenocarcinoma and poorly-differentiated gastric adenocarcinoma, containing signet-ring cells distinguished by immunohistochemical profiles. She had been treated with carboplatin and pemetrexed as a first-line chemotherapy for lung cancer, and had achieved partial responses for both lung and gastric cancers. These responses led to a favorable 12-month progression-free survival after the initiation of chemotherapy, and the patient is still alive more than 33 months after diagnosis.ConclusionsThis case suggests a new chemotherapeutic regimen for patients with synchronous multiple primary cancers that have an adenocarcinoma background.

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“…Because of its low incidence, there is as yet no established first-line chemotherapy, and prognosis is poor (10).In a previous study, a patient with MDCa, arising from gastric mucosa, failed first-line therapy with paclitaxel and cisplatinum and second-line therapy with S-1 and docetaxel. However, third-line chemotherapy with pemetrexed and carboplatinum resulted in reduction of the patient's ascites (11).Oxaliplatinum (L-OHP) is classified as a platinum-based cancer drug similar to cisplatinum (12). L-OHP inhibits DNA synthesis (13).…”

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confidence: 99%

Meckel’s Diverticulum Carcinoma Is Arrested by Oxaliplatinum and Eradicated by 5-Fluorouracil in a PDX Mouse Model Indicating Candidate First-line Treatment for a Rare Cancer

Masaki

Yonemura

Hozumi

et al. 2023

In Vivo

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Background/Aim: Meckel's diverticulum carcinoma (MDCa) is extremely rare. It is often advanced when found, and the prognosis is poor. Effective treatment for this cancer has not yet been developed. We previously established a patient-derived xenograft (PDX) nude-mouse model of MDCa. In the present study, we investigated the efficacy of oxaliplatinum (L-OHP) and 5-fluorouracil (5-FU) on an MDCa PDX nude-mouse model. Materials and Methods: PDX mouse models of MDCa were divided into three groups (five mice per group): untreated control; L-OHP-treated; and 5-FUtreated. Tumor volumes of the three groups were compared after 2 weeks. Results: L-OHP arrested tumor growth (p=0.038) and 5-FU apparently eradicated the tumor (p=0.007). Conclusion: L-OHP and 5-FU are candidates for clinical first-line therapy of MDCa.Meckel's diverticulum (MD), a true diverticulum, is the most frequent congenital abnormality of the gastrointestinal tract, occurring in approximately 2% of the general population (1-9) with a reported incidence of cancer only 0.5% to 3.2%. MD carcinoma (MDCa) is extremely rare, as most tumors that arise in the MD are carcinoid (10). Because of its low incidence, there is as yet no established first-line chemotherapy, and prognosis is poor (10).In a previous study, a patient with MDCa, arising from gastric mucosa, failed first-line therapy with paclitaxel and cisplatinum and second-line therapy with S-1 and docetaxel. However, third-line chemotherapy with pemetrexed and carboplatinum resulted in reduction of the patient's ascites (11).Oxaliplatinum (L-OHP) is classified as a platinum-based cancer drug similar to cisplatinum (12). L-OHP inhibits DNA synthesis (13). In clinical practice, L-OHP is used primarily for advanced colorectal cancer (14).5-Fluorouracil (5-FU) is a fluoropyrimidine-antimetabolite chemotherapy agent (15), used for a variety of adenocarcinoma types, including gastric, liver, colorectal, and breast cancer (16,17).We have previously established a patient-derived xenograft (PDX) mouse model of MDCa by subcutaneously implanting MD carcinoma obtained from a patient into nude (nu/nu) mice ( 18). In the present study, we determined the efficiency of L-OHP and 5-FU using the PDX mouse model of MDCa.

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Successful Treatment of Gastric Adenocarcinoma in a Meckel's Diverticulum with Pemetrexed Plus Carboplatin

Cited by 10 publications

References 3 publications

A case of primary adenocarcinoma of Meckel’s diverticulum presenting as ovarian mass and literature review

A case of primary adenocarcinoma of Meckel’s diverticulum presenting as ovarian mass and literature review

Synchronous lung and gastric cancers successfully treated with carboplatin and pemetrexed: a case report

Meckel’s Diverticulum Carcinoma Is Arrested by Oxaliplatinum and Eradicated by 5-Fluorouracil in a PDX Mouse Model Indicating Candidate First-line Treatment for a Rare Cancer

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