Seventy years of age woman noticed a mass inside her right breast before three years. Since she had ulcer bleeding, she visited our hospital. In actual conclusions, a hemorrhagic about 8 cm mass with an ulcer ended up being found in the top right breast. Breast ultrasonography revealed a big tumor of approximately 8 cm in the right A area, and needle biopsy disclosed unpleasant ductal carcinoma(ER positive, PgR positive, HER2 positive, Ki-67 low expression). Right axillary lymph node metastasis was verified, but no clear distant metastasis was seen. Pretreatment diagnosis had been right breast cancer, cT4bN1M0, Stage ⅢB, Luminal HER. Chemotherapy was started with pertuzumab, trastuzumab, and docetaxel, additionally the cyst ended up being decreased after 6 rounds. Due to side effects, the medication was changed to a molecular specific medication only plus the treatment had been continued. But, redness ended up being seen in the complete correct breast, and cancer of the breast epidermis metastasis ended up being lung viral infection suspected. Considering that the dermatitis due to metronidazole solution was also distinguished, the redness had been enhanced as soon as the application had been stopped. Whenever verified by a patch test, a reaction to metronidazole gel ended up being seen, resulting in the diagnosis of dermatitis caused by metronidazole gel.A 21-year-old girl ended up being accepted for preshock due to extreme anemia. A 5 cm gastrointestinal stromal tumor(GIST)at the jejunal flexure of her duodenum was diagnosed by enhanced CT evaluation. We performed an overall total laparoscopic pancreas- preserving duodenal sleeve resection with a 2 cm margin through the tumefaction. Functional end-to-end anastomosis had been done with the patient lying in a right half horizontal decubitus place so that you can shift the weight of this check details tumefaction and duodenal mesentery off to the right to stop medical pill harm. We experienced one case(5.5%)of peritoneal(recurrent)GIST after laparoscopic gastrectomy. Nevertheless, this really is typically a safe and useful means of laparoscopic duodenal sleeve resection of duodenal GIST at a distal section through the papilla Vater, whenever carried out by a skilled team.A 73-year-old guy presented with anemia, and gastroscopy revealed a nonpigmented tumefaction when you look at the esophagogastric junction. Caused by the tumefaction biopsy initially suspected badly differentiated adenocarcinoma. Nevertheless, extra immunohistochemical examination unveiled malignant melanoma. The ultimate analysis ended up being amelanotic malignant melanoma associated with the esophagogastric junction with adrenal and spinal metastasis. Although immunotherapy had been carried out, the patient died 132 times after diagnosis.We report an unusual instance of cavitary lung metastasis of rectal disease, identified initially as septic pulmonary embolism. A 55- year-old woman underwent crisis Hartmann’s procedure for perforation for the rectal cancer tumors with numerous liver metastases. A 2 cm-sized thin-walled cavitary lesion was observed in the left upperlobe regarding the lung by CT, and septic pulmonary embolism was suspected. She recoverd from sepsis after intensive attention therapy. Pathological diagnosis is adenocarcinoma (tub2), T3N1M1, Stage Ⅳ, she underwent chemotherapy. Serum CEA level had been large preoperatively but gradually reduced to normal 4 months after the procedure. Multiple liver metastases revealed calcification, additionally the lung lesions stayed unchanged on CT. She continued chemotherapy while changing the anticancer medicine because of negative effects. One year and 5 months after operation, lung CT showed thickened wall and spicula all over cavitary lesion. Serum CEA level was typical cancer precision medicine , SLX and NSE slightly increased and serum aspergillus antigen ended up being positive. Bronchial lavage cytology was Class Ⅰ and scrape cytology had been Class Ⅲ in bronchoscopy. Lung metastasis, primary lung cancer tumors or aspergilloma had been suspected and then we performed limited lung resection. The pathological analysis had been rectal cancer lung metastasis.The patient, a male in the 70s, visited our hospital with a chief problem of basic tiredness and slimming down. Upon a detailed examination, he had been diagnosed with sigmoid cancer of the colon, para-aortic lymph node metastases, and multiple liver metastases, for which he had been hospitalized as a result of a poor overall performance status(PS). FOLFOX treatment had been administered whilst the signs brought on by the main lesion were not acknowledged along with his basic problem was considered to be bad and therefore he had been considered to be inoperable. After completing 2 classes associated with the chemotherapy, although his PS improved, laparoscopic sigmoidectomy had been done with colonic stent positioning due into the incident of an intestinal obstruction due to an enlargement associated with main lesion. Following surgery, 2 courses of FOLFOX treatment and 4 classes of FOLFOX plus bevacizumab therapy had been administered and then he is alive at 5 months following the operation without progression.A 56-year-old man presented to our medical center with melena, and was diagnosed as having locally advanced sigmoid a cancerous colon invading the trigone for the bladder(cT4bN0M0). mFOLFOX6 plus panitumumab was administered as a preoperative chemotherapy. After 6 courses of management, the primary tumefaction shrunk but the bladder intrusion stayed. We told the patient that resection for the bladder had been essential for radical treatment of the cyst. While he declined a urostomy for urinary reconstruction, we opted ileal neobladder repair and performed lower anterior resection plus total cystectomy, which resulted in pathologically curative resection. No recurrence and almost no bladder control problems took place during the 8 months following the procedure.
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