Cases reported "Liver Neoplasms"

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1/48. Alpha-fetoprotein producing Barrett's esophageal adenocarcinoma: a case report.

    A 59-year-old man was admitted to our hospital with upper abdominal pain. His serum alpha-fetoprotein (AFP) level was very high, 1500 ng/ml. Upper gastrointestinal endoscopy revealed depressed lesion at 36 cm from the upper incisors, with columnar epithelium lining the esophagus circumferentially to the oral side of the lesion. Histological examination of biopsy specimens revealed a tubular adenocarcinoma as well as the presence of gastric columnar epithelium with intestinal metaplasia. immunohistochemistry demonstrated AFP in the tumor cells. From these results, a diagnosis of AFP-producing esophageal adenocarcinoma occurring in Barrett's esophagus, a condition which is extremely rare in japan, was established. Computed tomography (CT) showed multiple metastasis on the liver and wide-ranging lymph node metastasis. Chemotherapy was not effective and the patient died about 2 months after the start of treatment. The AFP-producing esophageal adenocarcinoma presented here had biological characteristics similar to those of AFP-producing gastric cancer.
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ranking = 1
keywords = esophagus
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2/48. Polypoid metastatic hepatocellular carcinoma of the esophagus occurring after endoscopic variceal band ligation.

    This report describes a rare case of metastatic hepatocellular carcinoma (HCC) presenting as a polypoid mass in the lower esophagus after endoscopic variceal band ligation (EVL). A 56-year-old man underwent EVL for variceal bleeding in September 1993. He presented with dysphagia and tarry stool in December 1993. An endoscopic examination revealed a semipedunculated polypoid mass at the lower part of the esophagus, where EVL had been performed 3 months previously. The histologic examination at autopsy revealed that the polypoid mass consisted of metastatic HCC that had spread via the retrograde portal flow.
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ranking = 3
keywords = esophagus
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3/48. Basaloid squamous carcinoma in the liver.

    This report concerns a 46-year-old female who presented with 3 months of abdominal pain and underwent a right hemi-hepatectomy for a 27 x 25 x 15 cm, centrally necrotic tumor that showed histological, immunohistochemical and ultrastructural features typical of a basaloid squamous carcinoma (BSC). A primary tumor at another site was not diagnosed and she died of disease 2 years later after several intra-abdominal recurrences. The entity of BSC was first described in 1986 and is a rare, poorly differentiated variant of squamous cell carcinoma occurring in various sites including the upper aerodigestive tract, esophagus, lung, anus, cervix and thymus. It has never been reported arising in the liver. It has characteristic histological, immunohistochemical and ultrastructural features and is associated with a poor prognosis. Whilst no other primary tumor was diagnosed, it is not possible to substantiate that this is a primary hepatic tumor in the absence of an autopsy examination to exclude an occult malignancy in another site.
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keywords = esophagus
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4/48. perfusion of the oesophagus and stomach during hepatic artery chemotherapy via an aberrant gastric artery.

    Symptoms of pain, dyspepsia and nausea arising during the administration of intrahepatic chemotherapy should be investigated with endoscopy to exclude inadvertent perfusion of the stomach.
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ranking = 2
keywords = esophagus
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5/48. Smooth muscle tumors of the esophagus: clinicopathological findings in six patients.

    Preoperatively, it is difficult to discriminate leiomyoma and leiomyosarcoma of the esophagus, which are rare smooth muscle tumors. The objective of this study was to evaluate the clinicopathological findings of this unusual lesion. A search of the surgery archives of the Toyama Prefectural Central Hospital of pathology revealed six cases of esophageal smooth muscle tumors. Clinicopathological findings were reviewed retrospectively. Only three patients (50%) presented with dysphagia, and the remaining three patients were asymptomatic. These patients underwent surgical excision. Histologically four of the six tumors were leiomyomas, and the other two tumors were leiomyosarcomas. Two tumors were in the upper to middle esophagus, and the remaining four were in the distal esophagus. On endoscopic examination, all tumors were noted to be polypoid. The two leiomyosarcomas measured over 5 cm and the four leiomyomas less than 4 cm. Neither ulceration nor necrosis proved to be of use in discriminating leiomyoma and leiomyosarcoma. The two patients with leiomyosarcoma died of liver metastasis 10 and 22 months after the treatment. patients with leiomyosarcoma presented with distant metastasis and/or recurrence, with hematogeneous metastasis being the predominant type of recurrence.
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ranking = 3.5
keywords = esophagus
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6/48. serum level of c-reactive protein may be a marker for proliferation of esophageal carcinoma.

    We herein show the significance of the serum level of c-reactive protein as an indicator of proliferation in esophageal carcinoma. The patient was a 70-year-old male with advanced squamous cell carcinoma in the lower location of the esophagus, and in whom an esophagectomy and reconstruction with a gastric tube through the intrathoracic route was performed. When he was later hospitalized again due to recurrent tumor, the serum c-reactive protein level was 5.0 mg/dL and it later increased to 10.8 mg/dL along with the proliferation of the tumor. After performing chemotherapy, the concentration of the serum c-reactive protein decreased to the negative level with a simultaneous improvement in his cachexic condition and the eventual disappearance of the tumor.
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ranking = 0.5
keywords = esophagus
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7/48. Long-term survival after gastric cancer and liver and paraaortic lymph node metastases: report of a case.

    We report the case of a 46-year-old man in whom successful resection of carcinoma of the stomach with liver and paraaortic lymph node metastases was carried out. The carcinoma was removed completely with combined resection of the lower esophagus, total stomach, distal pancreas, spleen, two metastatic liver nodes, and groups 1 and 2 and abdominal paraaortic lymph nodes. Adjuvant chemotherapy was administered postoperatively. The patient is currently well with a grade 1 performance status and no signs of recurrence 12 years after his operation. This experience suggests that even the presence of metastatic paraaortic lymph nodes and liver metastases is not necessarily a contraindication to surgery when the carcinoma can be resected curatively and safely.
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8/48. A squamous cell carcinoma of the gastric cardia showing submucosal progression.

    We report a case of squamous cell carcinoma (SCC) of the gastric cardia showing submucosal progression with direct invasion of the liver. A 71-year-old man was admitted with dysphagia. Esophagogastroscopy showed a protruding tumor covered with normal gastric mucosa in the anterior wall of the gastric cardia, although no abnormal findings were detected in the esophagus, including the esophagogastric junction. serum SCC-related antigen level was elevated (6.6 ng/ml; normal level, less than 2.5 ng/ml). Endoscopic biopsy specimens taken from this tumor did not show malignant cells. Based on these findings, the preoperative diagnosis was a submucosal tumor of the stomach. laparotomy was done; however, the tumor was not resected because it had direct invasion to the left lateral segment of the liver and adjacent tissues. As the tumor showed continuous bleeding from the stomach after surgery, total gastrectomy, combined with transhiatal lower esophagectomy, left lateral segmentectomy of the liver, splenectomy, and distal pancreatectomy was performed. Because histologic findings showed poorly or moderately differentiated SCC with direct invasion of the liver, the final diagnosis was SCC of the gastric cardia showing submucosal progression with hepatic invasion. Such a case of SCC of the gastric cardia showing submucosal progression is rare, and accurate preoperative diagnosis was very difficult. However, it may be important to consider SCC of the gastric cardia in such a situation.
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ranking = 0.5
keywords = esophagus
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9/48. Surgical treatment of synchronous hepatocellular and esophageal carcinoma: case report and review of literature.

    Simultaneous presentation of hepatocellular carcinoma and esophageal carcinoma is rare. Few cases have been reported as surgically curable. We treated a caucasian man of 68 years who presented a voluminous hepatocellular carcinoma in the right lobe of the liver and a superficial squamous cell carcinoma of the middle third of the esophagus. Both tumors seemed curable with surgery. We adopted a treatment consisting of two steps: 1) curative hepatic right trisegmentectomy; 2) three months later transhiatal esophagectomy. Two units of blood were transfused for both operations. Simultaneous hepatectomy and esophagectomy have been published in seven cases. We opted for resecting the tumors in two distinct procedures to lower the operative risk. Because of the large size of the hepatocellular carcinoma and the small size of the esophageal carcinoma, hepatectomy was performed first. The delay between the two interventions did not compromise the prognosis that is actually dependent of the hepatocellular carcinoma.
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keywords = esophagus
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10/48. Squamous cell carcinoma of the colon with an elevated serum squamous cell carcinoma antigen responding to combination chemotherapy.

    Primary squamous cell colorectal carcinomas are uncommon, and their characteristics are not well known. They seem to occur most commonly in the fifth decade of life with a slight predominance for men. The most commonly reported anatomic locations are the rectum and the proximal colon. Clinical features and common diagnostic methods do not easily differentiate squamous cell colorectal carcinomas from adenocarcinomas. Because of their extremely rare occurrence, it is difficult to study their natural course, clinical behavior, and response to therapy. This report presents the case of a pure squamous cell colorectal cancer and provides a brief review of the literature, which includes 60 previously published cases. The case of a patient with T3N2M0 primary squamous cell carcinoma of the rectosigmoid colon, which was initially treated with abdominoperineal resection followed by adjuvant chemotherapy and radiation, is presented. During the follow-up, an elevated squamous cell carcinoma antigen (SCC Ag) level led to restaging computed tomography scans, which confirmed recurrent metastatic disease in the liver. Response to chemotherapy with a decrease in tumor size correlated with a decrease in the serum SCC Ag level. Although SCC Ag has been used as a tumor marker for squamous cell cancers of the lung, head and neck, uterine cervix, and esophagus, this is the first reported case of a squamous cell colon carcinoma presenting with an elevated SCC Ag at the time of recurrence. In addition, this patient showed an objective partial response to combination chemotherapy, with a decrease in the serum level of this tumor marker.
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keywords = esophagus
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