Oat cell carcinoma of the esophagus

An oat cell carcinoma occurring in the esophagus of a 59-year-old man is described. A review of another 22 cases of such a tumor from the English literature is made. These tumors may have three histologic patterns; pure oat cell carcinoma, oat cell carcinoma with squamous cell carcinoma, and oat cell carcinoma with adenocarcinoma. They appear to arise from enterochromaffin cells; the neoplastic cells show argyrophilia and neurosecretory-type granules on electron microscopy. Resection has been the principal mode of therapy. Overall survival for these patients is about 6 months, with most patients dying of extensive metastatic disease.     

小于3cm的食管癌放射治疗的疗效分析

目的分析３ｃｍ以下食管癌病人的预后及与照射量之间的关系。材料与方法自１９７７年１月到１９８８年１２月共收治３ｃｍ以下的食管癌１９３例，男１１８例，女７５例。全部有病理证实，均为鳞癌。其中包括颈段癌３例，胸上段癌７８例，胸中段癌１０５例，胸下段癌７例。照射方法采用６０Ｃｏ外照射，常规３野，２００ｃＧｙ／次，５次／周，照射量４０８８～７３４５ｃＧｙ。结果１，３，５和８年生存率分别为７１．５％、４０．４％、３０．１％和１６．５％。以５０００～７０００ｃＧｙ组生存率最高，＞７０００ｃＧｙ组最差，且＜５０００ｃＧｙ组１和３年生存率明显高于＞７０００ｃＧｙ组，５和８年生存率无差别。结论食管癌病人的病变越短，生存率越高；病变部位与生存率的关系不大；最佳的照射量应为６０００ｃＧｙ左右／５周，对于３ｃｍ以下较早期的食管癌病人，放射治疗中不宜追求高剂量。     

Small cell carcinoma of the esophagus responding to fourth-line chemotherapy with weekly paclitaxel

A patient was diagnosed with a small cell carcinoma of the esophagus (T4N1M1b by the International Union Against Cancer [UICC] classification) in October 2002, and initially received two courses of concurrent chemotherapy with 5-fluorouracil (5-FU; 400 mg/m² by continuous infusion; days 1–5 and 8–12) and cisplatin (40 mg/m² by drip infusion; days 1 and 8) and radiation therapy (2 Gy/day, days 1–5, 8–12, and 15–19; total, 30 Gy per course) with the second course given after a 2-week interval. Two courses of chemotherapy with 5-FU (800 mg/m²; days 1–5) and cisplatin (80 mg/m²; day 1) given after this was completed. Although a complete response had been confirmed, recurrence with multiple liver and lymph node metastases was detected 3 months after the cessation of the second course of chemotherapy. Although the patient received second-line chemotherapy with irinotecan (150 mg/m²; every 2 weeks) from June 2003, the disease progressed. Brain metastases developed during third-line chemotherapy with gemcitabine (1000 mg/m² weekly by drip infusion). The symptoms were attenuated after whole-brain radiation (30 Gy), and fourth-line chemotherapy using paclitaxel (80 mg/m²; weekly) was initiated from November 2003. A computed tomography scan 1 month after the first course of paclitaxel showed remarkable regression of the liver metastases. The treatment strategy used for treating small cell carcinomas of the lung may be applicable for these carcinomas of the esophagus.     

26例食管小细胞癌的临床分析

目的:分析食管小细胞癌的临床特点及疗效,探讨合适的治疗模式。方法:采用回顾性分析方法,对行食管癌根治手术的26例食管小细胞癌行临床总结归纳。结果:病理的大体分型为溃疡型13例,髓质型5例,蕈伞型3例,腔内型1例,斑块型1例,粘膜粗糙型1例,2例未分型。92.3%(24/26)的患者手术病理中含有多种病理成分。总体疾病复发率53.8%(14/26),血行转移34.6%(9/26),非区域淋巴结转移26.9%(7/26),区域淋巴结转移15.4%(4/26),消化道其它部位肿瘤7.6%(2/26)。26例患者总体生存时间平均83.64个月(1~106个月);无病生存时间(DFS)平均44.59个月(1~106个月),中位DFS17个月(1~106个月)。各项因素中,无病生存的影响因素为病理分型,复发的影响因素为病变部位和病理分型;血行转移的影响因素为年龄和T分期。结论:食管小细胞癌符合起源于多潜能干细胞的理论。食管小细胞癌的治疗应当以手术为主,化放综合治疗有望提高疗效。临床上要密切观察肿瘤部位、病理分型等与疾病转归的可能关系。对远处淋巴结转移的患者应给与积极治疗。     

肾原发性大细胞神经内分泌癌伴高级别尿路上皮癌1例报道并文献复习

目的:探讨肾脏大细胞神经内分泌癌的临床病理特征、诊断和鉴别诊断。方法:分析1例肾原发性大细胞神经内分泌癌伴高级别尿路上皮癌患者的临床表现,对标本进行组织学观察,免疫组化染色,并复习相关文献。结果:患者为63岁男性,因间歇性血尿就诊。巨检:右肾中下部及肾盂处见一6cm×5cm×5cm肿块,切面灰白色,大部分实性质地中等、下极肾盂处部分呈乳头样质脆。镜检:实质性区域瘤细胞呈巢状、小梁状或条索状排列,片状坏死,瘤细胞Syn、ChgA和CD56均为阳性,Ki-67增殖指数达40%;乳头样结构处呈典型的尿路上皮乳头状癌图像。癌肿侵犯肾门脂肪组织伴肾门淋巴结转移。结论:肾原发性大细胞神经内分泌癌是罕见肿瘤,伴尿路上皮癌更罕见,具有高侵袭性,转归预后差,诊断主要依据病理形态学检查和免疫组织化学。     

Squamous cell carcinoma of the rectum: a case report and review of the literature

Squamous cell carcinoma of the colon and rectum are extremely rare neoplasms. Many questions regarding their histogenesis and biological behaviour remain unanswered. Surgery is the most effective therapy, and adjuvant chemotherapy and radiotherapy should be considered, especially for node-positive patients. We present a patient with squamous cell carcinoma of the middle rectum who underwent abdominoperineal resection and postoperative adjuvant chemotherapy. The pertinent literature is reviewed.     

Merkel细胞癌术后复发1例及相关文献复习

目的：探讨Merkel细胞癌的诊断、治疗及预后。方法：一位老年Merkel细胞癌患者，于2006年8月初发时先行化疗及放射治疗，1年后局部再发肿瘤，再次接受扩大性切除术及放疗和化疗。结果：术后1月Merkel细胞癌再次复发。结论：Merkel细胞癌是一种罕见且进展快的皮肤肿瘤。诊断主要依靠病理（包括免疫组化方法），即使综合治疗后仍有局部复发和远处转移的倾向，预后差。     

宫颈小细胞癌9例报告并文献复习

目的:提高对宫颈原发性小细胞癌的认识。方法:收集9例宫颈原发性小细胞癌病例进行临床病理学观察,其中5例为全子宫切除标本,另外4例为宫颈活检标本。结果:患者年龄34-60岁,平均43岁。患者主要以阴道不规则出血,有或无阴道异常排液,伴有头晕、低热或乏力等为主要症状。专科检查:阴道通畅,可见少量的血性分泌物,宫颈管扩张、增大,宫颈管内或宫颈外口处可见新生物。结论:宫颈原发性小细胞癌是一种宫颈罕见的高度恶性肿瘤,免疫组织化学染色有助于诊断与鉴别诊断。     

原发性喉小细胞癌6例报告及文献复习

目的 探讨原发性喉小细胞癌的临床特点、起源、病理、治疗及预后因素。方法 对本院收治的６例原发性喉小细胞癌的临床资料进行回顾性分析，其中５例为单纯小细胞癌，１例合并鳞癌。患者中位年龄５３岁，男：女灵２：１。主要症状为声间嘶哑、多发生于声门上区。治疗采用手术加放射治疗和化疗的综合治疗。５例术前或术后放射治疗采用＾６０Ｃｏ，６，８ＭＶＸ射线，常规照射，总剂量４０～７０Ｇｙ，４～７周。５例术后化疗采用ＣＥ     

Primary squamous cell carcinoma of the colorectum: case report and literature review of a rare entity

A case of primary squamous cell carcinoma of the rectum is presented. Although it is a rare condition, the diagnosis, treatment, and natural history of the disease are similar to that of adenocarcinoma of the colorectum. The patient in this report has done well to date with an abdominal perineal resection and early post-operative radiation. A review of the literature reveals that the precise etiology of this entity remains unknown.     

The role of radiation therapy in the treatment of small cell undifferentiated bronchogenic cancer.

The current enthusiasm for polychemotherapy in small cell undifferentiated bronchogenic carcinoma obscures the necessity for primary control by radiation therapy. One hundred and sixty-three patients with this diagnosis were treated in the periods 1965-67 (56) and 1974-76 (107). In the earlier period patients received radiation alone or radiation plus single-agent chemotherapy. In the latter period, all patients were treated with multiple-agent chemotherapy in addition to radiation therapy. Median survival time was extended approx. 4 weeks for the latter group of patients at the cost of much morbidity and occasional lethality. In the patients that were autopsied from both series, only 5/30 were free of disease within the treatment portals and all had received more than 4000 rad tumor dose regardless of adjuvant therapy. A total of 14 autopsies were performed on patients treated by chemo-immunotherapy alone during the 1974-76 period. All of these revealed disease in the primary site and mediastinum although some had no evidence of distant metastasis. Tumor volume is sufficiently large within the primary site and regional lymphatics that presently available chemoimmunotherapy without high dose irradiation is unlikely to sterilize loco-regional disease. Elective radiation to the whole brain was administered to 25 patients and only 3 developed cerebral metastases. Of the remaining 82 patients who were treated concurrently, 25 developed cerebral metastasis and then received radiation therapy to the whole brain, 10 of these patients subsequently died.     

Breast carcinoma with osteoclast-like giant cells: a case report and review of the Japanese literature

A 41-year-old premenopausal woman with a 3.5 cm freely mobile mass in the upper outer quadrant of the right breast was admitted to our hospital. Fine needle aspiration showed malignant epithelial cells and many multinucleated osteoclast-like giant cells (OGCs). Excisional biopsy revealed an invasive ductal carcinoma. A right modified radical mastectomy was subsequently performed. Macroscopically the tumor was well circumscribed with a dark brown cut surface. Microscopically, the tumor was a grade 2 invasive ductal carcinoma with many multinucleated OGCs adjacent the tumor cells and hemorrhage and infiltration of inflammatory cells in the stroma. The intra-mammary metastasis also contained OGCs and stromal reactions. By enzyme immunoassay, the tumor cells were negative for estrogen receptor but positive for progesterone receptor. The tumor cells were negative for both c-erbB-2 and p53. The OGCs showed positive immunostaining with the monoclonal antibody CD68, demonstrating a histiocytic origin. Lymph nodes were free of metastasis. We also review the Japanese literature concerning breast carcinoma with OGCs.     

原发性肝透明细胞癌1例临床分析及文献复习

目的：探讨原发性肝透明细胞癌的诊断和治疗方法。方法：分析我科收治的1例肝透明细胞癌治疗效果以及文献的相关报道。结果：1例54岁男性患者,表现为肝占位病变,经穿刺活检证实为肝透明细胞癌。经射频消融、经肝动脉介入治疗和γ刀治疗,患者生存27.0个月。结论：肝透明细胞癌的诊断须经病理免疫组化确诊,手术联合射频消融、经肝动脉介入化疗有助于提高肝透明细胞癌的治疗效果。     

原发性肝透明细胞癌1例临床分析及文献复习

目的:探讨原发性肝透明细胞癌的诊断和治疗方法.方法:分析我科收治的1例肝透明细胞癌治疗效果以及文献的相关报道.结果:1例54岁男性患者,表现为肝占位病变,经穿刺活检证实为肝透明细胞癌.经射频消融、经肝动脉介入治疗和γ刀治疗,患者生存27.0 个月.结论:肝透明细胞癌的诊断须经病理免疫组化确诊,手术联合射频消融、经肝动脉介入化疗有助于提高肝透明细胞癌的治疗效果.     

Small cell carcinoma of the esophagus: a case report and review of the literature

We present a case of small cell esophageal carcinoma (SCEC) treated with alternated chemotherapy (including cisplatin, etoposide, vincristine, cyclophosphamide and doxorubicin) and irradiation (36 Gy) followed by surgery. Despite a pathological complete response, the patient died of regional disease recurrence 29 months after the diagnosis. We reviewed the available literature on SCEC with regard to the incidence, clinical symptoms, radiological signs, diagnostic workup, therapeutic modalities and prognosis of this malignancy.     

膀胱小细胞神经内分泌癌与鳞癌混合性癌1例并文献复习

目的:通过对1例膀胱小细胞神经内分泌癌与鳞癌的混合性癌患者病例的分析,探讨该病的临床特点、病理学特点、临床诊断、治疗方法及预后。方法:回顾性分析遵义医学院附属医院泌尿外科2017年10月收治的1例术后病理组织学诊断为膀胱小细胞神经内分泌癌与鳞癌混合性癌患者的临床资料并进行国内外文献复习。结果:49岁男患,因“发现肉眼血尿2月余”入院,全麻下行腹腔镜根治性膀胱全切+回肠新膀胱+扩大淋巴结清扫术,术后经病理组织学确诊为膀胱混合性癌（小细胞神经内分泌癌+角化型鳞癌）。结论:膀胱小细胞癌(包括其与移行细胞癌、腺癌和鳞癌等复合癌)临床表现主要以肉眼血尿为主,呈现高度的恶性生物学行为,具有发现晚、进展快、转移早、恶性程度高、预后差等特点,需尽早完善病理学诊断,明确肿瘤的临床分期以达到早期治疗与有效改善其预后的目的。     

Metastasis of esophageal small cell carcinoma to the appendix: A case report and literature review

Primary small cell carcinoma (SCC) of the esophagus is characterized by high malignancy with a tendency to metastasize early through lymph and blood circulation. Metastasis of esophageal SCC frequently occurs to distant organs such as liver and lung. However, few cases of appendiceal metastasis have been reported. This paper first presents a pathologically confirmed case with metastasis of esophageal SCC to the appendix. This particular case highlights the importance of pathological diagnosis and provides new evidence of appendiceal metastasis from esophageal SCC.     

Primary oat cell carcinoma of the larynx: A case history and literature review

A case of primary oat cell carcinoma of the larynx is described and the literature reviewed. The origin of this rare tumor and the natural history of the disease are discussed. The different treatment modalities carried out so far are described.     

A case report of primary small cell carcinoma of the breast and review of the literature

Primary small cell carcinoma (SCC) of the breast, an exceedingly rare and aggressive tumor, is often characterized by rapid progression and poor prognosis. We report a case of primary SCC of the breast that was diagnosed through pathologic and immunohistochemical examinations. Computed tomography (CT) scans failed to reveal a non-mammary primary site. Due to the scant number of relevant case summaries, this type of tumor is proved to be a diagnostic and therapeutic challenge. Therefore, we also reviewed relevant literature to share expertise in diagnosis, clinicopathologic characteristics, treatment, and prognosis of this type of tumor. Future studies with more cases are required to define more appropriate treatment indications for this disease.     

Oat cell carcinoma (apudoma) of the esophagus: a case report.

An oat cell carcinoma occurring in the esophagus of a 62-year-old man is described. A strong argyrophilia of the oat cells together with the presence electron microscopically of neurosecretory type granules in their cytoplasm suggests a derivation of this tumor from the cells of the APUD series, and the tumor is diagnosed as apudoma. An aberrant columnar epithelium on the esophageal surface is presumed to be the source of its origin. A rapid postoperative course of the patient despite a rather circumscribed growth pattern of the primary tumor appears to characterize the clinical aspect of this case. An apparent accumulation of the cases with esophageal apudoma in Japan is discussed.