胰腺癌伴肝、左眼眶转移1例

眼眶转移癌发生比例较小,及早发现原发病灶非常关键。原发性胰腺癌眼眶转移更为罕见,机理尚不清楚。本文报告1例原发胰腺癌伴肝、左眼眼眶转移病例,为临床诊断提供了一定参考。患者经过颅骨和上腹部断层扫描、左眼眶占位摘除活检术,再结合术后病理及实验室检查结果拟诊。行单药健择化疗3周期,患者病症有所减轻。     

胰腺癌皮肤广泛转移2例

1 病例 例1,患者男性,78岁,因右上腹疼痛,向左腰背部放射3月入院。查体:慢性消瘦病容,胸背部、腹部、四肢均可扪及质硬,大小不等,约0.5cm～2.5cm,皮下结节共39枚,与皮下组织无粘连,部分大结节表现有溃烂,无触痛。腹部B超及CT检查均示:胰体尾占位病变约6cm×7cm,腹膜后淋巴结肿大。皮下结节活检病理报告为转移性腺癌。转外院行γ     

胰腺癌附睾转移1例报道及文献复习

患者,男,7l岁.发现右阴囊肿块5个月,右睾丸切除术后1周转入我院.5个月前,无明显诱因下,发现右阴囊肿块,并进行性增大伴胀痛.     

胰腺癌侵袭和转移机制的研究进展

胰腺癌是预后最差的消化系统恶性肿瘤之一，确诊后平均生存期不超过6个月，5年生存率低于5％，其主要原因是胰腺癌早期诊断困难，较早发生血液或淋巴转移。胰腺癌侵袭和转移的机制是目前研究的重要课题，探讨胰腺癌侵袭转移过程的有关分子机制，对提高胰腺癌治疗效果将具有重要的理论指导意义和临床应用价值。在以往研究中，对细胞外基质蛋白水解酶、黏附分子、转移抑制相关基因及肿瘤新生血管在胰腺癌侵袭转移中的作用机制的探讨较多，本主要围绕趋化因子、低氧微环境、一氧化氮、环氧合酶-2及失巢凋亡在胰腺癌侵袭转移中的研究进展作一综述。[第一段]     

18F-FDGPET-CT用于胰腺癌放疗的研究进展

胰腺恶性肿瘤的治疗是消化系统恶性肿瘤治疗的一个难点,结合各种治疗手段的现状,目前胰腺癌治疗的观念及模式需进一步转变。然而随着现代放射治疗技术图像引导放射治疗（IGRT）等精确放疗技术在胰腺癌治疗中的广泛引用,胰腺癌患者得到了明显生存获益。先进的影像学设备为精确放疗技术提供了重要的基础,本文主要围绕18F-PDG PET-CT 检查在胰腺癌放射治疗中各方面的临床价值进行综述。     

胰腺癌伴淋巴结转移的基因芯片研究

目的 利用基因芯片技术分析伴与不伴淋巴结转移胰腺癌组织中的差异表达基因。方法 将4000个人类全长基因的PCR产物点样于特殊处理后的玻片上制备基因芯片。用逆转录的方法,分别将两种荧光Cy3-dUTP和Cyt-dUTP标记正常胰腺组织和胰腺癌组织mRNA,以制备cDNA探针,并与芯片杂交。以ScanArray 3000荧光扫描仪扫描芯片上两种荧光信号,获得的荧光信号图像用计算机分析。每点上两种荧光信号的强度分别代表Cy3-dUTP和Cy5-dUTP的量。最后,计算每点的Cy5和Cy3比值。结果 在所检测的2例伴淋巴结转移和2例不伴淋巴结转移的胰腺癌标本中,56个基因（其中包括24个已知基因）有表达差异。结论 基因芯片技术为阐明人类胰腺癌伴淋巴结转移的特异性基因表达提供了有效方法。     

放射性125I粒子联合骨水泥椎体成形术治疗脊柱成骨性转移瘤的临床价值

目的 探讨放射性125 I粒子联合骨水泥椎体成形术治疗脊柱成骨性转移瘤的临床价值.方法 选取脊柱成骨性转移瘤患者80例,随机分为对照组和观察组,每组40例.对照组行单纯骨水泥椎体成形术治疗,观察组行放射性125 I粒子联合骨水泥椎体成形术治疗.观察患者视觉模拟(VAS)评分及功能障碍指数(ODI)评分、生活质量调查表(...     

胰腺癌侵袭和转移相关基因的研究进展

胰腺癌恶性生物学行为的1个重要特点就是具有明显的侵袭和转移性，在胰腺癌的早期就可以发生胰外播散，浸润至局部淋巴结、肠系膜血管、门静脉、胰周脏器和脂肪组织以及腹膜后神经丛等，或通过血行性转移至肺、肝等远处器官，导致3／4以上的胰腺癌患者就诊时丧失了根治性手术治疗的机会，使胰腺癌有较高的死亡率，5年生存率低于5％，因此深入揭示胰腺癌侵袭和转移的分子机制具有重要的理论和临床应用价值，     

Case Report: Long-Term Survival in Patients with Initial Lung-Only Metastasis from Pancreatic Adenocarcinoma

Purpose

Whilst surgery is the only potentially curative treatment for cholangiocarcinoma, many patients are either unfit for major surgery or have unresectable disease. Patients who undergo attempted curative resective surgery often have involved resection margins. The role of radiotherapy in these settings has not been clarified and is often not considered because of fears of late complications, especially liver and gastrointestinal toxicity. We present our experience of treating cholangiocarcinoma, either unresectable or locally advanced, with conformal radiotherapy and concurrent chemotherapy, examining survival, toxicity, patterns of failure and details of radiotherapy and chemotherapy administered.

Methods

Between 1995 and 2005, 20 patients, median age 60.5?years (range 45?C78?years) with cholangiocarcinoma received radical conformal radiotherapy (median dose 46?Gy in 1.8?C2.0?Gy fractions) with concurrent cisplatin/5-FU and sequential gemcitabine chemotherapy.

Results

Overall median survival was 20.4?months, 2?year survival, 43% and relapse-free survival, 9.6?months. 19/20 patients (95%) have died. One patient remains alive with liver and bone metastases. First site of failure was local and within radiotherapy field in 9/20 (45%) patients. No patient required interruption of radiotherapy for radiation toxicity, and none experienced subsequent late liver toxicity.

Conclusions

The survival of this group of historically poor prognosis patients is encouraging. Durable local control was achieved in a majority of patients having chemoradiotherapy and toxicity was not severe. Although most patients still succumbed to disease, treatment delayed onset of progression. Conformal radiotherapy should be considered as an integral component in new investigative approaches to treatment in this rare cancer.     

Skull Metastasis from Ampulla of Vater Adenocarcinoma: Case Report

We report a rare case of skull metastasis from ampulla of Vater adenocarcinoma in a patient with controlled primary neoplasm. This 65-year-old Korean man presented with headache and painful parietal scalp swelling, but he did not show any neurological deficits. Computed tomography revealed an osteolytic mass that invaded and expanded through the skull tables in full-thickness. On magnetic resonance images following Gadolinium injection, the mass appeared slightly hypointense signal on all sequences and intense heterogeneous enhancement. He underwent surgical excision with artificial grafting of calvaria and dura. Postoperative radiation therapy was ensued for metastatic adenocarcinoma, and he was well for the follow-up period of 3 months. To the best of our knowledge, this is the first such case that involved the skull.     

Laryngeal Metastasis from a Pulmonary Papillary Adenocarcinoma: A Case Report

Metastases to the larynx from distant primaries are very rare.The present article reports a case of metastatic papillary adenocarcinomaof the larynx of lung origin. The patient was a 59-yearold femalenon-smoker, who had a history of adenocarcinoma of the rightlung. For the laryngeal tumor, we performed a partial laryngectomyfollowing biopsy. The tumor of the larynx was a papillary adenocarcinomaresembling the lung tumor, both demonstrating positive immunohistochemical staining for pulmonary surfactant apoprotein.The findings emphatically indicated the laryngeal tumor to bemetastasis from the primary papillary adenocarcinoma of thelung. The present case report presents the clinical findings,course of disease and histopathological findings with briefreviews of the literature.     

空洞性肺转移瘤1例

1资料患者男性,66岁,2012年11月24日无明显诱因出现咳嗽,咳少量白痰,痰不易咳出,伴食欲不佳,活动后胸闷气急,于2012年12月16日到某市人民医院就诊,查胸部CT示:右肺下叶见团状块,余两肺野密布大量小结节灶。12月20日行气管镜检查示:右肺下叶开口唇形狭窄,背段开口明显狭窄,触之易出血,未见新生物。黏膜充血,粗糙,呈浸润样改变,该处刷片,病理     

肺腺癌心脏转移1例报道

肺癌是心脏恶性转移瘤中最常见的原发肿瘤，临床上心脏作为肿瘤的靶器官容易被忽略。我科最近收治1例肺腺癌心脏转移患者，报道如下。 1临床资料     

EGFR-Mutated Breast Metastasis of Lung Adenocarcinoma: A Case Report

Breast metastasis from other primary carcinoma is very rare and could be difficult to identify despite immunohistochemistry analysis. Breast metastasis from lung adenocarcinoma can mimic triple-negative breast cancer. Given the prognosis and therapeutic challenges, a correct diagnosis appears essential, and molecular biomarkers could be useful. We report the case of a 52-year-old woman with a breast mass initially diagnosed as primary breast cancer and secondarily attached to breast metastasis from an EGFR-mutated lung adenocarcinoma. The same activating EGFR mutations were identified in both the primary lung carcinoma and the breast metastasis.Key Words: Lung adenocarcinoma, Breast metastasis, EGFR mutation, Triple-negative breast cancer, EGFR tyrosine kinase inhibitors     

阑尾黏液腺癌1例

1 临床资料 患者,女性,24岁,因腹部胀痛进行性加重1周入院.患者入院前2个月余开始出现下腹疼痛,疼痛程度较轻,可忍受,在当地医院行腹部超声发现盆腔肿物,未在意,病情反复.1周前腹部胀痛症状加重,难以忍受入院.入院后查体:腹部平坦,未见胃肠型及蠕动波,全腹软,下腹压痛明显,无反跳痛,无肌紧张,肝脾肋缘下未触及,Murphy征阴性,全腹未触及明显异常包块,移动性浊音阴性,肠鸣音正常,腰大肌试验、闭孔内肌试验及结肠充气试验均阴性.辅助检查:术前腹部超声:肝胆胰脾肾未见异常,腹腔大量积液;盆腔CT:腹水、腹腔囊性占位,盆腔积液,膀胱充盈欠佳,子宫、附件显示欠清;两次腹水脱落细胞检查未见恶性细胞;胸片:未见实质性病灶.临床诊断为盆腔肿物.经术前准备,行盆腔肿物切除术,术中见腹膜壁散在分布粟粒样结节病灶,已出现腹膜转移,并为病理所证实.术后病理:(左卵巢)肠型交界性黏液性囊腺瘤,(阑尾)低级别(高分化)黏液腺癌,浸润阑尾壁全层,(腹膜)内有浸润性种植.“卵巢肠型交界性黏液性囊腺瘤术后,阑尾黏液腺癌术后”诊断明确.治疗上参照结肠癌化疗的方案.     

乳腺癌眶内转移1例

淋巴结、骨骼、肝脏、肺脏、胸壁等是乳腺癌常见转移部位,眼内转移较少见。恶性肿瘤转移至眼部的常见部位是葡萄膜,尤其是脉络膜,眼眶通常不是恶性肿瘤转移的常见部位,我院诊治1例乳腺癌眶内转移患者,报道如下。