多原发肺癌4例临床分析

目的探讨多原发性肺癌的诊断和治疗。方法自2000年以来我科收治病理确诊的4例多原发肺癌患者进行回顾性分析。结果4例多原发肺癌中同时癌3例,异时癌1例,均为双侧肺,第一原发肺癌与第二原发肺癌间隔时间为35月。结论多原发肺癌发病率不高,早期诊断,积极以手术治疗为主的综合治疗仍可获得较长的生存时间。     

异时性多原发结直肠癌临床特点分析31例

目的:探讨异时性多原发结直肠癌的临床特点, 为临床诊治提供参考.方法:回顾性总结31例异时性多原发结直肠癌的临床资料, 分析肿瘤发生、分布及治疗与预后.结果:31例患者, 平均5.1年出现次发癌, 平均3.8年后3例出现第3癌, 平均3.5年后2例再发第4癌. 45.2%的患者合并存在腺瘤. 59.5%的首发癌位于直肠、乙状结肠;大部分次发癌的分化程度、病理分期好于首发癌或与之相同;首发癌术后平均存活8.3年, 5年生存率84.8%.结论:大多数异时性多原发结直肠癌的首发癌位于直肠及乙状结肠. 合并存在腺瘤是发生该病的危险因素, 根治术后应进行定期复查.     

异时性原发性肺癌

本文提出对异时性原发性肺癌应引起临床重视,过去常把肺癌治愈后第二次,甚或第三次再患肺癌,认为是第一次肺癌的转移或复发,而放弃了应给于的积极治疗。     

结直肠同时性+异时性多原发四重癌一例报道并文献复习

多原发结直肠癌（MPCC）又称重复性结直肠癌,在临床上的发病率呈逐年上升趋势,其发病原因及机制不详,目前尚无统一、规范的诊治指南,临床医师极易漏诊,延误病情。本文报道1例结直肠同时性+异时性多原发四重癌的病例并复习文献,旨在提高临床医师对MPCC诊治的警觉性。     

结肠胃异时性重复癌一例

患者男，72岁。因便血、腹痛6个月余，于1998年6月结肠镜诊断为结肠癌，取病理6块，诊断为直肠腺癌。即行手术切除治疗，术后未作补充化疗。因进食后上腹部疼痛伴恶心6个月于2001年5月住院。查体：除剑突下有压痛外无其他异常。胃镜检查见胃底、胃体黏膜增粗、隆起、僵硬，蠕动消失，活检6块，质硬。诊断为胃癌(Borman‘sⅡ型)，病理诊断为胃的肝样腺癌。     

异时多原发恶性肿瘤8例临床分析

随着肿瘤患者生存率的不断提高,多原发癌(MPC)的发现也逐渐增多.本文收集我院8例军队老干部泌尿系统伴其他脏器MPC,就其发生机制、诊断、治疗和预后进行临床分析.1临床资料1.1一般资料本组均为男性,首次发病,年龄46～87[平均(70.9±16.9)]岁.第一原发癌中膀胱癌4例,肾癌1例,胃癌1例,肝癌1例,恶性淋巴瘤1例.发病时间大于6个月以上出现第二次原发肿瘤.第二次发病年龄66 ～88[平均(80.6±8.1)]岁.第二原发癌中膀胱癌3例,肾癌1例,肺癌2例,结肠癌1例,皮肤癌1例.     

以消化道大出血为表现的异时性肺、十二指肠多原发癌1例

肺癌合并十二指肠癌非常少见,一点癌临床上更罕见,极易误诊、漏诊,术前完善相关检查、术中仔细探查和定期随访是防止多原发癌漏诊、误诊的关键,确诊主要靠病理.本文撷取较罕见的一例以上消化道大出血为表现的异时性肺、十二指肠多原发癌进行分析和探讨.     

老年人多原性异时癌19例报告

多原性恶性肿瘤是指同一宿主的单个或两个器官的组织同时或先后发生两个以上原发恶性肿瘤而言。同时发现多发性原发癌为同时癌(包括半年以内);非同时发现的多发性原发癌为异时癌。本文就我院外科近十余年,确诊为老年人多原性异时癌19例报告如下。临床资料一、年龄和性别男6例,女13例,年龄60～78岁,平均64.5岁,首发原发癌发病年龄为42～76岁,平均为47.5岁。二、本组老年人多原性异时癌重复及分布情况本组均为癌瘤相互重复的异时癌,间隔时间为4～22年,平均8.6年。重复情况:非胃肠道脏器癌与胃肠道癌相     

同步性多原发肺癌1例

<正>同步性多原发肺癌(SMPLC)指肺内同时出现2种或以上原发性恶性肿瘤。由于其精确诊断非常困难,因此很难精确估计其发病率,推测大概在0.2%²0%之间〔1〕。随着多排CT、正电子发射计算机断层显像(PET)以及荧光内镜等早期检测手段的广泛应用,其检出率逐年增加〔2〕。组织学分型不同的多原发肺癌的诊断相对较容易,如果多原发肺癌的组织学分型相同,需要与原发性肺癌肺内转移相鉴别。     

双侧肺腺癌合并胃原发性腺癌1例

肺腺癌较为常见,但双侧腺癌(肺泡样腺癌)不多见,合并胃原发性腺癌就极为罕见了,尤其是有肺腺癌病史的患者,症状往往误导临床首先考虑胃转移性的腺癌.本例胃腺癌术前诊断明确,术后经病理免疫组化证实为原发性的腺癌,现将此例报道如下.     

Metachronous primary colon and periampullary duodenal cancer: A case report

Rationale:Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer.Patient concerns:We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer.Diagnoses:Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies.Intervention:The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer.Outcomes:The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis.Lessons:The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.     

空肠血管外皮瘤1例报道

空肠血管外皮瘤多发生于青年人,可发生于身体的任何部位,空肠血管外皮瘤发病率很低,临床表现多为无痛性肿块.病理学检查可见肿瘤实质内有丰富的薄壁血管,其相互连接成网状、树枝状或鹿角状.瘤细胞排列密集,可见核分裂.网状纤维染色瘤细胞位于血管外,包绕单个瘤细胞.免疫组化Vimentin(+),少数病例Desmin可散在阳性.空肠血管外皮瘤生物特性多样,恶性程度差别很大,根治性切除是治疗血管外皮瘤的有效方法.恶性血管外皮瘤可发生远处转移,放化疗尚无确切疗效.     

Metachronous small bowel adenocarcinoma after rectal adenocarcinoma: A case report

Rationale:Small bowel adenocarcinoma (SBA), an uncommon gastrointestinal malignant tumor, is difficult to diagnose at an early stage because of its non-specific disease presentation. Metachronous SBA is a special type of SBA that is rarely reported. We herein report a case of metachronous primary SBA following resection of rectal adenocarcinoma.Patient concerns:A 65-year-old man presented to our hospital after having experienced recurrent bowel obstruction for 6 months. He had undergone a Dixon operation 30 months previously followed by adjuvant chemotherapy with capecitabine plus oxaliplatin.Diagnosis:Abdominal computed tomography showed thickened bowel walls in the right lower abdomen, and the patient was initially misdiagnosed with intestinal adhesion. After the operation, he was diagnosed with primary SBA (T3N0M0, stage IIA).Interventions:Treatment with a transnasal ileus tube was ineffective. Therefore, we performed small intestinal segmental resection and side-to-side anastomosis through open surgery.Outcomes:The patient completed all postoperative adjuvant chemotherapy, and posttreatment surveillance revealed no further abnormalities.Lessons:This case suggests that patients with colorectal adenocarcinoma may have an increased risk of metachronous SBA. Corresponding symptoms in high-risk patients should raise clinicians’ suspicion for SBA, and further detailed examinations are imperative. Early screening for SBA may help to improve the patients’ prognosis.     

胃复合型腺癌伴小肠非霍奇金淋巴瘤1例

病例患者,男,72岁。无明显诱因出现食欲不振1个月,进食量明显减少入院,伴轻度腹胀,无反酸、恶心、呕吐,无乏力、黑便,无心慌、胸闷、嗳气等症状。查体：腹部平坦,无肠型及胃肠蠕动波,腹壁静脉无曲张,上腹部有深压痛,无反跳痛,无腹肌紧张。肝脾肋下未触及,全腹未扪及明显肿块。肠鸣音正常,3-4次/分,未闻及气过水声及金属音。实验室检查：血常规、肝肾功能、血糖、血生化、癌胚抗原均在正常范围内。     

Leiomyosarcoma of the sigmoid colon with multiple liver metastases and gastric cancer: a case report

ABSTRACT: BACKGROUND: Leiomyosarcoma (LMS) of the gastrointestinal tract is an extremely rare high-grade neoplasm with poor prognosis. For advanced LMS with distant metastasis, the decision as to the choice of the most appropriate therapeutic strategy, including chemotherapy and surgery, is difficult. Here, we present an unusual case of LMS of the sigmoid colon with liver metastases and gastric cancer. The survival of this patient was prolonged by a combined modality therapy involving chemotherapy and surgery. CASE PRESENTATION: A 66-year-old woman who had been diagnosed with advanced gastric cancer and multiple liver metastases was referred to our hospital. The initial treatment with docetaxel and S-1 considerably reduced both the gastric cancer and liver tumors; consequently we performed surgical resection. Pathological examination revealed that no viable tumor cells remained in the stomach and chemotherapy resulted in complete remission of the gastric cancer. The liver tumors were immunohistochemically diagnosed as LMS. A tumor of the sigmoid colon was subsequently discovered and the liver tumors were found to have recurred. The surgically resected sigmoid colon and liver tumors were all immunohistochemically diagnosed as LMS. These findings indicated that the multiple liver metastases arose from the LMS in the sigmoid colon, and that they were accompanied by advanced gastric cancer. We performed another surgical resection and administered chemotherapy to treat the recurring liver metastases. The patient survived for 4 years and 10 months after initial presentation at our hospital. CONCLUSION: Colonic LMS is rare and its joint occurrence with gastric cancer is extremely unusual. Although LMS is a high-grade neoplasm, a multimodal therapeutic approach can increase patient survival time even when multiple liver metastases are present.     

食管胃结合部腺癌1例

报道1例食管胃结合部腺癌(AEG),有助于内镜医师了解食管胃结合部肿瘤的特征.     

原发性降结肠恶性黑色素瘤1例

恶性黑色素瘤是一种来源于皮肤移行区交界痣黑色素细胞的高度恶性肿瘤,早期即发生血液或淋巴结转移,预后差.肛管直肠是仅次于皮肤及眼睛的第三好发部位,结肠原发性恶性黑色素瘤临床上罕见.本例患者在行根治性切除及淋巴结清扫手术后确诊结肠原发性恶性黑色素瘤,术后行全身化疗及生物免疫治疗效果佳,随访5年患者生存.     

Metachronous primary cancer of the tongue and malignant lymphoma of the small intestine: A case report

Rationale:Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma.Patients concerns:The patient was admitted to our department with the chief complaint of pain in the right tongue. Partial tongue resection and supraomohyoid neck dissection were performed. One year after surgery, the patient experienced abdominal pain and bloody stools.Diagnosis:Diffuse large B-cell lymphoma (DLBCL) was diagnosed via histological examination.Interventions:A terminal ileum resection was performed. Postoperatively, the patient received 6 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP).Outcomes:Five years after his initial diagnosis, there is no evidence of recurrence, metastasis, or other primary cancer.Lessons:Oral cancer patients should always be followed up owing to a possibility of malignant tumors in other areas.