Background/Aims: We report a case of solitary Peutz-Jeghers-type hamartomatous polyp of the duodenum in a 22-year-old Japanese woman along with the results of genomic analysis. Methods/Results: The patient was almost asymptomatic, though endoscopic examination revealed a solitary lobular polypoid lesion measuring 3 cm in diameter in the first portion of the duodenum. The lesion was resected endoscopically. Histopathological examination showed hyperplasia with a tree branch-like extension of the lamina propria derived from the muscularis mucosae, consistent with histological features of polyps of Peutz-Jeghers syndrome (PJS). No mucocutaneous pigmentation of the skin was evident and family history was negative. Analysis of the loss of heterozygosity at the locus of 19p 13.3 and mutation analysis of the STK11/LKB1 gene, which has recently been recognized as a susceptible gene in PJS, were performed. However, no evidence of genomic abnormality was found. Conclusion: The clinical and investigative findings in our case suggest that the solitary Peutz- Jeghers-type hamartomatous polyp can be regarded as a clinical entity separate from PJS.

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A 56-year-old man diagnosed a having multiple hepatocellular carcinoma (HCC) with liver cirrhosis underwent transcatheter arterial embolization (TAE). Five months later, recurrent HCC was detected in the liver as well as in the left adrenal gland. A second TAE was performed to treat the intrahepatic recurrence, which was followed by hand-assisted laparoscopic surgery (HALS) for the metastatic tumor in the left adrenal gland. The combination of the two procedures successfully controlled HCC. To our knowledge, this is the first report describing an adrenalectomy by HALS for adrenal metastasis from an HCC.

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We report herein the case of a 63-year-old man with cancer of the sigmoid colon and metastatic nodules in the liver who was effectively treated with a combination of cisplatin regional chemotherapy, given through the hepatic artery, in conjunction with a 3-week course of intravenous gamma-interferon (INF-gamma), following palliative sigmoidectomy and dissection of the regional lymph nodes. This was followed-up by a 3-month course of oral 5-fluorouracil. Hepatic imaging performed 6 months postoperatively showed no masses in the right hepatic lobe and an apparent decrease in the size of the tumor in the left lobe. A second-look operation with resection performed at this time confirmed the efficacy of the chemotherapy. The patient survived in excess of 30 months following his initial surgery before succumbing to hepatic failure.