A case of invasive ductal carcinoma of an ectopic pancreas in the stomach in a 74-year-old woman is presented. A 4.0 cm gastric submucosal tumor (SMT) was resected surgically. Histologically, the tumor showed cystic tissue consisting of an ectopic pancreas with foci of a moderately differentiated tubular adenocarcinoma. In this tumor, small pancreatic tissues, acini, Langerhans islets, and ductular cells were detected in the gastric SMT. The patient has experienced long-term survival. The incidence of pancreatic cancer of an ectopic pancreas is rare, and the etiology of this disease is discussed in the literature.

We retrospectively analyzed the records for 34,474 women who participated in mass screening for breast cancer by physical examination with or without ultrasonography (US) at Yamanashi Health Care Center between April, 1989 and March, 1994 to evaluate the usefulness of US in mass screening. In one group (15,935 women) conventional physical examination with inspection and palpation alone had been performed, and in another (18,539 women) both conventional physical and US examinations were performed. Breast cancer was detected in 27 of the women (0.08% of the total group screened), 22 of whom were in the group examined by US; moreover, 16 of these 22 women had early breast cancer, which was a non‐palpable tumor in 13. Half of the 22 women were examinees under the age of 50 years. Of the 22 tumors detected in the groups examined by US, 16 (73%) were early breast cancer. The overall detection of early breast cancer (0.09%) in the US group was significantly higher than that (0.01%) in the group examined by conventional methods (P < 0.05). Of the tumors detected in the US group, 59.1% were non‐palpable. These results suggest that early and non‐palpable breast cancer can be detected using US, and the incidence of detection of such tumors in women under the age 50 years is increased in mass screening including US examination. This examination is effective in mass screening for breast cancer, especially for early and non‐palpable breast cancer tumors.

Small-cell carcinoma of the gallbladder is a very rare tumor. In this report, we describe a patient with small-cell carcinoma combined with adenocarcinoma in the gallbladder. The patient was a 70-year-old man, who clinically manifested systemic lymphadenopathy. An incisional biopsy of Virchow's lymph node revealed small-cell carcinoma. Abdominal computed tomography (CT) showed massive multiple paraaortic lymph node swelling and a round mass in the gallbladder, although chest CT did not show any abnormal masses in the lung. After two courses of chemotherapy (PVP therapy; cisplatin [CDDP], 80 mg/m(2), day 1, intravenous injection; and etoposide [VP-16], 50 mg/m(2), every day, per oral intake; given every 3 weeks) were performed, the systemic lymphadenopathy had completely diminished and only the gallbladder tumor remained on clinical examinations. Endoscopic retrograde cholangiopancreatography (ERCP) revealed nodular tumors in the gallbladder fundus. Cholecystectomy with partial resection of the liver was performed. Pathological examination revealed small-cell carcinoma combined with adenocarcinoma of the gallbladder. We discuss the characteristics and the treatment of this rare tumor.

No abstract

No abstract