No abstract

We herein encountered a case of abdominal wall dermatofibrosarcoma protuberans (DFSP) that developed pulmonary and pancreatic metastases 5 years after complete resection. Because specific rearrangements of the platelet-derived growth factor beta (PDGFB) locus by a novel fluorescence in situ hybridization method was detected, the patient was treated with imatinib mesylate at 400 mg/day. A partial response was achieved by imatinib without any specific toxicity. Although metastatic DFSP is an extremely rare disease, an evaluation of PDGFB fusion is essential and imatinib mesylate should be considered as an optimal therapeutic choice in patients with metastatic or locally advanced DFSP.

A 75-year-old man was referred to the Department of Ophthalmology at our hospital due to pain in his left eye. An ophthalmologic examination revealed a tumor on the surface of the left iris at 3 o'clock (Picture 1), suggesting a metastatic malignant disease.18 F-Fluorodeoxy glucose positron emission tomography (FDG-PET) revealed abnormal uptake in the esophagus, liver, and lymph nodes as well as a lesion in the left eye (Picture 2). An endoscopic examination revealed type I advanced esophageal cancer 35 cm from the dental arches (Picture 3), and the histological findings indicated squamous cell carcinoma. Based on these findings, we diagnosed the patient with iris metastasis of esophageal cancer and the patient received radiotherapy for the left eye and esophagus. The tumor in the left eye reduced in size and the pain was also alleviated after radiotherapy, however, the patient's vision failed to improve. Metastasis of the iris in patients with esophageal cancer is extremely rare (1, 2).

Disseminated carcinomatosis of the bone marrow (DCBM) is often accompanied by disseminated intravascular coagulation (DIC) and has a poor prognosis. DCBM develops most frequently in gastric cancer and is rarely associated with intrahepatic cholangiocarcinoma. A 41-year-old man was incidentally found to have DIC on his regular visit for ulcerative colitis and was diagnosed with DCBM with intrahepatic cholangiocarcinoma. He received intensive care, including chemotherapy, but died suddenly from hyperkalemia, possibly due to tumor lysis syndrome (TLS). The autopsy showed the periductal infiltrating type of intrahepatic cholangiocarcinoma and tumor necrosis, possibly due to chemotherapy, indicating the effectiveness of chemotherapy for DCBM with intrahepatic cholangiocarcinoma.

A 58-year-old Japanese man was diagnosed with differentiated adenocarcinoma of the stomach. Histological findings of the resected specimen revealed well-to moderately-differentiated tubular adenocarcinoma (tub1, tub2), 13 mm in diameter, which invaded into the submucosa (SM1, 300 μm) and lymphovascular lumen (ly1). Serum antibody against Helicobacter pylori (Hp) and the 13 C-urea breath test were negative, and there were no atrophic changes in the tumor-adjacent mucosa. The immunohistochemical analysis showed that gastric mucin (MUC5AC) was strongly positive and intestinal mucin (MUC2) was weakly and partially positive. According to these results, the final diagnosis of Hp-negative well-differentiated early gastric cancer was made.