A 62-year-old man had been followed because of an elevated serum level of carcinoembryonic antigen without the detection of any cancer lesions. However, there was a sudden increase in the serum level of carcinoembryonic antigen, and abdominal imagings showed a hepatic tumor with peripheral intrahepatic bile duct dilatation, and a submucosal tumor at the sigmoid colon with intact mucosa. Histopathological findings showed that the hepatic tumor had perineural invasion, suggesting an intrahepatic cholangiocarcinoma, and that the colon tumor infiltrated the submucosa, while its mucosa was intact. Both tumors showed similar pathological features and were positive for cytokeratin 20 and 7. These findings suggested intrahepatic cholangiocarcinoma with metastatic sigmoid colon cancer.

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These results demonstrate that a high dose of CDDP can be administered with less systemic side effects by means of encapsulation in the microspheres, and that the administration of CDDP-MS into the mediastinum is more effective for delivering CDDP to the paratracheal lymph nodes. As a regional chemotherapy after esophageal cancer operation, the injection of CDDP-MS into the mediastinum for targeting of the lymph nodes thus promises to be an effective treatment.

Thoracic isomerism, or symmetric morphology, is frequently associated with cardiac and abdominal anomalies. We report an unusual case of isolated left thoracic isomerism with lung cancer. A 67-year-old woman was referred to our hospital for investigation of an abnormal shadow on a chest X-ray. Chest computed tomography (CT) showed bilateral hyparterial bronchi, and bronchofiberscopy showed bifurcation of the right main bronchus into two branches. Pulmonary arteriography subsequently revealed that the right pulmonary artery bifurcated at the hilum and that it was not a mirror image of the left pulmonary artery. No other malformations were found on echocardiography or abdominal CT scan. We performed segmental resection of right S(1+2) and S(3) for lung cancer and the patient had an uneventful postoperative course. It is important to clarify the anatomy of patients with thoracic isomerism before surgical manipulation.

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