BackgroundPeritoneal metastasis (PM) develop in more than 50 % of gastric cancer (GC) patients. Median survival without treatment is not more than 3–7 months, and 8–12 months after modern combination chemotherapy. Innovative therapeutic approaches are urgently needed.MethodsPhase-2, open label prospective clinical trial assessing safety and efficacy of bidirectional chemotherapy for treating peritoneal metastasis of gastric cancer (PMGC). Treatment protocol included initial staging laparoscopy or laparotomy, 3–4 courses of systemic chemotherapy (XELOX) followed by Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) procedures every 6 weeks until progression of disease or death. Primary endpoints were overall survival and histological peritoneal regression grading score after rebiopsy.Results31 patients were included (9 men, 22 women, mean age 52 years), 24 with synchronous PM at diagnosis, 7 with metachronous PM after previous chemotherapy. Mean PCI was 13.8 (min-max 6–34). XELOX was administered in all patients and combined with 56 PIPAC procedures. Complete and partial pathological response was found in 60 % of the 15 patients eligible for tumor response assessment (4 and 5 patients, respectively). Median survival was 13 months.ConclusionsBidirectional chemotherapy combining XELOX with PIPAC with cisplatin and doxororubicin is well tolerated, can induce objective tumor regression and is associated with a promising survival in PMGC.

Primary chondrosarcoma of the trachea is an extremely rare non-epithelial neoplasm with only few cases published in the literature. We present a rare case of tracheal chondrosarcoma with extensive extraluminal growth. We operated a patient with obstructive tumour of the upper third of the trachea via partial sternotomy. Before surgery, a Hanarostent was put into the trachea to treat a life-threatening stenosis. Postoperative period was uneventful. We discuss the incidence, clinical presentation and treatment options in patients with rare tracheal tumours. In some cases, a multidisciplinary approach (endoscopic intervention followed by surgical resection) is an effective treatment tool.

Objective: to evaluate the efficiency of ultrasound-guided multifocal core needle biopsy in the complex diagnosis of lymphoma. Subjects and methods. From January 2015 to June 2016, 89 patients with suspected lymphoma underwent ultrasound-guided multifocal core needle biopsy from the most accessible suspicious focus, followed by a morphological examination. Specimens were obtained from the altered peripheral lymph nodes (LNs) in 50 patients, from the mediastinum in 14, from retroperitoneal LNs in 13, from chest wall infiltration in 4, from the liver in 2, from a soft-tissue component of bone tumor in 2, from the small pelvis in 2, from the breast in 1, and from the testicle in 1. Results. Core needle biopsy, followed by a morphological examination, could establish the diagnosis in 86 (96.6%) patients. The latter could not be made after core needle biopsy in 3 (3.4%) cases; excisional LN biopsy was required. The diagnosis of lymphoma was morphologically verified in 80 (93%) patients; another diagnosis different from that of lymphoma was established in 6 (7%) patients. Conclusion. Ultrasound-guided multifocal core needle biopsy is a highly effective and safe technique to obtain specimens for morphological examinations in the diagnosis of lymphoma.

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