Peritoneal Dialysis and Malignancy: An Experience With a Patient Complicated by Gastric Carcinoma

Abstract

An 86-year-old man who had been treated with peritoneal dialysis for 14°months due to end-stage kidney disease secondary to hypertensive nephrosclerosis presented with a recent history of malaise, abdominal discomfort, and anorexia. An endoscopic evaluation revealed an elevated, ulcerated, and friable lesion around the lesser curvature of the stomach. The concurrent gastric biopsy specimens revealed moderately differentiated adenocarcinoma, while a cytological examination of the dialysis fluid revealed clusters of malignant cells. This is the first report illustrating a case of a Borrmann type 3 gastric cancer with synchronous peritoneal involvement in which the assessment of the disease state was aided by the cytological analysis of peritoneal effluent. Several concerns relating to this pathology are also discussed.

Knockdown of ST7-AS1 inhibits migration, invasion, cell cycle progression and induces apoptosis of gastric cancer

“…The overall survival of GC remains at 20%, which is a global health problem (6). Advanced GC has an extreme poor prognosis, with <15% of 5-year survival (7). Development of effective and sensitive hallmarks for GC contributes to improving the clinical outcome of the affected (8).…”

Cloudy fluid, cloudy diagnosis

“…It is necessary to individualise modality treatment decisions, considering the severity of the disease and the possible complications. 13 In our particular case, it was impossible to continue PD due to the significant fluid intake secondary to the treatment and heart failure, with an inability to manage fluid removal with PD and diuretics alone.…”

“…[7][8][9]11,12 Other malignancies corresponded to solid neoplasms of the intra-abdominal organs and peritoneal metastases. 5,6,10,13 Six of eight published cases remained on PD. [6][7][8][11][12][13] One of the patients required adjusting the PD prescription with the addition of one daily exchange of icodextrin to the five nocturnal exchanges with dextrose because of significant fluid retention, with good response.…”

“…5,6,10,13 Six of eight published cases remained on PD. [6][7][8][11][12][13] One of the patients required adjusting the PD prescription with the addition of one daily exchange of icodextrin to the five nocturnal exchanges with dextrose because of significant fluid retention, with good response. 11 One of the two patients converted to haemodialysis because of persistent abdominal pain attributed to the PD catheter prior to the malignancy diagnosis (although it is also possible that the pain may have been related to the solid tumour itself).…”

“…7 –9,11,12 Other malignancies corresponded to solid neoplasms of the intra-abdominal organs and peritoneal metastases. 5,6,10,13…”