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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To investigate the chance of discovery of metastatic lung tumors and the five-year survival rates of patients undergoing surgical resection, we followed 99 patients who underwent initial surgical treatment at our hospital between 1979 and 1996. With regard to primary organs or sites, 32 patients had rectal cancer, 27 patients had breast cancer, 19 patients had colon cancer and 21 patients had osteosarcoma. For 22 of 99 patients (22%), discovery was due to subjective symptoms such as cough and sputum (n = 12), chest (or back) pain (n = 7) or hemosputum (n = 5). Ten of 19 patients (53%) with colon cancer experienced subjective symptoms which led to the discovery of metastases. In 76 of 99 patients (78%), metastatic lung lesions were not discovered through subjective symptoms. In 63 of those 76 patients, such lesions were initially found by plain chest roentgenography or CT. In 20 of 21 patients (95%) who had osteosarcoma, metastatic lung tumors were discovered by chest roentgenography or CT. In 14 of 76 patients, all of whom had metastatic lung carcinomas, the lesions were discovered through elevated levels of tumor markers. Therefore the importance of periodic chest roentgenography and tumor marker testing was demonstrated. Disease-free interval (DFI) was over six years in five of 32 patients (16%) with rectal cancer and 13 of 27 (48%) with breast cancer. DFI was less than five years for 15 of 19 patients (79%) with colon cancer, and less than two years for 16 of 21 (75%) with osteosarcoma. Thus, DFI differed according to the sites of the tumors. The five-year survival rates of 97 patients were examined. Patients were divided according to the sites of their primary tumors, and then subdivided according to the type of surgery they received. Patients were thus divided into five categories: I) those who underwent incomplete resection of metastatic lung lesions, II) those who underwent complete resection of both pulmonary lesions and involved mediastinal lymph nodes, III) those who had undergone previous treatment for tumors in organs other than the lung, IV) those who underwent complete resection of multiple lung lesions, and V) those who underwent complete resection of solitary lung lesions. For all primary sites, none of the patients in group I) survived for more than two years. Therefore complete resection seems very important for the treatment of metastatic lung tumors. With regard to the other groups, several facts were noted. For rectal cancer, the five-year survival rate of groups V) and III) was 55.6% in either case. Therefore complete resection of rectal cancer metastatic to the lung may improve the five-year survival rate even for patients who have previously been treated for cancers in organs other than the lung. For colon cancer, the five-year survival rate of group V) was 51.4%. Complete resection of only a solitary lung lesion may improve the five-year survival rate for colon cancer. For breast cancer, the five-year survival rate of group V) was 37.5% and that of group II) was 60.0%. This may indicate that for patients who have both pulmonary lesions and mediastinal lymph node involvement, complete resection of both is important. For osteosarcoma the five-year survival rate of group IV) was 26.0%. Thus, osteosarcoma patients have a chance of survival if they undergo complete resection of lung metastases.
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PMID:[Diagnosis and surgical treatment of metastatic lung tumors]. 883 35

Three cases of metastatic lung tumor from colorectal cancer with an ineffectual systemic chemotherapy were examined based on the therapeutic effectiveness and safety of bronchial infusion (BAI) as a symptomatic therapy. Two out of three cases were rectal cancer and the third case being ascending colon cancer. After the operations, each of the three cases showed a multiple lung metastases recurrence at the primary and metastatic lesions of the lung. The lung metastases became large in size and thoracic symptoms (severe cough, chest pain) appeared in spite of the systemic chemotherapy of CPT-11, 5-FU and CDDP. A low dosage of BAI was administered by using CPT-11 (40 mg/m2) + CDDP (40 mg/m2) as one shot, and was repeated (three and six times respectively) for the two cases. When the low dosage of BAI was administered, there were light side effects and no complications were observed. The average hospital stay was 7.8 days. All three patients were stable and showed improvement in the condition of the disease. The prognoses from the first BAI were 3, 6, and 9 months in all three cases, respectively. BAI using low dosage of anti-cancer agents was effective, as means of improving the chest condition and quality of life in patients with metastatic lung tumor from colorectal cancer, with an ineffectual systemic chemotherapy.
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PMID:[Evaluation of bronchial arterial infusion (BAI) for metastatic lung tumor from colorectal cancer]. 1555 32

The patient presented here is a 30-year-old woman who underwent anterior resection for the initial treatment of rectal cancer. A postoperative study showed a single liver metastasis. The patient received adjuvant pelvic radiotherapy with concomitant 5-fluorouracil (5-FU) treatment followed by liver metastasectomy 6 weeks after the completion of radiation therapy and chemotherapy. Adjuvant therapy with 5-FU, leucovorin, and oxaliplatin (FOLFOX 4 regimen) was continued. The initial five cycles were well tolerated with the occurrence of only paresthesia that did not interfere with function. After the sixth cycle of the treatment, progressive dyspnea and persistent cough developed in the patient, although her clinical history was negative for lung disease. A chest radiograph revealed diffuse bilateral interstitial infiltrates, and a chest CT scan showed bilateral alveolar infiltrates predominant in the right lung. Lung biopsy by video-assisted thoracoscopy was performed, and the histologic report showed cryptogenic organizing pneumonitis (COP). Prednisone therapy (1 mg/kg/d) resulted in a very good clinical response. In fact, the patient had complete remission of respiratory symptoms including cough and dyspnea after 4 days of treatment, and the chest CT scan showed complete resolution of lung infiltrates after 4 weeks. One month later, the patient continued adjuvant treatment with six cycles of 5-FU, leucovorin, and irinotecan (ie, the FOLFIRI regimen) without complications. Thus, oxiplatin was implicated as the likely cause of this drug-induced lung toxicity, which is a very rare complication associated with platins. Diffuse interstitial lung disease, particularly COP, has been described following the administration of the cytotoxic agents bleomycin and busulfan, but a connection to oxaliplatin has not been reported before this case.
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PMID:Cryptogenic organizing pneumonitis during oxaliplatin chemotherapy for colorectal cancer: case report. 1807 34

We report a case of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa that responded to mFOLFOX6 chemotherapy and enabled survival for 19 months. A 68-year-old man was admitted to our hospital for a dry cough and dyspnea. Chest X-ray and CT examination revealed prominent pulmonary markings and abnormal infiltrating shadows. Interstitial pneumonia was suspected, and we started treatment with steroid medication, but this had no effect. A colonoscopy and barium enema revealed diffusely infiltrating rectal cancer. Abdominal CT and PET showed lymphangitis carcinomatosa of the lung, paraaortic lymph node swelling, and left hydronephrosis due to rectal cancer. The patient was diagnosed with stage IV rectal cancer. Thus, a curative operation was deemed impossible. Because of subileus, we performed a decompression loop colostomy in the transverse colon, and started treatment with mFOLFOX6 chemotherapy as salvage in spite of the patient's poor respiratory condition. Though the patient's tumor markers were very high (CEA 107 ng/mL, CA19-9 7,940 U/mL) prior to chemotherapy, they decreased dramatically (CEA 49.7 ng/mL, CA19-9 772 U/mL), and subjective symptoms (dry cough and dyspnea) also improved after 2 courses. After 3 courses of treatment the patient was discharged. After 7 courses, pulmonary markings and abnormal infiltrating shadows had disappeared on chest X-ray and CT. This condition was maintained for 19 months by ambulant chemotherapy without sacrificing high quality of life. Thus, mFOLFOX6 chemotherapy could be an effective salvage regimen in cases of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa.
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PMID:[A case of diffusely infiltrating rectal cancer with pulmonary lymphangitis carcinomatosa successfully treated with mFOLFOX6 chemotherapy as salvage]. 1901 52

A 70-year-old man undergoing treatment for diabetes presented with a cough and pyrexia that has lasted one week. Laboratory tests demonstrated evidence of inflammation. The patient was hospitalized and antibiotic treatment was initiated, but the condition of the patient did not improve. After 2 weeks, computerized tomography scanning demonstrated the presence of multiple small nodules in the lungs and a liver abscess. The patient also developed neck pain and numbness of the upper extremities and was then transferred to Tokai University Hachioji Hospital (Tokyo, Japan). Percutaneous transhepatic drainage (PTD) of the liver abscess was performed and antibiotic treatment was initiated. Detailed examination revealed there was pyogenic spondylitis of the cervical spine, therefore abscess drainage and an anterior cervical spinal fusion were performed. Culture of each lesion resulted in Klebsiella pneumoniae growth. While continuing antibiotic treatment and rehabilitation, the gastrointestinal tract was investigated and evidence of early rectal cancer was observed. The pulmonary nodules disappeared during treatment, indicating that these were multiple lung abscesses. Four weeks following abscess drainage and anterior cervical spinal fusion, lower anterior resection was performed. The present case report describes a patient who developed multiple abscesses associated with early rectal cancer and discusses the case with reference to the literature.
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PMID:Early rectal cancer accompanied by multiple systemic abscesses: A case report. 2662 22

Esophageal metastasis from colorectal carcinoma is uncommon, and diagnosis of esophageal metastasis is difficult. We report a case of a 54-year-old woman with postoperative recurrence of rectal cancer metastasizing to the esophagus. She underwent rectectomy and adjuvant chemotherapy with fluorouracil, leucovorin plus oxaliplatin for stage IIIB rectal cancer. Three years later, she presented with dysphagia and cough. Computed tomography showed thickening of the esophagus wall, enlargement of the lymph nodes in the mediastinum and abdomen, and ground-glass opacities in the right lung. Endoscopy revealed a submucosal tumor of the midthoracic esophagus. Histopathological analysis of the tumor biopsy showed infiltration of adenocarcinoma cells into the stroma of the esophagus; tumor cells were positive for caudal type homeobox 2 and negative for thyroid transcription factor 1. A transbronchial biopsy indicated pulmonary lymphangitic carcinomatosis of rectal adenocarcinoma. Based on those findings, she was diagnosed with recurrent rectal cancer. She received fluorouracil-based chemotherapy plus bevacizumab, which ameliorated her symptoms and induced a durable response without severe adverse events. Diagnosis of esophageal metastasis from rectal cancer can thus be made by repeated biopsy. Furthermore, aggressive systemic treatment with fluorouracil-containing chemotherapy and bevacizumab is a treatment option for colorectal cancer patients with esophageal metastasis.
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PMID:Esophageal Metastasis from Rectal Cancer Successfully Treated with Fluorouracil-Based Chemotherapy with Bevacizumab: A Case Report and Review of the Literature. 2862 98

A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel. Twenty-four hours postoperatively, the patient's pain intensity as assessed by the numeric rating scale was 0-1 during coughing, and a continuous intravenous analgesic was not needed. Colostomy is often necessary in colon obstruction. Epidural anesthesia for postoperative pain cannot be used in patients with a coagulation disorder. We report the use of a novel laparoscopic rectus sheath block for colostomy. There has been no literature described about the nerve block with transperitoneal approach. The laparoscopic rectus sheath block was performed safely and had enough analgesic efficacy for postoperative pain. This technique could be considered as an optional anesthetic regimen in acute situations.
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PMID:Novel technique of abdominal wall nerve block for laparoscopic colostomy: Rectus sheath block with transperitoneal approach. 2893 52