A Case of Long-Term Complete Remission of Advanced Gastric Adenocarcinoma with Liver Metastasis

Gastric cancer is a malignant tumor with a high degree of malignancy. Multiple liver metastases from gastric cancer (LMGCs) are common. However, the treatment of LMGCs is very difficult. It is rare to achieve complete remission (CR) and long-term survival after treatment. We present the case of a patient with gastric adenocarcinoma and multiple liver metastases who showed CR for more than 33 months after perioperative EOX (epirubicin, oxaliplatin, and capecitabine) combination chemotherapy with radical distal gastrectomy and resection of liver metastases. The patient is still in follow-up without tumor recurrence. These findings suggest that LMGC does not necessarily mean a poor prognosis; preoperative chemotherapy combined with surgery may be a good treatment option for LMGC in selected patients. Further studies are needed to support this treatment approach.

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Faculty Opinions recommendation of Platinum-based versus non-platinum-based chemotherapy as first line treatment of inoperable, advanced gastric adenocarcinoma: a meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718052196.793482906 ◽

2013 ◽

Author(s):

Ian Beales

Keyword(s):

Gastric Adenocarcinoma ◽

Meta Analysis ◽

Line Treatment ◽

First Line ◽

Platinum Based Chemotherapy ◽

Advanced Gastric Adenocarcinoma ◽

First Line Treatment

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A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

Surgical Case Reports ◽

10.1186/s40792-020-01028-z ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Takuhisa Okada ◽

Yasumitsu Hirano ◽

Shintaro Ishikawa ◽

Hiroka Kondo ◽

Toshimasa Ishii ◽

...

Keyword(s):

Small Intestine ◽

Lymph Node ◽

Gastrointestinal Tract ◽

Liver Metastasis ◽

Surgical Resection ◽

Clear Cell ◽

Clear Cell Sarcoma ◽

Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

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Gastric adenocarcinoma at stage IV with complete remission after neoadjuvant therapy concurrent with adenosquamous carcinoma of the ampulla of Vater: a case report and literature review

BMC Surgery ◽

10.1186/s12893-021-01133-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shuo Li ◽

Mengqing Sun ◽

Yingxin Wei ◽

Yunlu Feng ◽

Xiaoyan Chang ◽

...

Keyword(s):

Complete Remission ◽

Neoadjuvant Therapy ◽

Gastric Adenocarcinoma ◽

Adenosquamous Carcinoma ◽

Stage Iv ◽

Ampulla Of Vater ◽

Regional Lymph Node Dissection ◽

Contrast Enhanced Ct ◽

Supraclavicular Lymph Nodes ◽

Ampullary Tumor

Abstract Background Adenosquamous carcinoma (ASC) of the ampulla of Vater (AmV) is exceedingly rare with more aggressive behavior and worse prognosis than adenocarcinoma. The finding of ASC at the AmV in combination to the gastric adenocarcinoma has never been reported in the literature before. Case presentation An old lady was diagnosed as gastric adenocarcinoma at stage IV with enlargement of supraclavicular lymph nodes by gastroscopy and histopathological evaluation 3 years ago. Afterwards, the patient achieved complete remission after regular chemotherapy. However, the patient manifested yellow sclera and skin, choluria and clay colored stool 3 months ago. Preoperative contrast-enhanced CT, ERCP, MRCP, and PET/CT revealed the presence of an ampullary tumor. The patient then underwent laparoscopic radical gastrectomy and pancreaticoduodenectomy with regional lymph node dissection. Postoperative cytological analyses confirmed the diagnosis of gastric ulcer with complete response to neoadjuvant therapy and ASC at the AmV. The patient’s postoperative outcome was uneventful. Conclusion Drawing firm conclusions about the diagnosis of ampullary ASC is difficult because of the difficulty in acquiring both adenocarcinoma and SCC components by fine needle biopsy. The rarity of ASC of the AmV coexistent with gastric carcinoma makes it difficult to elucidate their clinicopathological characteristics, therapeutic strategies and overall prognosis. Surgical resection still remains the main treatment method.

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Gastric Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Western Center Case Series

Medical Sciences ◽

10.3390/medsci9030047 ◽

2021 ◽

Vol 9 (3) ◽

pp. 47

Author(s):

Marcus Fernando Kodama Pertille Ramos ◽

Marina Alessandra Pereira ◽

Arthur Youssif Mota Arabi ◽

Melissa Mello Mazepa ◽

Andre Roncon Dias ◽

...

Keyword(s):

Gastric Adenocarcinoma ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Comparison Group ◽

Case Series ◽

Clinicopathological Characteristics ◽

Neuroendocrine Neoplasms ◽

Rare Tumor ◽

Term Survival

Background: Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) represent a rare tumor composed of adenocarcinoma and neuroendocrine carcinoma components. This study reports a case series of gastric MiNEN and discusses issues related to its diagnosis, management, and outcomes. Methods: We retrospectively analyzed data from patients with gastric MiNEN who underwent surgical resection at our service from 2009 to 2020. Patients with gastric adenocarcinoma served as a comparison group. Clinical, pathologic, and surgical characteristics were compared. Results: During the selected period, 5 gastric MiNEN patients and 597 patients with gastric adenocarcinoma were included. Among the clinical variables, age, sex, BMI, and laboratory exams were similar between the two groups. Only ASA classification was different (p = 0.015). Pathological variables such as tumor size, lymphovascular invasion, number of retrieved lymph nodes, and pTNM staging were also similar between both groups. Lastly, early surgical outcomes and long-term survival did not differ between gastric MiNEN and adenocarcinoma patients. Conclusion: A MiNEN is a rare tumor that represents less than 1% of GC patients undergoing curative treatment, and demonstrated clinicopathological characteristics and outcomes similar to gastric adenocarcinoma.

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Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0194 ◽

2020 ◽

Vol 33 (11) ◽

pp. 1431-1441

Author(s):

Montserrat Negre Busó ◽

Amparo García Burillo ◽

Marc Simó Perdigó ◽

Pere Galofré Mora ◽

Maria Boronat de Ferrater ◽

...

Keyword(s):

Complete Remission ◽

Thyroid Carcinoma ◽

Children And Adolescents ◽

Differentiated Thyroid Carcinoma ◽

Radioiodine Treatment ◽

Persistent Disease ◽

Stage 4 ◽

Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

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