Surgical resection for small bowel obstruction due to right ovarian metastasis after ileocecal resection for cecal cancer: A case report

Although oophorectomy for ovarian metastasis from colorectal cancer is encouraged to improve the prognosis, that is also performed to relieve the symptom such as abdominal distention. We report a surgical case of intestinal obstruction due to ovarian metastasis after ileocecal resection for cecal cancer diagnosed at 77 years old.

A case of ramucirumab-induced renal failure with nephrotic-range proteinuria and its pathological findings

Ramucirumab-induced renal dysfunction is rarely reported. The pathology of ramucirumab-associated nephropathy in past reports primarily shows thrombotic microangiopathy (TMA) lesions but podocytopathy is not yet known. We report a case of kidney injury induced by ramucirumab in a 71-year-old man with cecal cancer. He was referred to our department for increasing serum creatinine (Cr) levels from 1.08 mg/dL to 2.56 mg/dL after changing anticancer drugs from bevacizumab to ramucirumab. He showed nephrotic-range proteinuria (12.1 g/gCr). A renal biopsy revealed endothelial cell injuries, such as TMA and podocytopathy with epithelial cell hyperplasia, which looked like a crescent. After discontinuing ramucirumab, his renal function and proteinuria improved, as seen by his Cr levels and proteinuria which decreased to 1.74 mg/dL and 1.21 g/gCr, respectively, in 3 months. Unlike previous reports, we found that ramucirumab caused podocyte injuries.

An Octogenarian Case of Sequential Laparoscopic Surgery for Synchronous Isolated Splenic Metastasis From Cancer of the Cecum

Introduction Because splenic metastasis from colorectal cancer is usually a result of metastasis from widely disseminated disease, cases with resectable isolated splenic metastasis are uncommon. Case presentation We report here a case of synchronous isolated splenic metastasis from cecal cancer that was treated with sequential laparoscopic splenectomy after short-term observation following laparoscopic ileocecal resection. Both postoperative courses were uneventful, allowing the patient to be discharged early. Two years have passed, without recurrence, since the second operation. Conclusions There are very few case reports on synchronous isolated splenic metastasis from colorectal cancer. Sequential laparoscopic resection might contribute to obtaining an uneventful postoperative course, especially in elderly patients such as ours.

An atypical case of necrotizing fasciitis secondary to perforated cecal cancer

Necrotizing fasciitis is an aggressive, life threatening soft tissue infection that requires high index of suspicion for diagnosis. Diagnosis is clinical with management including broad spectrum antibiotics and emergent operative debridement. The majority of cases are secondary to underlying medical processes, local tissue damage, abscess, or inciting procedure, with a paucity of data correlating causation with colon cancer. We describe the case of an 84-year-old man presenting with sepsis of unknown origin who was diagnosed with an atypical presentation of necrotizing fasciitis secondary to a perforated cecal malignancy. His case is unique in that a less virulent polymicrobial infection was likely involved as he initially improved with conservative management alone. He ultimately declined and expired secondary to overwhelming sepsis from his infection. This case highlights the importance of maintaining a high index of suspicion for necrotizing infection and considerations for alternative etiologies of infection including perforated malignancies.