[Necrosis of the hepatocellular carcinoma nodule can aggravate metastasis]
Matsumata T. Okamoto M. Ishikawa H. Nozoe T. Suehiro T. Funahashi S. Kitamura M. Yo R. Iso Y. Maeda T.
Department of Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan.
Since the stroma of hepatocellular carcinoma is composed of sinusoid-like structures, cancer cells are readily released from the primary tumor with possible injurious consequences. A 63-year-old woman with hepatocellular carcinoma underwent percutaneous ethanol injection therapy. During this treatment, tumor thrombus developed in the right hepatic vein. Partial hepatic resection was performed. Six months later, multiple nodules appeared in the lung fields. Partial necrosis may have allowed the release of cancer cells from the primary tumor. Perioperative therapy should have an effect on intrahepatic micrometastases, because removal of the main tumor can be done surgically.
[Asymptomatic pancreatic islet cell tumor (glucagonoma): case report]
Suto A. Takayama S. Miki H. Izumika H. Tanahashi T. Suzuki H. Takeshita T. Ohmiya H. Kijima H.
Department of Surgery, Yamato City Hospital, Japan.
A case of asymptomatic pancreatic islet cell tumor (glucagonoma) is reported. A 36-year-old woman undergoing a ultrasonic scan was found to have two masses in the body and tail of the pancreas measuring 5 cm and 4 cm in diameter, respectively. Investigations of serum peptide hormones revealed an elevated glucagon level of 27,500 pg/ml (normal < 100 pg/ml), suggesting the possibility of an islet cell tumor (glucagonoma). The patient, however, was asymptomatic although high levels of glucagon were present. The patient underwent distal pancreatectomy to remove the lesions in the body and tail of the pancreas. Histological findings revealed islet cell tumors of the pancreas, and immuno histochemical staining of the tumor cells demonstrated a positive reaction for chromogranin and glucagon.
[A case of rectal cancer metastatic to the tonsil]
Yajima H. Tomoyasu H. Tanimura S. Bamba J. Masaki M.
Department of Thoracic Surgery, Toranomon Hospital, Tokyo, Japan.
Metastatic tumors of the tonsils are rarer than primary tumors. Few cases of metastatic tonsillar tumor have been reported. A 51-year-old man expectorated a portion of a tumor from the left side of the pharynx after an operation for cancer metastatic to the lung. Biopsy revealed that the pharyngeal tumor was rectal cancer (adenocarcinoma) metastatic to the tonsil. To our knowledge, this is the first case of primary rectal cancer metastatic to the tonsil to be reported in Japan. The clinical features of metastatic tonsillar tumor are discussed.