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Miyama A, Chikaishi Y, Kobayashi D, Matsuo K, Ochi T, Nakamura K, Endo T, Kikuchi K, Katsuno H, Nishijima A, Morise Z. A case of non-ampullary duodenal adenosquamous carcinoma with successful emergency pancreaticoduodenectomy for gastrointestinal hemorrhage. Surg Case Rep 2023; 9:161. [PMID: 37698671 PMCID: PMC10497460 DOI: 10.1186/s40792-023-01749-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Although most duodenal carcinomas are pathological adenocarcinomas, a small number of cases have been reported of adenosquamous carcinoma, characterized by variable combinations of two malignant components: adenocarcinoma and squamous cell carcinoma. However, owing to the small number of cases of non-ampullary duodenal adenosquamous carcinoma, there have been no reported cases of emergency pancreaticoduodenectomy for gastrointestinal hemorrhage due to non-ampullary duodenal adenosquamous carcinoma. CASE PRESENTATION A 66-year-old Japanese male presented to the referring hospital with a chief complaint of abdominal pain, diarrhea, and dark urine that had persisted for 1 month. The patient was referred to our hospital because of liver dysfunction on a blood examination. Laboratory results of the blood on the day of admission showed that total and direct bilirubin levels (12.0 mg/dl and 9.6 mg/dl) were markedly increased. An endoscopic retrograde biliary drainage tube was inserted for the treatment of obstructive jaundice, and imaging studies were continuously performed. Contrast-enhanced computed tomography and endoscopy revealed an ill-defined lesion involving the second portion of the duodenum, predominantly along the medial wall, and measuring 60 mm in diameter. No metastases were observed by positron emission tomography. Pancreaticoduodenectomy was planned based on the pathological findings of poorly differentiated adenocarcinoma. However, 2 days before the scheduled surgery, the patient experienced hemorrhagic shock with melena. Owing to poor hemostasis after endoscopic treatment and poor control of hemodynamic circulation despite blood transfusion, radiological embolization and hemostasis were attempted but were incomplete. An emergency pancreaticoduodenectomy was performed after embolizing the route from the gastroduodenal artery and pseudoaneurysm area to reduce bleeding. The operation was completed using an anterior approach without Kocherization or tunneling due to the huge tumor. The operation time was 4 h and 32 min, and blood loss was 595 mL The pathological diagnosis was adenosquamous carcinoma. The postoperative course was uneventful with 17 day hospital stay and the patient is currently well, with no signs of recurrence 9 months after surgery. CONCLUSIONS This report presents an extremely rare case of successful emergency pancreaticoduodenectomy for gastrointestinal hemorrhage caused by non-ampullary duodenal adenosquamous carcinoma.
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Affiliation(s)
- Arimasa Miyama
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Yuko Chikaishi
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Daigo Kobayashi
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Kazuhiro Matsuo
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Takayuki Ochi
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Kenichi Nakamura
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Tomoyoshi Endo
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Kenji Kikuchi
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Hidetoshi Katsuno
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan
| | - Aki Nishijima
- Department of Diagnostic Pathology, Okazaki Medical Center, Fujita Health University School of Medicine, Okazaki, 444-0827, Japan
| | - Zenichi Morise
- Department of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, 1 Gotanda Harisakicho, Okazaki, Aichi, 444-0827, Japan.
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Haider MS, Master MF, Atluri S, Nfonoyim J. Superior Vena Cava Syndrome Due to Thrombosis: A Case Report. Cureus 2022; 14:e24811. [PMID: 35686261 PMCID: PMC9172051 DOI: 10.7759/cureus.24811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/05/2022] Open
Abstract
Superior vena cava (SVC) syndrome is a clinical entity with signs and symptoms resulting from obstruction of blood flow through the SVC. The resulting obstruction leads to edema in the upper body, including the head, neck, and upper extremities. Clinical signs and symptoms can include plethora, cyanosis, dyspnea, stridor, cough, and hoarseness, as well as more serious complications such as cerebral edema leading to headache, confusion, and coma. Here, we present an interesting case of a 66-year-old female, with a medical history of esophageal cancer in remission and thyroid cancer currently undergoing radiation therapy, who was admitted for facial and upper extremity swelling. The initial impression was of angioedema or an allergic reaction. Imaging studies showed thrombus in the SVC resulting in SVC syndrome. The patient was treated with heparin initially, with a plan for an interventional radiologist to perform catheter-guided thrombolysis. However, the patient became unstable and ended up requiring mechanical ventilation. The patient was eventually discharged on oral anticoagulants. This case was rare as the patient developed SVC syndrome from venous thrombosis in the absence of any external tumor compression or as a result of an intravascular catheter.
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Bui TM, Wiesolek HL, Sumagin R. ICAM-1: A master regulator of cellular responses in inflammation, injury resolution, and tumorigenesis. J Leukoc Biol 2020; 108:787-799. [PMID: 32182390 DOI: 10.1002/jlb.2mr0220-549r] [Citation(s) in RCA: 402] [Impact Index Per Article: 100.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023] Open
Abstract
ICAM-1 is a cell surface glycoprotein and an adhesion receptor that is best known for regulating leukocyte recruitment from circulation to sites of inflammation. However, in addition to vascular endothelial cells, ICAM-1 expression is also robustly induced on epithelial and immune cells in response to inflammatory stimulation. Importantly, ICAM-1 serves as a biosensor to transduce outside-in-signaling via association of its cytoplasmic domain with the actin cytoskeleton following ligand engagement of the extracellular domain. Thus, ICAM-1 has emerged as a master regulator of many essential cellular functions both at the onset and at the resolution of pathologic conditions. Because the role of ICAM-1 in driving inflammatory responses is well recognized, this review will mainly focus on newly emerging roles of ICAM-1 in epithelial injury-resolution responses, as well as immune cell effector function in inflammation and tumorigenesis. ICAM-1 has been of clinical and therapeutic interest for some time now; however, several attempts at inhibiting its function to improve injury resolution have failed. Perhaps, better understanding of its beneficial roles in resolution of inflammation or its emerging function in tumorigenesis will spark new interest in revisiting the clinical value of ICAM-1 as a potential therapeutic target.
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Affiliation(s)
- Triet M Bui
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Hannah L Wiesolek
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ronen Sumagin
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Funamizu N, Nakabayashi Y, Dairaku K, Tomori K, Hiramoto Y, Kurihara K. Intestinal obstruction caused by primary adenosquamous cell carcinoma of the small intestine: A case report and review of the literature. Mol Clin Oncol 2019; 10:235-238. [PMID: 30680200 DOI: 10.3892/mco.2018.1785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 12/03/2018] [Indexed: 01/17/2023] Open
Abstract
Primary adenosquamous cell carcinoma (ASCC) arising from the ileum is an exceptionally rare malignant neoplasm exhibiting mixed glandular and squamous differentiation. The clinicopathological characteristics of ASCC have not been clearly determined due to its rarity. We herein report a case of a 74-year-old man with a successfully treated ASCC of the ileum. The patient visited a medical clinic due to abdominal pain. Abdominal computed tomography imaging revealed an intestinal tumor in the ileum. Prior to undergoing capsule endoscopy, the patient complained of severe abdominal pain due to intestinal obstruction from the patency capsule and the tumor. Thus, the patient was referred to our hospital for emergency surgery. Upon relieving the obstruction by partial resection of the ileum, an impacted patency capsule with a tumor with ulceration was identified. On histological examination, the tumor consisted of malignant glandular and squamous cell elements. The postoperative course was uneventful, without complications. The patient subsequently received adjuvant chemotherapy with oxaliplatin and capecitabine for 6 months. The patient has no evidence of recurrence 20 months after surgery. To the best of our knowledge, only 8 cases of ASCC have been reported in the English literature to date. This case serves as an important reminder to consider small intestinal carcinoma, including ASCC, in the differential diagnosis of intestinal obstruction.
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Affiliation(s)
- Naotake Funamizu
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
| | - Yukio Nakabayashi
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
| | - Katsushi Dairaku
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
| | - Kenta Tomori
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
| | - Yuki Hiramoto
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
| | - Kazunao Kurihara
- Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama 333-0833, Japan
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Ghorbani H, Vakili Sadeghi M, Hejazian T, Sharbatdaran M. Superior vena cava syndrome as a paraneoplastic manifestation of soft tissue sarcoma. Hematol Transfus Cell Ther 2018; 40:75-78. [PMID: 30057975 PMCID: PMC6001923 DOI: 10.1016/j.htct.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/11/2017] [Indexed: 01/18/2023] Open
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