Kondo Shohei, Ishizaki Tetsuo, Wada Takahiro, Mazaki Junichi, Iwasaki Kenichi, Enomoto Masanobu, Nagakawa Yuichi, Katsumata Kenji, Tsuchida Akihiko
Dept. of Gastrointestinal and Pediatric Surgery, Tokyo Medical University.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2413-2415.
Although there are reports of goblet cell carcinoid(GCC)treated by chemotherapy using the treatment protocol for colon cancer, the benefit of chemotherapy for GCC remains controversial and unclear. Herein we report 2 cases of patients with GCC who were successfully treated by surgical resection and oxaliplatin-based adjuvant chemotherapy, without evidence of recurrence. The first case was a 57-year-old man who underwent laparoscopic ileocecal resection after being diagnosed with adenocarcinoma of the appendix by biopsy via colonoscopy. Pathological and immunohistochemical analyses demonstrated the presence of signet-ring-like cells, chromogranin A-positive and synaptophysin-positive cells, leading to a diagnosis of GCC of the appendix. Folinic acid, fluorouracil, oxaliplatin(FOLFOX)was administered for 6 months as an adjuvant chemotherapy. The patient has shown no signs of systematic metastasis and has been alive for more than 3 years after the operation. The second case was a 41-year-old woman who presented to our hospital complaining of lower abdominal pain starting 2 months previously. A computed tomography(CT)scan indicated a pelvic tumor, and she underwent ileocecal resection and hystero-oophorectomy due to an appendix tumor and an ovarian metastatic tumor. Pathological and immunohistochemical analyses demonstrated the presence of signet-ring-like cells, chromogranin A-positive, and synaptophysin-positive cells, confirming the diagnosis of GCC of the appendix. The patient received capecitabine and oxaliplatin(CapeOX)as an adjuvant chemotherapy for 6 months. The patient has been free from recurrence for 22 months following surgery.
尽管有报告称采用结肠癌治疗方案的化疗方法治疗杯状细胞类癌(GCC),但化疗对GCC的疗效仍存在争议且不明确。在此,我们报告2例GCC患者,他们通过手术切除和以奥沙利铂为基础的辅助化疗成功治愈,且无复发迹象。第一例患者为一名57岁男性,经结肠镜活检诊断为阑尾腺癌后,接受了腹腔镜回盲部切除术。病理和免疫组化分析显示存在印戒样细胞、嗜铬粒蛋白A阳性和突触素阳性细胞,从而诊断为阑尾GCC。给予亚叶酸、氟尿嘧啶、奥沙利铂(FOLFOX)进行6个月的辅助化疗。该患者未出现系统性转移迹象,术后已存活3年多。第二例患者为一名41岁女性,2个月前开始出现下腹部疼痛,遂来我院就诊。计算机断层扫描(CT)显示盆腔有肿瘤,因阑尾肿瘤和卵巢转移瘤,她接受了回盲部切除术和子宫卵巢切除术。病理和免疫组化分析显示存在印戒样细胞、嗜铬粒蛋白A阳性和突触素阳性细胞,确诊为阑尾GCC。该患者接受了卡培他滨和奥沙利铂(CapeOX)辅助化疗6个月。术后22个月,该患者无复发。