This paper reports the first case of a patient with hepatocellular carcinoma with lymph node metastasis treated by sorafenib combined with gemcitabine plus oxaliplatin,with a partial response and normalization of α f...This paper reports the first case of a patient with hepatocellular carcinoma with lymph node metastasis treated by sorafenib combined with gemcitabine plus oxaliplatin,with a partial response and normalization of α fetoprotein,which allowed curative surgery.The potential synergy between these three drugs needs to be confirmed,and is currently being investigated in a randomized phase Ⅱ trial.展开更多
AIM:To investigate the feasibility of small bowel polypectomy using double balloon enteroscopy and to evaluate the correlation with capsule endoscopy(CE).METHODS:This is a retrospective review of a single tertiary hos...AIM:To investigate the feasibility of small bowel polypectomy using double balloon enteroscopy and to evaluate the correlation with capsule endoscopy(CE).METHODS:This is a retrospective review of a single tertiary hospital.Twenty-five patients treated by enteroscopy for small bowel polyps diagnosed by CE or other imaging techniques were included.The correlation between CE and enteroscopy(correlation coefficient of Kendall for the number of polyps,intra-class coefficient for the size and coefficient of correlation kappa for the location) was evaluated.RESULTS:There were 31 polypectomies and 12 endoscopic mucosal resections with limited morbidity and no mortality.Histological analysis revealed 27 hamartomas,6 adenomas and 3 lipomas.Strong agreement between CE and optical enteroscopy was observed for both location(Kappa value:0.90) and polyp size(Kappa value:0.76),but only moderate agreement was found for the number of polyps(Kendall value:0.47).CONCLUSION:Double balloon enteroscopy is safe for performing polypectomy.Previous CE is useful in selecting the endoscopic approach and to predicting the difficulty of the procedure.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract.As most of them harbor a KIT mutation(75%),selective kinase inhibitors are the therapeutic option a...BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract.As most of them harbor a KIT mutation(75%),selective kinase inhibitors are the therapeutic option and show a sustained objective response among patients with metastatic or unresectable GISTs.A wellknown higher risk of neoplasm has been described among renal transplant recipients(RTRs).Nevertheless,only few cases of GIST onset among transplant patients have been reported in the literature.CASE SUMMARY Here,we describe 2 cases of gastric GIST occurring during the follow-up of RTRs.We also review the existing literature concerning GIST occurrence in transplant patients.In total and in association with our 2 cases,16 patients have been reported.The median age was 59.5 years and 69%were male.With a median tumor size of 45 mm,no patient displayed metastatic dissemination at diagnosis.Time from transplantation to diagnosis was highly variable between 5 mo and 21 years.Histopathological data mostly revealed high risk of progression(43%).Death increased to 29%during follow-up.Surgical treatment was systematically performed when the tumor was operable(94%).The use of adjuvant therapy was uncommon(19%).CONCLUSION GISTs represent rare but potentially severe malignant complication among transplant patients.展开更多
文摘This paper reports the first case of a patient with hepatocellular carcinoma with lymph node metastasis treated by sorafenib combined with gemcitabine plus oxaliplatin,with a partial response and normalization of α fetoprotein,which allowed curative surgery.The potential synergy between these three drugs needs to be confirmed,and is currently being investigated in a randomized phase Ⅱ trial.
文摘AIM:To investigate the feasibility of small bowel polypectomy using double balloon enteroscopy and to evaluate the correlation with capsule endoscopy(CE).METHODS:This is a retrospective review of a single tertiary hospital.Twenty-five patients treated by enteroscopy for small bowel polyps diagnosed by CE or other imaging techniques were included.The correlation between CE and enteroscopy(correlation coefficient of Kendall for the number of polyps,intra-class coefficient for the size and coefficient of correlation kappa for the location) was evaluated.RESULTS:There were 31 polypectomies and 12 endoscopic mucosal resections with limited morbidity and no mortality.Histological analysis revealed 27 hamartomas,6 adenomas and 3 lipomas.Strong agreement between CE and optical enteroscopy was observed for both location(Kappa value:0.90) and polyp size(Kappa value:0.76),but only moderate agreement was found for the number of polyps(Kendall value:0.47).CONCLUSION:Double balloon enteroscopy is safe for performing polypectomy.Previous CE is useful in selecting the endoscopic approach and to predicting the difficulty of the procedure.
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract.As most of them harbor a KIT mutation(75%),selective kinase inhibitors are the therapeutic option and show a sustained objective response among patients with metastatic or unresectable GISTs.A wellknown higher risk of neoplasm has been described among renal transplant recipients(RTRs).Nevertheless,only few cases of GIST onset among transplant patients have been reported in the literature.CASE SUMMARY Here,we describe 2 cases of gastric GIST occurring during the follow-up of RTRs.We also review the existing literature concerning GIST occurrence in transplant patients.In total and in association with our 2 cases,16 patients have been reported.The median age was 59.5 years and 69%were male.With a median tumor size of 45 mm,no patient displayed metastatic dissemination at diagnosis.Time from transplantation to diagnosis was highly variable between 5 mo and 21 years.Histopathological data mostly revealed high risk of progression(43%).Death increased to 29%during follow-up.Surgical treatment was systematically performed when the tumor was operable(94%).The use of adjuvant therapy was uncommon(19%).CONCLUSION GISTs represent rare but potentially severe malignant complication among transplant patients.
