Small cell lung cancer(SCLC)is a common type of primary lung cancer that contributes to approximately 15%of cases.It is closely associated with tobacco risk factors.It is also known as a type of lung cancer that has a...Small cell lung cancer(SCLC)is a common type of primary lung cancer that contributes to approximately 15%of cases.It is closely associated with tobacco risk factors.It is also known as a type of lung cancer that has a high mortality rate within a short time due to its rapid growth rate(with tumor doubling time of 30 days)and its tendency to metastasize early in the disease process.The primary sites of metastasis in SCLC are similar to those in other primary lung cancers and often include the brain,bones,adrenal glands,liver,and lymph nodes.However,there are a few clinical reports of uncommon metastases,such as gastric metastasis from SCLC.Although the incidence of this clinical presentation is very low,reported cases have generally resulted in early mortality due to inadequate treatment.The purpose of this letter is to discuss the knowledge related to gastric metastasis from SCLC and remind clinical doctors not to miss atypical symptoms,thereby providing the right attitude to improve the prognosis for these patients.展开更多
BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively hig...BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.CASE SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.展开更多
BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased r...BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.展开更多
Small cell lung carcinoma metastatic to the stomach,whether synchronous or metachronous,is a rare phenomenon accounting for<0.5%of lung cancers.Hence it can be overlooked by clinicians resulting in delayed diagnosi...Small cell lung carcinoma metastatic to the stomach,whether synchronous or metachronous,is a rare phenomenon accounting for<0.5%of lung cancers.Hence it can be overlooked by clinicians resulting in delayed diagnosis.This manuscript comments on Yang et al’s article which reported 3 such cases.The main diagnostic features are based on routine morphology comprised of small cells with hyperchromatic nuclei,scant cytoplasm,brisk mitoses and necrosis.This can be supplemented by immunohistochemistry demonstrating positivity for cytokeratin,thyroid transcription factor-1 and neuroendocrine markers as well as a high Ki-67 labelling index.Imaging modalities such as positron emission tomography/contrast computed tomography help to confirm lung origin and rule out the possibility of extra-pulmonary small cell carcinoma.The predominant mechanism of spread is most likely hematogeneous.Prognosis is generally poor since this represents stage 4 disease but survival can be improved by chemo/ra-diotherapy and palliative surgery in select cases.Though outcomes have not changed much in the last several decades,the recent Food and Drug Adminis-tration approval of immune checkpoint inhibitors was a significant milestone as was the delineation of small cell lung carcinoma molecular subtypes.Liquid biopsies are increasingly being used for biomarker studies in clinical trials to assess treatment response and prognosis.展开更多
Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is th...Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is the most common acute hyperglycemic emergency in uncontrolled type 1 diabetes(T1DM).[4]More than 60%of DKA patients experience gastrointestinal symptoms such as nausea,vomiting,and abdominal pain,[5,6]which sometimes lead to the neglect of other serious underlying conditions.Although delayed gastric emptying,intestinal obstruction,electrolyte imbalance,and metabolic acidosis are associated with DKA,the underlying mechanism has not been fully elucidated.[7]This study aimed to report a DKA patient complicated with intussusception.展开更多
BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastro...BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.展开更多
文摘Small cell lung cancer(SCLC)is a common type of primary lung cancer that contributes to approximately 15%of cases.It is closely associated with tobacco risk factors.It is also known as a type of lung cancer that has a high mortality rate within a short time due to its rapid growth rate(with tumor doubling time of 30 days)and its tendency to metastasize early in the disease process.The primary sites of metastasis in SCLC are similar to those in other primary lung cancers and often include the brain,bones,adrenal glands,liver,and lymph nodes.However,there are a few clinical reports of uncommon metastases,such as gastric metastasis from SCLC.Although the incidence of this clinical presentation is very low,reported cases have generally resulted in early mortality due to inadequate treatment.The purpose of this letter is to discuss the knowledge related to gastric metastasis from SCLC and remind clinical doctors not to miss atypical symptoms,thereby providing the right attitude to improve the prognosis for these patients.
文摘BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.CASE SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.
基金Capital Health Development Research Special Project,No.2020-4-5123.
文摘BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.
文摘Small cell lung carcinoma metastatic to the stomach,whether synchronous or metachronous,is a rare phenomenon accounting for<0.5%of lung cancers.Hence it can be overlooked by clinicians resulting in delayed diagnosis.This manuscript comments on Yang et al’s article which reported 3 such cases.The main diagnostic features are based on routine morphology comprised of small cells with hyperchromatic nuclei,scant cytoplasm,brisk mitoses and necrosis.This can be supplemented by immunohistochemistry demonstrating positivity for cytokeratin,thyroid transcription factor-1 and neuroendocrine markers as well as a high Ki-67 labelling index.Imaging modalities such as positron emission tomography/contrast computed tomography help to confirm lung origin and rule out the possibility of extra-pulmonary small cell carcinoma.The predominant mechanism of spread is most likely hematogeneous.Prognosis is generally poor since this represents stage 4 disease but survival can be improved by chemo/ra-diotherapy and palliative surgery in select cases.Though outcomes have not changed much in the last several decades,the recent Food and Drug Adminis-tration approval of immune checkpoint inhibitors was a significant milestone as was the delineation of small cell lung carcinoma molecular subtypes.Liquid biopsies are increasingly being used for biomarker studies in clinical trials to assess treatment response and prognosis.
文摘Intussusception is relatively rare in adults but common in children.[1,2]An untreated intussusception often causes intestinal obstruction,intestinal perforation,peritonitis,and shock.[3]Diabetic ketoacidosis(DKA)is the most common acute hyperglycemic emergency in uncontrolled type 1 diabetes(T1DM).[4]More than 60%of DKA patients experience gastrointestinal symptoms such as nausea,vomiting,and abdominal pain,[5,6]which sometimes lead to the neglect of other serious underlying conditions.Although delayed gastric emptying,intestinal obstruction,electrolyte imbalance,and metabolic acidosis are associated with DKA,the underlying mechanism has not been fully elucidated.[7]This study aimed to report a DKA patient complicated with intussusception.
文摘BACKGROUND Currently,perioperative complications of classic Whipple surgery occur at a rate of approximately 40%.Common complications include delayed gastric emptying,pancreatic fistula,and bile leakage,whereas gastrojejunostomy(GJ)leakage is rare.CASE SUMMARY This case report will assess the management of a GJ leak in a 71-year-old male patient following the Whipple procedure.After surgery,the patient was trans-ferred to the clinic after four days of intensive care,where vacuum therapy was used to handle a developing subcutaneous collection.The patient,who had bile in the drains and incision during follow-up,underwent endoscopic examination on the 21st day after the operation.An opening of approximately 4 mm was observed in the GJ anastomosis during endoscopy.Five titanium clips were used to close the openings.The drainage of bile decreased to less than 50 mL on the first day after the procedure,and the patient's oral intake was opened.CONCLUSION Current literature reports a GJ leakage rate of 0.54%following Whipple surgery,with clinical findings lasting on average between 4-34 days.Surgery was the main form of therapy for this case,with a success rate of 84%,and percutaneous drai-nage was also utilized as a treatment option.This case report is the first to docu-ment endoscopic treatment of GJ leaks following the classic Whipple procedure.
