[Show abstract][Hide abstract] ABSTRACT: A 68-year-old woman with diarrhea and melena was found in irrigoscopy to have haustra disappearing along the cecum through the descending colon in the narrowed lumen with partial thumb-printing. Lower gastrointestinal endoscopy indicated mucosal edema and erosion at the same site, suggesting ischemic enteritis. She was followed up in conservative treatment with a drug for controlling intestinal function. Lower gastrointestinal endoscopy conducted about 5 months later due to sustained diarrhea showed no change in observations. Abdominal plain radiography and abdominal computed tomography indicated linear emergence of reticulate calcification along the cecum through the mesentery of the descending colon occurring since the first visit. Because these findings suggested phlebosclerotic colitis, we biopsied the lesion. The deposition of amorphous substances (HE staining) and collagen fibers (Azan staining) in the mucosa found in biopsy confirmed the diagnosis of phlebosclerotic colitis. We conducted laparoscope-assisted subtotal colectomy to relieve symptoms. The woman's postoperative course was favorable, with symptoms relieved. She is now being followed up in an ambulatory setting.
[Show abstract][Hide abstract] ABSTRACT: Carcinomatous meningitis is clinically less common than brain metastasis or spinal cord compression, but has dire consequences for both the quality of life and the overall survival of patients with various kinds of malignancies. It occurs in about 5% of all adult cancer patients, though autopsies may double this number. The primary tumors that frequently cause carcinomatous meningitis include lung cancer, breast cancer, leukemia, lymphoma, and melanoma. Carcinomatous meningitis secondary to primary tumors in the gastrointestinal tract is clinically infrequent. In this report, we describe a 73-year-old man with lower bile duct cancer, who developed carcinomatous meningitis following surgical resection of the primary cancer. To our knowledge, this is the third case of carcinomatous meningitis secondary to cholangiocarcinoma described in the literature so far.
No preview · Article · Feb 2008 · Journal of Hepato-Biliary-Pancreatic Surgery