Gan no rinsho. Japan journal of cancer clinics
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Case Reports
[Chronic subdural hematoma secondary to metastasis of adenocarcinoma of the dura mater and skull--a case report].
A 72 year-old woman was hospitalized with the complaint of headache and nausea. Under the diagnosis of right chronic subdural hematoma, a small craniotomy was performed for the total removal of the hematoma. The patient died 14 days after the operation because of the complication of acute DIC. ⋯ Previously reported cases of subdural hematoma secondary to cancer were reviewed in the literature. It is considered that a coagulation defect such as DIC may play a significant role in the development of subdural hematoma. It is suggested that the chronic subdural hematoma in the present case was caused by chronic DIC due to metastasis of bone marrow, and that the patient deteriorated as a result of acute DIC triggered by the surgical therapy.
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A growing interest has been shown in antiemetics with important advances in understanding the physiology of vomiting and the development of new anticancer agents having high emetic potential such as cisplatin. At present, high-dose metoclopramide, dexamethasone and butyrophenones have shown effective antiemetic action. ⋯ While improvements have been made in acute chemotherapy-induced emesis, anticipatory and delayed emesis is still a difficult problem. Further studies under well-designed trials are necessary to establish which of the available agents, doses, routes of administration, and schedules are best for reducing emesis depending on the chemotherapeutic drugs used.
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Pain-alleviating effects of epidural spinal cord stimulation (ESCS) were assessed in patients with chronic intractable pain including cancer pain, and some aspects concerning its mechanisms were discussed. The temporary ESCS with percutaneously inserted electrodes was employed in 105 patients, and the implantable systems for long-term use in 19 patients. ⋯ The N1 wave of the SCP was inhibited up to 120 ms, while the P2 wave was facilitated for more than 100 ms, suggesting that the presynaptic inhibitory action at the dorsal horn is responsible for mechanism of the ESCS. CSF concentration of norepinephrine was significantly decreased by the ESCS therapy, indicating the existence of the relationship between norepinephrinergic descending inhibitory system and the ESCS in pain-alleviating mechanism.
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We report a case of gastric lymphosarcoma associated with early carcinoma (type IIa). Lymphosarcoma was also seen in the small intestine, but there were no metastatic lesions in the lymph nodes , liver, and peritoneum. ⋯ Microscopically, the early carcinoma was a moderately differentiated tubular adenocarcinoma. Only two earlier cases of coexistent gastric lymphosarcoma and early gastric carcinoma have been reported in the literature.