The case was a 75-year-old man. The patient had back pain and an abdominal CT scan was performed. The scan revealed an 8 cm mass in the left lower abdomen, containing both fatty and solid components. An abdominal MRI showed the mass had shifted position, with the solid component exhibiting high signal intensity on diffusion-weighted imaging, suggesting a liposarcoma originating from the small bowel mesentery. For diagnosis and treatment, laparoscopic-assisted surgery was performed. Laparoscopic observation revealed a mobile mass within the jejunal mesentery, and a small laparotomy was conducted to remove it. Histologically, the tumor was identified as a liposarcoma with both well-differentiated and dedifferentiated components. There was no recurrence for 6 years after the surgery.
For decades, hyperbaric oxygen therapy has been considered a treatment option in patients with chronic radiation-induced proctitis after pelvic radiation therapy. Refractory cases of chronic radiation-induced proctitis include ulceration, stenosis, and intestinal fistulas with perforation. Appropriate treatment needs to be given. In the present study, we assessed the efficacy of hyperbaric oxygen therapy in five patients with radiation-induced rectal ulcers. Significant improvement and complete ulcer resolution were observed in all treated patients; no side-effects were reported. Hyperbaric oxygen therapy has a low toxicity profile and appears to be highly effective in patients with radiation-induced rectal ulcers. However, hyperbaric oxygen therapy alone failed to improve telangiectasia and easy bleeding in four of the five patients; these patients were further treated with argon plasma coagulation (APC). Although hyperbaric oxygen therapy may be effective in healing patients with ulcers, it seems inadequate in cases with easy bleeding. Altogether, these data suggest that combination therapy with hyperbaric oxygen therapy and APC may be an effective and safe treatment strategy in patients with radiation-induced rectal ulcers.
The patient is a 63-year-old woman who presented to our hospital with anorexia. A CT scan revealed a lead pipe-like structure extending from the cecum, characterized by wall thickening and a villous appearance. Initially suspecting appendicitis with abscess, she was managed with interval appendectomy and antimicrobial therapy. However, with minimal abdominal pain and considering the possibility of appendiceal cancer, colonoscopy was performed on the 8th day of admission, revealing a protruding lesion compressing the appendiceal orifice. Pathological examination confirmed adenocarcinoma, leading to the diagnosis of appendiceal cancer. On the 16th day of hospitalization, she underwent laparoscopic ileocecal resection with D3 lymph node dissection. The final diagnosis was appendiceal mucinous carcinoma, T1, N1a, M0, Stage ⅢA. She received 10 courses of postoperative adjuvant chemotherapy with mFOLFOX6 and has remained recurrence-free for 29 months post-surgery. The preoperative diagnosis of primary appendiceal cancer is challenging. Appendicitis with nonspecific physical findings should raise suspicion of appendiceal cancer as a complication.
