A 52-year-old man presented with a postoperative abdominal ultrasound of left renal cell carcinoma, which revealed a dilated main pancreatic duct in the pancreatic body tail. A 15 mm tumor was noted in the pancreatic head-neck region on CT, and was diagnosed as invasive pancreatic cancer on EUS-FNA. The tumor was diagnosed as resectable pancreatic head-body cancer, and after neoadjuvant chemotherapy, a subtotal stomach-preserving pancreaticoduodenectomy was performed. Postoperative histopathology showed well-differentiated adenocarcinoma, TS1(9 mm), T1bN0M0, Stage Ⅰ, preoperative chemotherapy efficacy was Grade 2, and R0 resection was obtained. At the same time, a 4 mm-sized nodule was found in the center of the pancreatic head, far from the primary pancreatic cancer, and was diagnosed as renal cell carcinoma intrapancreatic metastasis. He received 4 courses of S-1 therapy as postoperative adjuvant chemotherapy for pancreatic cancer, and is alive 23 months postoperatively without recurrence. The coexistence of primary pancreatic cancer and pancreatic metastasis of renal cell carcinoma is extremely rare, and we report this case with a review of the literature.
A simple filter-disc-absorption technique for sampling human cervical mucus had been developed by colleagues of author. Using this technique, electrophoretic patterns of proteins and phosphorylase in cervical mucus had been reported. In this presentation, I report isoenzyme patterns of alkaline phosphatase (ALP) in the cervical mucus of normal pregnant women and patients with various gynecological diseases using this developed technique. Electrophoresis was carried out with 11.25% polyacrylamide separating gel. The separating gel was prepared using the stacking buffer system at pH 6.7. By this system, the stacking effect was maintained in the gel and the molecular sieve effect was sharpened. ALP activity was demonstrated using 5-bromo-3-indolyl phosphate as the substrate. Placental ALP was identified by its electrophoretic mobility and thermostability. Placental ALP was demonstrated in cervical mucus from 85 pregnant women as early as 6 weeks' gestation. In sera, however, the enzyme activity was demonstrated after 21 weeks' gestation. In cervical mucus and sera of non-pregnant women, and of patients with myoma of the uterus, ovarian tumor and cervical cancer, placental ALP was not demonstrated.
