title: Complete cure of malignant lymphoma of the stomach with a huge adrenal lesion achieved by preoperative chemotherapy and surgery: report of a case.
abstract: We report herein the case of a 53-year-old woman with malignant lymphoma of the stomach who was successfully treated by preoperative chemotherapy and surgery. The patient consulted our hospital with the chief complaint of upper abdominal pain. Endoscopy demonstrated a protruding lesion at the antral posterior wall of the stomach, and a post-biopsy pathological diagnosis of diffuse large cell type B-cell lymphoma was established. Moreover, abdominal ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a tumor measuring approximately 10cm in diameter in the left adrenal gland. A total of three courses of chemotherapy using the CHOP regimen were given preoperatively. The CHOP regimen consisted of 100mg of prednisolone administered for 8 days together with 1.9mg of vincristine, 1,000mg of cyclophosphamide, and 60mg of epirubicin administered intravenously on the first day. This resulted in tumor shrinkage, and a distal gastrectomy, lymph node dissection, and left adrenalectomy were subsequently performed. Since the pathological findings of the resected tissue specimen demonstrated complete elimination of the malignant lymphoma, this combination of procedures was defined as having resulted in a complete response. The postoperative course of this patient was uneventful. She is still alive without any sign of tumor recurrence 6 years after her operation, and is being followed up at the outpatient clinic.
authors.affiliation: Department of Gastroenterology, Nippon Medical School Tama-Nagayama Hospital, Tama-shi, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsuda
authors.forename: Y
authors.initials: Y
authors.lastname: Okihama
authors.forename: K
authors.initials: K
authors.lastname: Egami
authors.forename: M
authors.initials: M
authors.lastname: Wada
authors.forename: M
authors.initials: M
authors.lastname: Yoshioka
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: M
authors.initials: M
authors.lastname: Onda
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007262:Infusions, Intravenous; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011239:Prednisolone / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D015251:Epirubicin; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone