[A case of advanced gastric adenocarcinoma with mild elevation of serum SCC that responded remarkably to adjuvant chemotherapy of ADM, CDDP, ETP and 5-FU (ACVF)].
A 65-year-old man was referred to our hospital because of weight loss. Endoscopic examination and computed tomography (CT) revealed an advanced gastric cancer with multiple abdominal lymph node swellings. Distal partial gastrectomy was performed but lymph node resection was not done, since it was not thought to be curative. Adjuvant chemotherapy was performed for 4 courses with a regimen of ADM 20 mg/m2 day 1, CDDP 50 mg/m2 day 1, ETP 100 mg/day days 3-7, 5-FU 600 mg/m2 every other day on days 3-29. After 3 courses of ACVF therapy, the patient's serum CEA and SCC level normalized and the lymph node metastases became undetectable by CT scan. No severe side effects were observed at any time during the administration of these medications. In this case, serum SCC level was elevated even though histologic examination did not reveal squamous cell carcinoma but poorly differentiated adenocarcinoma. On immunohistochemical analysis, these tissues were stained diffusely with CEA, locally with AE1 + 3, and partially with PAS or Alcian blue. We speculate that this tumor could have developed the potency of SCC secretions without structural change into squamous metaplasia.
Niki
Toshiharu
T
Dept. of Gastroenterology, Hyogo Medical Center for Adults.
Matsumoto
Ippei
I
Nishisaki
Hogara
H
Inoue
Hiroki
H
Hamano
Kenichi
K
Maeda
Tetsuo
T
Okutani
Toshio
T
Hirohata
Shigeya
S
Nakashima
Takatoshi
T
Yasutake
Kouichi
K
Kawaguchi
Katsunori
K
Sashikata
Terumasa
T
D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy*; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005047:Etoposide / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D012074:Remission Induction; D015843:Serpins; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy*; D005641:Tegafur / Q000008:administration & dosage
D000951:Antigens, Neoplasm; D004338:Drug Combinations; D011725:Pyridines; D015843:Serpins; C051072:squamous cell carcinoma-related antigen; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D005047:Etoposide; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil