Weekly administration of paclitaxel attenuated rectal stenosis caused by multiple peritoneal recurrence 8 years after the resection of gastric carcinoma.
We report a patient with rectal stenosis caused by peritoneal recurrence 8 years after a curative resection of advanced stage gastric carcinoma; the recurrence was effectively treated with the weekly administration of paclitaxel. The patient was a 66-year-old Japanese woman who was admitted to our hospital complaining of abdominal pain and frequent bowel movements. She had undergone total gastrectomy, due to advanced-stage gastric carcinoma with extensive lymph node metastasis, 8 years before, and had taken an oral anticancer agent, fluoropyrimidine, for 4 years after the operation. Colonofiberscopy performed on admission revealed circumferential rectal stenosis located 10 cm from the anal verge. Barium enema study demonstrated extensive poor expansion of the upper and lower rectum and irregularity of the descending colon. Abdominal computed tomography (CT) scanning revealed wall thickening in the rectum and descending colon. These findings were compatible with rectal stenosis caused by the peritoneal recurrence of gastric carcinoma. Weekly administration of paclitaxel was started. The abdominal symptoms soon disappeared when the second cycle of paclitaxel was completed, and they have not appeared since then. The rectal stenosis was attenuated, as confirmed by imaging analyses. Weekly paclitaxel has been effective for more than 13 months, suggesting that the patient is in a state of tumor dormancy of recurrent gastric carcinoma.
Sakurai
Yoichi
Y
Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
Yoshida
Ikuo
I
Tonomura
Shuhei
S
Sakai
Wakana
W
Nakamura
Yasuko
Y
Imazu
Hiroki
H
Matsubara
Toshiki
T
Ochiai
Masahiro
M
D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D002277:Carcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D003251:Constriction, Pathologic / Q000188:drug therapy / Q000209:etiology; D004334:Drug Administration Schedule; D005260:Female; D005743:Gastrectomy; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary*; D012002:Rectal Diseases / Q000188:drug therapy* / Q000209:etiology; D012008:Recurrence; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel