title: [A case of anal canal carcinoma with systemic lymph node metastases successfully treated by bevacizumab+mFOLFOX6 therapy].
abstract: We describe our experience with a patient who had unresectable anal signet-ring cell carcinoma with extensive metastases to the lymph nodes, lungs, and bones. The patient was treated with bevacizumab (Bev)+mFOLFOX6 and achieved complete response (CR). He was a man in his fifties, who visited a local doctor with the chief complaints of swelling in the axillary and inguinal regions. Signet-ring cell carcinoma was diagnosed by examination of a biopsy specimen from the inguinal lymph nodes. A search for the primary tumor was performed, and anal canal carcinoma with pagetoid spread was detected in the perianal region. Positron emission tomography-computed tomography (PET-CT) showed an accumulation in lymph nodes throughout the body, as well as in the lungs and the bones. Bev+mFOLFOX6 therapy was initiated. After completion of 4 courses, the lymph nodes were no longer palpable. PET-CT scanning showed no accumulation. During the 8th course, tumor markers decreased to the normal range, and CR was diagnosed. When 13 courses had been completed, the patient experienced grade 3 numbness of the hands and feet, so his treatment was changed to Bev+FOLFIRI therapy. In conclusion, Bev+mFOLFOX6 therapy achieved 6 months of CR in our patient who had anal signet-ring cell carcinoma with systemic metastases, which seemed likely to have a very poor prognosis.
authors.affiliation: Department of Surgical Oncology, Kanazawa Medical University.
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Yoshitani
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hosokawa
authors.forename: Miki
authors.initials: M
authors.lastname: Yokoi
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Omote
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Ueda
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakano
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
mesh_terms: D001003:Anal Canal; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000068258:Bevacizumab; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy* / Q000473:pathology; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil