[A case of unknown primary cancer responding to chemotherapy selected based on the results of an anticancer drug sensitivity test].
METHODS
The patient was a 64-year-old man. In 1998, he underwent proximal gastrectomy for gastric cancer. In September 2007, follow-up CT revealed multiple tumors around the hilum of the spleen, and he was referred to our hospital. On the initial consultation, the marked retention of ascites was noted. The levels of tumor markers such as PIVKA-II and a-fetoprotein were markedly increased. Despite various examinations, the primary focus could not be determined. In November 2007, an exploratory laparotomy was performed, but the primary focus was unclear, so one of the nodules of the major omentum was excisionally biopsied. An anticancer drug sensitivity test showed that the specimen was sensitive to 5-FU and CDDP. Therefore, the combined chemotherapy with 5-FU and CDDP was performed. The patient responded to this therapy. Ascites and tumor markers remarkably decreased, and the performance status improved from 3 to 1.


CONCLUSIONS
These results suggest the usefulness of an anticancer drug sensitivity test in the treatment of cancer in which the primary focus is unclear.
Miura
Kazuhiro
K
Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine.
Tsukikawa
Satoshi
S
Nishio
Kenji
K
Katagiri
Hideyuki
H
Sakurai
Joe
J
Shimamura
Tsukasa
T
Makizumi
Ryoji
R
Otsubo
Takehito
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001201:Ascites / Q000188:drug therapy / Q000209:etiology; D001706:Biopsy; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
D002945:Cisplatin; D005472:Fluorouracil