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A 57-year-old man was admitted to our hospital with a complaint of perineal pain. He was diagnosed as advanced rectal cancer with an invasion of prostate, and we conducted neoadjuvant capecitabine, oxaliplatin, bevacizumab and radiation therapy. After chemoradiation therapy, the tumor regressed to an ulcerative lesion without invasion of the prostate. Abdominoperineal resection was then performed without radical resection. The tumor regressed to an ulcer and only a few cancer cells were detected in the submucosal layer pathologically.

A 67-year-old man underwent right hemi-colectomy for ascending colon cancer in 2007. One year later, he was diagnosed as early gastric cancer, and endoscopic submucosal dissection was performed. Pathologically, cancer cells were detected on the vertical margin, so we conducted distal gastrectomy. A dissected lymph node around the hepatic artery was histologically proved to contain adenocarcinoma cells. The cancer cells were positive for CK20. Colon cancer cells were also positive for CK20 but gastric cancer cells were focally positive for CK20. This pattern of CK staining suggested the ascending colon cancer metastasized to a gastric regional lymph node.

A 73-year-old woman was diagnosed with solitary hepatocellular carcinoma (18 cm in diameter) in the right lobe. Right hepatic lobectomy was performed in March 2004. Solitary pulmonary metastasis in the left lung was detected by CT scan in April 2006. Thoracoscopic resection of pulmonary metastasis was performed. But in February 2007, solitary pulmonary metastasis in the right lung was detected by CT again. Second thoracoscopic pulmonary resection was performed. Fifty-one months after the initial surgery, she is alive without recurrence in the lung. In patients with pulmonary metastasis of hepatocellular carcinoma, if recurrence in the remnant liver is well controlled and pulmonary metastasis is completely resectable, repeated resections of pulmonary metastasis can be an effective treatment and improve survival.

In the management of inoperable patients who have advanced gastric cancer, it is important to control an active tumor bleeding for the purpose of keeping the patient's quality of life well. We treated two patients: embolization with coil to aneurysm in the gastric tumor in one case, and embolization and chemoradiationtherapy with S-1 in the other. In results, we have never seen an active tumor bleeding and anemic state requiring a blood transfusion after the treatment. Both patients died from other diseases. We think these treatments are useful for patients with active bleeding in advanced gastric cancer.

A 53-year-old woman was admitted for left axillary mass. The computed tomography showed an invasive mass in the left axilla and left supraclavicular lymph node swelling. Histological findings of axillary mass revealed infiltrating ductal carcinoma of scirrhous type. We diagnosed advanced accessory breast cancer, and the patient was treated by combination chemotherapy with paclitaxel and trastuzumab. The lesions disappeared after 4 courses of chemotherapy and was clinically diagnosed as complete response (CR).