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Metastatic involvement of the cecal appendix as a cause of acute appendicitis is rare. A case of a male patient with a diagnosis of stage IV small cell lung cancer is presented, who comes to the Emergency Department due to symptoms compatible with acute appendicitis. An open appendectomy is performed. Pathology demonstrates small cell lung cancer metastasis as the cause of appendicitis. Surgical intervention is the treatment of choice in patients with acute appendicitis of metastatic cause, even in advanced stages of the disease., La afectación metastásica del apéndice cecal como causa de apendicitis aguda es infrecuente. Se presenta un caso de paciente varón, con diagnóstico de cáncer de pulmón de células pequeñas en estadio IV que acude a Urgencias por un cuadro compatible con apendicitis aguda. Se lleva a cabo una apendicectomía abierta. La anatomía patológica demuestra una metástasis de cáncer de células pequeñas de pulmón como causa de la apendicitis. La intervención quirúrgica es el tratamiento de elección en los pacientes con apendicitis aguda de causa metastásica, aun es estadios avanzados de la enfermedad.Recibido: 27 de Diciembre de 2022Aceptado:23 de Julio de 2023Publicado online:27 de Julio de 2023

Metastatic involvement of the cecal appendix as a cause of acute appendicitis is rare. A case of a male patient with a diagnosis of stage IV small cell lung cancer is presented, who comes to the Emergency Department due to symptoms compatible with acute appendicitis. An open appendectomy is performed. Pathology demonstrates small cell lung cancer metastasis as the cause of appendicitis. Surgical intervention is the treatment of choice in patients with acute appendicitis of metastatic cause, even in advanced stages of the disease., La afectación metastásica del apéndice cecal como causa de apendicitis aguda es infrecuente. Se presenta un caso de paciente varón, con diagnóstico de cáncer de pulmón de células pequeñas en estadio IV que acude a Urgencias por un cuadro compatible con apendicitis aguda. Se lleva a cabo una apendicectomía abierta. La anatomía patológica demuestra una metástasis de cáncer de células pequeñas de pulmón como causa de la apendicitis. La intervención quirúrgica es el tratamiento de elección en los pacientes con apendicitis aguda de causa metastásica, aun es estadios avanzados de la enfermedad.Recibido: 27 de Diciembre de 2022Aceptado:23 de Julio de 2023Publicado online:27 de Julio de 2023

Pulmonary tuberculosis and lung cancer are public health problems, causing significant morbidity and mortality worldwide. The coexistence of the two diseases has rarely been reported while their causative association has been noticed leading to diagnosis delayed and prognosis worsening. In this case report, we present the case of a patient with coexistence of pulmonary tuberculosis and small cell lung carcinoma. A 54-year-old male was presented with the complained of lower left chest pain for six months, which was getting worse four days before admission to the hospital. The patient also complained of cough and decreased appetite and weight loss. Initial chest X-ray revealed an infiltrate and cavity in the upper right lung and inhomogeneous consolidation in the left paracardial. After the patient was diagnosed with pulmonary tuberculosis and was given anti-tuberculosis drugs for two months, the cavity and consolidation decreased with no clinically significant improvement. We performed a bronchoscopy with suspicion of lung cancer and a forceps biopsy in which small cell carcinoma was confirmed. The patient received two cycles of chemotherapy and anti-tuberculosis was continued for four months. During the observation in the fourth month, there was a reduction in the tumor size. This case highlights that similarity of clinical symptoms between pulmonary tuberculosis and lung cancer often lead to misdiagnosis of both. Therefore, in the absence of complete clinical and radiological improvement in pulmonary tuberculosis patients, the coexistence of lung cancer should be considered. This also highlights that early diagnosis is critical for the favorable outcome.

A 65-year-old man visited our hospital with the complaint of rapid exacerbation of dysphagia. He had no otolaryngological or digestive system disorders. He was initially suspected to have acute bulbar palsy, a subtype of Guillain-Barré syndrome, and managed accordingly; however, the patient did not respond to treatment. Subsequently, he developed multiple cranial neuropathies and sensory neuronopathy. Additional tests revealed that he had positive anti-Hu antibodies. No obvious mass lesions were noted, but 3 months later, the patient developed enlarged isolated lymph node near the para-aortic lymph nodes. Excision of the focal lymph node revealed small cell carcinoma, without evidence of small cell carcinoma in the lungs. Therefore, the primary lesion was unknown. The patient was diagnosed with paraneoplastic neurological syndrome. In such cases, tumor search often needs to be repeated because neurological symptoms may precede the tumor onset.

A 65-year-old man visited our hospital with the complaint of rapid exacerbation of dysphagia. He had no otolaryngological or digestive system disorders. He was initially suspected to have acute bulbar palsy, a subtype of Guillain-Barré syndrome, and managed accordingly; however, the patient did not respond to treatment. Subsequently, he developed multiple cranial neuropathies and sensory neuronopathy. Additional tests revealed that he had positive anti-Hu antibodies. No obvious mass lesions were noted, but 3 months later, the patient developed enlarged isolated lymph node near the para-aortic lymph nodes. Excision of the focal lymph node revealed small cell carcinoma, without evidence of small cell carcinoma in the lungs. Therefore, the primary lesion was unknown. The patient was diagnosed with paraneoplastic neurological syndrome. In such cases, tumor search often needs to be repeated because neurological symptoms may precede the tumor onset.

Background and Purpose: Small cell carcinoma of the esophagus (SCEC) is a rare subtype of esophageal cancer for which optimal treatment is unknown. We analyzed the impact of treatment factors on outcome in patients with nonmetastasized SCEC. Methods: Patients with a histologically confirmed SCEC without distant metastases were analyzed in a nationwide multicenter retrospective cohort. All patients received radiotherapy as part of curative treatment between January 2000 and December 2014. Details on treatment and outcome were retrieved from individual charts. Cox regression analysis was used to determine prognostic factors for survival. Results: Fifty-eight patients were analyzed. Median survival was 16 months (95% confidence interval, 11-21 mo). Infield recurrences occurred in 25%, distant metastases in 45%, and brain metastases in 12%. In total, 63% of patients developed a recurrence. Most recurrences (67%) occurred within 1 year. In univariable analyses an increased number of chemotherapy cycles (>3) and lower radiotherapy doses (<45 Gy) were associated with improved survival. T-stage, N-stage, treatment period, type of chemotherapy, prophylactic cranial irradiation, and age were not associated with survival. In multivariable analyses, only the number of chemotherapy cycles was associated with better survival (hazard ratio, 0.78; P=0.006). Conclusions: SCEC recurs frequently at distant sites after definitive chemoradiotherapy and usually within 1 year after curative treatment. With a dose of 45 to 50 Gy, infield recurrence rate was low. We found a relationship between number of received chemotherapy cycles and survival with best results obtained after at least 4 cycles of chemotherapy.

Background. Using DNA microarrays, we previously identified 451 genes expressed in 19 different human tissues. Although ubiquitously expressed, the variable expression patterns of these "housekeeping genes" (HKGs) could separate one normal human tissue type from another. Current focus on identifying "specific disease markers" is problematic as single gene expression in a given sample represents the specific cellular states of the sample at the time of collection. In this study, we examine the diagnostic and prognostic potential of the variable expressions of HKGs in lung cancers. Methods. Microarray and RNA-seq data for normal lungs, lung adenocarcinomas (AD), squamous cell carcinomas of the lung (SQCLC), and small cell carcinomas of the lung (SCLC) were collected from online databases. Using 374 of 451 HKGs, differentially expressed genes between pairs of sample types were determined via two-sided, homoscedastic t -test. Principal component analysis and hierarchical clustering classified normal lung and lung cancers subtypes according to relative gene expression variations. We used uni- and multi-variate cox-regressions to identify significant predictors of overall survival in AD patients. Classifying genes were selected using a set of training samples and then validated using an independent test set. Gene Ontology was examined by PANTHER. Results. This study showed that the differential expression patterns of 242, 245, and 99 HKGs were able to distinguish normal lung from AD, SCLC, and SQCLC, respectively. From these, 70 HKGs were common across the three lung cancer subtypes. These HKGs have low expression variation compared to current lung cancer markers (e.g., EGFR, KRAS) and were involved in the most common biological processes (e.g., metabolism, stress response). In addition, the expression pattern of 106 HKGs alone was a significant classifier of AD versus SQCLC. We further highlighted that a panel of 13 HKGs was an independent predictor of overall survival a

Background. Using DNA microarrays, we previously identified 451 genes expressed in 19 different human tissues. Although ubiquitously expressed, the variable expression patterns of these "housekeeping genes" (HKGs) could separate one normal human tissue type from another. Current focus on identifying "specific disease markers" is problematic as single gene expression in a given sample represents the specific cellular states of the sample at the time of collection. In this study, we examine the diagnostic and prognostic potential of the variable expressions of HKGs in lung cancers. Methods. Microarray and RNA-seq data for normal lungs, lung adenocarcinomas (AD), squamous cell carcinomas of the lung (SQCLC), and small cell carcinomas of the lung (SCLC) were collected from online databases. Using 374 of 451 HKGs, differentially expressed genes between pairs of sample types were determined via two-sided, homoscedastic t -test. Principal component analysis and hierarchical clustering classified normal lung and lung cancers subtypes according to relative gene expression variations. We used uni- and multi-variate cox-regressions to identify significant predictors of overall survival in AD patients. Classifying genes were selected using a set of training samples and then validated using an independent test set. Gene Ontology was examined by PANTHER. Results. This study showed that the differential expression patterns of 242, 245, and 99 HKGs were able to distinguish normal lung from AD, SCLC, and SQCLC, respectively. From these, 70 HKGs were common across the three lung cancer subtypes. These HKGs have low expression variation compared to current lung cancer markers (e.g., EGFR, KRAS) and were involved in the most common biological processes (e.g., metabolism, stress response). In addition, the expression pattern of 106 HKGs alone was a significant classifier of AD versus SQCLC. We further highlighted that a panel of 13 HKGs was an independent predictor of overall survival a

Small cell carcinoma of the vagina is rare, so rare in fact that the total number reported in English-language journals is less than 30. Due to this extremely low incidence, no specific treatment guidelines have been established, and most of what is clinically known is derived from a handful of single case reports. However, as befitting its highly aggressive histologic features, which are reminiscent of small cell lung cancer (SCLC), first-line treatment is modeled after SCLC. Herein is reported the case of a 51-year-old African-American patient with metastatic biopsy-proven small cell carcinoma of the vagina that progressed through multiple therapies: first-line cisplatin and etoposide (making it platinum-resistant) and radiotherapy, followed by the tumor macrophage-stimulating agent RRx-001 in a clinical trial called QUADRUPLE THREAT, which per protocol preceded a mandated rechallenge with cisplatin and etoposide. RECIST v.1.1 tumor progression on both RRx-001 and cisplatin/etoposide was accompanied by central necrosis in several of the enlarged lymph nodes and hepatic metastases, which may have been evidence of pseudoprogression, accounting for her ongoing longer-than-expected survival, since the necrotic tissue may have primed the activity of the PD-1 inhibitor. The lack of response to RRx-001 is hypothesized to have correlated with sparse tumor macrophage infiltration, seen on pre- and post-treatment biopsies, since the mechanism of action of RRx-001 relates to stimulation of tumor-associated macrophages.

Carcinomas of the thyroid with Ewing family tumor element (CEFTEs) are small-cell thyroid tumors with epithelial differentiation that disclose p63 expression and EWSR1-FLI1 rearrangement, carry a favorable prognosis and may co-exist with papillary thyroid carcinoma (PTC) foci. Two histogenetic hypotheses have been advanced regarding the origin of CEFTEs: arising in PTCs or in solid cell nests (SCN). A total of 3 CEFTEs, 54 PTCs, and 10 SCNs were reviewed, and fluorescence in situ hybridization (FISH) technique was performed in all cases to search for the presence of EWSR1 rearrangements. The three CEFTEs disclosed the EWSR1-FLI1 rearrangement both in the small cell and in the PTC component. Out of the 54 PTC cases, 28 (51.9%) were positive, 20 (37.0%) were negative, and 6 (11.1%) were inconclusive for EWSR1 rearrangement; in two of the positive PTC cases, the EWSR1-FLI1 rearrangement was detected. Classic PTC disclosed more often the EWSR1 rearrangement than other PTC variants (p = 0.031). PTCs with EWSR1 rearrangement disclosed a lower percentage of nuclei with EWSR1 polysomy than those without EWSR1 rearrangement (p = 0.001). Out of the 10 SCNs, 7 (70.0%) were negative and 3 (30.0%) were inconclusive for the EWSR1 rearrangement. Monosomic nuclei were more frequent (mean of 44.3%) in SCNs than in PTCs (p < 0.001). The presence of the EWSR1-FLI1 rearrangement in PTC component of all studied CEFTEs and the existence of the EWSR1 rearrangement in some PTCs favor the origin of CEFTE from PTC. The high frequency of EWSR1 rearrangements in PTC may represent a new diagnostic marker of these tumors., Funding agencies:Instituto de Salud Carlos III, the Ministry of Economy and Competitiveness, Spain PI15/01501-FEDER

Small cell carcinoma of the vagina is rare, so rare in fact that the total number reported in English-language journals is less than 30. Due to this extremely low incidence, no specific treatment guidelines have been established, and most of what is clinically known is derived from a handful of single case reports. However, as befitting its highly aggressive histologic features, which are reminiscent of small cell lung cancer (SCLC), first-line treatment is modeled after SCLC. Herein is reported the case of a 51-year-old African-American patient with metastatic biopsy-proven small cell carcinoma of the vagina that progressed through multiple therapies: first-line cisplatin and etoposide (making it platinum-resistant) and radiotherapy, followed by the tumor macrophage-stimulating agent RRx-001 in a clinical trial called QUADRUPLE THREAT, which per protocol preceded a mandated rechallenge with cisplatin and etoposide. RECIST v.1.1 tumor progression on both RRx-001 and cisplatin/etoposide was accompanied by central necrosis in several of the enlarged lymph nodes and hepatic metastases, which may have been evidence of pseudoprogression, accounting for her ongoing longer-than-expected survival, since the necrotic tissue may have primed the activity of the PD-1 inhibitor. The lack of response to RRx-001 is hypothesized to have correlated with sparse tumor macrophage infiltration, seen on pre- and post-treatment biopsies, since the mechanism of action of RRx-001 relates to stimulation of tumor-associated macrophages.

Introduction: Cryotherapy is the application of repetitive freezing and thawing cycles that cause tissue damage and destruction. The process enables larger airway lung cancer treatment via rigid or flexible bronchoscopy. American College of Chest Physicians evidence-based clinical practice guidelines (2nd Edition) recommend cryotherapy as a treatment option for patients with superficial non-small cell carcinoma who are not surgical candidates (Grade 1C). Case Report: A 68-year-old male smoker, with history of weight loss, presented with severe right-sided pneumonia. CT chest showed right lower lobe, apical segment (RB6), consolidation upon a background of severe emphysema. At fibreoptic bronchoscopy there was the incidental finding of a small mucosal tumour within the right upper lobe, between posterior segment (RB2) and anterior segment (RB3). Biopsy confirmed moderately differentiated squamous cell carcinoma. The tumour was staged as carcinoma in situ after review of CT and PET scans. Given co-morbidities the patient was deemed medically inoperable and subsequently underwent cryotherapy to treat the superficial tumour. The outpatient procedure was well tolerated with no complications encountered. Surveillance bronchoscopies with endobronchial biopsies, at three to six monthly intervals, over a 13-month period, have not demonstrated local recurrence. Conclusion(s): Surgical resection is the optimal treatment for Stage I and II lung cancer. This case report highlights the utility of cryotherapy in effectively managing the uncommon clinical situation of carcinoma in-situ in non-surgical candidates. Long term radiological and endoscopic surveillance is required in such individuals, where there is high risk of synchronous tumours.

Introduction: Cryotherapy is the application of repetitive freezing and thawing cycles that cause tissue damage and destruction. The process enables larger airway lung cancer treatment via rigid or flexible bronchoscopy. American College of Chest Physicians evidence-based clinical practice guidelines (2nd Edition) recommend cryotherapy as a treatment option for patients with superficial non-small cell carcinoma who are not surgical candidates (Grade 1C). Case Report: A 68-year-old male smoker, with history of weight loss, presented with severe right-sided pneumonia. CT chest showed right lower lobe, apical segment (RB6), consolidation upon a background of severe emphysema. At fibreoptic bronchoscopy there was the incidental finding of a small mucosal tumour within the right upper lobe, between posterior segment (RB2) and anterior segment (RB3). Biopsy confirmed moderately differentiated squamous cell carcinoma. The tumour was staged as carcinoma in situ after review of CT and PET scans. Given co-morbidities the patient was deemed medically inoperable and subsequently underwent cryotherapy to treat the superficial tumour. The outpatient procedure was well tolerated with no complications encountered. Surveillance bronchoscopies with endobronchial biopsies, at three to six monthly intervals, over a 13-month period, have not demonstrated local recurrence. Conclusion(s): Surgical resection is the optimal treatment for Stage I and II lung cancer. This case report highlights the utility of cryotherapy in effectively managing the uncommon clinical situation of carcinoma in-situ in non-surgical candidates. Long term radiological and endoscopic surveillance is required in such individuals, where there is high risk of synchronous tumours.

We analysed the typical features of primary small cell carcinoma of the esophagus (SCCE) with emphasis on occurrence, behaviour, outcome and treatment options. This metaanalysis was aimed at collecting and analyzing information from international studies about handling this disease. This seems necessary due to the rarity of this disease. Studies were acquired from electronic databases and reference lists. We finally analysed 313 patient cases from the literature with oesophageal SCC. A data extraction was accomplished referring to 13 evaluable features that are described in the "methods", whereof 7 were analyzed with univariate and multivariate tests. Three hundred thirteen cases were analyzed, 109 patients (35%) had limited stage (LS), whereas 167 (54%) had extensive stage (ES). There is no information about the remaining 35 patients concerning the stage. Univariate and multivariate analysis showed only age (<50 years vs. >50 years, HR 1.024; 95% CI 1.000-1.041, P <0.0001) and disease stage (LS vs. ES, HR 4.884; 95% CI 2.572-9.27, P <0.0001) as significant prognostic factors. There also was a statistically significant difference in survival between those patients who received therapy compared to those who only received best supportive care (11.6 months vs. 0.8 months, HR 0.093, CI 95% 0.053-0.16, P <0.001). In this first multivariate analysis for SCCE we show that SCCE is an aggressive type of tumour with a shorter survival rate compared to its counterpart from the lung. It is demonstrated that only disease stage (limited vs. extensive stage), age (<50 years vs. >50 years) and therapy are independent significant predictors of prognosis., Gegenstand unserer Untersuchungen war die Erhebung typischer Eigenschaften des kleinzelligen Ösophaguskarzinoms mit Berücksichtigung des Auftretens, des Verlaufs, der Auswirkung und der Behandlungsoptionen. Ziel unserer Metaanalyse bestand darin, Informationen aus internationalen Studien, die sich mit dieser Krankheit befassten, zu sammeln und auszuwerten. Dies scheint notwendig aufgrund der Seltenheit der Krankheit. Die verwendeten Studien wurden von elektronischen Datenbanken und Referenzlisten ermittelt. Insgesamt wurden 313 Patientenfälle mit einem kleinzelligen Ösophaguskarzinom aus der Literatur ausgewertet. Die erhobenen Daten beziehen sich auf 13 auswertbare Kriterien, die in den "Methoden" beschrieben sind, wovon sieben Kriterien mit univariaten und multivariaten Tests untersucht worden sind. Von 313 analysierten Patientenfällen waren 109 (35%) Patienten im limitierten Stadium der Erkrankung und 167 (54%) im ausgedehnten Stadium. Über die übrigen 35 Patienten sind keine Informationen bezüglich des Stadiums bekannt. Univariate und multivariate Analysen zeigten nur das Alter (<50 Jahre vs. >50 Jahre, HR 1.024; 95% CI 1.000-1.041, P <0.0001) und das Krankheitsstadium (LS vs. ES, HR 4.884; 95% CI 2.572-9.27, P <0.0001) als signifikante prognostische Faktoren. Ebenfalls gab es einen statistisch signifikanten Unterschied in der Überlebenschance zwischen jenen Patienten, die therapiert worden sind, und jenen, die außer bestmöglicher unterstützender Fürsorge nicht therapiert worden sind (11,6 Monate vs. 0,8 Monate, HR 0.093, CI 95% 0.053-0.16, P <0.001). In dieser ersten multivariaten Analyse für das kleinzellige Ösophaguskarzinom zeigen wir, dass diese Form des Krebses eine sehr aggressive Form ist, die mit einer kürzeren Überlebensrate einhergeht verglichen mit seinem Pendant, dem kleinzelligen Bronchialkarzinom. Es wurde gezeigt, dass nur das Krankheitsstadium (limitiert vs. ausgedehnt), das Alter (<50 Jahre vs. >50 Jahre) und die Therapie als Kriterien eigenstä

Ve své bakalářské práci "Radioterapie karcinomu plic a úloha radiologického asistenta při ní" popisuji problematiku maligního onemocnění plic. Práce je rozdělena na teoretickou a praktickou část. V teoretické části se věnuji popisu základní anatomie, epidemiologie, příznakům nemoci a její diagnostice. V další řadě se zabývám rozdělením onemocnění na dvě základní skupiny: malobuněčný a nemalobuněčný karcinom plic a jejich léčbě. V praktické části už přímo popisuji léčbu karcinomu plic pomocí radioterapie s podporou fotografické dokumentace., In my bachelor thesis "Radiotherapy of the lung carcinoma and the role of the radiology assistant during it", the issues of malignant lung disease are described. The thesis is divided into a theoretical and a practical part. The theoretical part is focused on the basic anatomy description, epidemiology, the disease symptoms and its diagnostics. Furthermore, it concerns the division of the disease into two groups: small cell and non-small cell lung carcinoma and their treatment. In the practical part, the treatment of the lung carcinoma is described with help of the radiotherapy supplemented with photodocumentation., Katedra informatiky, managementu a radiologie, Hodnocení vedoucího: velmi dobře Hodnocení oponenta: velmi dobře Doplňující otázky k obhajobě: 1. Co víte o možnosti screeningu plicního karcinomu některou ze zobrazovacích diagnostických metod? Jaký je Váš názor na tento problém? Obhajoba bakalářské práce s prezentací velmi dobrá.

A 74-years old man was referred to our hospital for treatment of a rectal mass. Colonoscopy revealed villous tumor covering all the lower rectal lumen. Biopsy yielded a diagnosis of adenoma. CT examination showed tumor shadows of the rectum and the liver. Pelvic MRI examination showed a 10.5 8 7 cm tumor with high signal intensity on the T2 weighted images in the rectum. Rectosigmoidectomy with lymph node dissection was performed with the diagnosis of rectal cancer that metastasized to the liver. Histological and immuno- histochemical features showed coexistent poorly-differentiated small cell neuroendocrine cell (NEC) carcinoma and non-invasive well-differentiated adenocarcinoma in tubulovillous adenoma. However the chemotherapy with FOLFOX and Bevacizumab was performed postoperatively, the patient died in cancer 3 months after surgery. Rectal poorly-differentiated NEC carcinomas are thought to be a tumor with a high malignant potential. Recently, the UICC TNM classifications of malignant tumors, 7th edition and the Guidelines for colorectal NEC tumors of European Neuroendocrine Tumor Society have been published. They would be evaluated, and effective multimodal therapy for NEC carcinomas should be established.

Extrapulmonary small cell and small cell neuroendocrine tumors of unknown primary site are, in general, aggressive neoplasms with a short median survival. Like small cell lung cancer (SCLC), they often are responsive to chemotherapy and radiotherapy. Small cell lung cancer and well differentiated neuroendocrine carcinomas of the gastrointestinal tract and pancreas tend to express somatostatin receptors. These tumors may be localized in patients by scintigraphic imaging using radiolabeled somatostatin analogues. A patient with an anaplastic neuroendocrine small cell tumor arising on a background of multiple endocrine neoplasia type 1 syndrome is reported. The patient had a known large pancreatic gastrinoma and previously treated parathyroid adenopathy. At presentation, there was small cell cancer throughout the liver and skeleton. Imaging with a radiolabeled somatostatin analogue, 111In- pentetreotide (Mallinckrodt Medical B. V., Petten, Holland), revealed all sites of disease detected by routine biochemical and radiologic methods. After six cycles of chemotherapy with doxorubicin, cyclophosphamide, and etoposide, there was almost complete clearance of the metastatic disease. 111In-pentetreotide scintigraphy revealed uptake consistent with small areas of residual disease in the liver, the abdomen (in mesenteric lymph nodes), and posterior thorax (in a rib). The primary gastrinoma present before the onset of the anaplastic small cell cancer showed no evidence of response to the treatment. The patient remained well for 1 year and then relapsed with brain, lung, liver, and skeletal metastases. Despite an initial response to salvage radiotherapy and chemotherapy with carboplatin and dacarbazine, the patient died 6 months later.

New cell lines (ECC10 and ECC12) derived from endocrine cell carcinoma (ECC) or small cell carcinoma (SCC) of the stomach were established and characterized. Primary tumor of ECC10 was an early carcinoma composed of ECC with squamous cell carcinoma (SQCC) and of well differentiated tubular adenocarcinoma, while that of ECC12 was an advanced carcinoma solely composed of ECC. Inoculation tumor of ECC10 was hepatic metastatic tumor with ECC and SQCC and that of ECC12 was skin metastatic tumor with ECC. ECC10 grew as both of adherent and floating aggregates and ECC12 grew as adherent aggregates. Both cell lines showed aneuploidy, about 46 hours of population doubling time, and successful xenotransplantation into athymic nude mice. ECC10 and ECC12 were composed of argyrophil cells with constant neurosecretory granules. Immunohistochemically ECC10 was negative for serotonin, peptide hormones, and chromogranin A. But, ECC12 contained some cells positive for serotonin, peptide YY, neuropeptide Y, and chromogranin A. Neuron specific enolase was positive in both cell lines, but carcinoembrionic antigen was negative. ECC10 and ECC12 still retain the characteristics of ECC components of their parent tumors and share many properties with classic type of pulmonary SCC cell lines. They are the first gastric ECC cell lines and can provide unique tools for elucidating the biological properties of gastric ECC.

peer-reviewed, A 69-year-old woman was admitted electively for a laparoscopic cholecystectomy. Pre-operatively she had an ultrasound abdomen which demonstrated a large gallbladder (GB) stone. Intraoperatively, a nodule was noted on the liver superolateral to GB. The procedure was subsequently converted to open and the lesion was resected en-bloc with GB. The histology result showed small cell carcinoma (SCC) of the gallbladder with invasion into the liver parenchyma. A staging computerized tomographic of the thorax, abdomen and pelvis was performed. This demonstrated enlarged adenopathy locally and systemically with metastasis to medial segment of the left hepatic lobe and right lung. Following multi-disciplinary team meeting she was referred to Oncology for chemotherapy. The patient has survived for 7 months after the initial diagnosis of SCC.