Clinical Journal of Gastroenterology最新文献

Simultaneous gastric and colonic metastasis of invasive lobular carcinoma of the breast. 浸润性乳腺小叶癌同时发生胃、结肠转移。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-07 DOI: 10.1007/s12328-026-02355-8

Seri Okawa, Hideharu Ogiyama, Takahiro Amano, Hirotsugu Saiki, Yoshitaka Yamaguchi, Nobuyasu Fukutake, Kunimaro Furuta, Hisashi Ishida, Takashi Azama, Masahide Oshita

{"title":"Simultaneous gastric and colonic metastasis of invasive lobular carcinoma of the breast.","authors":"Seri Okawa, Hideharu Ogiyama, Takahiro Amano, Hirotsugu Saiki, Yoshitaka Yamaguchi, Nobuyasu Fukutake, Kunimaro Furuta, Hisashi Ishida, Takashi Azama, Masahide Oshita","doi":"10.1007/s12328-026-02355-8","DOIUrl":"https://doi.org/10.1007/s12328-026-02355-8","url":null,"abstract":"Breast cancer commonly metastasizes to the lungs, bones, liver, and brain; however, gastrointestinal involvement is uncommon. Simultaneous metastases to both the stomach and colon are extremely rare. We report the case of a 53-year-old woman with bilateral breast cancer (right invasive ductal carcinoma and left invasive lobular carcinoma [ILC]) who developed gastric and colonic metastases, presenting with rare endoscopic findings characterized by multiple polypoid lesions, along with disseminated carcinomatosis of the bone marrow. Biopsies from the stomach and colon revealed poorly differentiated adenocarcinomas that were estrogen receptor-positive and negative for E-cadherin in the colon, consistent with ILC metastases. Endocrine therapy with letrozole led to systemic improvement. However, diarrhea and abdominal pain persisted until palbociclib was initiated, after which both symptoms markedly improved. Follow-up endoscopy demonstrated regression of the gastric and colonic lesions. This case is of educational value because it demonstrates, with high-quality images, subtle mucosal changes with a polypoid appearance that are not widely recognized as typical findings of colonic metastasis from ILC, and includes a review of previously reported cases. In patients with breast cancer, particularly ILC, persistent gastrointestinal symptoms may suggest metastasis. Careful endoscopic evaluation with biopsy is essential for diagnosis and monitoring the treatment response.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perihepatic dedifferentiated liposarcoma mimicking IgG4-related disease. 模拟igg4相关疾病的肝周去分化脂肪肉瘤。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-07 DOI: 10.1007/s12328-026-02351-y

Soushi Shibusawa, Yuki Yamashita, Tomoyuki Tanaka, Takefumi Kimura, Shusei Sano, Hisashi Tamada, Yusuke Oka, Yoshiki Ozawa, Hiromitsu Mori, Shuichi Wada

{"title":"Perihepatic dedifferentiated liposarcoma mimicking IgG4-related disease.","authors":"Soushi Shibusawa, Yuki Yamashita, Tomoyuki Tanaka, Takefumi Kimura, Shusei Sano, Hisashi Tamada, Yusuke Oka, Yoshiki Ozawa, Hiromitsu Mori, Shuichi Wada","doi":"10.1007/s12328-026-02351-y","DOIUrl":"https://doi.org/10.1007/s12328-026-02351-y","url":null,"abstract":"Background: Dedifferentiated liposarcoma (DDLPS) may originate in perihepatic adipose tissue, but can radiologically present as a hepatic mass. Moreover, dense Immunoglobulin G4 (IgG4)-positive plasma cell infiltration may mimic IgG4-related disease (IgG4-RD) and delay curative-intent resection. We herein describe a unique case that exemplifies this diagnostic pitfall.Case presentation: A 67-year-old woman was incidentally found to harbor a hepatic mass in segment 6 along with small mesenteric nodules. Cross-sectional imaging showed heterogeneous non-fat containing lesions, while needle biopsy revealed abundant IgG4-positive plasma cells. Prednisolone treatment was commenced for presumed IgG4-related inflammatory pseudotumor. Although the lesions initially shrank slightly, they both enlarged during steroid tapering. Segment 6 hepatectomy with limited bowel resection was subsequently performed. Pathohistological examination revealed atypical stromal cells arising in perihepatic adipose tissue, and Mouse double minute protein 2 (MDM2) amplification confirmed liposarcoma infiltration into the liver and mesentery. Following the discontinuation of steroids, the patient has remained recurrence-free for fourteen months after surgery.Conclusion: DDLPS can masquerade as IgG4-RD and even show temporary steroid responsiveness. When clinical or imaging treatment findings are atypical, comprehensive tissue evaluation with molecular analysis is essential to prevent diagnostic delay.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rapid regression of advanced hepatic fibrosis in a patient with metabolic dysfunction-associated steatotic liver disease and severe obesity: a case report highlighting lifestyle-induced NETosis activation through serum proteomic analysis. 代谢功能障碍相关脂肪变性肝病和严重肥胖患者的晚期肝纤维化快速消退：通过血清蛋白质组学分析强调生活方式诱导的NETosis激活的病例报告

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-06 DOI: 10.1007/s12328-026-02356-7

Toru Nakamura, Shigemune Bekki, Dan Nakano, Atsutaka Masuda, Keisuke Amano, Masahito Nakano, Takumi Kawaguchi

{"title":"Rapid regression of advanced hepatic fibrosis in a patient with metabolic dysfunction-associated steatotic liver disease and severe obesity: a case report highlighting lifestyle-induced NETosis activation through serum proteomic analysis.","authors":"Toru Nakamura, Shigemune Bekki, Dan Nakano, Atsutaka Masuda, Keisuke Amano, Masahito Nakano, Takumi Kawaguchi","doi":"10.1007/s12328-026-02356-7","DOIUrl":"https://doi.org/10.1007/s12328-026-02356-7","url":null,"abstract":"Metabolic dysfunction-associated steatotic liver disease (MASLD) is a progressive condition linked to obesity and insulin resistance, potentially leading to cirrhosis. While lifestyle intervention is a primary treatment, the molecular mechanisms driving the regression of advanced fibrosis remain poorly understood. We report a man in his 30 s with severe obesity (BMI 35.2 kg/m2) and advanced fibrosis (liver stiffness measurement [LSM] 18 kPa) who underwent a 12-month caloric restriction and resistance training program. He achieved 33.8% weight loss while preserving skeletal muscle, resulting in normalized liver enzymes and an 80.6% reduction in LSM. Comparative serum proteomic analysis revealed that the \"Neutrophil extracellular traps (NETs) formation\" pathway was the most significantly upregulated, contrasting with downregulated metabolic pathways. Detailed mapping confirmed increased expression of NETosis-essential proteins, including peptidylarginine deiminase 4 (PAD4), neutrophil elastase (NE), myeloperoxidase (MPO), and citrullinated histone H3 (citH3), alongside upstream signaling such as ROS, Akt/mTOR, and NADPH oxidase components. This case demonstrates that intensive lifestyle intervention can induce rapid regression of advanced fibrosis in MASLD. The transition from metabolic stress to NETosis activation indicates that neutrophil-mediated immune regulation may be a key driver in the systemic and hepatic remodeling process.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Durvalumab and tremelimumab combination therapy achieved remarkable response in primary hepatic undifferentiated carcinoma with high PD-L1 expression. Durvalumab和tremelimumab联合治疗原发性肝癌PD-L1高表达的疗效显著。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-04 DOI: 10.1007/s12328-026-02329-w

Michihiko Kawahara, Hatsue Fujino, Yasutoshi Fujii, Atsushi Ono, Tomokazu Kawaoka, C Nelson Hayes, Masataka Tsuge, Tetsuya Nakagiri, Koji Arihiro, Shiro Oka

{"title":"Durvalumab and tremelimumab combination therapy achieved remarkable response in primary hepatic undifferentiated carcinoma with high PD-L1 expression.","authors":"Michihiko Kawahara, Hatsue Fujino, Yasutoshi Fujii, Atsushi Ono, Tomokazu Kawaoka, C Nelson Hayes, Masataka Tsuge, Tetsuya Nakagiri, Koji Arihiro, Shiro Oka","doi":"10.1007/s12328-026-02329-w","DOIUrl":"https://doi.org/10.1007/s12328-026-02329-w","url":null,"abstract":"Primary hepatic undifferentiated carcinoma is an extremely rare and aggressive malignancy with no established systemic therapy, and the efficacy of immune checkpoint inhibitors (ICIs) remains unknown. We report a 67-year-old man with compensated hepatitis C-related cirrhosis who presented with a 27 mm segment 8 liver lesion and lymph node and bone metastases. Liver biopsy revealed undifferentiated carcinoma with high programmed death-ligand 1 (PD-L1) expression, and combination therapy with durvalumab and tremelimumab (Dur/Tre) was initiated. Shortly after treatment, the patient developed cranial nerve palsies (III, VII, VIII), suspected to represent either an immune-related adverse event or Ramsay Hunt syndrome; his symptoms improved with prednisolone and valaciclovir, allowing Dur/Tre to be resumed. After four courses, partial tumor shrinkage was achieved, and after 17 courses the primary tumor had decreased to 10 mm with complete resolution of nodal metastases, without further significant adverse events. To our knowledge, this is the first report of primary hepatic undifferentiated carcinoma with high PD-L1 expression demonstrating a sustained response to Dur/Tre. This case suggests that PD-L1 expression may serve as a potential biomarker for predicting ICI responsiveness in this rare and aggressive tumor.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management. 肝硬化隐蔽性肝性脑病：早期诊断和适当治疗的意义。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-04 DOI: 10.1007/s12328-026-02354-9

Chisato Saeki, Takahiko Toyonaga, Yuichi Torisu, Masayuki Saruta, Akihito Tsubota

{"title":"Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.","authors":"Chisato Saeki, Takahiko Toyonaga, Yuichi Torisu, Masayuki Saruta, Akihito Tsubota","doi":"10.1007/s12328-026-02354-9","DOIUrl":"https://doi.org/10.1007/s12328-026-02354-9","url":null,"abstract":"Covert hepatic encephalopathy (CHE) is a frequent and clinically relevant complication of liver cirrhosis, affecting approximately 30-70% of patients. Despite the absence of overt neurological symptoms, CHE is associated with impaired quality of life and increased risks of falls, traffic accidents, hospitalization, progression to overt HE (OHE), and mortality. The pathophysiology of HE, including CHE and OHE, is multifactorial and involves complex interactions among hyperammonemia, systemic inflammation, oxidative stress, gut dysbiosis, bile acid dysregulation, and sarcopenia along the gut-liver-brain axis. Several diagnostic tools are available, including psychometric batteries, computerized neuropsychological assessments, the Stroop test, critical flicker frequency, and the inhibitory control test. However, time and resource constraints hinder their routine implementation in real-world clinical settings, leading to substantial underdiagnosis of CHE. Although treatment strategies for CHE have not yet been fully established, non-absorbable disaccharides and rifaximin have emerged as promising ammonia-lowering therapies and microbiota-targeted interventions for improving cognitive function and reducing the risk of progression to overt HE. Early recognition and multidisciplinary intervention for CHE are essential to prevent disease progression and improve clinical outcomes. This review summarizes the current evidence on the epidemiology, pathophysiology, diagnosis, clinical significance, and therapeutic approaches for CHE in cirrhosis, with the aim of enhancing its recognition and optimizing patient management.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Takotsubo syndrome following delayed bleeding after gastric endoscopic submucosal dissection: a case report. 胃内镜下粘膜下剥离后迟发性出血后Takotsubo综合征1例报告。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-04 DOI: 10.1007/s12328-026-02347-8

Yoshika Saito, Masaki Nakashima, Hiroaki Saito, Tadanori Nakata, Satoshi Ito, Ryuta Suzuki, Daichi Togo, Norio Tada, Tomoki Matsuda

{"title":"Takotsubo syndrome following delayed bleeding after gastric endoscopic submucosal dissection: a case report.","authors":"Yoshika Saito, Masaki Nakashima, Hiroaki Saito, Tadanori Nakata, Satoshi Ito, Ryuta Suzuki, Daichi Togo, Norio Tada, Tomoki Matsuda","doi":"10.1007/s12328-026-02347-8","DOIUrl":"https://doi.org/10.1007/s12328-026-02347-8","url":null,"abstract":"Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer that enables the en bloc resection of large lesions. However, it is associated with a significant risk of delayed bleeding, particularly in patients receiving antithrombotic therapy. Delayed bleeding after ESD causes anemia and serious systemic complications, including cardiovascular events. Here, we report a rare case of Takotsubo syndrome triggered by delayed bleeding after gastric ESD that culminated in cardiac arrest. A man in his 70s who underwent gastric ESD experienced delayed bleeding six days after the treatment, requiring emergency endoscopic hemostasis. The following day, the patient developed sudden ventricular fibrillation without prior chest symptoms. After resuscitation with electrical defibrillation, left ventriculography revealed apical ballooning consistent with Takotsubo syndrome. With intensive care, cardiac function recovered, and the patient was discharged ambulatory. Takotsubo syndrome is typically induced by stress, and often triggers psychological and physical stimuli. Although most patients present with chest pain or discomfort, our patient showed no preceding symptoms and developed sudden arrhythmia and cardiac arrest. This case highlights the need for aggressive bleeding prevention and enhanced post-ESD cardiac surveillance to mitigate rare but potentially fatal complications.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revisiting plasma exchange in persistent cholestasis. 持续性胆汁淤积的血浆置换。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-03 DOI: 10.1007/s12328-026-02357-6

Mehmet Akif Agir

引用次数: 0

Lymphoepithelial carcinoma of the esophagus with primary squamous cell carcinoma of the hypopharynx: complete response was achieved by chemoradiation therapy. 食管淋巴上皮癌合并原发性下咽鳞状细胞癌：经放化疗完全缓解。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-03 DOI: 10.1007/s12328-026-02346-9

Hirotaka Kashima, Akihisa Fukuda, Takafumi Kurokami, Makoto Suzuki, Kazuya Ohno, Hiroshi Seno

{"title":"Lymphoepithelial carcinoma of the esophagus with primary squamous cell carcinoma of the hypopharynx: complete response was achieved by chemoradiation therapy.","authors":"Hirotaka Kashima, Akihisa Fukuda, Takafumi Kurokami, Makoto Suzuki, Kazuya Ohno, Hiroshi Seno","doi":"10.1007/s12328-026-02346-9","DOIUrl":"https://doi.org/10.1007/s12328-026-02346-9","url":null,"abstract":"A 52-year-old male presented with a 3-month history of dysphagia. Laryngological examination showed a left-sided hypopharyngeal tumor, and biopsy of biopsy the tumor revealed moderately differentiated squamous cell carcinoma (SCC). Computed tomography (CT) and esophagogastroduodenoscopy also revealed a 50 mm mass in the middle thoracic esophagus. Biopsy of the esophageal tumor revealed lymphoepithelial carcinoma (LEC), characterized by lymphoplasmacytic infiltration and atypical immunohistochemical markers: The infiltrated cells were positive for EMA, partially positive for cytokeratin (CK) AE1/AE3, slightly positive for p63, and negative for CK5/6, synaptophysin, chromogranin A, CK7, p40, S100, HMB45, Melan A, and EBER-ISH. The patient underwent chemoradiotherapy (CRT) with 50.4 Gy in 24 fractions and concurrent chemotherapy with cisplatin and 5-fluorouracil. After CRT, both the tumors showed complete resolution on CT and endoscopy. No recurrence has been observed for 17 months. LEC, often associated with Epstein-Barr virus (EBV), is extremely rare in the esophagus. To our knowledge, this is the first reported case of coexistence of esophageal LEC and primary hypopharyngeal SCC, in which complete response was achieved by CRT.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of immune-mediated adverse events enterocolitis and duodenitis with gastrointestinal bleeding successfully treated with ustekinumab. 1例免疫介导的不良事件小肠结肠炎和十二指肠炎合并消化道出血成功治疗ustekinumab。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-05-02 DOI: 10.1007/s12328-026-02341-0

Ryo Morikawa, Yuka Hachisu, Toshimitsu Fujii, Hiromi Kondo, Akifumi Mochizuki, Risa Onizawa, Iichiroh Onishi, Kazuo Ohtsuka, Ryuichi Okamoto

{"title":"A case of immune-mediated adverse events enterocolitis and duodenitis with gastrointestinal bleeding successfully treated with ustekinumab.","authors":"Ryo Morikawa, Yuka Hachisu, Toshimitsu Fujii, Hiromi Kondo, Akifumi Mochizuki, Risa Onizawa, Iichiroh Onishi, Kazuo Ohtsuka, Ryuichi Okamoto","doi":"10.1007/s12328-026-02341-0","DOIUrl":"https://doi.org/10.1007/s12328-026-02341-0","url":null,"abstract":"Gastrointestinal immune-mediated adverse events (imAEs) complicated by bleeding may result in a severe clinical course. We report the case of a 64-year-old man with immune-mediated colitis who relapsed after initial treatment with prednisolone, improved following treatment with infliximab, but subsequently developed immune-mediated enterocolitis. Infliximab was reintroduced after hospitalization; however, his condition worsened and was complicated by bloody stools, then his condition progressed to hemorrhagic shock. A proton pump inhibitor was initiated, and upper gastrointestinal endoscopy revealed duodenal ulcers. The clinical course was considered consistent with immune-mediated enterocolitis complicated by duodenitis. Treatment with infliximab was discontinued and ustekinumab was initiated. Follow-up endoscopy showed no bloody retention in the duodenum; however, bloody stool persisted, suggesting additional bleeding sources in the small intestine or colon. Bloody stool improved 15 days after initiation of ustekinumab. ImAE sometimes cause severe gastrointestinal bleeding requiring blood transfusion. Although several immunosuppressive therapies have been reported to be effective in such cases, to our knowledge, ustekinumab has not been reported to be effective. This case highlights the potential role of ustekinumab as a therapeutic option for gastrointestinal imAEs complicated by bleeding.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of conversion surgery for a pancreatic neuroendocrine neoplasm with tumor seeding-related peritoneal dissemination after endoscopic ultrasound-guided fine-needle biopsy. 内镜超声引导下细针活检后胰腺神经内分泌肿瘤伴肿瘤播散的腹腔转移手术一例。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-29 DOI: 10.1007/s12328-026-02350-z

Mitsuhiro Shimura, Masaharu Ishida, Keigo Murakami, Takayuki Miura, Shimpei Maeda, Masamichi Mizuma, Shin Miura, Toru Furukawa, Atsushi Masamune, Michiaki Unno

{"title":"A case of conversion surgery for a pancreatic neuroendocrine neoplasm with tumor seeding-related peritoneal dissemination after endoscopic ultrasound-guided fine-needle biopsy.","authors":"Mitsuhiro Shimura, Masaharu Ishida, Keigo Murakami, Takayuki Miura, Shimpei Maeda, Masamichi Mizuma, Shin Miura, Toru Furukawa, Atsushi Masamune, Michiaki Unno","doi":"10.1007/s12328-026-02350-z","DOIUrl":"https://doi.org/10.1007/s12328-026-02350-z","url":null,"abstract":"Background: Peritoneal dissemination (PD) following endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is rare, particularly in pancreatic neuroendocrine neoplasms (PanNEN). Clinical indications for conversion surgery (CS) in PanNEN patients with PD remain poorly defined.Case: A 65-year-old man was referred for evaluation of a pancreatic tail mass detected during bladder cancer treatment. EUS-FNB diagnosed PanNEN (G2). Laparoscopic distal pancreatectomy (LDP) was aborted after multiple PD nodules were identified within the lesser sac. Peritoneal cytology was negative, and no PD-suspected nodules were identified outside the lesser sac, raising suspicion of FNB‑related tumor seeding. Because lanreotide therapy maintained stable disease for 18 months without the development of distant metastasis, CS was planned. LDP with regional lymphadenectomy was successfully performed, achieving R0 resection. Pathology showed a well-demarcated pancreatic tail tumor and a white nodule with identical immunohistochemical profiles, suggesting a common origin. No evidence of recurrence has been observed at 4 months postoperatively.Conclusion: Given the rarity of PD and FNB-related tumor seeding in PanNEN, the present case provides valuable clinical insight into both the potential procedural risk and the feasibility of multimodal management incorporating systemic therapy, followed by curative-intent CS. CS may be a feasible option for selected PanNEN patients with PD after EUS-FNB.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0