Pictures in oncology

NOWOTWORY Journal of Oncology

2022, volume 72, number 3, 201

DOI: 10.5603/NJO.2022.0026

© Polskie Towarzystwo Onkologiczne

ISSN 0029–540X, e-ISSN: 2300-2115

www.nowotwory.edu.pl

Peritoneal recurrence of RCC and gastric cancer treated with cytoreductive surgery and HIPEC

Tomasz Jastrzębski12Marian Brodecki2Michał Spychalski2Tomasz Sylwestrzak1Adam Dziki23
1Surgical Oncology Department, Medical University of Gdansk, Gdansk, Poland
2Surgical Oncology Department, District Health Centre Hospital, Brzeziny, Poland
3General and Colorectal Surgery Department, Medical University in Lodz, Lodz, Poland

How to cite:

Jastrzębski T, Brodecki M, Spychalski M, Sylwestrzak T, Dziki A. Peritoneal recurrence of RCC and gastric cancer treated with cytoreductive surgery and HIPEC.
NOWOTWORY J Oncol 2022; 72: 201.

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

A 65-year-old male patient was admitted to the surgical oncology clinic after an examination in August 2020 revealed 10 mm ulceration in the gastric stump (fig. 1); earlier, on 1st Feb 2019, a subtotal gastric resection was performed due to a gastric adenocarcinoma. A histopathological examination revealed cancer cells in 4 out of 10 of the removed lymph nodes, the margins – R0. The patient did not qualified for adjuvant therapy after the surgery, but was qualified for another surgical procedure and HIPEC in a clinical center accredited by the surgical associations after considering the non-radical character of the previous gastric surgery [1]. During the surgery on 16th Sep 2020 on the gastric stump, the intestinal loop, pancreas tail, part of the pancreas body, the spleen and tumor were removed. Cisplatin was administered. PCI was
2 points and the procedure was macroscopically radical – CC-0. The histopathological examination revealed high grade adenocarcinoma in the gastric stump with the obstruction of the lymphatic vessels. Renal clear cell carcinoma presence was confirmed in the spleen and pancreas area. Furthermore, there were renal cancer cells in the splenic vessels and pancreas tail vessels. The radiological examination from March 2021 did not show any signs of cancer recurrence. It may be the first record describing treatment of recurrent renal cancer with HIPEC. This example suggests that in some cases of metastatic RCC in the abdominal cavity, it is worth considering, further research on the subject due to the known fact of HIPEC being an effective solution in different cases of neoplasms [2] and lack of trials in that specific matter.

Figure 1. A CT scan of a gastric stump tumor

References

  1. Jastrzębski T, Richter P, Zegarski W, et al. Guidelines from the Polish Surgical Society and Polish Society of Oncological Surgery Concerning Quality Assurance for Centres Performing Cytoreductive Procedures and HIPEC Procedures in the Treatment of Primary and Secondary Peritoneal Tumours. Nowotwory J Oncol. 2020; 70(3): 85–91, doi: 10.5603/njo.2020.0019.
  2. Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003; 21(20): 3737–3743, doi: 10.1200/JCO.2003.04.187, indexed in Pubmed: 14551293.

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