Primary follicular lymphoma of the prostate is extremely rare, with this case representing only the 13th reported in the English literature. This report includes a review of the literature and details of a case in a 75-year-old male with concurrent primary follicular lymphoma and adenocarcinoma of the prostate. The patient was referred to our department due to prostate enlargement observed on CT and complaints of a decreased urinary stream. His PSA level was elevated at 8.9 ng/ml. MRI showed a PI-RADS category 4 lesion in the right peripheral zone of the prostate, with an estimated prostate volume of 60 ml. A transrectal prostate biopsy identified adenocarcinoma in two cores from the right base and one from the left apex, leading to a diagnosis of prostate cancer cT2aN0M0. Subsequently, the patient underwent robotic-assisted laparoscopic radical prostatectomy. Pathological findings confirmed adenocarcinoma in the right and left lobes (pT2a, pN0, EPE0, SV0, LVl1, RM0) and identified concurrent primary follicular lymphoma within the anterior fibromuscular stroma, which was positive for CD20, CD10 and Bcl-2. A complete clinical investigation, including an 18F-fluorodeoxyglucose positron emission tomography scan and bone marrow biopsy, revealed no involvement of other sites, and the patient was ultimately diagnosed with Ann Arbor stage IE lymphoma. No additional treatment was administered, and the patient has been followed up regularly. At six months postoperatively, there was no evidence of recurrence of either prostate cancer or lymphoma.

We report a case of superior vena cava syndrome and trousseau syndrome in a patient with metastatic urothelial carcinoma treated with enfortumab vedotin. The patient was a 59-year-old woman diagnosed with left renal pelvic cancer with multiple lymph node metastases and liver metastasis. Treatment with gemcitabine and cisplatin reduced the size of the local tumor but resulted in liver metastasis progression after three cycles. The patient was switched to pembrolizumab which resulted in rapid tumor growth causing superior vena cava syndrome and trousseau syndrome. Hyper-progression was suspected and the patient was immediately switched to enfortumab vedotin. After enfortumab vedotin therapy, the tumor and multiple metastases shrank significantly and tumor reduction was maintained.

Comprehensive genomic profiling for metastatic castration-resistant prostate cancer (mCRPC) is rapidly becoming widespread. This study sought to investigate the gene alteration profiles of Japanese patients with mCRPC. We retrospectively reviewed 80 consecutive mCRPC patients who underwent comprehensive genomic profiling tests at our institution between 2021 and 2022. All patients underwent next-generation sequencing (NGS) : FoundationOne® CDx (F1-CDx) or FoundationOne® Liquid CDx (F1L-CDx). F1LCDx was indicated for cases in which tissue specimens were older than 5 years or could not be analyzed using F1-CDx. The median patient age was 74 years. Thirty-five and 45 patients received F1-CDx and F1LCDx, respectively. At least one pathogenic variant was found in 35 (100%) who received F1-CDx and 43 (95%) who received F1L-CDx. In total, 11 and 1 patients had pathogenic variants of BRCA2 and BRCA1, respectively. Among them, 4 cases (33%) were found to be germline variants. TP53, CDK12, and PTEN were found in ＞ 20% of cases who received F1-CDx. DNMT3A, TP53, AR, and TET2 were found in ＞ 20% of cases who received F1L-CDx. The proportion of gene alteration subtypes of amplification and loss in F1L-CDx was less common than that in F1-CDx. Pathogenic variants were successfully detected in almost all F1-CDx and F1L-CDx cases in our mCRPC cohort. The total proportion of BRCA1/2 pathogenic variant patients was similar to those in previous reports.

The patient was an 82-year-old man. A posterior mediastinal tumor was noted on chest computed tomography (CT). Magnetic resonance imaging (MRI) scan showed a high signal on both T1- and T2-weighted imaging. Lipoma was suspected, but since the border with the vertebral body was partially unclear, video-assisted tumor resection was performed for diagnosis and treatment purposes. Finally, we diagnosed it as non-infiltrating angiolipoma. Angiolipoma is a benign tumor that accounts for 5-17% of all lipomas. Pathologically, they can be divided into two types:infiltrating and non-infiltrating. Most are non-infiltrating, but recurrent cases of the infiltrating type have been reported. Angiolipoma commonly occurs in subcutaneous tissues of the upper extremity and trunk, but we report a rare case that occurred in the posterior mediastinum.

We present a case of a 66-year-old man who initially presented with spinal cord lesions and was ultimately diagnosed with intravascular large B-cell lymphoma (IVLBCL) by autopsy after two inconclusive random skin biopsies (RSB). Prior steroid use may have contributed to the reduced diagnostic sensitivity of the skin biopsies. Given that brain and spinal cord biopsies are highly invasive, if IVLBCL of the central nervous system is strongly suspected for such reasons as elevated IL-10 in the cerebrospinal fluid, positron emission tomography (PET) may help identify non-neural or non-nervous organ lesions as the target of subsequent biopsies, potentially allowing the definite histological diagnosis when RSB are inconclusive.

A 65-year-old man was diagnosed with gallbladder cancer during a medical checkup that revealed liver dysfunction. He was referred to our hospital seeking bloodless treatment due to religious beliefs. Blood tests revealed elevated hepatobiliary enzyme levels, and abdominal echocardiography revealed a broad nodular protuberant lesion in the body of the gallbladder and marked dilatation of the common bile duct. PET revealed marked abnormal accumulation of FDG in the gallbladder mass and duodenal papilla. Based on the imaging findings, double cancers of the gallbladder and duodenal papilla were diagnosed. A subtotal gastric-sparing pancreaticoduodenectomy was performed along with resection of the liver bed, gallbladder, and bile ducts, and D2 regional lymph node dissection. Both of postoperative histopathologic diagnosis were papillotubular adenocarcinoma. The patient has remained recurrence-free for 5 years postoperatively. Double cancers of the gallbladder and duodenal papilla are rare, and we report this case based on a review of the literature.

A 70-year-old man presented with anorexia and cough, and CT showed an infiltrative shadow in the right upper lobe. Bronchoscopy revealed unresectable advanced lung carcinoma(cT4N2M1a, cStage ⅣA). The patient had chronic renal failure due to type 2 diabetes mellitus and had been undergoing hemodialysis for 6 years. Four courses of primary chemotherapy( atezolizumab+carboplatin[CBDCA]+nab-paclitaxel[nab-PTX][atezolizumab 1,200 mg/body weight, CBDCA target AUC=5, nab-PTX 100 mg/m2 every 3 weeks])were administered. Thereafter, 3 courses of maintenance treatment with atezolizumab alone(1,200 mg/body weight every 3 weeks)were administered. At this point, the primary tumor was enlarged, and the patient was diagnosed with progressive disease(PD). After 4 courses of second-line chemotherapy with docetaxel(DTX)+ramucirumab(RAM)(DTX 60 mg/m2 day 1, RAM 8 mg/kg day 1, 15, every 4 weeks), the primary tumor temporarily shrank but then re-expanded; therefore, the patient remained in a state of PD. The general condition deteriorated, and he was referred to the palliative care department where he died peacefully.

An 80-year-old woman presented with lower abdominal distension for the past 3 days. Abdominal contrast-enhanced CT revealed an irregularly shaped mass measuring 80×50 mm in the right lower abdomen, with a contrast effect. The final diagnosis was locally advanced appendiceal cancer with multiple invasions into the adjacent ileum and retroperitoneum. After 7 courses of preoperative chemotherapy with mFOLFOX6 plus bevacizumab, the tumor reduced in size, and laparoscopic ileocecal resection with D3 lymph node dissection was performed 4 months after diagnosis. Histopathological examination revealed appendiceal cancer, tub1-tub2, ypT4aN0M0, pStage ⅡB, with a histological Grade of 2 and a curative degree of A. The patient had no signs of recurrence 2 years and 6 months after surgery without receiving adjuvant chemotherapy. We reported a case of locally advanced appendiceal cancer that was successfully treated with mFOLFOX6 plus bevacizumab as preoperative chemotherapy and was curatively resected without combined resection of surrounding organs, with a discussion of the relevant literature.

In this case report, we explored the effectiveness of chemoradiotherapy(CRT)for an unresectable large HER2-positive advanced gastric cancer in a 67-year-old male patient. The patient presented with upper abdominal distension and severe anemia. Contrast-enhanced CT scan revealed a 13 cm large tumor in the stomach, with multiple metastases to the liver and lungs. The patient was treated with CRT, combining radiotherapy with FOLFOX chemotherapy to manage persistent massive bleeding. Bleeding was successfully controlled within approximately 2 weeks, eliminating the need for further transfusions and allowing the patient to resume oral intake. Following CRT, trastuzumab-based chemotherapy resulted in significant tumor shrinkage, enabling continued treatment. This case highlights the potential of CRT as an effective treatment option for unresectable HER2-positive advanced gastric cancer complicated by massive bleeding. The successful control of bleeding using CRT might improve both the prognosis and quality of life(QOL)for such patients. We present this case to highlight the therapeutic benefits of CRT in similar clinical scenarios.

Recent advancements of surgery including robotic surgery have improved the clinical outcomes of resectable solid tumors. Although preoperative chemotherapy is often performed for high-risk cancers, the risk of postoperative recurrence remains a critical issue. So far, recurrence has been monitored through periodic imaging tests; however, molecular residual disease (MRD)has caught much attention as the means to detect minimal cancerous lesions at an earlier stage. With the rapid advancements in circulating tumor DNA(ctDNA)analysis using next-generation sequencing, MRD testing is emerging as a promising tool for predicting recurrence in multiple types of cancer. Thus, in this article, we discuss the current status of MRD testing in urogenital cancers and its potential impact on future treatment strategies.

A woman in her 50s. Since October of X-1, she had been suffering from lower back and occipital pain. Despite undergoing medical evaluations at multiple hospitals, no discernible abnormalities were identified. As her symptoms worsened, she presented to our department in January of X, reporting severe pain in the left occipital to posterior neck that increased with both neck flexion and extension. A neurological examination revealed a left-sided deviation of the tongue (left hypoglossal nerve paralysis). A head MRI revealed signal abnormalities in the left occipital condyle and multiple nodules with contrast effects in the brain parenchyma. A computed tomography (CT) scan revealed a mass in the left lung, multiple intrahepatic masses, and bone destruction in the spine and left occipital condyle. In light of these findings, a diagnosis of lung cancer with metastasis to multiple organs and occipital condyle syndrome due to metastasis to the left occipital condyle was suspected. Subsequent cytological analysis of bronchoalveolar lavage fluid and liver biopsy substantiated the diagnosis of adenocaricinoma. The subsequent administration of osimertinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, led to a reduction in the size of the tumor, as well as improvements in the hypoglossal nerve palsy and occipital pain. It is imperative to note that occipital condyle syndrome signifies the metastasis of a malignancy to the base of the skull, necessitating meticulous observation and management.

The treatment of recurrent or metastatic cervical cancer has entered a new era, with immune checkpoint inhibitors now being used as first-line standard of care options. Meanwhile, there is a lack of second-line and subsequent treatment options that can adapt to this changing treatment landscape, highlighting the need for the development of new treatments with novel mechanisms of action. Tisotumab vedotin (recombinant) is an antibody-drug conjugate (ADC) consisting of tisotumab, an anti-human tissue factor (TF) monoclonal antibody (IgG1κ), the microtubule inhibitor monomethyl auristatin E (MMAE), and a valine-citrulline linker. When the linker is cleaved by a protease in a tumor cell, MMAE is released to induce cell cycle arrest and apoptosis via disruption of the microtubular network. In non-clinical studies, tisotumab vedotin demonstrated concentration-dependent cytotoxic and anti-tumor activities. Tisotumab vedotin also mediated antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP) activities. In a global Phase III study of tisotumab vedotin as second- or third-line therapy in patients with recurrent or metastatic cervical cancer (Study SGNTV-003/innovaTV 301), the drug demonstrated higher efficacy than the investigator's choice of chemotherapy. Although some eye-related adverse events occurred as unique toxicities, the safety profile of tisotumab vedotin was generally manageable. The results of analysis in the Japanese subpopulation of the SGNTV-003 (innovaTV 301) study were consistent with those of the overall population. Based on these results, tisotumab vedotin received regulatory approval in Japan in March 2025 for the indication of "advanced or recurrent cervical cancer that has progressed after cancer chemotherapy".

We report a case of a patient with squamous cell carcinoma metastasis confined to a mediastinal lymph node, with no identifiable primary tumor. The patient remains cancer-free 2 years after diagnosis. Although various theories exist regarding the etiology of lymph node carcinoma of unknown primary origin, advances in elucidating its pathogenesis and integrating treatment strategies based on genetic profiling are expected to form the foundation of future clinical practice.

A 70s-year-old woman with a history of Lynch syndrome had ovarian, colon, and right renal pelvic cancers, all of which were detected early and surgically treated with no recurrence. Ten years have passed since the most recent surgical procedure. In September 2020, she developed hematuria and underwent an examination, which revealed left renal pelvic cancer with liver and lung metastases. Chemotherapy(GEM+CBDCA)was initiated in October 2020; however, imaging in April 2021 revealed disease progression. Treatment with an immune checkpoint inhibitor(ICI: pembrolizumab 240 mg/body)was initiated, but after 4 months, the disease progressed and the treatment was discontinued. The patient was then referred to our hospital. Immunological testing revealed a decrease in T cells; therefore, immune-cell therapy(αβT cell therapy)was initiated to improve this condition. After 4 sessions of αβT cell therapy at 2-week intervals, a CT scan in November 2021 revealed shrinkage of the liver metastases and renal pelvis tumor, and the patient was assessed as having a partial response. By February 2022, after a total of 7 sessions of αβT cell therapy, further tumor shrinkage was observed, and the tumor was almost completely resolved on imaging. Although further immunotherapy is rarely administered in patients for whom ICI is ineffective, our findings suggest the potential for significant immune-cell therapy efficacy even after ICI failure.

A 78-year-old male was under follow-up after gallbladder cancer surgery when CT imaging revealed thickening of the rectal wall, along with enlarged mesenteric and left-sided lymph nodes. Colonoscopy identified a semi-circumferential, tumor-like lesion in the lower rectum, and biopsy results confirmed a diagnosis of poorly differentiated adenocarcinoma. Pelvic MRI further revealed a separate tumor in the prostate, leading to a diagnosis of concurrent rectal and prostate cancer. The prostate cancer was managed with endocrine therapy following rectal resection. For the rectal cancer, neoadjuvant chemoradiotherapy(NACRT)was administered prior to surgical treatment. The resected specimen was evaluated for potential lymphatic metastasis of prostate cancer to the rectum. The patient is currently undergoing endocrine therapy and has remained recurrence-free for 2 years.

A 39-year-old man patient was admitted to a nearby clinic with bloody stool. Digital rectal examination revealed a mass lesion in the lower rectum. The patient was referred to our hospital and finally diagnosed with cT4a, N1b, M0, and c-Stage Ⅲb locally advanced rectal cancer. Neoadjuvant chemotherapy(NAC)with CAPOX and bevacizumab was administered to facilitate R0 resection, permitting anal preservation. When the chemotherapeutic regimen was evaluated to have achieved a complete clinical response, the patient underwent laparoscopic low anterior resection. He was shortly discharged without complications. No residual cancer was revealed upon histopathological examination, demonstrating a complete pathological response. Although NAC for rectal cancer has not been recommended by the Japanese guidelines, high response rates have recently been reported. Herein, we present the utility of NAC in the treatment of rectal cancer.

A 60-year-old female presented at our hospital with a mass in her left breast. Needle biopsy of the breast mass confirmed a diagnosis of invasive lobular carcinoma, and the patient underwent left mastectomy and axillary lymph node dissection. The patient received adjuvant chemotherapy and was started on continuous endocrine therapy. Three years post-surgery, she experienced recurrence of multiple bone metastases and received a combination of hormone therapy and selective cyclin-dependent kinases 4/6 inhibitors. Therapeutic efficacy was poor, allowing bone metastases to spread. Four months post-recurrence, blood tests revealed moderate thrombocytopenia. Despite the switch to chemotherapy, the patient's platelet count did not recover. CT revealed splenomegaly, which was not present three months earlier. Bone marrow biopsy revealed severe myelofibrosis with infiltration of small dysplastic cells into dense fibrotic tissue. The patient developed microangiopathic hemolytic anemia, but DIC was not observed during the course of the disease. Ten months after recurrence, a brain metastasis was detected, and the patient died the following month.

The prognosis for unresectable or recurrent biliary tract cancer is generally unfavorable. However, recent reports suggest that combination therapy with immune checkpoint inhibitors may improve outcomes. We report the case of a 79-year-old woman with intrahepatic cholangiocarcinoma who underwent radical resection. Three months post-surgery, she developed a recurrence in an intra-abdominal lymph node. Treatment with 4 courses of gemcitabine+cisplatin+durvalumab(GCD)resulted in a complete response, with no measurable lesions detected on imaging. The patient continued treatment and was subsequently transitioned to durvalumab monotherapy. Although treatment was discontinued due to drug-induced pneumonia, she has remained relapse-free since. To our knowledge, this is the first reported case of a complete response to GCD therapy in biliary tract cancer.

Intracystic papillary neoplasms(ICPN)are very rare. Pancreaticoduodenectomy was performed in patients with a history of cholecystectomy for ICPN. A 76-year-old woman with no complaints was referred to our hospital and was diagnosed with adenomyomatosis preoperatively. Laparoscopic cholecystectomy was performed, and the patient was diagnosed with ICPN based on pathological findings. A follow-up CT performed 6 months after the surgery showed dilated CBD and MPD. Cholangiography revealed a filling defect in the distal bile duct, with a positive cytology test. A pancreaticoduodenectomy was performed, and the patient was discharged on postoperative day 28. The pathological findings revealed the presence of ampullary cancer. Patients with ICPN may require sufficient follow-up and further detailed examinations, if necessary.

Preoperative chemotherapy for gastric cancer with obstructive symptoms traditionally requires bypass surgery.