WCIM 2014 SEOUL KOREA 527
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0821 Upper GI Tract
Primary Malignant Melanoma of the Esophagus: A Case Report
Jihyun Lee1, Ki-Nam Shim1, Min Sun Ryu1, Kwang Jin Woo1, Jeon Mi Lee1, Hey Won Yoon1, Chung Hyun Tae1, Chang Mo Moon1, Seoung Eun Kim1, Hye Kyung Jung1, Sung-Ae Jung1
Ewha Womans University Mokdong Hospital, Korea1
Primary malignant melanoma of the esophagus is an extremely rare disease which counts for approximately 0.1-0.2% of all esophageal malignancies. It is also a very aggressive disease with a poor prognosis, with its 5yr survival rate ranging from 2.2%
- 37.5%. Here we report a case of primary malignant melanoma of the esophagus in a patient whose diagnosis was made relatively early and thus total resection by an Ivor Lewis procedure was possible. A 51 year old Asian woman visited our hospital with epigastric discomfort. The patient had no noticeable medical history. She complained of mild nausea and dyspepsia, but there was no vomiting or weight loss. Physical examination showed no palpable lymph nodes in the head and neck region. There was no tenderness or rebound tenderness on the abdomen. For evaluation of her upper gastrointestinal symptoms, she had the upper endoscopy done. Endoscopy identifi ed a few dark pigmented, polypoid lesions scattered from 22cm to 30cm from the incisor tooth. The lesions were various in size, ranging from 0.2cm to 4-5cm and were fl at, slightly elevated with a irregular base. Biopsy done from two spots showed a well de- marcated, slightly elevated and black pigmented tumor. For stage work-up, additional examinations were performed. The chest CT showed no abnormal thickening of the esophagus or any enlarged lymph nodes in the mediastinum. The PET-CT showed a mild focal abnormal uptake in the upper thoracic esophagus. The patient underwent an Ivor-Lewis procedure in June, 2013. Pathologic examination revealed spindle shaped malignant melanocytes with hyperchromated nucleis and black pigmentation. The lesion had invaded the submucosal layer. Thus the patient was diagnosed as esopha- geal malignant melanoma, stage T2N0M0. She is now under close observation at the out-patient department and has been disease free for 13 months.e
PS 0822 Upper GI Tract
The Clinical Value of Tumor 18F-FDG Uptake for Predicting Regional Lymph Node Metastasis and Non- Curative Surgery in Primary Gastric Carcinoma
Ju Young Choi1, Ki-Nam Shim1, Seong-Eun Kim1, Hye-Kyung Jung1, Sung-Ae Jung1, Kwon Yoo1
Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Korea1
Background: we investigated the value of 18F-FDG PET/CT for preoperative detection of lymph node(LN) metastasis and evaluation of tumor resectability in gastric cancer.
Methods: This study included 156 gastric cancer patients who underwent surgery. The standardized uptake value (SUV) was calculated.
Results: The rates of FDG uptake in the primary tumor were higher in the following parameters: AGC vs. EGC (85.5% vs. 43.6%, p < 0.001), tumor size = 3 cm vs. < 0.001), LN metastases in histology (86.8% vs. 46.1% p < 0.001). Patients with advanced and large tumor sizes and underwent non-curative surgery showed relatively high uptake rates in the local LN. When the SUV of the primary tumor was greater than 3.75, the sensitivity and specificity of PET/CT with regard to the diagnosis of metastatic LN were 73.5% and 74.5%. When the SUV was greater than 4.35 and the FDG uptake of LN was positive, non-curative surgery was predicted with a sensitivity of 58.8% and specifi city of 91.6%.
Conclusions: A high FDG uptake rate and SUV of the gastric tumor was related to histologic positive LN and non-curative surgery.
PS 0823 Upper GI Tract
Dosage of PPI Dose Not Effect the Eradication Rate of Helicobacter pylori
Sang Woo Han1, Suk Pyo Shin1, Ji Su Kim1, Ju Hwan Kim1, Ga Won Song1, Sung Pyo Hong1
Cha Bundang Medical Center, Korea1
Background & Aims: Many guidelines recommend strong acid inhibition with antibi- otics for Helicobacter pylori (H. pylori) eradication. However, previousely reported some trials showed that high dose proton pump inhibitor(PPI) for H. pylori eradication does not improve H. pylori eradication rate. In this study we tried to assess the eradication rate of triple therapy with low dose PPI for H. pylori eradication.
Methods: H. pylori eradication rates between January 2014 and July 2014 in CHA Bundang medical center were analyzed. H. pylori infection status was assessed by at least one of the following: histology, serological test, rapid urease test(CLO) or urea breath test (UBT). First-line treatment for H. pylori eradication was PPI bid, clarithro- mycin 500mg bid and amoxicillin 1g bid. We assumed pantoprazole 20mg, lansopra- zole 15mg, esomeprazole 10mg and rabeprazole 10mg as half dose and double dosage of half dose as standard dose.
Results: 534 patients were enrolled initially. 511 patients were returned for follow-up.
Eradication rates were 70.2% by intention to treat analysis and 73.4% by per protocol.
The group receiving half and standard dose of PPI, included 101 and 410 patients re- spectively. Further analysis were performed in accordance with the half and standard dose of PPI. Eradication rates of half dose group and standard dose group were 76.2%
and 71.1% respectively. This was statistically indifferent with P value 0.361
Conclusions: There was no difference in eradication rates between half dose and standard dose of PPI in triple therapy for H. pylori eradication.
