Distal gastrectomy was carried out in 4 away from 5 bulbous cases, and pancreatoduodenectomy was performed within the other 3 cases standard cleaning and disinfection . The pathological stage because of the 8th edition associated with the UICC TNM classification was Stage Ⅰ(T1a/T2, N0)in 3 instances, ⅡA(T3, N0)in 1, ⅢA(N1)in 2, and ⅢB(N2)in 1. R0 resection was achieved in all situations. Adjuvant chemotherapy with S-1 ended up being performed in 3 of 4 clients with Stage Ⅱ or more advanced level phase. There have been no tumefaction recurrences in 4 clients with Stage Ⅰ and Stage ⅡA, but recurrence was occurred in 2 of 3 clients with Stage ⅢA or even more. The surgical outcome for duodenal carcinoma without lymph node metastasis were great. On the other hand, the prognosis for advanced situations with lymph node metastasis were poor. Therefore, the introduction of effective adjuvant chemotherapy is strongly expected.A 70-year-old man visited our medical center due to a body dieting. Upper intestinal fiberscope revealed a kind 3 cyst and a sophisticated MRI showed 30 or higher liver metastases. He received docetaxel plus cisplatin plus S-1(DCS)therapy. Although primary tumefaction had shrinked just partially, multiple liver metastases could never be detected. Therefore, he was performed distal gastrectomy. After gastrectomy, he received S-1 plus oxaliplatin(SOX)therapy followed closely by S-1 therapy. Two years and 2 months after surgery, chemotherapy had been finished because of no signs and symptoms of tumefaction progression. He’s alive without recurrence for 2 many years and 11 months after gastrectomy.The proband ended up being a 77-year-old guy who was simply accepted to a nearby medical center for fecal occult bloodstream. He was clinically determined to have descending colon carcinoma, T4a, N1, M0, Stage Ⅲb, and rectal adenoma. He had withstood surgeries for rectal disease at 52 years and cecum cancer of the colon at 57 years. Regarding his genealogy, 5 first-degree and 3 second- level fever of intermediate duration relatives had a history of gastrointestinal and gynecological types of cancer, therefore fulfilling 2 regarding the 5 criteria associated with the modified Bethesda guidelines. The microsatellite-instability(MSI)test performed utilizing preoperative biopsy areas demonstrated high-frequency MSI(MSI-H). Hartmann’s procedure had been carried out for MSI-H cancer of the colon under a good suspicion of Lynch syndrome. Pathological findings were in line with descending colon carcinoma, tub2, pT3, pN0, M0, pStage Ⅱa. He had been then regarded our hospital. We performed the immunohistochemistry(IHC)analysis associated with the mismatch repair protein utilizing surgical specimens. The IHC analysis revealed defective phrase of this MSH2/MSH6 protein. We found a pathogenic variant in the mismatch restoration gene, MSH2(c.1510+2T>G), through genetic testing and finally identified the individual with Lynch problem. After disclosure for the brings about the proband, 7 loved ones underwent hereditary evaluating when it comes to MSH2 variation. Four loved ones had exactly the same variant and were additionally clinically determined to have Lynch syndrome. They later underwent surveillance for Lynch syndrome-associated types of cancer. In 2 variant providers with a history of very early colorectal cancer tumors, an earlier cancer of the colon was identified and effectively resected endoscopically. Surveillance for Lynch syndrome-associated cancer is continuous when it comes to proband and variant carriers.The proband ended up being a 49-year-old lady who had encountered total colectomy, ileorectostomy, and bilateral ovariectomy when it comes to treatment of cecal(T3N0)and sigmoid colon(T4a, N2b, M1c2[Ova], Stage Ⅳc)cancers. Pathological conclusions revealed 6 adenomas and 2 adenocarcinoma-in-adenomas into the right colon, aside from advanced level colon cancers. She had a family reputation for colorectal disease meeting the Amsterdam Criteria I, but none of her family members had definite polyposis. Thinking about the risk of Lynch syndrome, the microsatellite-instability ensure that you immunohistochemistry(IHC)examination for the mismatch repair protein had been done, resulting in the results of microsatellite steady and proficient mismatch repair protein phrase. Therefore, we performed the multigene panel test containing 26 genes utilizing the next-generation sequencing technology. Within the APC(5q22.2)gene, a pathogenic variant(exon 12 c.994C>T/p.Arg332*)was identified, leading to a diagnosis of attenuated familial adenomatous polyposis(AFAP). After disclosure of this leads to the proband, the single-site variant analysis was carried out on her 3 daughters. Inside her 2nd and 3rd daughters, exactly the same variation was verified, and laparoscopic total colectomy ended up being performed 23 and 35 months following the disclosure associated with the hereditary analysis outcomes, respectively. Presently, we’re conducting periodical surveillance for the residual rectum.A 60-year-old man underwent thoracoscopic subtotal esophagectomy and posterior mediastinal gastric tube repair after neoadjuvant chemotherapy. Twelve months and 8 months postoperatively, recurrence had been seen in the abdominal lymph nodes across the celiac artery and stomach aorta. Chemoradiotherapy was started, accompanied by chemotherapy. Two months following the completion of chemoradiotherapy, the patient created epigastric discomfort and anorexia due to the necrotic lymph node penetrating the gastric tube with hole development. Upper intestinal endoscopy unveiled a 25- mm-sized ulcer with central necrotic slough in the posterior wall surface of the belly. Abdominal symptoms relieved after conservative treatment learn more with fasting and administration of antibiotics, and also the inflammatory reaction enhanced.