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A metastatic gastric cancer mimicking a chronic myeloproliferative disorder

100%

Beyan E. , Beyan C.

tom 5

nr 1

140-143

It is known that coexistence of extreme thrombocytosis and thrombosis is observed frequently in chronic myeloproliferative disorders. In this paper, we report a patient who was prediagnosed with chronic myeloproliferative disorder; however, later on the diagnosis was confirmed as metastatic gastric cancer. The patient was a 75-year old female who was admitted with pain, swelling and erythema on her right arm. White blood cell count was 20 ×109/l, hemoglobin 5.2 g/dl and platelet count 1 088 ×109/l. Doppler ultrasonography revealed acute thrombotic process in right brachial vein. Since brachial vein thrombosis, thrombocytosis and anemia were seen together, the presumed diagnosis for this patient was chronic myeloproliferative disorder, and therapy with hydroxyurea, allopurinol and enoxaparin was started. One day after the heparin treatment, hematemesis and melena occurred. Eusophagogastroduodenal endoscopy showed an ulcerated and hemorrhagic polipoid lesion extending towards the cavity in the cardia region. Hydroxyurea treatment was stopped since the myeloproliferative disorder was excluded. Abdominal ultrasonography and tomography proved multiple metastatic lesions in the liver. Gastric and liver biopsies revealed “well differentiated adenocarcinoma” and 5-fluorouracil chemotherapy plus folinic acid was planned. As a result, in cases with thrombocytosis and thrombosis, metastatic cancers should be kept in mind besides chronic myeloproliferative disorders.

The effect of glycemic control on CEA, CA 19-9, amylase and lipase levels

41%

Ata N. , Dal K. , Kucukazman M. , Yeniova A. Ö. , Karakaya S. , Unsal O. , Dagdeviren M. , Akın K. O. , Baser S. , Beyan E. , Ertugrul D. T.

Open Medicine

2014

tom 10

nr 1

Background: Diabetes mellitus is closely related to pancreas cancer. In this study we aimed to investigate the effect of hyperglycemia on tumor and inflammation markers, as well as pancreatic exocrine functions.Methods: A total of 98 consecutive diabetic patients with poor glycemic control, and 50 healthy controls were included in the study. We measured hsCRP, erythrocyte sedimentation rate (ESR), CA19-9, CEA, amylase and lipase in addition to routine biochemistry tests, before and after euglycemia was achieved.Results: Fasting blood glucose, HbA1c, CA19-9,CEA, hsCRP, ESR, triglycerides, AST, ALT, GGT, ALP, total cholesterol and LDL-C levels decreased significantly with the regulation of glycemic control. Amylase and lipase levels increased with the regulation of glycemic control. After glycemic control, CA19-9 and CEA levels were still higher, whereas amylase and lipase levels were still lower in the diabetic group compared with the control group. Basal HbA1c showed significant correlation with CA19-9, CEA, amylaseand lipase.Conclusions: We propose to repeat observations of tumor markers after hyperglycemia is resolved, in order to avoid unnecessary invasive tests. Our data also suggest that pancreatic exocrine function was improved with lowering blood glucose in a short period of time.