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A 88-year-old man who underwent abdominoperineal resection for rectal cancer 40 years earlier. The patient visited our hospital because of abdominal pain and vomiting. An abdominal CT scan showed an abdominal incisional hernia with a 23×15mm orifice in the midline of lower abdomen. The patient diagnosed with severe aortic valve stenosis on echocardiography. We performed elective surgery under intravenous anesthesia using ketamine and local anesthesia. The patient was discharged on postoperative day 8, and the postoperative course was uneventful. No recurrence has occurred 16 months after the operation. In conclusion, our strategy for patient with severe aortic valve stenosis is safe and effective.

Anaplastic large cell lymphoma(ALCL)is a rare peripheral T-cell lymphoma. According to anaplastic lymphoma kinase(ALK)expression, the World Health Organization classifies ALCL into two subtypes:ALK-positive or ALK-negative. Anthracycline-based combination chemotherapy is a standard frontline treatment for ALK-positive ALCL, with a long-term event- free survival rate of 60%-70%. For the salvage treatments of relapsed or refractory cases, the efficacies of brentuximab vedotin or ALK inhibitor have been established. We undertook a phase II clinical trial to investigate the efficacy and safety of alectinib, which is a second-generation ALK inhibitor, for relapsed or refractory ALK-positive ALCL. Ten patients were enrolled, and objective responses were documented in eight patients(80%),with six complete responses. Allogeneic hematopoietic stem cell transplantation(allo-HSCT)has also been reported to be one of curative treatments for relapsed or refractory ALCL. However, a high rate of treatment-related mortality was observed in allo-HSCT because of the myeloabrative conditioning regimen. We have reported the efficacy of the reduced-intensity conditioning(RIC)regimen for relapsed or refractory ALCL including the patients who did not obtain complete remission at allo-HSCT. The RIC regimen might be able to improve the outcomes of allo-HSCT by reducing treatment-related mortality.