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1.
Gan To Kagaku Ryoho ; 49(13): 1777-1779, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36732996

RESUMO

A 73-year-old woman was referred to our hospital after a liver tumor was discovered during an abdominal ultrasonography. Thirty-one years ago, she underwent a total hysterectomy for uterine myoma and was diagnosed with a leiomyoma. Twenty years ago, she underwent a bilateral oophorectomy for an ovarian tumor and was diagnosed with a luteinized theca cell tumor accompanied by sclerosing peritonitis. A CT scan and MRI revealed a 65-mm tumor in the S6-7 of the liver. There was no sign of any lesions other than in the liver, and TACE was performed for suspected hepatocellular carcinoma. However, a favorable treatment outcome was unable to be obtained and a posthepatic segmental resection was performed. Histopathological morphology suggested a similarity to endometrial stromal cells and, considering the history of myoma of the uterus and ovarian tumor, immunohistological staining was carried out. The myoma of the uterus and the ovarian and liver tumors were all CD10(+), α⊖SMA(-), MIB-1 index 3%. The uterine myoma, which was initially operated on, was rediagnosed as a low-grade endometrial stromal sarcoma. After 11 years, ovarian metastasis was observed, and after 31 years liver metastasis occurred. Examples of resection of liver metastasis of endometrial stromal sarcoma are extremely rare and, we will include a review of the literature in this report.


Assuntos
Neoplasias do Endométrio , Leiomioma , Neoplasias Hepáticas , Mioma , Neoplasias Ovarianas , Sarcoma do Estroma Endometrial , Feminino , Humanos , Idoso , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/diagnóstico , Sarcoma do Estroma Endometrial/cirurgia , Sarcoma do Estroma Endometrial/diagnóstico , Sarcoma do Estroma Endometrial/patologia , Neoplasias Hepáticas/cirurgia
2.
Gan To Kagaku Ryoho ; 46(13): 2309-2311, 2019 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-32156914

RESUMO

A 43-year-old woman who underwent surgical resection of invasive ductal carcinoma in the left breast at the age of 37 years old presented at our hospital for evaluation of pancreatic tumor. The original tumor was estrogen receptor(ER)progesterone receptor(PgR)and HER2 positive. At that time, she underwent radical mastectomy with no evident nodal disease. Postoperatively, the patient was placed on adjuvant tamoxifen therapy for several years. Six years following the original diagnosis of breast cancer, she was referred to the hospital for routine check-up while asymptomatic. Follow-up examination showed a solitary hypodense mass approximately 0.9 cm in size in the pancreas body on dynamic CT scan. The patient underwent a standard distal pancreatectomy with standard regional lymphadenectomy. Histopathological examination and immunohistochemical features revealed that the tumor was compatible with metastatic pancreatic adenocarcinoma from breast cancer.


Assuntos
Adenocarcinoma , Neoplasias da Mama , Neoplasias Pancreáticas , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Adulto , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Recidiva Local de Neoplasia , Neoplasias Pancreáticas/secundário
3.
J Hepatobiliary Pancreat Sci ; 25(10): 433-439, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30218495

RESUMO

BACKGROUND: Detailed endoscopic findings of the bile duct mucosa have not been fully established. This fundamental ex vivo study assesses the relationship between magnified endoscopic findings and pathological findings of the bile duct mucosa. METHODS: Forty-one surgically resected common bile duct mucosae were investigated. Each common bile duct was cut open longitudinally for ex vivo endoscopic observation. A magnifying endoscope commonly used for the gastrointestinal tract was used, using both white light imaging and narrowband imaging. After pathological diagnosis, the association between the magnifying endoscopic findings and histopathology was evaluated. RESULTS: Totally, 39 non-neoplastic mucosae and 13 neoplastic mucosae were evaluated. In 13 non-neoplastic mucosae without inflammation, an oval-shaped depressed area and a fine, regular network of microvessels were observed. These findings were not clearly seen or not seen at all in the non-neoplastic mucosae with inflammation. Although vessels with loop-like structure were observed on all eight papillary tumors of 13 neoplastic mucosae, no characteristic vessels were seen on the other five. CONCLUSIONS: Ishida and colleagues assessed the association between magnifying endoscopic findings and histopathological findings of the bile duct mucosa ex vivo. Oval-shaped, depressed areas and a fine, regular network of microvessels are characteristic features of normal bile duct mucosa, while loop structures may be indicative of a type of tumor vessel.


Assuntos
Discinesia Biliar/patologia , Ducto Colédoco/patologia , Neoplasias do Sistema Digestório/patologia , Endoscopia do Sistema Digestório/métodos , Mucosa/patologia , Imagem de Banda Estreita , Humanos , Luz , Imagem Óptica
4.
Gan To Kagaku Ryoho ; 43(12): 1761-1763, 2016 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-28133123

RESUMO

Needle tract implantation after percutaneous ethanol injection therapy(PEIT)for hepatocellular carcinoma(HCC)is rare. Surgical treatment of such HCC implants is still controversial. We herein report the case of a patient who underwent laparoscopic resection for peritoneal dissemination after PEIT. An 81-year-old man underwent PEIT for primary HCC at another hospital. Thereafter, percutaneous radiofrequency ablation(RFA)was performed twice for intrahepatic recurrence. After the second RFA, a mass lesion was detected at the subhepatic space on computed tomography(CT). We reevaluated the CT and diagnosed the patient with peritoneal dissemination after PEIT. Laparoscopic resection was performed. However, the patient developed recurrences at the thoracic wall and peritoneum 12 months after laparoscopic surgery. Those 2 tumors were resected, and he remains alive, approximately 30 months after the laparoscopic resection. Laparoscopic extirpation of tract seeding may provide better clinical outcomes in select patients.


Assuntos
Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Neoplasias Peritoneais/cirurgia , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/secundário , Ablação por Cateter , Etanol , Humanos , Laparoscopia , Neoplasias Hepáticas/patologia , Masculino , Neoplasias Peritoneais/secundário , Recidiva
5.
Gan To Kagaku Ryoho ; 42(12): 2376-8, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26805369

RESUMO

The patient was a 64-year-old woman. She was referred to our institute because of a chief complaint of upper abdominal pain. Abdominal computed tomographic scan revealed a 35 mm hypovascular tumor in the pancreatic head and superior mesenteric vein (SMV), as well as thrombosis. We chose neoadjuvant chemoradiation therapy (NACRT) (S-1/RT, 50.4 Gy/28 Fr) and anticoagulants. After the treatment, the primary lesion showed a partial response, and the SMV thrombosis was reduced. We performed pancreaticoduodenectomy. Histopathological examination revealed no cancer cells in the pancreas. Pathological evaluation revealed grade Ⅳ tumor according to the Evans classification. The patient had had no recurrence for 10 months after the pancreaticoduodenectomy.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Terapia Neoadjuvante , Ácido Oxônico/uso terapêutico , Neoplasias Pancreáticas/terapia , Tegafur/uso terapêutico , Quimiorradioterapia , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia , Resultado do Tratamento
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