scholarly journals A case of 18 years disease-free survival after combined pancreatoduodenectomy and hemicolectomy for carcinosarcoma of the transverse colon

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Susumu Ohwada ◽  
Amika Moro ◽  
Nair Amit ◽  
Kazunari Sasaki ◽  
Shinji Sakurai ◽  
...  
Keyword(s):  
Transverse Colon ◽  
Malignant Tumors ◽  
Submucosal Tumor ◽  
Tumor Resection ◽  
Pancreatic Head ◽  
Disease Free Survival ◽  
En Bloc ◽  
Abdominal Ultrasonography ◽  
Cross Sectional ◽  
Pancreas Head

Abstract Background Ascertaining the origin of large tumors located in the region of the pancreas head and adjacent mesocolon can pose a challenge preoperatively. En bloc pancreatoduodenectomy with hemicolectomy is often required towards curative tumor resection (R0) of malignant tumors in this region. Case presentation Herein we report a case of a 48-year-old man with two contiguous masses each 5 cm in size, located in the pancreatic head. The masses were detected incidentally by abdominal ultrasonography at an annual health check. Endoscopic biopsies revealed inflammation with no malignancy. Cross-sectional imaging showed the tumor direct invasion of the uncinate process of the pancreas, and the third portion of the duodenum. Based on imaging, a malignant submucosal tumor originating from mesenchymal cells in the mesentery of the transverse colon was made preoperatively. The mass required en bloc pancreatoduodenectomy, right hemicolectomy, and resection of the superior mesenteric vein. The final pathology was carcinosarcoma of the transverse colon. The patient survived 18 years after surgery without recurrence. Conclusions Malignant tumors located in the region of the pancreas head should be considered for an en bloc curative tumor resection and adjuvant chemotherapy treatments offered that might be beneficial for carcinosarcoma.

scholarly journals Craniofacial Resection for Cranial Base Malignancies Involving the Infratemporal Fossa

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-339-ONS-347 ◽  
Author(s):  
Mark H. Bilsky ◽  
Brandon Bentz ◽  
Todd Vitaz ◽  
Jatin Shah ◽  
Dennis Kraus
Keyword(s):  
Malignant Tumors ◽  
Infratemporal Fossa ◽  
Survival Rates ◽  
Tumor Resection ◽  
Cranial Base ◽  
Outcome Analysis ◽  
Cancer Center ◽  
En Bloc ◽  
Craniofacial Resection ◽  
Anterior Cranial Base

Abstract OBJECTIVE: Cranial base malignancies involving the infratemporal fossa have been considered unresectable. Advanced operative techniques have made tumor resection feasible in an en bloc fashion with negative histological margins, but there are limited data regarding outcome analysis in patients who have undergone resection of malignant tumors in this area. METHODS: At Memorial Sloan-Kettering Cancer Center, 25 patients underwent anterolateral cranial base resections for tumors that involved the infratemporal fossa during a 7-year period. The most common tumors were sarcoma (n = 9), squamous cell carcinoma (n = 6), and adenoid cystic carcinoma (n = 3). The median size of the tumors was 6 cm, and 12 tumors involved the anterior cranial base and/or orbit. Tumor resections were divided into three types. Twelve patients underwent Type 1 dissection for tumors involving only the infratemporal fossa and maxillary sinus; 2 patients underwent Type 2 dissections involving the infratemporal fossa and anterior cranial base; and 11 patients underwent Type 3 dissection, which included the infratemporal fossa, anterior cranial base, and orbit. All patients required free flap reconstruction, 22 of which were rectus abdominis free flaps. RESULTS: Complications occurred in seven patients, including a single mortality resulting from a myocardial infarction. The 2-, 3-, and 5-year survival rates were 69, 63, and 56%, respectively. The relapse-free survival rates were 47% at 2 and 3 years and 41% at 5 years. Recurrences were local in nine patients and distant in four patients. CONCLUSION: Despite the extensive nature of many infratemporal fossa tumors, they can be resected with acceptable morbidity. Survival rates approach those of anterior cranial base malignancies without infratemporal fossa involvement.

scholarly journals Central Bisegmentectomy for Malignant Liver Tumors: Experience in 8 Patients

2014 ◽  
Vol 99 (5) ◽  
pp. 612-615 ◽  
Author(s):  
Hiroaki Shiba ◽  
Koichiro Haruki ◽  
Yasuro Futagawa ◽  
Tomonori Iida ◽  
Kenei Furukawa ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Tumors ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Liver Volume ◽  
Optimal Solution ◽  
Disease Free Survival ◽  
University Hospital ◽  
Remnant Liver ◽  
En Bloc

Abstract Central bisegmentectomy (CBS) of the liver is an en bloc hepatic resection of Couiaud segments 4, 5, and 8. The indications for CBS include benign and malignant tumors occupying both the left medial and right anterior segments. However, CBS has rarely been reported. Here, we investigate CBS in patients with suboptimal liver function for whom an extended lobectomy is not an optimal solution. Each case was 1 of 8 patients who underwent CBS for hepatocellular carcinoma (HCC) or colorectal cancer liver metastasis (CRLM) at the Department of Surgery, Jikei University Hospital. Indications for CBS consisted of CRLM in 3 patients and HCC in 5 patients. The median duration of operation was 552 minutes, and median blood loss was 2263 g. No postoperative nor in-hospital mortalities occurred. In this study, 1-, 2-, and 3-year disease-free survival rates were 62.5%, 12.5%, and 12.5%, respectively, and 1-, 2-, and 3-year overall survival rates were 100%, 100%, and 85.7%, respectively. CBS is advocated for central liver tumors in patients with suboptimal liver function for whom extended lobectomy could result in less than optimal remnant liver volume and function.

scholarly journals Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Daisuke Udagawa ◽  
Motohide Shimazu ◽  
Tadayuki Sakuragawa ◽  
Shotaro Maruyama ◽  
Yusuke Uchi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Portal Vein ◽  
Tumor Thrombus ◽  
Malignant Tumors ◽  
Pancreatic Head ◽  
Portal Vein Tumor Thrombus ◽  
Maximum Diameter ◽  
Histopathological Diagnosis ◽  
Carcinoma Of The Pancreas ◽  
Pancreas Head

Abstract Background The portal vein is occasionally invaded by advanced malignant tumors in the pancreatic head region. However, pancreatic cancer rarely has portal vein tumor thrombi. We report a case of pancreatic cancer with a massive portal vein tumor thrombus undergoing pancreatoduodenectomy with combined resection of the portal vein. Case presentation A 71-year-old man visited a clinic with complaints of abdominal discomfort and vomiting. Gastroscopy showed a massive tumor in the duodenum. He was referred to our hospital for further examinations and treatment. The CT showed a low-density tumor with a maximum diameter of 10 cm located on the pancreas head. A tumor widely invaded the duodenum and had a 6-cm portal vein tumor thrombus. MRCP did not show obvious stenosis of the pancreatic duct due to tumor invasion. There were no findings suggesting distant metastases. Biopsy of the duodenum revealed adenocarcinoma. He was diagnosed with primary pancreatic cancer or duodenal cancer with portal vein tumor thrombus and underwent pancreatoduodectomy with resection and reconstruction of the portal vein. He suffered no postoperative complications and was discharged 2 months after surgery. The final histopathological diagnosis was pancreatic colloid carcinoma. He received adjuvant chemotherapy, but died 16 months after surgery. Conclusions Colloid carcinoma of the pancreas is rare, and pancreatic carcinoma seldom forms a portal vein tumor thrombus. We experienced a very rare case of pancreatic colloid carcinoma with portal vein tumor thrombus and performed radical resection of the pancreas and portal vein.

scholarly journals Demographic and Clinical Characteristics of Patients With Pancreatic Cancer, A Study in Kerman, Iran

2021 ◽  
Author(s):  
Mohammad Shafiee ◽  
Maryam Kouhestani Parizi ◽  
Akram Arabi ◽  
Mohammad Reza Lashkarizadeh ◽  
Mehran Ebrahimi Shah-abadi ◽  
...  
Keyword(s):  
Population Aging ◽  
Tumor Resection ◽  
Pancreatic Head ◽  
Tumor Location ◽  
Palliative Surgery ◽  
Common Type ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Statistical Population ◽  
Kerman City

Abstract PurposePancreatic cancer (PC) has the worst prognosis among cancers and is the only cancer whose annual incidence is higher than its prevalence. Considering that many PC cases are annually diagnosed in the world, and the fact that the disease has the worst prognosis among cancers, and the prevalence of its risk factors such as diabetes, high-fat diets, smoking, population aging, etc. has been on the rise, the incidence of PC is expected to increase in the future. So, our aim was to assess the demographic features of PC patients in an Iranian population.MethodsThe present study was a descriptive cross-sectional research conducted in 2018 in the teaching hospitals affiliated with Kerman University of Medical Sciences (i.e., Afzalipour and Bahonar hospitals). The statistical population of this study was all the patients with PC, referring to these hospitals. The files of all the patients diagnosed with PC (confirmed clinically and pathologically) from the beginning of 2009 to the end of 2019 were assessed. Treatments (i.e., surgical tumor resection or other alternative treatments) were recorded into a data collection sheet. Finally, the data was entered into SPSS version 20 for performing statistical analyses. ResultsIn this study, 380 patients with PC were studied, of whom 60.5% were male, and 39.5% female. Most of the patients were in the age range of 61-70 years (26.1%), and most of them were residents of Kerman city (62.9%), followed by Jiroft (5.5%) and Bam and Iranshahr (each 4.7%). A history of alcohol consumption was noted in 9.3%, and 33.7% were exposed to cigarette smoke. The most common symptoms of the patients were jaundice (65.3%), abdominal pain (54.7%), and anorexia (50.7%). The most common tumor location was the head of the pancreas (62.4%), and the most common type of the tumors was adenocarcinoma (71%). Overall, 23.7% and 76.3% of the patients underwent chemotherapy and surgery, respectively. Of those who had surgeries, 63.8% underwent palliative surgery. Of all 380 patients, 30 (7.8%) individuals were still alive, and 350 (91.4%) had died.ConclusionThe results of this study showed that most of the PC patients were male, had an age between 61 and 70 years, and lived in Kerman and Jiroft cities. The most common tumor site was the pancreatic head, and the most common type of the tumors among both sexes was adenocarcinoma. Surgery, mostly palliative surgery, was the most frequent treatment of choice among all patients.

Die Anämie bei malignen Tumorerkrankungen

1989 ◽  
Vol 28 (06) ◽  
pp. 247-254
Author(s):  
E. Aulbert
Keyword(s):  
Malignant Tumors ◽  
Gradient Centrifugation ◽  
Tumor Resection ◽  
Hemoglobin Concentration ◽  
Limiting Factor ◽  
Novikoff Hepatoma ◽  
Tumor Mass ◽  
Lysosomal Fraction ◽  
Proliferation Activity ◽  
Morris Hepatoma

The cellular uptake and lysosomal accumulation of 67Ga-labelled transferrin within tumors of different malignancy were examined using tissue fractionation and immunological techniques. As tumor models the slowly growing Morris hepatoma 5123C, the moderately growing Novikoff hepatoma and the fast and aggressive Yoshida hepatoma AH 130 were investigated. Isolation of subcellular fractions of tumor homogenates was performed by differential centrifugation and density-gradient centrifugation. The intracellular 67Gatransferrin was found to be highly concentrated within the purified lysosomes. The transferrin within the lysosomal fraction was identified by radial immunodiffusion technique using monospecific antiserum. The accumulation of 67Gatransferrin by the tumors resulted in a faster disappearance of 67Ga-transferrin from the blood. This loss of circulating 67Ga-transferrin correlated with the proliferation activity and the spread of the tumors. Since transferrin is indispensible for the utilization of iron by the heme-synthesizing red cell precursors, transferrin concentration in the blood is the limiting factor for the utilization of iron in hemoglobin synthesis. Thus, in a further series of experiments we investigated the development of anemia in tumor-bearing rats. With increasing tumor mass a progressive fall of hemoglobin concentration was found. The anemia was more severe in the faster growing Novikoff hepatoma than in the slowly growing Morris hepatoma. The most significant reduction of hemoglobin concentration was found in the very fast growing Yoshida hepatoma. After total tumor resection hemoglobin concentration and red blood cell count normalized completely within 6-8 weeks. We conclude from these data that the uptake of transferrin by the tumor cells results in a faster disappearance of transferrin from the blood. This loss of circulating transferrin correlates with tumor mass and proliferation activity and is one of the factors responsible for the anemia seen in patients with malignant tumors.

The Anatomical and Biomechanical Superiority of Novel Posterior En Bloc Elevation Cervical Laminoplasty

2021 ◽  
pp. 155335062098465
Author(s):  
Dong-Lai Wang ◽  
Guo-Qing Zhu ◽  
An-Quan Huang ◽  
Hong Zhang ◽  
Chuan Feng ◽  
...  
Keyword(s):  
Biomechanical Testing ◽  
Cervical Laminoplasty ◽  
Open Door ◽  
Lateral Bending ◽  
En Bloc ◽  
Cross Sectional ◽  
Expansion Pattern ◽  
Intact Condition ◽  
Axial Symptoms ◽  
The Common

Objectives. In this study, we performed a novel type of posterior en bloc elevation cervical laminoplasty (PEEL) to keep the integrity of the posterior structure, aiming to reduce axial symptoms complicated by a conventional cervical laminoplasty procedure. Methods. Twelve human cervical cadaveric spines (C2-T1) were sequentially tested in the following order: intact condition, open-door laminoplasty (ODL) through bilateral intermuscular approach (mini-invasive ODL), PEEL, and laminectomy (LN). After bilateral transecting at the junction of lamina and lateral mass through the tubular retraction system, the PEEL procedure symmetrically elevated all the posterior structure which was further stabilized with bone grafts and titanium plates. Computed tomography (CT) scan and biomechanical testing were performed after each condition. Results. Both mini-invasive ODL and PEEL procedures were accomplished with 2 small incisions on each side. Two types of laminoplasties could enlarge the spinal canal significantly both in cross-sectional area and anteroposterior diameter comparing with intact condition. The PEEL procedure demonstrated a significantly higher enlargement rate on a canal area and a symmetrical expansion pattern. Compared with intact condition, mini-invasive ODL performed from C3-C7 demonstrated significantly decreased motion in all testing directions except the flexion range of motion (ROM); the PEEL procedure showed mild and insignificant decrease on ROM in all directions. Laminectomy resulted in a statistically significant increase in all directions except the lateral bending ROM. Conclusions. Posterior en bloc elevation cervical laminoplasty can enlarge the canal more effectively and preserve better ROM after operation than the ODL procedure. Although technically challenging, the PEEL procedure probably would decrease the common complications associated with ODL laminoplasty.

scholarly journals Large intraperitoneal lipoleiomyoma in a pre-menopausal woman: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara L. Schaefer ◽  
Amy L. Strong ◽  
Sheena Bahroloomi ◽  
Jichang Han ◽  
Michella K. Whisman ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Smooth Muscle ◽  
Case Report ◽  
Smooth Muscle Actin ◽  
Abdominal Mass ◽  
Histopathological Analysis ◽  
Menopausal Woman ◽  
En Bloc ◽  
Cross Sectional

Abstract Background Lipoleiomyoma is a rare, benign variant of the commonplace uterine leiomyoma. Unlike leiomyoma, these tumors are composed of smooth muscle cells admixed with mature adipose tissue. While rare, they are most frequently identified in the uterus, but even more infrequently have been described in extrauterine locations. Case presentation We describe a case report of a 45-year-old woman with a history of in vitro fertilization pregnancy presenting 6 years later with abdominal distention and weight loss found to have a 30-cm intra-abdominal lipoleiomyoma. While cross-sectional imaging can narrow the differential diagnosis, histopathological analysis with stains positive for smooth muscle actin, desmin, and estrogen receptor, but negative for HMB-45 confirms the diagnosis of lipoleiomyoma. The large encapsulated tumor was resected en bloc. The patients post-operative course was uneventful and her symptoms resolved. Conclusions Lipoleiomyoma should be considered on the differential diagnosis in a woman with a large intra-abdominal mass. While considered benign, resection should be considered if the mass is symptomatic, and the diagnosis is unclear or there is a concern for malignancy.

scholarly journals Double-targeting CDCA8 and E2F1 inhibits the growth and migration of malignant glioma

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Xiaoxiong Wang ◽  
Heping Wang ◽  
Jiajun Xu ◽  
Xu Hou ◽  
Haoqiang Zhan ◽  
...  
Keyword(s):  
Malignant Glioma ◽  
Malignant Tumors ◽  
Disease Free Survival ◽  
High Grade Glioma ◽  
Poor Overall Survival ◽  
Survival Prognosis ◽  
Who Grade ◽  
And Migration

AbstractHigh-grade glioma is the most common and aggressive primary brain tumor in adults with poor therapeutic efficiency and survival prognosis. Cell division cycle associated 8 (CDCA8) has been well known as a cell cycle regulator and tumor promotor in various malignant tumors. However, its biological role in glioma still remains unclear. Our results showed that high level of CDCA8 was significantly correlated with advanced WHO grade and poor overall survival and disease-free survival prognosis. In vitro and in vivo investigations demonstrated that CDCA8 promoted the glioma malignancy by promoting cell proliferation, cell migration, and inhibiting cell apoptosis. Moreover, we found its synergetic biological protein—E2F1 by the gene microarray chip. In this study, we revealed that CDCA8 synergized with E2F1 facilitated the proliferation and migration of glioma. In conclusion, our study provides a novel promising therapeutic targets and prognostic biomarkers for malignant glioma treatment.

En bloc laminoplasty without dissection of paraspinal muscles

2005 ◽  
Vol 3 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Noboru Hosono ◽  
Hironobu Sakaura ◽  
Yoshihiro Mukai ◽  
Takahiro Ishii ◽  
Hideki Yoshikawa
Keyword(s):  
Ct Scanning ◽  
Cord Compression ◽  
Neck Muscle ◽  
Open Door ◽  
En Bloc ◽  
Cross Sectional ◽  
Content Type ◽  
Spinous Processes ◽  
Significant Difference ◽  
Fine Print

Object. Although conducting cervical laminoplasty in patients with multisegmental cord compression provides good neurological results, it is not without shortcomings, including C-5 palsy, axial neck pain, and undesirable radiologically detectable changes. Postoperative kyphosis and segmental instability can cause neurological problems and are believed mainly to result from neck muscle disruption. The authors developed a new laminoplasty technique, with the aim of preserving optimal muscle function. Methods. The present technique is a modification of unilateral open-door laminoplasty. By using an ultrasonic osteotome in small gaps of muscle bellies, a gutter is made without disrupting muscles, spinous processes, or their connections on the hinged side. Ceramic spacers are then positioned between elevated laminae and lateral masses at C-3, C-5, and C-7 on the opened side, which is exposed in a conventional manner. This new procedure was used to treat 37 consecutive patients with compression myelopathy. Postoperative computerized tomography (CT) scanning revealed a significant difference in a cross-sectional area of muscles between the hinged and opened side. The mean follow-up period was 40.2 months (range 24–54 months). Changes in alignment were observed in only one patient, and vertebral slippage developed in two. Performed at regular intervals, CT scanning demonstrated that the elevated laminae remained in situ throughout the study period. Conclusions. In using the present unilateral open-door laminoplasty technique, deep extensor muscles are left intact along with their junctions to spinous processes on the hinged side. Radiologically documented changes were minimal because the preserved muscles functioned normally immediately after the operation.

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