scholarly journals Gallbladder Cancer Showing a Great Response to Paclitaxel Plus Carboplatin Chemotherapy: A Case Report

2019 ◽  
Vol 103 (1-2) ◽  
pp. 66-71
Author(s):  
Yoshihiro Inoue ◽  
Masato Ota ◽  
Kensuke Fujii ◽  
Junna Matsuda ◽  
Nao Kawaguchi ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Venous Invasion ◽  
Lymphatic Invasion ◽  
Japanese Woman ◽  
Unknown Primary ◽  
Chemotherapeutic Regimen ◽  
D2 Lymph Node Dissection ◽  
Great Response ◽  
Complete Surgical Resection ◽  
Old Japanese

Currently, complete surgical resection is the most effective and the only potentially curative treatment for gallbladder carcinoma (GBC). However, GBC frequently presents various manifestations as it progresses, including liver invasion, bile duct invasion, hepatoduodenal invasion, venous invasion, and lymphatic invasion. Although there is a clear need for effective chemotherapeutic methods in the management of GBC, no standard chemotherapeutic regimen for advanced GBC has been established to date, and the prognosis remains poor. Herein, we report a case of successful treatment in a patient with advanced GBC who showed a great response to combination chemotherapy and who was subsequently able to undergo curative resection. A 38-year-old Japanese woman was first diagnosed with unknown primary cancer with bilateral ovarian, hepatic, and peritoneal metastases. Combination paclitaxel plus carboplatin chemotherapy was started at a dose of 653 mg of carboplatin and 248 mg of paclitaxel once a week for 3 weeks. After 6 cycles, the tumor had shrunk in size and was detected as only a slightly contrasted lesion in Couinaud's hepatic segments 4 and 5. One month after the final cycle of chemotherapy, we performed cholecystectomy and right lobectomy of the liver with D2 lymph node dissection. The patient exhibited an uneventful postoperative course. Five months have passed since the operation, with no signs of recurrent disease. Our findings suggest that combination chemotherapy with paclitaxel and carboplatin may be effective against advanced GBC.

Rhabdomyosarcoma of the maxillary sinus

1984 ◽  
Vol 98 (4) ◽  
pp. 405-415 ◽  
Author(s):  
M. Suzuki ◽  
Y. Kobayashi ◽  
Y. Harada ◽  
T. Kyo ◽  
H. Dohy ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Primary Source ◽  
Metastatic Tumor ◽  
Japanese Woman ◽  
High Dose ◽  
X Rays ◽  
Chemotherapeutic Regimen ◽  
X Ray ◽  
Old Japanese ◽  
Left Maxillary Sinus

AbstractA rare case of adult rhabdomyosarcoma originating from the left maxillary sinus is reported. A 22-year-old Japanese woman was referred to the Department of Otolaryngology, Hiroshima University, for investigation of the primary source of a metastatic tumor in the bone marrow. An X-ray of the sinuses revealed a tumor in the left maxillary sinus with extension into the nasal cavity, ethmoidal and sphenoidal sinuses. The patient was managed with a chemotherapeutic regimen consisting of high-dose methotrexate, adriamycin, vincristine, cyclophosphamide and prednisolone. After three courses of this chemotherapy, the tumor had decreased in size by about 90 per cent, as indicated by X-rays. The remaining tumor was removed by an extended Denker's operation. Following the surgery another seven courses of chemotherapy were given and during the eight months following the operation the patient has been free from any local recurrence.

Pharmacokinetics of Methotrexate in Plasma and Cerebrospinal Fluid

1997 ◽  
Vol 31 (10) ◽  
pp. 1153-1156 ◽  
Author(s):  
Norifumi Morikawa ◽  
Teruaki Mori ◽  
Tatsuya Abe ◽  
Makoto Ghoda ◽  
Masaharu Takeyama ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Blood Brain Barrier ◽  
Combination Chemotherapy ◽  
Japanese Woman ◽  
Brain Barrier ◽  
Pharmacokinetic Parameters ◽  
Tumor Removal ◽  
Blood Brain ◽  
Old Japanese ◽  
The Right

OBJECTIVE: To investigate the pharmacokinetics of methotrexate (MTX) in plasma and cerebrospinal fluid (CSF) during osmotic disruption of the blood-brain barrier and the intraarterial administration of combination chemotherapy postoperatively in a patient with glioblastoma. CASE SUMMARY: A 60-year-old Japanese woman with a glioblastoma received two courses of combination intraarterial chemotherapy. In the first course of treatment, 20 mL of mannitol 20%, peplomycin 10 mg, vindesine 2 mg, and MTX 500 mg were administered via the right internal carotid artery, and then via the right vertebral artery. In the second course of treatment, 20 mL of mannitol 20%, peplomycin 15 mg, vindesine 2.5 mg, and MTX 1000 mg were similarly administered. Blood samples and CSF samples from the ventricle and the space left by tumor removal were obtained; the MTX concentrations were measured from these sites by fluorescence polarization immunoassay. The pharmacokinetic parameters of MTX in plasma and CSF were estimated. DISCUSSION: The plasma concentration of MTX decreased in a biexponential decay pattern during each course of treatment. CSF concentrations of MTX in the ventricle and in the space left by tumor removal peaked at 2 and 6 hours, respectively, after drug administration and decreased monoexponentially. When the dose of MTX was doubled, the AUC for the plasma MTX concentration increased 2.4-fold and the AUCs for MTX in the ventricle and the space left by tumor removal increased 3.4- and 9.1-fold, respectively. The half-life of MTX in the CSF in the space left by tumor removal exceeded the half-lives of MTX in the plasma and in the ventricular CSF. CONCLUSIONS: The CSF AUCs of MTX in the ventricle and the space left by tumor removal increased markedly and in parallel with the MTX dosage increase during osmotic disruption of the blood-brain barrier and intraarterial combination chemotherapy. Such treatment improves the delivery of chemotherapy agents to the brain.

scholarly journals Neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus

2012 ◽  
Vol 2 (1) ◽  
pp. 16
Author(s):  
Takeshi Kusunoki ◽  
Katsuhisa Ikeda
Keyword(s):  
Maxillary Sinus ◽  
Neuroendocrine Carcinoma ◽  
Past History ◽  
Japanese Woman ◽  
Old Japanese ◽  
Weighted Magnetic Resonance Imaging ◽  
Maxillary Cyst ◽  
Left Maxillary Sinus ◽  
Eye Movement Disorders ◽  
Cheek Swelling

We report a case of a neuroendocrine carcinoma arising in a wound of the postoperative maxillary sinus that was difficult to distinguish from a postoperative maxillary cyst. The patient was a 65-year-old Japanese woman who complained of left exophthalmos with cheek swelling and eye movement disorders. In past history, she had, 40 years previously undergone operation on the bilateral maxillary sinus by Caldwell-Luc’s method. In a preoperative computed tomography, a mass occupied the left maxillary sinus showing irregular densities with destruction of the posterior bone walls and invasion into the left orbital. Both TI and T2 weighted magnetic resonance imaging showed low intensities and unevenness in the mass. We performed a biopsy of the maxillary tumor according to Caldwell-Luc’s method. Histological examination diagnosed neuroendocrine carcinoma. Radiation therapy (total 66Gy) resulted in partial response for this tumor. However, sinonasal neuroendocrine carcinoma has been identified as highly aggressive, with a high probability of recurrence and metastasis.

scholarly journals Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuki Yamauchi ◽  
Hiraku Kameda ◽  
Kazuno Omori ◽  
Michio Tani ◽  
Kyu Yong Cho ◽  
...  
Keyword(s):  
Herpes Zoster ◽  
Cushing’S Disease ◽  
Cardiopulmonary Arrest ◽  
Severe Infection ◽  
Japanese Woman ◽  
The Body ◽  
Cushing's Disease ◽  
Old Japanese ◽  
Subclinical Cushing’S Disease ◽  
Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

scholarly journals Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932096938
Author(s):  
Yuki Suzuki ◽  
Toshihiko Kasashima ◽  
Kazutoshi Hontani ◽  
Yasuhiro Yamamoto ◽  
Kanako Ito ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Screening Method ◽  
Oxygen Demand ◽  
Japanese Woman ◽  
Trauma Patients ◽  
Lung Field ◽  
Old Japanese ◽  
Femoral Intertrochanteric Fracture ◽  
Novel Coronavirus ◽  
The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

Rapid Deterioration of Latent HBV Hepatitis during Cushing Disease and Posttraumatic Stress Disorder after Earthquake

2017 ◽  
Vol 78 (04) ◽  
pp. 407-411 ◽  
Author(s):  
Ryosuke Tashiro ◽  
Teiji Tominaga ◽  
Yoshikazu Ogawa
Keyword(s):  
Hepatic Dysfunction ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Japanese Woman ◽  
Hbv Reactivation ◽  
Cushing Disease ◽  
Old Japanese ◽  
Threatening Condition ◽  
The Right ◽  
Subtotal Removal

AbstractReactivation of the hepatitis B virus (HBV) is a risk in the 350 million HBV carriers worldwide. HBV reactivation may cause hepatocellular carcinoma, cirrhosis, and fulminant hepatitis, and HBV reactivation accompanied with malignant tumor and/or chemotherapy is a critical problem for patients with chronic HBV infection. Multiple risk factors causing an immunosuppressive state can also induce HBV reactivation.We present a case of HBV reactivation during an immunosuppressive state caused by Cushing disease and physical and psychological stress after a disaster. A 47-year-old Japanese woman was an inactive HBV carrier until the Great East Japan Earthquake occurred and follow-up was discontinued. One year after the earthquake she had intractable hypertension, and her visual acuity gradually worsened. Head magnetic resonance imaging showed a sellar tumor compressing the optic chiasm, and hepatic dysfunction with HBV reactivation was identified. Endocrinologic examination established the diagnosis as Cushing disease. After normalization of hepatic dysfunction with antiviral therapy, transsphenoidal tumor removal was performed that resulted in subtotal removal except the right cavernous portion. Steroid hormone supplementation was discontinued after 3 days of administration, and gamma knife therapy was performed for the residual tumor. Eighteen months after the operation, adrenocorticotropic hormone and cortisol values returned to normal. The patient has been free from tumor regrowth and HBV reactivation throughout the postoperative course.Accomplishment of normalization with intrinsic steroid value with minimization of steroid supplementation should be established. Precise operative procedures and careful treatment planning are essential to avoid HBV reactivation in patients with this threatening condition.

scholarly journals Pure Well-Differentiated Adenocarcinoma Is a Safe Factor for Lymph Node Metastasis in T1 and T2 Colorectal Cancer: A Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Naohisa Yoshida ◽  
Masayoshi Nakanishi ◽  
Ken Inoue ◽  
Ritsu Yasuda ◽  
Ryohei Hirose ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Venous Invasion ◽  
Lymphatic Invasion ◽  
Clinicopathological Factors ◽  
Node Metastasis ◽  
Kappa Value ◽  
T1 And T2 ◽  
Well Differentiated

Background and Aims. Various risk factors for lymph node metastasis (LNM) have been reported in colorectal T1 cancers. However, the factors available are insufficient for predicting LNM. We therefore investigated the utility of the new histological factor “pure well-differentiated adenocarcinoma” (PWDA) as a safe factor for predicting LNM in T1 and T2 cancers. Materials and Methods. We reviewed 115 T2 cancers and 202 T1 cancers in patients who underwent surgical resection in our center. We investigated the rates of LNM among various clinicopathological factors, including PWDA. PWDA was defined as a lesion comprising only well-differentiated adenocarcinoma. The consistency of the diagnosis of PWDA was evaluated among two pathologists. In addition, 72 T1 cancers with LNM from 8 related hospitals over 10 years (2008–2017) were also analyzed. Results. The rates of LNM and PWDA were 23.5% and 20.0%, respectively, in T2 cancers. Significant differences were noted between patients with and without LNM regarding lymphatic invasion (81.5% vs. 36.4%, p<0.001), poor histology (51.9% vs. 19.3%, p=0.008), and PWDA (3.7% vs. 25.0%, p=0.015). The rates of LNM and PWDA were 8.4% and 36.1%, respectively, in T1 cancers. Regarding the 73 PWDA cases and 129 non-PWDA cases, the rates of LNM were 0.0% and 13.2%, respectively (p<0.001). Among the 97 cases with lymphatic or venous invasion, the rates of LNM in 29 PWDA cases and 68 non-PWDA were 0% and 14.7%, respectively (p=0.029). The agreement of the two pathologists for the diagnosis of PWDA was acceptable (kappa value > 0.5). A multicenter review showed no cases of PWDA among 72 T1 cancers with LNM. Conclusions. PWDA is considered to be a safe factor for LNM in T1 cancer.

scholarly journals Aphakic Pupillary Block by an Intact Anterior Vitreous Membrane after Total Lens Extraction by Phacoemulsification

2021 ◽  
pp. 882-888
Author(s):  
Michihiro Kono ◽  
Akiko Ishida ◽  
Sho Ichioka ◽  
Masato Matsuo ◽  
Hiroshi Shimizu ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Cataract Extraction ◽  
Japanese Woman ◽  
Acute Angle ◽  
Angle Closure ◽  
Pupillary Block ◽  
Lens Extraction ◽  
Old Japanese ◽  
Acute Angle Closure ◽  
Vitreous Prolapse

An 85-year-old Japanese woman with acute primary angle closure in her right eye underwent cataract extraction. Because of the weakness of the Zinn’s zonules, all of the lens tissue including the lens capsule was removed by phacoemulsification. Because of the absence of vitreous prolapse into the anterior chamber, vitrectomy was not performed. Nine days postoperatively, acute angle closure due to pupillary block by an anterior vitreous membrane developed. To resolve the pupillary block, anterior vitrectomy was performed on the same day. Postoperatively, her symptoms resolved, the anterior chamber deepened, and the intraocular pressure normalized. Although rare, acute angle closure due to pupillary block by an anterior vitreous membrane can occur after total lens extraction with phacoemulsification. If no vitreous prolapse occurs with total lens extraction, an intentional hyaloidotomy using an anterior vitreous cutter or iridectomy should be considered to avoid secondary angle closure.

scholarly journals Pericardial effusion in the course of fabry disease cardiomyopathy: A case report

2021 ◽  
Author(s):  
Toshihiro Tsuruda ◽  
Yoshimasa Higashi ◽  
Toshihiro Gi ◽  
Shoichiro Nakao
Keyword(s):  
Pericardial Effusion ◽  
Fabry Disease ◽  
Interleukin 6 ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Japanese Woman ◽  
Pericardial Fluid ◽  
Interleukin 18 ◽  
Previous Diagnosis ◽  
Old Japanese

Abstract Background Fabry disease is an X chromosome-linked inherited disorder of glycosphingolipid metabolism due to deficient or absent lysosomal α-galactosidase A activity. Case summary A 51-year-old Japanese woman with a previous diagnosis of Fabry disease presented with pericardial effusion. The exudative pericardial fluid contained globotriaosylsphingosine. Left ventricular hypertrophy progressed despite regular administration of agalsidase alfa every 2 weeks over a 7-year period, with increases in plasma levels of globotriaosylsphingosine and interleukin-18. In addition, the interleukin-6 level in the pericardial fluid was markedly higher than that in plasma. Discussion This case suggests that elevated interleukin-6 and interleukin-18 levels in pericardial fluid and plasma indicate the severity of Fabry disease cardiomyopathy.

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