| 1. |
Kiyotaka Mizoguchi, Kinuko Nagayoshi, Yusuke Mizuuchi, Koji Tamura, Masafumi Sada, Kohei Nakata, Kenoki Ouchida, Masafumi Nakamura, A case report of sigmoid colon cancer with the inferior mesenteric artery directly originating from the superior mesenteric artery, Surg Case Rep, 10.1186/s40792-023-01671-2, 9(1):89, 2023.04, Background: There are few reports describing the unusual origin of the inferior mesenteric artery (IMA). We report a rare case of advanced sigmoid colon cancer with the IMA arising from the superior mesenteric artery.
Case presentation: A 59-year-old man with diarrhea and abdominal distention was diagnosed with advanced sigmoid colon cancer. Colonoscopy revealed a semi-circumferential cancer lesion in the sigmoid colon. Enhanced CT scan and CT angiography showed that the IMA directly originated from the superior mesenteric artery at the level of the second lumbar vertebra. PET-CT suggested metastases in the para-intestinal lymph nodes and the liver, but not in the central lymph nodes along the IMA. Preoperative diagnosis was sigmoid colon cancer cT4aN2aM1a cStage IVA(UICC, 8th edition). We performed laparoscopic complete resection as the radical treatment of the primary region prior to resection of the liver metastases. Intraoperative findings showed that the IMA was running parallel to the abdominal aorta; meanwhile, the colonic autonomic nerve was supplied from the lumbar splanchnic nerve at the caudal side of the duodenum. Central lymph nodes around the colonic autonomic nerve were dissected en bloc with the regional lymph nodes. Pathological radical resection including the regional lymph nodes metastasis was achieved. Two months later, complete resection of the liver metastasis was performed. After the adjuvant chemotherapy, no recurrence was observed 1.5 years after the liver resection was performed.
Conclusions: Preoperative confirmation of the anatomy helped us to safely complete radical surgery in a patient with unusual bifurcation of the IMA.
Keywords: IMA anomaly; Laparoscopic low anterior resection; Sigmoid colon cancer.. |
| 2. |
Masahiro Yamamoto, Yusuke Mizuuchi, Koji Tamura, Masafumi Sada, Kinuko Nagayoshi, Kohei Nakata, Kenoki Ohuchida, Yoshinao Oda, Masafumi Nakamura, Nonmass-forming type anorectal cancer with pagetoid spread: A report of two cases, Asian J Endosc Surg, 10.1111/ases.13217, 16(4):747-752, 2023.04, Pagetoid spread (PS) of anorectal cancer is relatively rare and associated with poor prognosis. While a primary tumorous lesion is usually obvious in most PS cases, we experienced two cases of nonmass-forming type anorectal cancer with PS. It remains challenging to decide strategies. In both cases, histological findings of a perianal skin biopsy showed proliferation of atypical cells that were positive for cytokeratin (CK) 7, CK20, and caudal type homeobox 2 and negative for Gross cystic disease fluid protein 15, suggesting PS. Abdominoperineal resection (APR) with extensive anal skin resection was performed in both patients. The pathological diagnosis in each was nonmass-forming type anorectal cancer with PS. Neither has experienced recurrence in postoperative courses. Even nonmass-forming type anorectal cancer with PS could have high malignant potentials. APR with lymph nodes dissection and wide skin excision and regular surveillance might be necessary.
Keywords: anal canal cancer; nonmass-forming type; pagetoid spread.. |
| 3. |
Koji Tamura, Toshifumi Gushima, Hiromichi Nakayama, Reiko Yoneda, Yusuke Watanabe, Hiroshi Kono, Hirofumi Yamamoto, Takashi Ueki, Masayuki Okido, Hitoshi Ichimiya, Advanced Hepatocellular Carcinoma in which Gallbladder Invasion Mimicked Primary Gallbladder Neoplasm, Archives of Clinical Case Reports, DOI無し, 4(1):5-7, 2021.04. |
| 4. |
Tamura K, Nakayama H, Kono H, Kuroki R, Maeyama R, Yamamoto H, Ueki T, Okido M, Ichimiya H, Atypical Clinical Presentation of Mechanical Small Bowel Obstruction With Superior Mesenteric Vein Occlusion Caused by a Retained Free Intraperitoneal Staple After Laparoscopic Appendectomy: A Case Report, Asian J Endosc Surg, 10.1111/ases.12797, 13(14):556-559, 2020.04, Abstract
Mechanical small bowel obstruction (SBO) is a common postoperative complication,
and most cases are caused by postoperative adhesions. We herein
report a case of SBO with superior mesenteric vein occlusion caused by a metal
staple after laparoscopic appendectomy. A 35-year-old Japanese woman presented
to our department with severe upper abdominal pain and vomiting. She
had undergone laparoscopic appendectomy using a linear stapler 7 years
before. Abdominal CT showed mild small intestinal dilation with mesenteric
edema and volvulus of the small bowel mesentery. Moreover, occlusion of the
superior mesenteric vein was observed. Emergency exploratory laparoscopy
revealed a strangulated SBO caused by a free unformed staple. The obstruction
was released by a laparoscopic technique without bowel resection. The number
of laparoscopic surgeries has recently been increasing, and complications specific
to laparoscopic surgery have been recognized. All spilled and unformed
staples should be removed to the greatest extent possible during laparoscopic
operations. |
| 5. |
Hayashi M, Date K, Kodama T, Yamasuji A, Fukumori K, Tamura K, Maehara N, Recurrent intradactal papillary mucinous neoplasms of the pancreas mimicking ampullary cancer, Annals of Gastroenterology, 10.20524/aog.2020.0501, 33(5):536-539, 2020.04. |
| 6. |
Tamura K, Umemura Y, Hijioka S, Date K, Maehara N, Asymptomatic malignant melanoma of the gallbladder with multiple brain metastases diagnosed with endoscopic ultrasound-guided fine-needle aspiration cytology, Clin J Gastroenterol, 10.1007/s12328-019-00957-z, 12(5):490-494, 2019.04, Malignant melanoma of the gallbladder (MMG) is extremely rare and its early stage diagnosis is difficult. Most reports of MMG describe metastatic tumors. We herein report a rare case of presumed primary MMG diagnosed by endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) cytology without surgical resection. A 72-year-old Japanese male was diagnosed with multiple brain metastases. Fluorodeoxyglucose (FDG) positron emission tomography showed an abnormal uptake of FDG at the gallbladder; enhanced CT and MRI also showed an enhanced gallbladder lesion, which indicated a malignancy. We performed endoscopic naso-gallbladder drainage. However, cytological examination of the drained bile showed no evidence of malignancy. Finally, EUS-FNA was performed to confirm the histological diagnosis; cytopathological assessment, including immunohistochemical analysis, showed a cluster of small to large-sized cells with nuclear pleomorphism and melanin pigm
ent, which was compatible with malignant melanoma. The patient subsequently underwent chemotherapy; however, he died 2 months after diagnosis. In patients with gallbladder tumors, MMG should be suspected even in patients with no history of malignant melanoma or any cutaneous lesions. EUS-FNA is safe and useful to confirm histological diagnoses and to determine optimal treatment strategies.. |
| 7. |
Tamura K, Ohtsuka T, Ideno N, Aso T, Kono H, Nagayoshi Y, Shindo K, Ushijima Y, Ueda J, Takahata S, Ito T, Oda Y, Mizumoto K, Tanaka M, Unresectable pancreatic ductal adenocarcinoma in the remnant pancreas diagnosed during every-6-month surveillance after resection of branch duct intraductal papillary mucinous neoplasm: a case report, JOP, 10(14):450-453, 2013.04, Abstract
CONTEXT:
There are few studies regarding the surveillance period and interval of resected or observed branch duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas in terms of early detection of concomitant pancreatic ductal adenocarcinoma. Despite a strict surveillance protocol, some patients are diagnosed with metastatic distinct ductal adenocarcinoma after resection of IPMN.
CASE REPORT:
We herein report a patient with unresectable pancreatic ductal adenocarcinoma that developed in the remnant pancreas 18 months after resection of branch duct IPMN. Although the patient was surveyed every 6 months after the operation and imaging studies at 6 and 12 months postoperatively demonstrated no evidence of recurrence, invasive ductal adenocarcinoma with liver metastasis appeared 18 months after the operation. The patient subsequently underwent chemotherapy; however, he died 9 months after the diagnosis of metachronous pancreatic ductal adenocarcinoma.
CONCLUSIONS:
In some patients with branch duct IPMNs, 6-month surveillance seems to be insufficient to detect resectable concomitant pancreatic ductal adenocarcinoma. Therefore, identification of high-risk patients who require surveillance at shorter intervals is urgently needed.
. |
| 8. |
Tamura K, Nakashima H, Makihara K, Ishikawa N, Cyaen T, Hachiya Y, Fukuyama T, Hamada T and Hirano Y, Granulocyte colony-stimulating factor and IL-6 producing carcinosarcoma of the esophagus manifesting as leukocytosis and pyrexia: a case report , Esophagus, 8(4):295-301, 2011.04. |
