Biomedical subjects

K Matsukuma

Publications and source records attributed to K Matsukuma.

At least 19 recordsLinked to original sources

PubMed1991

Microscopic ovarian metastasis of the uterine cervical cancer.

Six hundred forty-seven cases of carcinoma of the uterine cervix with FIGO stages Ib or more were initially treated with hysterectomy at Kyushu University Hospital from 1973 to 1987. In these, 597 cases could be pathologically reviewed for ovarian metastasis. In these 597 cases, 335 were stage Ib, 71 IIa, 185 IIb, and 6 IIIb. Only 3 (0.5%) of 597 showed ovarian metastasis. All 3 cases were stage IIb. None of stage Ib cancer cases had ovarian metastasis. One (0.19%) of 524 squamous cell carcinomas metastasized to the ovary, whereas 2 (5.5%) of 36 pure adenocarcinomas revealed ovarian metastasis. Interestingly, all ovarian metastatic lesions were microscopic in size and found in the ovarian hilus. As for the primary lesion, all cases with ovarian metastasis showed deep myometrial invasion, corpus invasion, and lymphatic permeation. Two cases showed pelvic lymph node metastases and positive peritoneal washing cytology. From the results of our study, it can be said that it is fairly safe to preserve the ovary at the time of radical operation in squamous cell carcinoma of the uterine cervix, but it may not be safe to preserve the ovary in pure adenocarcinoma of the uterine cervix.

Adenocarcinoma↗

PubMed1990

Glassy cell carcinoma of the endometrium.

A case of glassy cell carcinoma of the endometrium in a 62-year-old woman is reported. Microscopically, a cytoplasm of ground-glass appearance was observed with a distinct cell wall and large nuclei containing prominent nucleoli. These histologic characteristics are consistent with those of glassy cell carcinoma of the cervix. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection followed by external irradiation to the whole pelvis. The patient was alive without evidence of disease at 5 1/2 years.

Adenocarcinoma↗

PubMed1990

[Mesenteric hematoma; a pediatric case].

A 3-Year-old girl was admitted to National Beppu Hospital due to abdominal mass. US examination revealed cystic mass with multiple scattered nonreverberatory echoes in right upper abdomen. CT examination revealed almost homogeneous mass (29-31 H.U.) with a few internal components (36-42 H.U.). US and CT were useful methods for diagnosis of mesenteric hematoma.

Child, Preschool↗

PubMed1990

[A serous cystadenoma of the ovary of borderline malignancy with a fifteen-year history. A case report].

A case of a serous cystadenoma of a ovary of borderline malignancy is reported. Sixteen years earlier, the patient had undergone an exploratory laparotomy because of ovarian tumor, and the histologic diagnosis had been a serous cystadenocarcinoma. Postoperative chemotherapy was not effective and drainage of the tumor fluid had been performed for 15 years, with the estimated drainage volume estimated to have reached, 1,000 1. Gradual malnutrition and marked tumor growth then become apparent. A reevaluation of the initial histologic slides and her clinical course strongly suggested a serous cystadenoma of borderline malignancy. Thus a tumor resection, a bilateral salpingo-oophorectomy, and a hysterectomy was performed. A histologic diagnosis of a resected specimen confirmed a serous cystadenoma of borderline malignancy and the histologic features were quite similar to those of the initial biopsy specimens. The patient is living well postoperatively for 8 months without postoperative chemotherapy.

Adult↗

PubMed1989

[Seven cases of primary adenocarcinoma of the fallopian tube].

Seven patients with primary adenocarcinoma of the fallopian tube were treated at Kyushu University Hospital from 1978 to 1987. They were 0.59% of all patients with gynecologic malignancies in our hospital. Their mean age was 56.0 years old. Four of 7 patients presented with abnormal genital bleeding. Pelvic mass was detected in 6 of 7 patients. One patient showed abnormal cervical cytology and 3 of 6 patients had positive endometrial cytology and/or histology. No diagnosis of tubal cancer was made preoperatively. Primary surgical treatments were performed in all patients. Four patients, who underwent dissection and/or biopsy of pelvic and paraaortic lymph nodes, had no metastasis. However, at the time of recurrence, paraaortic and/or neck lymph nodes metastases were present in 3 of 4 patients. Following surgery, combination chemotherapy with cyclophosphamide, doxorubicin and cisplatin (CAP) was administered to 6 of 7 patients. Partial responses were obtained in 2 patients with recurrent and evaluable lesions. The mean survival time of 7 patients as yet was 36.0 months after diagnosis. In conclusion, the difficulty of preoperative diagnosis of tubal cancer was reconfirmed. CAP combination chemotherapy seemed to be effective for the treatment of tubal cancer and further study with more cases is warranted.

Adenocarcinoma↗

PubMed1989

Hyperreactio luteinalis in normal singleton pregnancy.

A case of hyperreactio luteinalis in a patient with normal singleton pregnancy is reported. The course of pregnancy had been normal until the 24th week of gestation, when the mother developed lower abdominal pain and signs of virilization. She delivered of a normal female infant at 39 weeks' gestation. The baby did not show any signs of masculinization. Serum testosterone, delta 4-androstene-dione, and 5 alpha-dihydrotestosterone of the mother were markedly elevated. They remained high after the delivery but returned to the normal ranges soon after the partial resection of the enlarged ovaries. Reported causes of hyperreactio luteinalis are reviewed. Their maternal serum androgen levels were compared with cases of luteoma of pregnancy.

Adult↗

PubMed1989

Malignant ovarian tumors associated with pregnancy: report of six cases.

Six cases of pregnancy associated malignant ovarian tumors, four epithelial cancers, one immature teratoma and one metastatic cancer of colon origin, are reported. One patient with mucinous cystadenocarcinoma had a history of persistent ovarian tumor during her past three pregnancies. Another patient was found to have mucinous cystadenocarcinoma after an emergency operation for twisted ovarian tumor. Immature teratoma associated with pregnancy is very rare and our case seems to be the 8th reported such case.

Adult↗

PubMed1989

Early adenocarcinoma of the uterine cervix--its histologic and immunohistologic study.

Eight cases of early adenocarcinoma selected from 101 adenocarcinomas of the uterine cervix were studied to establish the criteria of early adenocarcinoma. Lesions of these 8 cases were small in size. In 7 of 8 cases, these tumors originated in the area of the squamocolumnar junction (SCJ). Tumor cells consisted of two types of atypical columnar cells, i.e., tall columnar cells with enlarged and deeply eosinophilic cytoplasm and clear cells with enlarged and clear vacuoles. Tall columnar cells showed weak or negative reaction to high iron diamine (HID) stain and negative to Alcian blue (AB) stain. Clear cells showed negative reaction to HID stain and positive to AB stain. Although normal endocervical columnar cells showed markedly positive reaction to HID stain and negative reaction to AB stain, invasive adenocarcinoma cells showed similar reaction to early adenocarcinoma cells. From this study, it is surmised that early adenocarcinoma of the uterine cervix originates in the area of the SCJ and consists of tall cells in all cases and clear cells in 4 of 8 cases, and that HID-AB stain is useful in differentiating early adenocarcinoma cells from normal endocervical columnar cells.

Adenocarcinoma↗

PubMed1989

The problem of stage Ia (FIGO, 1985) carcinoma of the uterine cervix.

The FIGO definition of stage Ia (microinvasive) carcinoma of the uterine cervix had been vague and caused continued confusion. In 1985 FIGO revised the definition of stage Ia by including measurements in the definition and it also subdivided stage Ia into stages Ia1 and Ia2. One hundred and eighteen of eight hundred and sixty patients with stage 0 to IIb carcinoma, who retrospectively satisfied the new FIGO definition of stage Ia, were reviewed with respect to depth of invasion, horizontal spread, number of invasive foci, vascular space involvement, pattern of invasion, incidence of lymph node metastasis, and clinical outcome. There were three potentially high-risk patients: one with pelvic lymph node metastases, one with parametrial metastasis, and the third with recurrence 23 months after initial treatment. It was pointed out that the border between stages Ia1 and Ia2 is very vague in the 1985 FIGO definition. It was proposed that a lesion with 3-mm or less stromal invasion and without vascular space involvement and confluency be defined as stage Ia1 and be safely treated with simple means.

Adult↗

PubMed1989

Clinicopathologic study of squamous cell carcinoma of the ovary.

Clinicopathologic study was performed on 10 squamous cell carcinomas of the ovary. All four patients with stage II or III lesions had deteriorated within 1 year after the operation, and four of six patients with stage I lesions had survived over 5 years. Clinical findings of the patients with ovarian SCC, including age, chief complaint, clinical stage, and outcome of the patients, were similar to those of common epithelial cancer. The effectiveness of chemotherapy was not shown in this study. Histopathologic study revealed that squamous cell carcinoma may arise not only from epidermis, but also from squamous metaplastic epithelium of respiratory gland.

Adult↗

PubMed1989

Carcinoma of the uterine cervix with variegated histological patterns and calcitonin production.

This is a report of a calcitonin-producing cervical cancer with variegated histological patterns. The levels of calcitonin correlated with the clinical course. Multiple lung metastases were completely controlled by cisplatin/Adriamycin/cyclophasphamide combination chemotherapy, although only for a short period. Microscopically, the tumor showed dominant small cell carcinoma; however, it did show differentiation into large cell nonkeratinizing carcinoma, keratinizing carcinoma, adenocarcinoma, and possibly carcinoid. Ultrastructural study revealed a few dense core secretory granules. Multiple immunohistochemical studies were performed. It is presumed that the tumor originated from the totipotent, immature precursor cells in the cervix and differentiated into endocrine carcinoma, squamous cell cancer, and adenocarcinoma.

Aged↗

PubMed1989

Preoperative CT study of lymph nodes in cervical cancer--its correlation with histological findings.

A study was conducted to retrospectively evaluate the accuracy of abdominopelvic computed tomography (CT) in the diagnosis of paraaortic and pelvic lymph node metastases from carcinoma of the uterine cervix. Seventy patients with a diagnosis of invasive carcinoma of the cervix had preoperative CT of abdomen and pelvis and subsequently underwent a radical hysterectomy with pelvic lymph node dissection and paraaortic lymph node biopsy or an exploratory laparotomy with paraaortic lymph node biopsy. Five of six patients with metastatic paraaortic lymph nodes larger than 15 mm in diameter on the histologic slides were diagnosed by CT scan to have enlarged nodes. CT diagnosis was true-positive in five of seven patients with paraaortic lymph node metastases (71.4%). Two patients with false-positive paraaortic lymph nodes had clusters of small lymph nodes less than 10 mm in diameter on the histologic slides. In contrast, only a small number of the metastatic pelvic nodes were diagnosed by CT as enlarged nodes. CT diagnosis was true-positive in 5 of 11 sites with pelvic lymph node metastases (45.5%).

False Positive Reactions↗

PubMed1989

[Surgical management of pulmonary metastasis from carcinoma of the uterine cervix].

The present study was designed to evaluate the efficacy of surgical management of pulmonary metastasis from carcinoma of the uterine cervix. We saw 609 cases of carcinoma of the uterine cervix from 1979 to 1987, and during the same period also saw 110 cases of recurrent carcinoma of the uterine cervix. Fourteen of these 110 cases were identified as having pulmonary metastasis, and in 11 of 14 cases the recurrent tumors were limited to the lung. Seven of these 11 cases underwent pulmonary resection. Six of the 7 survived more than 2 years after pulmonary resection. Among them, 1 patient has survived more than 4 years, and 1 patient more than 8 years. The tumor cells were thought to metastasize to the lung through the vertebral venous plexus (Batson's plexus) which was suggested as a metastatic route by Thomford et al. in their report on recurrent colon cancer. As a result of this study, if the recurrent tumor is clinically limited to the lung in patients with recurrent carcinoma of the uterine cervix, they should be treated by surgical resection of the pulmonary tumor.

Adenocarcinoma↗

PubMed1989

[An evaluation of scalene lymph node metastasis in patients with gynecologic malignancies].

From 1981, through 1985, 90 patients with primary or recurrent gynecologic malignancies underwent a scalene lymph nodes (SLN) biopsy. Pelvic lymph nodes (PN) and paraaortic lymph nodes (PAN) also were examined for metastasis with CT, lymphography, and palpation or were biopsied after a laparotomy. Twenty-three of these 90 patients (25.6%) were found to have positive SLN. In 5 of these 23 (21.7%), their SLN had not been palpable on physical examination. All signs of PN, PAN and SLN were examined in 42 patients. Twenty-one of these 42 (50%) had positive PN, 14 (66.7%) had positive PAN, and 4 (28.6%) had positive SLN. Seven patients with negative PAN had no SLN metastasis. Of twenty-one patients with negative PN, 2 had positive PAN and none had an SLN metastasis. Thus, it has been concluded that an evaluation of SLN is important for the management of a gynecologic malignancy in patients with positive PAN.

Biopsy↗

PubMed1989

[Diagnosis and treatment of cervical dysplasia].

Between 1981 and 1986, 219 patients with cervical dysplasia were treated at the Kyushu University Hospital. All patients were diagnosed by cervical smear, colposcopy, and cervical biopsy and/or endo cervical curettage. They have been followed for more than one year (average 37 months). Of the 219 patients, 63 had mild dysplasia, 99 had moderate dysplasia, and 57 had severe dysplasia. One hundred and forty patients were treated with carbon dioxide laser. The remission rate was 95.0% after one treatment and 98.6% after two treatments. The laser therapy is effective, but a certain rate of recurrence is to be expected. Recently, 23 patients were treated with the cryotherapy and the remission rate was 83%.

Adult↗

PubMed1989

[Study on the treatment of malignant vulvar diseases].

During the past 15 years, 8 squamous cell carcinoma in situ and 21 invasive squamous cell carcinoma were treated in our department. Squamous cell carcinoma in situ was adequately treated by either wide local excision or CO2 laser vaporization. Radical vulvectomy was the main treatment modality in our department. Older patients tolerated well the surgery and had better outcome than those treated with radiotherapy alone. Histologically proven groin node metastasis was the risk factor to be overcome.

Adult↗

PubMed1989

[Evaluation of pre-radiotherapy staging laparotomy in cancer of the uterine cervix].

Staging laparotomy prior to radiotherapy was performed in 70 patients with cervix cancer. Biopsy proven para-aortic lymph node metastases were found in 16(22.9%) patients. Pelvic lymph node metastases were estimated by palpation at laparotomy and 36(51.4%) patients were thought to be positive. Other laparotomy findings were: invasion to the bladder muscle in 14, cul-de-sac metastasis in 10, adnexal metastasis in 2, other intrapelvic metastasis in 3, and positive peritoneal cytology in 9. At laparotomy several hemostatic clips were put on the serosal surfaces of the uterine wall in order to visualize the uterine contour in the localization X-ray films. By this method, six patients were proved to have uterine perforation at the time of small source insertion. Five-year survival rates for each clinical stage were: Stage I, 60%; II, 35.7%; III, 56.8%; and IV 0%. It seems that stage II is worse than stage III, but statistical differences were not found among stages I, II, and III. Three patients with para-aortic metastasis survived for more than four years. Late radiation complications occurred in 25(35.7%) of the patients. This complication rate was statistically higher than that of the patients who had not undergone staging laparotomy (21.1%).

Adult↗

PubMed1988

Alpha-fetoprotein producing endometrial adenocarcinoma: report of a case.

A case of endometrial adenocarcinoma which is producing alpha-fetoprotein (AFP) is described. AFP has been reported to be a tumor marker of gynecologic tumors, such as endodermal sinus tumor and embryonal carcinoma of the ovary. However, to our knowledge, there has been no report of AFP producing endometrial adenocarcinoma. The histologic study showed poorly differentiated adenocarcinoma of the endometrium and AFP was detected in the tumor cells by an immunoperoxidase-peroxidase-antiperoxidase technique.

Adenocarcinoma↗