Biomedical subjects

N Eriguchi

Publications and source records attributed to N Eriguchi.

At least 37 records · Page 2Linked to original sources

PubMed1999

Endocrine tumor of the pancreas--an evaluation of eighteen patients who underwent resection followed by long-term survival.

Tumors arising from the pancreatic endocrine (islet) cells represent a heterogeneous group of lesions. Some tumors present with well characterized syndromes, while others appear to be nonfunctioning. Eighteen patients with pancreatic endocrine tumors who received surgical treatment at Kurume University Hospital during a 24-year period were reviewed. There were 10 patients with nonfunctioning tumors including 3 patients with benign tumors, and 8 patients with insulinomas. No patients had multiple endocrine neoplasms. Location of the pancreatic tumor was determined preoperatively in 83.3% of the patients. Immunohistochemical analysis of the resected specimens showed multi immunoreactivity to gut hormones among benign lesions and one malignant lesion, whereas malignant lesions showed no or mono immunoreactivity except in one case. In this series, there were no characteristic immunohistochemical findings in the tumors. Both patients with malignant and benign lesions have good prognoses if the main tumors and metastatic lesions are removed.

Adult↗

PubMed1999

A resected case of pancreatic metastasis from primary renal cell carcinoma.

A 71-year-old man, who had received a right nephrectomy for a primary renal cell carcinoma 8 years earlier, and had two years later received a distal gastrectomy for duodenal ulcer, was admitted. In the subsequent clinical course, a solitary low echographical tumor was found in the pancreas. Abdominal computed tomography revealed a tumor of low density area, and celiac angiography revealed a hypervascular tumor stain of the pancreas. From the above findings, a diagnosis of pancreatic tumor was made, and a distal pancreatectomy was performed. Examination of the resected tissues confirmed the presence of a solitary tumor in the pancreatic tail. Histologically, the tumor corresponded to the initial renal cell carcinoma and pancreatic metastasis of renal cell carcinoma was diagnosed. We report a resected case of such a metastasis and review the literature.

Aged↗

PubMed1999

Angiomyolipoma of the liver--a case report and review of 48 cases reported in Japan.

Hepatic angiomyolipoma was considered to be a rare benign tumor, but the number of cases has been increasing recently as imaging techniques improve. We describe a case of hepatic angiomyolipoma for which a definitive diagnosis could not be made on imagings and in which resection was performed. The patient had anti-HCV antibody and slight dysfunction of the liver. The tumor showed a heterogeneous high echo on ultrasonography and a low attenuation value of +32.6 Housfield Units, which was much higher than fat density, on plain computed tomography. Discrimination from hepatocellular carcinoma with fatty change was difficult preoperatively. Microscopically, the tumor consisted of spindle-shaped and epithelioid smooth muscles, adipose tissues and proliferating blood vessels and these histological findings confirmed the diagnosis of hepatic angiomyolipoma. The appearance of hepatic angiomyolipoma on imaging diagnosis varies widely due to the fact that the relative proportion of vessels, muscles and fats varies widely from tumor to tumor. The tumor in our case had relatively few fat components. We review 48 cases reported in Japan and discuss imaging diagnosis and surgical indications for tumors.

Angiomyolipoma↗

PubMed1999

A so-called carcinosarcoma of the gallbladder in a patient with multiple anomalies--a case report.

The patient was a 65-year-old woman with a chief complaint of right upper quadrant pain. Under the diagnosis of gallbladder tumor, preduodenal portal vein and absence of the pancreatic tail, cholecystectomy was performed. Intraoperative findings resulted in a diagnosis of gallbladder tumor, absence of the pancreatic tail, presence of preduodenal portal vein, and malrotation of the intestine. Histological examination of the resected specimens showed a so-called carcinosarcoma. Carcinosarcoma of the gallbladder is a rare tumor of the hepatobiliary region. The present case differs from previously reported cases in its presentation with multiple anomalies including the presence of preduodenal portal vein. Many cases of preduodenal portal vein in an association with duodenal stenosis in children have been reported, but reports of cases of preduodenal portal vein in adult patients are rarely seen in the literature.

Adult↗

PubMed1999

A case of Turner's syndrome complicated with desmoid tumor of the transverse colon.

The association of Turner's syndrome and endometrial carcinoma has been previously established, but has never been described in conjunction with a desmoid tumor of the colon. A case is described of a colonic desmoid tumor developing in a 38-year-old female with Turner's syndrome. The association has not been previously reported. In this report, we describe a 38-year-old woman who has Turner's syndrome with a colonic desmoid and review the literature.

Adolescent↗

PubMed1999

A case of lymphoepithelial cyst of the pancreas.

We report a relatively rare case of lymphoepithelial cyst of the pancreas. The patient, a 43-year-old man with no subjective symptoms, was found to have a pancreatic tumor during a physical examination. Based on the ultrasonographic and abdominal computed tomographic findings, a pancreatic cystic tumor was diagnosed. Endoscopic retrograde pancreatography showed a normal duct system. Enucleation was easily performed. Macroscopically, the cyst resembled an atheroma. Histopathologic examination disclosed lymphoepithelial cyst of the pancreas.

Adult↗

PubMed1999

A long-term survival patient with advanced gallbladder cancer massively metastasizing to the liver.

A case of gallbladder carcinoma was reported. A 42-year-old woman was admitted with epigastralgia. Abdominal ultrasonography, computed tomography, and other diagnostic modalities suggested gallbladder carcinoma with multiple liver metastases. These findings indicated no surgical procedure because of the advanced nature of her disease. After the hepatic arterial chemoinfusion therapy, her multiple liver metastatic lesions showed a decrease in size and number. Therefore, extended left lobectomy of the liver with gallbladder and bile duct resection were performed. Five years after initial operation, a solitary liver metastatic lesion (S5) was diagnosed by ultrasonography. Partial resection of the liver was performed for the liver metastasis, and her postoperative recovery was uneventful and had a good follow-up course. One year after the second operation bone metastases occurred, therefore, peroral administration of UFT (Tegafur + Uracil) and radiation therapy for the metastatic lesions of sternum and lumbar vertebra (L1) were performed.

Adult↗

PubMed1999

Evaluation of curability and prediction of prognosis after surgical treatment for hepatocellular carcinoma by lens culinaris agglutinin-reactive alpha-fetoprotein.

The clinical significance of serum lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3), which can distinguish between hepatocellular carcinoma and hepatitis by detecting a sugar chain micro heterogeneity, was evaluated for its possible ability to recognize previously undetectable residual tumors, and for increasing the accuracy of prognosis after surgical treatment for hepatocellular carcinoma. Serum lens culinaris agglutinin-reactive alpha-fetoprotein was measured pre- and post-operatively in 130 patients who underwent curative surgical treatment for hepatocellular carcinoma. The preoperative AFP-L3 positive rate was 35.4%. AFP-L3 remained positive postoperatively in 28 of the 46 preoperative AFP-L3 positive patients, and converted to positive in 4 of the 84 preoperative AFP-L3 negative patients. Regardless to preoperative AFP-L3, the postoperative AFP-L3 positive patients had a poorer recurrence-free rate (p<0.0001). The postoperative L3 positive patients had a high incidence of recurrence due to metastasis, but did not have recurrence due to multicentric origin. Multivariate analysis revealed that AFP-L3 (p<0.0001) was the most independently significant factor for predicting survival after surgery among several conventional prognostic factors. Thus, AFP-L3 is a valuable marker for evaluation of curability of surgical treatment and for improving the accuracy of prognosis.

Aged↗

PubMed1998

Serous cystadenocarcinoma of the pancreas with liver metastases.

Serous cystadenocarcinoma of the pancreas is a rare entity. We report a primary tumor of the pancreas in a 56-year-old woman that was histologically indistinguishable from microcystic adenoma, but which behaved in a malignant fashion. Metastatic lesions were found in the liver at the time of the initial operation. Nine years after the initial operation, new metastatic liver nodules were found, and the histologic characteristics of these lesions were quite similar to those of the pancreatic neoplasm. This is a very rare case which may support the existence of the entity, serous cystadenocarcinoma of the pancreas.

Angiography↗

PubMed1998

Ileo-abdominal wall fistula caused by diverticulum of the ileum.

We report a very rare case of ileo-abdominal fistula caused by penetration of the ileal diverticulum. Small bowel diverticulosis is generally considered to be an innocuous condition. In this report, we describe a case of ileal diverticulitis associated with an abdominal wall abscess.

Abdominal Muscles↗

PubMed1998

Angiodysplasia of the stomach confirmed by endoscopy and selective angiography--report of a case.

Gastric angiodysplasia that caused continuous gastrointestinal bleeding is reported in a 75-year-old woman who had been treated with repeated blood transfusions because of severe anemia. Endoscopic examination was performed and revealed a bright-red lesion on the anterior wall of the upper gastric body. Injection therapy was performed at first, but the follow-up endoscopy showed a recurrent red lesion in same place. Selective angiography revealed a dense stain suggestive of a hypervascular lesion, measuring about 1 cm in diameter. Partial gastrectomy including resection of the lesion was performed. During a follow-up period of more than 12 months, there was no sign of recurrence of bleeding.

Aged↗

PubMed1998

A case of giant leiomyosarcoma of the rectum.

A 63 year-old-man was admitted to our hospital with the chief complaint of dyschezia. Digital examination revealed a large solid mass on the posterior wall of the rectum. Endoscopically, the tumor was covered by an intact mucosal layer. Under the diagnosis of rectal leiomyosarcoma, abdominoperineal resection of the rectum was performed. The tumor was 10 x 9 x 8 cm in size, and its cross section showed a gray-white tumor with central necrosis. Microscopically, the large tumor of the rectum was mainly located in the proper muscle layer and adventitia, and showed cellular proliferation of spindle-shaped and mild pleomorphic stromal cells, arranged in interlacing fashion, and focal necrosis. The histologic findings support the diagnosis of leiomyosarcoma. Leiomyosarcoma of the rectum is a relatively uncommon disease. We report our case with reference to the literature.

Humans↗

PubMed1998

Treatment of bile leaks from cystohepatic and common hepatic duct after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is widely accepted by patients and physicians despite the lack of controlled trials comparing this technology with conventional cholecystectomy. The cystohepatic ducts represent accessory bile ducts of variable size which frequently travel within the gallbladder fossa or in the posterior wall of the gallbladder. These ducts can be injured during laparoscopic cholecystectomy and can result in bile collection if transected. Recently, we have experienced two cases of injury to the bile duct during operation. One case was a transection of the accessory bile duct, the other one was an injury to the common hepatic duct. We present herein the clinical course of the two cases, in which biliary leakage, following laparoscopic cholecystectomy, was successfully managed by the end to end anastomosis of the bile duct.

Adult↗

PubMed1998

Three cases of the giant gastric leiomyosarcomas.

We report three cases of giant gastric leiomyosarcoma. Diagnosis was made prior to surgery using various diagnostic modalities. The patients were two women (77 and 77 years old) and one man (40 years old) whose chief complaints were abdominal pain, anorexia, and tarry stool. All patients presented with a large palpable mass in their upper abdomen at the time of admission. Based on characteristic findings from a gastric barium study, computed tomography (CT), and angiography, the patients were diagnosed as having gastric leiomyosarcomas displaying extramural growth. In the first case, a patient received a total gastrectomy, while local resection was performed in the second case because of pedunculated extragastric development. In the third case, total gastrectomy was combined with splenectomy and resection of the pancreatic tail. Twenty-two months after the original operation, the first case had multiple liver metastases. We present the three cases here, and review the literature.

Adult↗

PubMed1998

A case of leiomyosarcoma of the small bowel mesenterium.

Leiomyosarcoma of the small bowel mesenterium is a rare entity. Approximately 21 cases originating from the small bowel mesenterium have been described in the Japanese literature. Differentiation from its benign counterpart, leiomyoma, and other connective tissue tumors is often difficult, but it is important because each respective tumor type has an entirely different prognosis. The case of a 65 year-old-man in whom an 9 x 6 x 5 cm leiomyosarcoma of the mesenterium was excised surgically is presented.

Aged↗

PubMed1998

Jejunal varices as a cause of massive gastrointestinal bleeding--a case report.

This report describes a 49-year-old woman with recurrent massive gastrointenstinal bleeding from jejunal varices without portal hypertension. Preoperative diagnosis was obtained by abdominal computed tomography, superior mesenteric arterial angiography and percutaneous transhepatic portography. Percutaneous transhepatic portographic findings revealed no step-up of oxygen concentration and normal pressure in the portal vein, only dilation of superior mesenteric vein. Jejunal resection and anastomosis resulted in complete resolution of the bleeding, and the patient has experienced no recurrent bleeding over a 4 year follow-up period. A review of the literature shows that this syndrome is nearly always characterized by portal hypertension, generally due to liver cirrhosis. Accurate preoperative diagnosis is often difficult. We report a very rare case of jejunal varices without portal hypertension.

Female↗

PubMed1998

Pseudomyxoma peritonei. A report of three cases and a review of published reports.

Pseudomyxoma peritonei is a disease characterized by the progressive accumulation of mucinous ascites within the abdomen and pelvis. Metastatic disease outside the peritoneal cavity is unusual. Gastrointestinal function is lost from external compression of stomach, small bowel, and large bowel. We present three cases of pseudomyxoma peritonei which were treated by different therapeutic methods. Case 1 was a 61-year-old man who underwent treatment by appendectomy with administration of Cisplatin and Doxorubicin hydrochloride into the intraperitoneal cavity. Case 2 was a 64-year-old woman who underwent bilateral oophorectomy with administration of Cisplatin and ADM into the intraperitoneal cavity. About 4 years after the first operation, she died of peritonitis due to small and large bowel perforations underlying recurrent tumors. Case 3 was a 79-year-old woman who underwent surgery to evacuate about 4000 ml of mucinous ascites, and received intraperitoneal administration of 5-Fluorouracil (500 mg/day) for 5 days without severe complications.

Combined Modality Therapy↗

PubMed1998

A case of gastric cancer with nephrotic syndrome.

A 77-year-old woman complaining of anorexia and nausea was referred to the hospital with a diagnosis of advanced gastric cancer. The patient also had congestive heart failure with atrial fibrillation and severe hypoproteinemia. Proteinuria, hypoproteinemia and other laboratory data suggested that she had nephrotic syndrome. Total protein level was 4.6 g/dl and albumin level was 1.6 g/dl. In order to avoid postoperative complications such as wound dehiscence, anastomotic leakage and so on, careful pre- and post-operative management of nephrotic syndrome is necessary. Administration of albumin and fresh frozen plasma regimen was continued after the operation. Urinary protein level started to decrease after subtotal gastrectomy. Histological examination revealed moderately differentiated tubular adenocarcinoma with nodal metastases. Her post-operative course was uneventful. Although the signs and symptoms of nephrotic syndrome did not improve immediately, twelve months after operation she has become well and has no symptoms of ascites and hypoproteinemia.

Aged↗