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Shigeru Ehara

Publications and source records attributed to Shigeru Ehara.

At least 19 recordsLinked to original sources
PubMed2004

Rapid involution of proliferative fasciitis.

A process of evolution and involution is a characteristic feature of reactive fibrous lesions, but has not been emphasized in either the radiology or pathology literature. We report a case of proliferative fasciitis, pseudotumorous fibrous proliferation similar to nodular fasciitis, showing evolution and involution during a 1-month period. A 35-year-old Japanese woman presented with a tender soft tissue mass in the forearm that had grown over a 2-week period. MR imaging revealed a soft tissue mass of nonspecific signal intensity on the muscle fascia. Needle biopsy revealed diffuse proliferation of fibroblastic spindle cells representing proliferative fasciitis. Two weeks after biopsy the mass had rapidly decreased in size, and the pain subsided. MR imaging obtained 1 month later demonstrated only minimal residual reactive change along the fascia. Conservative treatment may be a reasonable treatment option for this condition.

Adult↗
PubMed2004

Skeletal muscle metastases of carcinoma: a clinicopathological study of 12 cases.

OBJECTIVE: To clarify the clinical and magnetic resonance (MR) imaging features of a rare condition of metastasis of carcinoma to skeletal muscle. METHOD: Clinicopathological findings for 12 patients (10 male, two female, age range 48-89 years, mean age 68 years) with skeletal muscle metastases of carcinomas were reviewed retrospectively. RESULTS: In nine of the 12 patients the skeletal muscle metastasis was presented as "painful mass". The lung was found to be the most common primary source, accounting for 33% of the cases, and the lower extremity was the most common metastatic site, accounting for 67% of the current series. Diagnosis was made by biopsy in all cases. Overall, MR images were not specific, but on the gadolinium-DTPA enhanced MR images, extensive peritumoral enhancement associated with central necrosis was found in 11 of the 12 patients (92%). Seven patients died within 2-19 months (average: 9 months) after the detection of the skeletal muscle metastasis, among whom only one patient was continuously disease free for 92 months after wide excision of the metastatic lesion. CONCLUSION: Skeletal muscle metastasis is often presented as a painful mass in patients with known primary carcinoma. For diagnosis, needle biopsy is mandatory. However, a painful mass with an extensive peritumoral enhancement should be highly suspected to represent carcinoma metastasis to skeletal muscles. In selected patients, wide excision with combined chemotherapy could yield unexpectedly good results.

Aged↗
PubMed2003

Tetraparesis caused by chondroblastoma of the cervical spine: a case report.

STUDY DESIGN: A chondroblastoma of the posterior component of the seventh cervical vertebra with tetraparesis was reported. Imaging studies showed an expansile destructive lesion with mineralization. OBJECTIVES: To emphasize the occurrence of tetraparesis caused by chondroblastoma in the cervical spine. SUMMARY OF BACKGROUND DATA: Chondroblastoma is a rare benign neoplasm of the bone. Only eight cases of chondroblastoma occurring in the vertebra are reported in the literature, including five in the cervical vertebrae. However, there was no reported case of tetraparesis in the literature. METHODS: A 19-year-old man had a tetraparesis caused by chondroblastoma of the posterior component of the seventh cervical vertebra, which invaded the vertebral body with an extraosseous involvement. Imaging studies showed an expansile destructive lesion with mineralization. Curettage of the lesion was performed from both anterior and posterior approaches. The defect of the vertebral body was reconstructed by autologous iliac bone graft with posterior fusion using the Luque instrumentation system. RESULTS: Histologically, the tumor cells were forming cartilage with round or oval nuclei, which often were indented or had a longitudinal groove. There was no sign of local recurrence, and the neurologic deficit had fully recovered 2 years and 3 months after surgery. CONCLUSIONS: Chondroblastoma should be included in the differential diagnosis of lytic expansile destructive lesion of the spine, although there is an extraosseous involvement. Prompt adequate surgery should be performed as soon as possible after establishment of the correct histologic diagnosis to restore the neurologic deficit.

Adult↗
PubMed2003

Magnetic resonance imaging features of epidermoid cyst in the extremities.

BACKGROUND: Epidermoid cyst is a common benign soft-tissue tumor that occurs in the skin. There have been very few descriptions about the magnetic resonance (MR) images of epidermoid cysts in the extremities. MR imaging findings of epidermoid cysts may be characteristic enough to make the preoperative diagnosis possible. The purpose of this paper is to elucidate the MR imaging features of epidermoid cysts arising in the limbs. METHODS: We evaluated the MR images of five patients with an epidermoid cyst in the limbs. MR imaging and other radiological examinations were evaluated. T1-weighted (T1W), T2-weighted (T2W), and Gd-enhanced T1W images were taken in all the patients. RESULTS: The size of the lesion ranged from 2 to 10 cm with an average of 5.2 cm. All the tumors were located in the subcutaneous tissue with a well-circumscribed margin. On T1W MR imaging, the tumor had a slightly high signal intensity in three out of five cases and iso-signal intensity in the remaining two cases. On T2W images, they all showed high signal intensity. Irregular low signal intensity areas were noted in the tumors on both T1W and T2W images. No enhancement was observed inside the tumors. CONCLUSION: Subcutaneous tumor location, well-circumscribed margin, and isosignal to slightly high signal intensity with some heterogeneity on T1W MR images and high signal intensity T2W MR images, and no enhancement are useful features for a diagnosis of epidermoid cyst of the extremity.

Adult↗
PubMed2003

Iridium-192 brachytherapy for hemorrhagic angiosarcoma of the scalp: a case report.

A 60-year-old woman presented with multicentric skin tumors of the head. The histologically proven hemangioendothelioma was bleeding as a result of disseminated coagulopathy. In addition to immunotherapy, 6 MeV electron beam radiotherapy was used for the purpose of hemostasis with a single portal, 20 x 20 cm in size, covering the whole scalp from the top of the head. The radiotherapy was discontinued after 39 Gy/13 fractions/20 days because of the progress in size of a peripheral tumor and the stability of coagulopathy. After another electron boost delivery by two portals focused to exophytic parietal and temporal tumors of 20 Gy/10 fractions, high dose rate brachytherapy with a surface mold technique was performed, 3 Gy/fraction, four fractions/week, for a total of 36 Gy. It induced partial regression of the tumor and complete recovery of platelet counts from 2.5 x 10(4) to 18.2 x 10(4). The tumor disappeared in 3 months. No late side effects occurred, except for permanent alopecia. The patient developed a cervical lymph node metastasis 1 year after and marginal recurrence 2 years after the initial treatment. Both recurrent tumors were successfully treated by 4 MV external photons of 60 Gy/20 fractions/46 days and electron beam irradiation of 60 Gy/20 fractions/29 days, respectively. She has remained disease free for 3 years after the initial presentation.

Brachytherapy↗
PubMed2003

Radiologically and histologically mixed liposarcoma: a report of two biphasic cases.

We report two cases of liposarcomas showing biphasic patterns, radiologically and histologically. The first case was a 52-year-old man with a 17 x 12 cm intramuscular tumor in the right thigh. MR imaging revealed a mass composed of two components: a fat component and another soft tissue component. Histological diagnosis revealed mixed-type liposarcoma consisting of well-differentiated and myxoid liposarcoma. The second case was a 62-year-old man with a 22 x 15 cm intramuscular tumor in the left calf. MR imaging showed a mass composed of fat and non-fat components. The histological diagnosis was well-differentiated and pleomorphic liposarcoma.

Diagnosis, Differential↗
PubMed2002

Leiomyosarcoma of the lumbar spine: case report.

STUDY DESIGN: A primary leiomyosarcoma in the L2 vertebral body without any neurologic deficit is reported. The radiologic diagnosis was a metastasis, and the histologic diagnosis was confirmed by transpedicular needle biopsy. OBJECTIVE: To emphasize the occurrence of primary leiomyosarcoma in the lumbar spine. SUMMARY OF BACKGROUND DATA: Leiomyosarcoma is a rare malignant neoplasm of the bone, and only one report of the primary spinal tumor exists. In the case of leiomyosarcoma of the bone, metastasis, most commonly of the uterus or gastrointestinal tract, must be carefully ruled out before the diagnosis of primary leiomyosarcoma in the bone is confirmed. METHODS: Leiomyosarcoma of the second lumbar vertebra in a 47-year-old woman with no neurologic deficit is reported. Imaging findings indicated a nonspecific high-grade lesion. A total spondylectomy of L2 with en bloc excision of the lower half of L1 and the upper third of L3 vertebral bodies was performed after preoperative radiation therapy. The defect of the vertebral body was reconstructed by titanium mesh cage, and T11 to S1 vertebrae were instrumented by the pedicle screw and rod system. RESULTS: The surgical margin was marginal. Histologically, the tumor cells were elongated, with abundant cytoplasm and cigar-shaped nuclei, showing proliferation in fascicles and bundles. No sign of local recurrence or metastasis was evident 2 years and 1 month after surgery. CONCLUSIONS: Leiomyosarcoma should be included in the differential diagnosis of spindle cell tumor of the spine, and it should be confirmed or excluded by immunohistochemical and/or ultrastructural studies. If the expected surgical margin is definitive, a total en bloc spondylectomy should be performed.

Diagnosis, Differential↗