Shintaro Fukuda

Tachikawa Medical Center

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[A Case of Huge Colon Cancer Accompanied with Severe Hypoproteinemia].

PubMed (2017)

Sakurao Hiraki Kou Kanesada Toshio HARADA Kousuke TADA Shintaro Fukuda

We report a case of huge colon cancer accompanied with severe hypoproteinemia. A7 4-year-old woman was referred to our hospital because of abdominal fullness. Blood examinations revealed anemia(hemoglobin 8.8 g/dL)and sever hypopro- teinemia(total protein 4.5 g/dL, albumin 1.1 g/dL). Computed tomography examination of abdomen revealed ascites and large tumor(12.5×10.5 cm)at the right side colon. By further examinations ascending colon cancer without distant metastasis was diagnosed, then we performed right hemicolectomy and primary intestinal anastomosis by open surgery. Ahuge type 1 tumor(18×12 cm)was observed in the excised specimen, which invaded to terminal ileum directly. The tumor was diagnosed moderately differentiated adenocarcinoma without lymph node metastasis(pT3N0M0, fStage II ). Postoperative course was uneventful and serum protein concentration recovered gradually to normal range. Protein leakage from the tumor cannot be proved by this case, so we can't diagnose as protein-losing enteropathy, but we strongly doubt this etiology from postoperative course in this case.

Hypoproteinemia

Protein losing enteropathy

Ascending colon

Hemicolectomy

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Proportional Difference in the Incidence of Adenomas and Carcinomas between Colonic and Rectal Mucosa

Nihon Daicho Komonbyo Gakkai Zasshi (2007)

Seiji Kimura Shintaro Fukuda Masao Tanaka

大腸癌は腺腫から発生するとされるが, 結腸と直腸ではその比率が異なる可能性がある. 今回両者における腺腫と癌の発生頻度を比較して, 腫瘍発生の場としての相違を検討した. 腺腫964病変, m癌219病変, sm癌37病変, mp以深癌178病変を, 肛門から15cmを境界として結腸腫瘍 (C群) と直腸腫瘍 (R群) に分類した. 合計1,398大腸病変のうちC群は77.5%, R群は22.5%を占めた. 腺腫はC群82.7%, R群17.3%, m癌はC群74.4%, R群25.6%, sm癌はC群56.8%, R群43.2%, mp以深癌はC群57.3%, R群42.7%の比率だった. R群ではm癌, sm癌, mp以深癌の比率は腺腫に比較し, それぞれ有意に高かった. さらにsm癌, mp以深癌の比率はm癌に比較し, それぞれ有意に高かった. しかしsm癌とmp以深癌の比率には有意差がなかった. 一方C群の中で腺腫は73.6%, m癌は15.1%, sm癌とmp以深癌は11.3%を占め, R群の中で腺腫は53.0%, m癌は17.8%, sm癌とmp以深癌は29.2%を占め, 結腸に比べて直腸では腺腫の比率は低いものの浸潤癌の比率は高かった. 以上より両者の浸潤癌の発生過程には相違があると推測される.

10.3862/jcoloproctology.60.406

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Synchronous Occurrence of Advanced Gastric Carcinoma with Retroperitoneal Liposarcoma: A Case Report

American Journal of Case Reports (2021)

Hiroshi Kobayashi Riuko Ohashi Masuo Ujita Kana Ueki Ryouya Seki

BACKGROUND Gastric carcinoma (GC) remains one of the most common and deadly neoplasms in the world. Liposarcoma (LPS) is the most common sarcoma of adults. However, synchronous or metachronous occurrence of GC with LPS seems to be very rare. Tumor staging and differential diagnosis with these cases are extremely difficult. CASE REPORT The patient was a man in his 70s, who reported anorexia and weight loss of 4 kg over 2 months. Gastroscopy demonstrated a large tumor of Borrmann type 3, of which histology was moderately to poorly differentiated adenocarcinoma. The clinical stage was initially defined as IVb due to a 11×6 cm retroperitoneal (RP) tumor. Despite chemotherapy for GC, the RP tumor rapidly enlarged. Endoscopic ultrasound-guided fine-needle aspiration biopsy showed that it was an undifferentiated sarcoma. He died of hepatorenal failure secondary to severe jaundice. The autopsy revealed a synchronous occurrence of GC and RP sarcoma. GC had no areas admixed with sarcoma. Histology of RP sarcoma showed that it mainly consisted of undifferentiated sarcoma and focally of well-differentiated LPS characterized by well-differentiated adipocytes admixed with scattered atypical stromal cells. The tumor cells in both areas were positive for MDM2 and CDK4 by immunohistochemistry. The diagnosis of the RP sarcoma was revised to dedifferentiated LPS. CONCLUSIONS There were no previous case reports of synchronous occurrence of GC with LPS in the English and Japanese literature. GC and LPS pose challenging problems in their diagnoses, staging, and treatments when they occur synchronously or metachronously.

10.12659/ajcr.934586

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Citations (2)

Cystic lymphangioma of the mediastinum and the small bowel: a case report and a review of literature.

PubMed (1977)

Shintaro Fukuda Zakir Hossain

Lymphangioma

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A Case of Neuroendocrine Carcinoma of the Breast

Yamaguchi Medical Journal (2020)

Hidefumi KUBO Takahiro Watanabe Noriaki Hashimoto Sakurao Hiraki Shintaro Fukuda

われわれは乳腺原発神経内分泌癌の１例を経験したので報告する．症例は73歳女性，左乳房に腫瘤を自覚して受診．マンモグラフィ検査でカテゴリー３と診断され，乳腺エコー検査で左乳房D領域に直径16mm大の比較的境界明瞭な腫瘤が認められた．腫瘤はMRI検査で早期に強く造影され，その後造影効果は漸減した．PETでは軽度の集積が認められ悪性が疑われた．針生検で浸潤癌と診断されたため乳房部分切除およびセンチネルリンパ節生検が施行された．病理学的検査で腫瘍細胞はロゼット形成や血管周囲に偽ロゼット形成が認められ，免疫染色でChromogranin A陽性，NSE陽性，CD56少数陽性，Synaptophysin陽性が示された．核分裂像が多く細胞異型も強く，病理組織学的に乳腺神経内分泌癌と確定診断された．術後，放射線治療が追加され，現在アロマターゼ阻害薬の内服継続下に経過観察中である．低分化型の神経内分泌癌は悪性度がより高いとされており，今後も注意深い経過観察が必要である．

Neuroendocrine carcinoma

Breast carcinoma

10.2342/ymj.69.81

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A HEMATOLOGICAL STUDY ON CASES WITH ESOPHAGEAL TRANSECTION WITHOUT SPLENECTOMY FOR ESOPHAGEAL VARICES

The journal of the Japanese Practical Surgeon Society (1982)

Kohei Misaki Kinichiro Tatebayashi Masahiro Toshimitsu Osamu Santoki Katsura Tanzan

[in Japanese]

10.3919/ringe1963.43.1335

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A CASE OF CA19-9 PRODUCING DUODENAL CANCER, WHICH PRESENTED WITH AN INITIAL SYMPTOM OF OBSTRUCTIVE JAUNDICE

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (2007)

Takayuki Torigoe Kaoru Miyashita Shintaro Fukuda Bun Sano

閉塞性黄疸にて発症したCA19-9産生十二指腸癌の1例を経験したので報告する. 症例は68歳, 女性. 褐色尿, 胸やけを主訴に当院内科を受診. ビリルビン・肝胆道系酵素の上昇, 血中CA19-9の高値 (425.2U/ml) を示し, 腹部CT検査にて約2cm大の膵頭部腫瘍を認めた. 閉塞性黄疸をきたした膵頭部癌の診断にて減黄処置後, 膵頭十二指腸切除術を施行した. 病理組織学的検査にて膵浸潤を伴う原発性十二指腸癌と診断した. また抗CA19-9抗体による免疫組織染色にて腫瘍細胞は陽性に染まった. 閉塞性黄疸にて発症した原発性十二指腸癌は膵浸潤を伴い進行例がほとんどであるが, 積極的な外科的切除にて予後の改善が期待できる.

CA19-9

Obstructive jaundice

10.3919/jjsa.68.2764

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A CASE OF MALIGNANT LYMPHOMA OF THE SPLEEN DURING OBSERVATION OF EOSINOPHILIA

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (2006)

K. Morita Noriko SAMPEI Sakurao Hiraki Akitoshi Kudo Shintaro Fukuda

原因不明の好酸球増多症として7年間経過観察後に生じた脾臓原発悪性リンパ腫を経験した. 81歳,男性で末梢血白血球数は軽度高値であったが,好酸球分画は15～22%と異常高値であった.感染,アレルギー,肺疾患,皮膚疾患,膠原病,悪性疾患などは否定されていた. 2004年9月腹部エコーで脾腫,脾腫瘍を指摘され, CT, MRIで多発性脾腫瘤, Gaシンチで脾臓への集積をみた.血液検査で可溶性IL-2R値の上昇あり,全身検索にて他臓器に異常は認めず,脾臓原発悪性リンパ腫を疑い脾摘した.開腹時,脾臓以外に病変は認めなかった.病理診断はB cell non-Hodgkin's lymphoma, follicular, mixed typeであった. T cell系の悪性リンパ腫では好酸球増多をみることがあるが, B cell系では極稀である.原因不明の好酸球増多症では悪性疾患の発生も念頭に経過観察が必要であると思われた.

Malignant lymphoma

10.3919/jjsa.67.885

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A Case of Persistent Sciatic Artery Aneurysm Treated by Transcatheter Arterial Embolization Alone.

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (2001)

Toru Kawaoka Akitoshi Kudo Sakurao Hiraki Shintaro Fukuda Nobuo Eguchi

遺残坐骨動脈瘤は胎生初期の下肢の発達に主役をなす坐骨動脈が生後も残存し,これが動脈瘤を形成する稀な疾患である.その治療法として以前は瘤切除あるいは結紮術,必要ならば下肢血行再建術の付加といった外科的療法が中心であった.しかし,最近ではinterventional radiology (以下IVR)の発達により経カテーテル的動脈塞栓術(以下TAE)による加療例も報告されている.今回われわれは既往に多くの疾患をもつ78歳女性の遺残坐骨動脈瘤を経験した.血管造影にて遺残坐骨動脈と膝窩動脈との間の交通がない不完全型と診断, TAE単独のみでなんら合併症の発現なく瘤の完全閉塞に成功し,瘤破裂を予防する事が出来た.遺残坐骨動脈瘤に対するTAEは,外科的療法の様に瘤に癒着した坐骨神経を損傷する可能性もなく,安全かつ低侵襲でもある為, poor risk例や高齢者にも適応しうる非常に有用な手段である.

Arterial Embolization

10.3919/jjsa.62.249

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[A case of various cardiac disorders due to interferon-alpha].

PubMed (1996)

Yutaka Kawada Takafumi Hiro Shintaro Fukuda Toshihiro Sakumura M Matsuzaki

Alpha (finance)

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Citations (1)