Katsuro TAKETOMI

Social Insurance Institute

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Masao Kishikawa

Osaka Dental University

Takayuki NAKAZAKI

Japanese Red Cross Society, Japan

Tomonori Nakasone

Edogawa Hospital

Koji Tobinaga

Agencia de Evaluación de Tecnologías Sanitarias

Koji Kimino

Nagasaki University

Kouji KIMINO

Nagasaki University

Kouji TOBINAGA

Hideki Yamashita

Yokohama Municipal Citizen's Hospital

Tomonari NAKASONE

Yoshihito SHIBATA

Japanese Red Cross Society, Japan

Cooperative Institutions

Nagasaki University

Agencia de Evaluación de Tecnologías Sanitarias

Japanese Red Cross Society, Japan

Ureshino Medical Center

Shinshu University

Japan Community Healthcare Organization

National Hospital Organization

Nagasaki Medical Center

Sasebo City General Hospital

Naga Municipal Hospital

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Mucosal de Novo Cancer of the Rectum Following Radiation Therapy for Uterine Cancer.

Internal Medicine (1993)

Takenori Matsuo Masahiro Ito Ichiro Sekine Masao Kishikawa Katsuro TAKETOMI

A 54-year-old woman who underwent a hysterectomy and radiation therapy for carcinoma of the uterine cervix developed mucosal de novo cancer of the rectum 12 years later. The rectal lesion was elevated, measuring 0.8×0.7×0.3cm, and its surface was relatively smooth. Microscopically, this tumor consisted of a well-differentiated tubular adenocarcinoma which had invaded the depth of the mucosa. Late radiation injuries were observed around the tumor. We diagnosed this lesion as a radiation-induced mucosal de novo adenocarcinoma of the rectum on the basis of the criteria of Black and Ackerman (Clin Radiol 16: 278, 1965). This case underscores the need for careful longterm follow-up studies of the large intestines of patients who underwent therapeutic irradiation for uterine cancer.(Internal Medicine 32: 427-429, 1993)

Uterine cancer

Corpus Uteri

10.2169/internalmedicine.32.427

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A CASE OF PRIMARY MALIGNANT MELANOMA OF THE ESOPHAGUS

The journal of the Japanese Practical Surgeon Society (1997)

Koji Kimino Tomonori Nakasone Takayuki NAKAZAKI Hideki Yamashita Katsuro TAKETOMI

A case of primary malignant melanoma of the esophagus is reported. A 69-year-old woman was admitted to the hospital because of dysphagia. Barium meal study revealed elevated lesions in the middle thoracic esophagus. Endoscopic examination of the esophgus revealed four blackish elevated tumors and esophageal melanosis. Biopsy findings indicated malignant melanoma. Thoracic esophagectomy combined with cervical and mediastinal lymphoadenectomy was performed. The resected specimen included four localized blackish tumors, one of which was pedunculated and another one of which was located in the esophageal melanosis. The #107 and left #104 lymph nodes showed blackish swelling. Histological examination demonstrated primary malignant melanoma with junctional activity in pathological stage IV which was shown by #104 metastatic lymph node. Electron microscopy revealed tumor cells containing melanosomes. The DNA patterns of the esophageal tumors and #104 lymphnode were aneuploid. The patient received postoperative irradiation therapy, but died of lung metastasis 35 months after the surgery.

Esophagectomy

Barium meal

10.3919/ringe1963.58.373

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TWO CASES OF RECTAL CANCER ACCOMPANIED WITH RADIATION COLITIS

The journal of the Japanese Practical Surgeon Society (1996)

Takayuki NAKAZAKI Koji Tobinaga Katsuro TAKETOMI Koji Kimino Tomonari NAKASONE

This paper presents two cases of rectal cancer accompanied with radiation colitis. Case 1 was a 53-year-old woman, who had a history of underdoing radiation therapy for a uterine cervical cancer 11 years before. She was seen at the hospital because of constipation and pointed out a IIa like lesion on the rectum by colonoscopy. Abdominoperineal resection was performed. The surgical specimen showed the IIa like lesion on the rectum. Pathological findings revealed well differentiated adenocarcinoma. Immunohistochemical staining of p53 showed positive cells in atrophic glands. Case 2 was a 62-year-old woman complaining of diarrhea. There was a previous history of receiving radiation therapy for a uterine cancer 20 years before. Colonoscopy showed a Borrmann type 2 cancer on the rectum. Abdominoperineal resection was performeed. Histological findings revealed moderately differentiated adenocarcinoma invading to the propria muscle. The features of radiation colitis were observed around the cancer int he two cases which provided a clue to diagnose the lesions with radiation induced cancer.

Abdominoperineal resection

10.3919/ringe1963.57.416

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CLINICOPATHOLOGICAL STUDY OF MUCINOUS CARCINOMA OF THE LARGE INTESTINE

The journal of the Japanese Practical Surgeon Society (1997)

Takayuki NAKAZAKI Kouji TOBINAGA Katsuro TAKETOMI Kouji KIMINO Tomonori Nakasone

Clinicopathological features of 17 cases (3.2%) of mucinous carcinoma of the large intestine were compared with those of 473 cases of well or moderately differentiated adenocarcinoma of the large intestine. The male-to-female ratio and the average age of patients with mucinous carcinoma almost matched of the controls. Mucinous carcinomas occurred more frequently in the right side of the large intestine. The microscopical invasion of the mucinous carcinoma was deeper or equal to musucularia propria in all cases. The incidence of lymph node metastasis and lymphatic invasion of mucinous carcinomas were significantly higher than those of the controls. There was no significant difference in the incidence of liver metastasis between both groups, but mucinous carcinomas had a likelihood of peritoneal dissemination than the controls. The 5-year survival rate in mucinous carcinoma cases was 32.8% versus 53.3% in curative resection cases. The patients with mucinous carcinoma had a poorer prognosis than that of the control group. The immunohistochemical stainings of p53 and CEA were not related with the prognosis of mucinous carcinomas. It is thought that early detection of the cancer and wide lymph node dissection are important for the improvement of the prognosis of mucinous carcinomas.

Mucinous carcinoma

10.3919/ringe1963.58.1975

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METASTATIC LYMPH NODE OF AN ESOPHAGEAL CANCER PENETRATING TO THE STOMACH-A CASE REPORT-

The journal of the Japanese Practical Surgeon Society (1994)

Koji Kimino Koji Tobinaga Katsuro TAKETOMI Tomonori Nakasone Naoki Kawazoe

In lower esophageal cancers, lymph nodes involvement is frequently seen in the celiac region, but the lesion rarely penetrates to the gastric wall. This paper presents a recent experience with a case of stomach penetration by a metastatic node of esophageal cancer to the superior gastric region. A 64-year-old male was admitted to the hospital because of a swallowing disturbance and weight loss. A Borr. 2type lesion on the lower thoracic esophagus, second protruding lesion with deep ulceration on the cardia, and third IIc type on the prepyrorus were found by preoperative examination. Surgery, including subtotal resection of the thoracic esophagus, total gastrectomy and splenectomy was performed. From the histopathologic and macroscopic findings, the second lesion was found to be a metastatic lymph node of the esophageal cancer penetrating to the stomach.

10.3919/ringe1963.55.2561

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A CASE OF PERIANAL RHABDOMYOSARCOMA

The journal of the Japanese Practical Surgeon Society (1996)

Takayuki NAKAZAKI Kouji TOBINAGA Katsuro TAKETOMI Kouji KIMINO Tomonori Nakasone

We describe a case of perianal rhabdomyosarcoma. A 21-year-old female was seen at the hospital because of a perianal mass and anal pain. A hard hemisherical mass was palpable subcutaneously in her anus. The tumor 6cm in diameter was excised. Pathological findings showed alveolar type of rhabdomyosarcoma. Seven months later, the tumor recurred, and an abdominoperineal resection was performed. After the operation, local recurrence and paraaortic lymph node metastasis appeared. Radiation therapy and chemotherapy were done, but ineffective. The patient died 13 months after the operation. Rhabdomyosarcoma is a very rare entity and only 12 cases have been reported so far.

Abdominoperineal resection

Anus

Paraaortic lymph nodes

10.3919/ringe1963.57.1421

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A CASE OF RECTAL CANCER PRESENTING AS NEPHROTIC SYNDROME

The journal of the Japanese Practical Surgeon Society (1995)

Takayuki NAKAZAKI Koji Tobinaga Katsuro TAKETOMI Koji Kimino Tomonari NAKASONE

This paper reports a case of rectal cancer complicated with nephrotic syndrome. A 47-year-old woman was seen at the hosipital because of edema, and admitted under a diagnosis of nephrotic syndrome. Laboratory studies showed an elevated serum CEA level (81ng/ml). Barium enema and colonoscopy revealed rectal carcinoma. Abdominoperineal resection and left renal biopsy were perfor-med. Pathological findings of the kidney revealed membranous glomerulonephritis. Proteinuria decreased after the operation and nephrotic syndrome was improved. It is presumed that tumor antigen-associated immune complexes are cause of the membranous glomerulonephritis. This case strongly suggested the association of nephrotic syndrome and the rectal cancer, for the nephrotic syndrome was remitted after the resection of the rectal cancer.

Barium enema

Membranous Nephropathy

10.3919/ringe1963.56.1647

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A CASE OF RECTAL CANCER ASSOCIATED WITH CROHN'S DISEASE

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) (1998)

Takayuki NAKAZAKI Kouji TOBINAGA Katsuro TAKETOMI Kouji KIMINO Masafumi Morinaga

Recently, an increased incidence of carcinoma of the large intestine has been described in patients with Crohn's disease in the same way as ulcerative colitis. We report a case of rectal cance with Crohn's disease with a review of the literature. A 32-year-old woman was admitted to the hospital because of anal pain. She had been diagnosed as having Crohn's disease 15 years before ago and had a history of undergoing resection of the intestine three times because of stenosis or fistula. Barium enema and colonoscopy revealed a rectal tumor, and a biopsy of the tumor showed adenocarcinoma. Abdominoperineal resection was performed and the posterior wall of the vagina was resected, for the tumor invaded to the vagina. The tumor was diffusely infiltrating type and 25×30mm in size. Histological findings were poorly differentiated adenocarinoma, ai (vagina), ly3, v3, and n0.

Barium enema

Abdominoperineal resection

10.3919/jjsa.59.450

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A CASE OF APPENDICEAL MUCOCELE WITH A HIGH LEVEL OF CEA IN CYSTIC FLUID

The journal of the Japanese Practical Surgeon Society (1997)

Takayuki NAKAZAKI Koji Tobinaga Katsuro TAKETOMI Kouji KIMINO Tomonori Nakasone

Appendiceal mucocele is a relatively rare disease. We report a case of appendiceal mucocele with a high level of CEA in the cystic fluid. A 74-year-old woman was admitted to the hospital because of an ileocecal mass. Barium enema and colonoscopy revealed a submucosal tumor in the cecum. Abdominal computed tomography and ultrasonography showed a cystic mass in the ileocecum. Appendectomy was performed with the diagnosis of appendiceal mucocele. The appendix swelled to be 7.0×4.0cm in size. The CEA level of the cystic fluid was extremely high, 62577ng/ml. Pathologically, it was diagnosised as mucinous cystadenoma and immunohistochemical staining of CEA was positive.

Mucocele

Mucinous cystadenoma

Barium enema

Cecum

10.3919/ringe1963.58.1294

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Primary neuroendocrine carcinoma of the lung with various pathological findings; a case report.

The Journal of the Japanese Association for Chest Surgery (1995)

Tomonori Nakasone Koji Kimino Katsuro TAKETOMI Koji Tobinaga Masao Kishikawa

症例は66歳男性.胸部X線上右上肺野に2×1.5cmの辺縁明瞭な陰影を認め精査のため当院内科入院.気管支鏡下擦過細胞診で低分化腺癌の診断のため右上葉切除術, 縦隔リンパ節郭清を施行した.組織学的には, カルチノイド様パターン, 巨細胞, bizarre細胞が混在し, 電顕像でdense cored vesicleを認め多彩な組織像を呈した肺原発neuroendocrine carcinomaと診断した.リンパ節転移は認められずP-TINOMOでI期であったがDNAploidy分析ではaneuploidyであることから自験例は予後不良と考えられた.本邦でも本腫瘍に関して今後の症例の集積による腫瘍動態, 治療, 再発, 予後等に関しての検討が必要と考えられた.

Neuroendocrine carcinoma

Primary (astronomy)

10.2995/jacsurg.9.652

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