jibi to rinsho
Online ISSN : 2185-1034
Print ISSN : 0447-7227
ISSN-L : 0447-7227
Volume 54, Issue 4
Displaying 1-8 of 8 articles from this issue
  • Hideki SHIRATSUCHI, Torahiko NAKASHIMA, Naoya HIRAKAWA, Yuichi SEGAWA, ...
    2008 Volume 54 Issue 4 Pages 179-185
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Myoepitheliacl arcinomai n the deep soft tissue of the neck is extremely rare. This report describest he case of 30-year-oldm an with a myoepitheliacl arcinomaa risingf rom the deep soft tissue of the neck. The patient becamea ware of a tumor on the left side of his. A benignt umor was suspectedb ecauseo f the clinical course and the imaging results and the tumor was surgically resected. The final pathological diagnosis was a myoepithelial carcinoma. Because the margin was closed radiation therapy was also administered. A myoepithelial carcinoma is low-grade tumor and the patient will require cautious follow-up in the future.
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  • experiences of three tumors more than 7cm
    Muneyuki MASUDA, Takahiro WAKASAKI, Akihiro TAMAE, Noritaka KOMUNE, Ta ...
    2008 Volume 54 Issue 4 Pages 186-194
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Either the transcervical approach (TCA) or transparotid-cervicarl approach (TPCA) without mandibulotomy is widely used for the removal of parapharyngeal space tumors(PPST). In the present study, we demonstrate three cases of large (>7cm) PPSTs, which well reflected the indications, limitations and pitfalls associated with these procedures. Case1 demonstrated that, when a tumor is benign and smoot even a large tumor(about10cm in size) can be removed satisfactorily by TCA/TPCA without a mandibulotomy. Case2 showed the limitations of TPCA without a mandibulotomy for a malignant tumor. In Case3, we encountered uncontrollable brisk bleeding from the pterygoid venous plexus, which is one of the fatal pitfall associated with TPCA for large recurrent tumors.
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  • Yoshihiro UMENO, Ryuji YASUMATSU, Torahiko NAKASHIMA, Hideki KADOTA, H ...
    2008 Volume 54 Issue 4 Pages 195-199
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Fibromatosis is a histologically benign fibrous neoplasm that arises from the musculoaponeurotic tissues of the body. It is microscopically benign but it can be locally invasive with a tendency to also recur locally after resection. We experienced a case of a fibromatosis occurring in the parapharyngeal space. A 73-year-old female with a low grade performance status (PS) presented at our department with a right neck mass. The MRI findings demonstrated a well-enhanced tumor lesion within the left parapharyngeal space. Histological examinations indicated the tumor to be fibromatosis. Due to her low grade PS, we did not perform surgical treatment. First, the patient received steroid pulse therapy to treat the parapharyngeal lesion. Despite administeringth e steroidt herapy, the tumor increasedi n size, and she complainedo f severep ain. Therefore, we planned to perform external irradiation as a palliative therapy. As a result, a partial response was achieved with a relief of the severe pain from the tumor. The tumor has not increased in size after the radiation therapy.
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  • Takanori SATO, Koji ABE, Shinichi NAKAGAWA, Noriaki TAKEDA, Eiji KONDO ...
    2008 Volume 54 Issue 4 Pages 200-205
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Orbital apex syndrome is characterized by mydriasis, blepharoptosis, exophthalmos, ocular motility disorder, eyelid sensory disorder and visual disorder due to damage of the oculomotor nerve, the trochlear nerve, the abducens nerve, the trigeminal nerve and the optic nerve at the orbital apex. A tumor, cyst, inflammation and injury can cause orbital apex syndrome. This report describes a case of 55-year-old male whose maxillary paries anterior was destroyed by an exploding bolt that impacted the maxillary bone chip to the orbital apex caused lose of left vision, left mydriasis, absence of the left light reflex, ocular motility disorder in all directions and left facial imperception. Damage of the left optic nerve was recognized by CT and MRI. The bone chip was surgically removed under general anesthesia. The ocular motility improved after the operation, but the visual handicap thereafter remained.
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  • Tomoko TAMURA, Hitomi HIGUCHI, Takafumi YAMANO, Mayumi SUGAMURA, Tetsu ...
    2008 Volume 54 Issue 4 Pages 206-211
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    The clinical pathway is a schedule beginning with patient education, followed by clinical examinations, an operation, medication, post-operative treatment, and a meal during hospitalization. The goal of the pathway is the improvement in the medical quality, effective use of medical resources, and the informed consent of the patient. The clinical pathway for a palatine tonsillectomyw as thereforee stablished at the Fukuoka University Hospital Otolaryngology Department in 2000. A statistical evaluation of the palatine tonsillectomyc ases was conductedb efore and after the introductiono f the clinical pathway. The periodo f hospitalizationw as significantlyd ecreasedd uet o the establishmento f the pathway. Onp ostoperative6 day, the ratio for the regular use of a pain reliever and a normal dietary food intake were lower and higher, respectively with the introduction of the pathway. A comparison of the indications for surgery after the introduction showed that the regular use of pain reliever was observed more often in those with chronic tonsillitis than the other conditions. In contrast, no difference was observed in the dietary intake.
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  • Yoshikazu KIKUCHI, Naoya HIRAKAWA, Yasuhiro KAKAZU, Yuichi SEGAWA, Tor ...
    2008 Volume 54 Issue 4 Pages 212-216
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    This report presents a rare case of sinonasal hemangiopericytoma in a 46-year-old female. She came to the hospital complaining of a nasal obstruction which was diagnosed to be a benign nasal tumor of vascular origin and she was thereafter carefully observed for 4 years. The patient underwent surgical treatment due to an enlargement of tumor. She underwent a lateral rhinotomy after embolization of the feeder artery. The histopathological examination of the surgical specimens revealed a sinonasal hemangiopericytoma of low grade malignancy. The patient has been asymptomatic without any evidence of recurrence after 6 months of postoperative observation. Immediate surgery should therefore be considered for any tumor of vascular origin to determine its possible malignancy.
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  • Ryunosuke KOGO, Hideki SHIRATSUCHI, Junichi FUKUSHIMA, Naoya HIRAKAWA, ...
    2008 Volume 54 Issue 4 Pages 217-221
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
    Intraoral malignant minor salivary gland tumors are relatively rare, but minor salivary gland tumors in adolescents are extremely rare. This report describes the case of an acinic cell carcinoma occurring in an adolescent. The patient was a 9-year-old boy who became aware of a tumor on the anterior floor of his mouth and had a checkup in this department. A benign tumor was suspected because of the clinical course and the imaging results the tumor was initially enucleated surgically. The pathological diagnosis of the resected tumor was an acinic cell carcinoma and additional tissue was resected. After the second operation the margin was pathologically negative, so the patient was observed in the outpatient department without either chemotherapy or radiation. An acinic cell carcinoma is generallyt hought to be a low grade tumor in the salivary gland tumor, but it is pathologically categorized into three grades. An intraoral tumor in the minor salivary gland tumor is very rare, and there is no uniform treatment and this patient will require a careful follow-up in the future.
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  • [in Japanese]
    2008 Volume 54 Issue 4 Pages 222-225
    Published: July 20, 2008
    Released on J-STAGE: May 10, 2013
    JOURNAL FREE ACCESS
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