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Ichiro Sugimoto, Takashi Ishino, Sachio Takeno, Masaya Takumida, Katsu ...
2006 Volume 2006 Issue Supplement117 Pages
1-6
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Many reports demonstrated that some histological changes occurred in paranasal sinus bones in acute and/or chronic sinusitis, but only a few authors discussed the metabolic mechanisms of these changes. Recently, it has been reported in other fields, such as orthopedics, that stimulating osteoblasts with both Vitamin D
3 and K
2 improved bone metabolisms.
In this study, we investigate metabolic mechanisms of paranasal sinus bones in chronic sinusitis by stimulating osteoblasts with Vitamin D
3, Vitamin K
2 and warfarin, which is an antagonist of Vitamin K
2.
Stimulation with both Vitamin D
3 and K
2 increased mineralization ability, osteocalcin concentrations and alkaline phosphatase activities, and the addition of warfarin to Vitamin D
3 and K
2 decreased these effects in cultured osteoblasts. Our study demonstrates that these agents may regulate the metabolism of human paranasal sinus bones, and that using these agents in therapies for sinusitis might lead to further improve of treatment effects.
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Masaya Takumida, Katsuhiro Hirakawa, Koji Yajin
2006 Volume 2006 Issue Supplement117 Pages
7-11
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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To review the literature relating to intratympanic gentamicin injection therapy for Meniere's disease to detect consistencies and differences that might suggest optimal technique. Twenty-seven papers from the literature regarding clinical experience with intratympanic gentamicin injections for treatment of Meniere's disease were reviewed and tabulated. All papers reported high success rate in treating episodic vertigo of Meniere's disease, but technique, dose, duration, and treatment philosophy varied considerably. Hearing loss was typically reported in about 26% of patients. Based on our review, a titration protocol may be most suitable. The dose should be less than 10 mg at each administration and total dose should be less than 50 mg.
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Kazumasa Takeda, Sachio Takeno, Katsuhiro Hirakawa, Koji Yajin
2006 Volume 2006 Issue Supplement117 Pages
12-15
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We evaluated hearing improvement of 81 cases who underwent surgical treatment for middle ear cholesteatoma between July 1997 and December 2003. The post-operative follow-up periods were no less than 6 months after final ossicular reconstruction in all cases. We classified surgical results to be successful when the postoperative hearing level met at least one of three conditions: 1) air-bone gap was less than 20 dB,2) hearing levels were above 30 dB, or 3) hearing gain was more than 15 dB according to the guidelines in middle ear and mastoid surgery (Otology Japan 11,2001). In most cases, the canal wall down method with canal reconstruction was employed and autologaus auricular cartilage was used for ossicular reconstruction. The overall success rate was 74% (60 out of 81 cases). Single staged tympanoplasty was performed in 39 cases and the success rate was 69% (27 out of 39 cases). Programmed staged tympanoplasty was performed in 42 cases and the success rate was 78% (33 out of 42 cases). Tympanoplasty type III was most frequently employed for ossicular chain reconstruction and the success rate was 85%.
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Atsushi Hisayuki, Kazumasa Takeda, Takao Hamamoto, Takashi Ishino, Sac ...
2006 Volume 2006 Issue Supplement117 Pages
16-20
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We reviewed 24 cases of maxillary carcinoma who were treated at the Department of Otolaryngology, Hiroshima University Hospital between 1993 and 2002. They were 18 males and 6 females and their ages ranged from 32 to 88 years old. The overall three-year and five-year survival rates were 49.3% and 43.8%, respectively. According to the UICC classification system (1987), one patient was classified in Stage II,5 were in Stage III, and 18 were in Stage IV. The five-year survival rates were 60.0% in Stage III and 42.0% in Stage IV. We assume that relative increase in number of patients in advanced stages may account for reduced survival rates observed in this study as compared with the previous report in 1994.
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a 10-year survey
Tsuyoshi Okubo, Katsushi Sato, Hidemasa Ishii, Takaharu Tatsukawa, Mas ...
2006 Volume 2006 Issue Supplement117 Pages
21-27
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We reviewed 17 consecutive patients with nasopharyngeal carcinoma treated at our hospital between 1993 and 2004. The male to female ratio was 13: 4. The most frequent chief complaint was cervical mass. Most of the patients were classified stages III or IV.
The overall 5-year survival rate was 67.8 % (Kaplan-Meier method). An improvement was shown compared with a past data for our department (51.3%).
When investigating according to the method of treatment, one patient was treated by radiotherapy alone, five were treated by neoadjuvant chemotherapy, eight were treated by neoadjuvant chemotherapy and adjuvant chemotherapy, three were treated by concurrent hemoradiotherapy and adjuvant chemotherapy.
The results according to the method of treatment showed no significant differences.
We conclude that Type I of the WHO classification and N3 of the TNM classification are the poor prognostic factors.
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Keishin Go, Masaaki Hajima, Atsushi Hisayuki, Takaharu Tatsukawa, Kats ...
2006 Volume 2006 Issue Supplement117 Pages
28-35
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We report a clinical study of 60 patients with tongue carcinoma initially treated at Hiroshima University Hospital between 1993 and 2002. The overall 5 year survival rate was 81% (Stage I; 93%, Stage II; 84%, Stage III; 90%, Stage IV; 50%). This paper shows that the control the cervical lymph node metastasis is an important factor for better prognosis and that external irradiation is an effective adjuvant therapy to control cervical lymph node metastasis.
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Yasuyuki Nishi, Shin Masuda, Tsuyosi Okubo, Hidemasa Ishii, Takaharu T ...
2006 Volume 2006 Issue Supplement117 Pages
36-45
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Ninety-seven cases of laryngeal cancer, who had been treated at our department between 1994 and 2003, were investigated retrospectively. Of these patients,56 cases were glottis type,31 epiglottic type,3 subglottic type, and 7 transglottic type. The five-year survival rates were overall; 85.4%, stage I 95.0%, stage II 90.6%, stage III 81.9%, stage IV 66.9%. The five-year organ preservation rates for T1 to T4 were 91.9%,67.9%,29.3%, and 18.2% respectively. The present study also included 30 cases with multiple primary cancer, and 11 cases who died of cancers other than laryngeal cancer.
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Yosuke Nakashimo, Sachio Takeno, Rika Osada, Hidemasa Ishii, Katsuhiro ...
2006 Volume 2006 Issue Supplement117 Pages
46-53
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We reviewed 133 cases of major salivary gland tumors treated in our department during the past 10years and investigated the accuracy and diagnostic impact of preoperative radiological examination. Of the 133 cases,110 were originated from the parotid gland and 23 were from the submandibular gland. According to the WHO classifications (1991), the most common benign tumor both in the parotid and the submandibular glands was pleomorphic adenoma, followed by Warthin's tumor. Mucoepidermoid carcinoma was the most common malignant tumor in both glands, followed by adenocarcinoma and adenoid cystic carcinoma.
A combination of preoperative examination including CT, MRI, ultrasound echography, radioisotope imaging, and fine needle aspiration biopsy proved to be useful in making decisions about therapeutic plan. Surgery alone was performed in all benign tumor cases who accepted the indication. Surgical treatment modalities for the malignant tumors included lobectomy, total parotidectomy, and neck dissection for cervical lymph node metastasis. Postoperative radiotherapy and adjuvant chemotherapy were performed in some cases. Regarding the survival rate in malignant cases, all patients of stage I (n=14), II (n=3), and III (n=2) are alive, but 4 out of 9 patients of stage IV died. We experienced 37 cases (27.8%) of facial palsy,2 cases of salivary fistula and 4 cases of Frey's syndrome.34 cases (91.8%) of facial palsy were transient.
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Kazuhiro Iwata, Ichiro Sugimoto, Atushi Hisayuki, Takaharu Tatsukawa, ...
2006 Volume 2006 Issue Supplement117 Pages
54-59
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Seventy-seven patients with thyroid tumors were treated at Hiroshima University Hospital between 1992 and 2001. There were 31 patients with benign tumor, and 46 patients with malignant tumor. Echography, CT and/or MRI were done in most patients. Pathologically, papillary and follicular adenocarcinoma, and undifferentiated carcinoma were diagnosed in 39,1, and 4 patients respectively. Thyroid lobectomy was carried out mostly in benign and malignant tumors. Neck dissection including Dl was performed in most patients. In 7 cases, recurrence occurred. The ten-year survival rate was 95.2% in papillary adenocarcinoma.4 patients were diagnosed with undifferentiated carcinoma, and chemotherapy, radiation therapy, and operation were performed, but they died within a year.
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Marin Miyasato, Katsushi Sato, Sachio Takeno, Tomoyuki Ogawa, Atsushi ...
2006 Volume 2006 Issue Supplement117 Pages
60-65
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Endoscopic sinus surgery (ESS) achieves favorable results in the treatment of chronic sinusitis and has become the initial operative procedure. We examined surgical effects of ESS obtained from 90 patients who were treated in the department hospital. The patients were subdivided into four groups categorized by the existence of allergic rhinitis, asthma, and eosinophil infiltration. Preoperative and postoperative assessment was done and the severity of the disease was scored according to CT scanning and endoscopic nasal findings. Furthermore, we investigated whether the use of low dose macrolide, mucolytic agents, antihistamines, and antileukotrienes may improve postoperative nasal findings and prevent relapse of nasal polyps.
Patients with high eosinophil infiltration showed significant increase in preoperative CT scores and those with allergic rhinitis or asthma showed higher endoscopic nasal scores. After surgery,82% of the whole patients obtained satisfactory improvement of endoscopic nasal scores, whereas the proportion was reduced to 59% in the asthmatic group. Asthmatic patients generally showed reactive and unstable sinus mucosa with high eosinophil infiltration particularly in their ethmoid cells. The combination of antihistamines and antileukotrienes used as postoperative medical treatment significantly reduced endoscopic nasal scores both in allergic rhinitis and in eosinophil infiltration. These findings substantiate the fact that eosinophil infiltration with or without allergy plays a pivotal role in the persistent inflammation occurring in non-infectious chronic sinusitis. A new set of medical therapies including antihistamines, antileukotrienes, and corticosteroids as potent anti-inflammatory agents should be considered to obtain symptomatic and objective relief from the disease after sinus surgery.
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Tsuyoshi Okubo, Takaharu Tatsukawa, Katsuhiro Hirakawa, Koji Yajin
2006 Volume 2006 Issue Supplement117 Pages
66-70
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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For severe obstructive sleep apnea-hypopnea syndrome (OSAHS), nasal continuous positive airway pressure (n-CPAP) treatment is the most effective method. For mild or moderate OSAHS, it was reported that oral appliance (OA) therapy is effective. However, because of nasal obstruction, some people dropped out from n-CPAP, and some people could not use OA.
Twenty-five patients with OSAHS were treated with conservative management. The average of the apnea-hypopnea index before management was 43.24, after the conservative management, the average was decreased to 26.22.
It seemed therefore that conservative management for OSAHS was an option, and that it was important to consider the state of the nasal mucosa in diagnosis and treatment of OSAHS.
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Keiji Ishihara, Takaharu Tatsukawa, Katsuhiro Hirakawa, Koji Yajin
2006 Volume 2006 Issue Supplement117 Pages
71-76
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We reviewed 87 cases of dysosmia treated at the Department of Otolaryngology, Hiroshima University Hospital during the five years and five months from May 1998 to October 2003. Of the 87 patients,34 were male and 53 female. The ages of the patients ranged from 12 to 83 years, with a mean age of 56.3 years. Distribution of the diseases causing dysosmia was as follows: 32 cases of viral infection,15of sinusitis,8 of head trauma,6 of allergic rhinitis,3 drug-induced and 32 of unknown origin.
Treatment was mainly based on a topical nose drop with triamcinolone acetonide or 0.15 % betamethasone.
The improvement rate analysed revealis complete recovery in 9.2%, improvement in 33.3%, slightly improvement in 41.3% and no change in 16.2%.
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Shin Masuda, Yuka Ueda, Yoshie Ichioka, Mai Yoshioka, Kazuhiro Iwata, ...
2006 Volume 2006 Issue Supplement117 Pages
77-82
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Cochlear implants require periodic adjustments of their speech processing program. The present study investigated the necessity and frequency of adjustment of the cochlear implant speech processing program in adult patients. Subjects were 19 adult patients who underwent cochlear implantation at our department and had worn the implant continuously for more than one year. A cochlear implant manufactured by Cochlear Ltd. was used in all patients: the Nucleus 22 system in 13 patients, and the Nucleus 24 system in 6 patients. Excluding adjustments made within the first month of implantation, adjustment of the speech processing program, i. e., MAPping, was performed a total of 860 times. Changes in MAP within the past three months or previously were classified as those performed to improve hearing or to alleviate adverse effects (uncomfortable noisy sensation, dizziness, earache and headache). The results were analyzed in relation to patient age at the time of surgery and hearing performance. The study showed that when MAPping was performed frequently to reduce noise, patients often experienced dizziness, earache or headache. If a patient experiences an adverse effect, while MAP might need to be adjusted, this could also worsen hearing. However, at our department, MAPping was done to deal with adverse effects without negatively affecting hearing performance.
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Makoto Shirane, Tsutomu Ueda, Nobuyuki Miyahara, Yasuyuki Nishi
2006 Volume 2006 Issue Supplement117 Pages
83-89
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Chemo-radiotherapy with cisplatin (CDDP) and 5-fluorouracil (5FU) employed as a first-line treatment was evaluated in fifty patients with head and neck squamous cell carcinoma from 1996 to 2001. Thirteen patients were in stage 1/II and thirty-seven patients were in stage III/IV. Forty-one patients had resectable disease and nine patients had un-resectable disease. An average of 1.6 cycles of chemotherapy consisting of 5FU,600 mg/m2 by continuous infusion on days 1 to 5 and CDDP,60∼70 mg/m
2/day on day 4 were applied. Conventional radiotherapy with a daily dose of 2 Gy was administered concurrently and sequentially in thirty-six and three patients respectively to a total dose of 60 Gy. The remaining eleven patients, all of whom had tongue carcinoma, underwent brachytherapy (either Au-198 grain or Radium-226 needle) following CDDP/5FU chemotherapy. The overall response rate to chemo-radiotherapy was 96%, with 82% complete and 14% partial response rates. With a median follow-up of 48 months, the disease specific 5-year survival and organ preservation rates were 69% and 74% for all patients,79% and 81% for patients with concurrent chemo-radiotherapy and 62% and 57% for patients with neo-adjuvant chemo-radiotherapy respectively. Fifteen patients had loco-regional recurrences at a mean time of 7.6months and four patients who were loco-regionally controlled developed distant metastasis at a mean time of 18 months after chemo-radiotherapy. Even though there was no statistically significant difference, the concurrent chemo-radiotherapy tended to achieve better outcomes compared to the neo-adjuvant one in both the survival and the organ preservation rates. On the other hand, there was no difference between the concurrent and neo-adjuvant chemo-radiotherapy in the incidence of distant metastasis. For the improvement of survival rate in advanced head and neck squamous cell carcinoma, the control of distant metastasis as well as the loco-regional recurrence is indispensable and effective adjuvant chemotherapy should be introduced following first-line chemo-radiotherapy.
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Tsutomu Ueda, Makoto Shirane, Nobuyuki Miyahara
2006 Volume 2006 Issue Supplement117 Pages
90-95
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We report a case of pulmonary metastases of oropharyngeal cancer that responded well to chemotherapy using TS-1. The patient was a 58-year-old man who underwent concurrent chemoradiotherpy consisting of 2 courses of chemotherapy and radiation therapy at 60 Gy as first-line therapy for oropharyngeal cancer (T
2N
2bM
20, stage IVa). The primary tumor and the metastatic lesions in cervical lymph nodes showed a complete response. Four months later, multiple metastases to the lung were noted, for which TS-1 was administered. One course consisted of consecutive administration of TS-1 for 28 days and withdrawal for 14 days. After the completion of 3 courses, the pulmonary metastases could not be detected in chest radiographs. Although there were recurrences of the pulmonary and liver metastases after 5and 2 courses of treatment respectively, medication could be continued for 18 months following the occurrence of the pulmonary metastases. Adverse effects were limited to mild anorexia and no hospitalization was required during the TS-1 treatment. It is suggested that the administration of TS-1 enhanced both the survival time and the quality of life in this patient.
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Clinical Significance of the Abscesses Caused by Streptococcus milleri Group
Tomohisa Hirai, Shinji Kimura, Naoki Mori, Hiroshi Hidaka
2006 Volume 2006 Issue Supplement117 Pages
96-101
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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A retrospective review of 31 patients diagnosed with head and neck abscesses at Onomichi General Hospital, Hiroshima, between April 2001 and September 2003 was performed. The patient median age was 55 years (age range,17-80 years). There were 18 males and 13 females. We divided the 31 patients into three groups by the sites of abscesses;“peritonsillar lesion”group (n=10),“deep neck”group (n=6) and“other sites”group (n=15). The majority of deteriorated cases belonged to the “deep neck infection”group. There were 27 cases with discharge from infectious sites. The predominant organisms isolated from these 27 specimens were of the
Streptococcus milleri group (n=11). Four cases had infections by SMG mixed with anaerobes Five cases had undergone deteriorated course, which had necessitated emergency intratracheal intubations and/or repeated surgical drainages. Three of these were infections by SMG with anaerobes. There was a deteriorated case with gas gangrene unresponsive to repeated surgical drainage and intravenous antibiotic therapy. Finally hyperbaric oxygen therapy improved the condition.
Streptococcus milleri group (SMG) comprises organisms which are common inhabitants of the mouth and gastrointestinal tract. They can be aggressive pathogens and cause abscess formation in various sites of the body, but have rarely been listed as causes of head and neck infections. We describe the clinical features and management of SMG in head and neck infections. It is important to recognize SMG as a pathogen of head and neck infection. In addition, we should be aware that the infectious diseases caused by SMG with anaerobes can deteriorate rapidly.
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Mamoru Fujii
2006 Volume 2006 Issue Supplement117 Pages
102-105
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Canalith repositioning procedures (CRPs) are a widely recognized effective method for the treatment of benign paroxysmal positional vertigo (BPPV), however, there still remain recurrent cases after these therapies.
In this series, recurrence rate was 10% (8/80) in posterior type BPPV,14.6% (7/78) in lateral type BPPV. Recurrences were observed three times or more in 4 of the cases of lateral type BPPV. The major parts of recurrent episodes (16/21=76.2 %) occurred in the same side of the same canal. From these findings, it was supposed that the recurrence of BPPV, especially that which occurred in the same canal, was caused by particles which were not only originally attached to the surface of the utricular macula but also were originally attached to the surface of the vestibular dark cells of the canals, and these particles (probably the degenerated otoconia) were affected by the metabolic changes of the canals and had the tendency of releasing from the surface of the dark cells.
For preventing recurrence and for future treatment of non-responders to CRPs, further research must be done to analyze precisely the mineral metabolism of the micro-environment of the canal.
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Kazuhiro Iwata, Tomoyuki Ogawa, Tuyoshi Okubo, Katsushi Sato, Shin Mas ...
2006 Volume 2006 Issue Supplement117 Pages
106-110
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We reported a case of oxyphilic cell tumor of the thyroid gland. A 30-year-old female consulted our hospital with a neck tumor. Echography revealed a tumor in the right lobe of the thyroid. The thyroglobulin value was high. The tumor in the right lobe and isthmus was resected. Pathological examination confirmed the diagnosis of oxyphilic cell adenoma of the thyroid gland.
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Shin Masuda, Shoji Mihara, Tomoyuki Ogawa, Hidemasa Ishii, Yoshie Ichi ...
2006 Volume 2006 Issue Supplement117 Pages
111-114
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Dermatomyositis is an autoimmune disease characterized by symmetric muscular weakness of the proximal extremities and characteristic eruptions. We encountered a 17-year-old female patient in whom dermatomyositis presented with dysphagia. She experienced a sensation of ear blockage, pharyngeal discomfort and an articulation disorder. The articulation disorder gradually deteriorated and swallowing was also affected. A fiberscopic study confirmed dysphagia accompanied by characteristically impaired pharyngeal clearance of bolus, suggesting dermatomyositis. However, the diagnosis could not be confirmed due to the absence of physical findings indicating myositis and skin eruptions. After a period of remission, Gottron's sign and interstitial pneumonia were confirmed. The patient was therefore diagnosed with dermatomyositis at this stage, a period of 15 months from onset.
The present case illustrates that the disorder m a y be difficult to diagnose as dermatomyositis. It is important to conduct long-term follow-up of patients with deteriorating articulation disorder or swallowing disorder, even when myositis or skin eruptions are absent.
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Tomohisa Hirai, Shinji Kimura, Naoki Mori, Hiroshi Hidaka
2006 Volume 2006 Issue Supplement117 Pages
115-117
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Some researchers reported that the feeding method with repeated insertions of naso-gastric tubes was useful for the patients with dysphagia. A study was conducted to evaluate the efficacy of this swallowing exercise for patients with dysphagia caused by cerebral infarction or bleeding. Between January 2002 and March 2003, we applied this method to 7 stroke patients with dysphagia. The patient median age was 67 years (age range,57-82 years). There were 5 males and 2 females. Eventually, all 7 patients were able to eat orally. The feeding method with repeated insertions of naso-gastric tubes was considered to be useful for stroke patients with dysphagia.
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Approach from the Anterior Side of a Tonsil
Tomohisa Hirai, Shinji Kimura
2006 Volume 2006 Issue Supplement117 Pages
118-121
Published: January 20, 2006
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A new method of tonsillectomy is proposed. In general, tonsillectomy is performed by approaching from the upper side of a tonsil and completed by ligature of the inferior side of it. The new method is as follows: tonsillectomy is approached from the anterior side to the posterior side of a tonsil. This method, has some advantages in facilitating tonsillectomy and reducing such complications as hemorrhage and hypogeusia.
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Noriaki Tanimitsu, Nobuharu Tagashira, Yoshie Horibe, Yosuke Nakashimo ...
2006 Volume 2006 Issue Supplement117 Pages
122-125
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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A rare case of malignant lymphoma arising in the paranasal sinuses with orbital apex syndrome is reported. The patient was a 52-year-old women with a complaint of headache, double vision and pain in her eye. CT scans showed a slightly hyperdense shadow in the bilateral ethmoid and sphenoid sinuses with slight ring enhancement, but neither bone destruction nor mass was seen in the paranasal sinuses. We therefore diagnosed sinusitis with orbital apex syndrome and endoscopic sinus surgery was done as an emergency procedure to decompress the bilateral ethmoid and sphenoid sinuses. The histological diagnosis was malignant lymphoma of the diffuse large B cell type. The patient was treated by chemotherapy at the blood internal department and the clinical symptoms of her eye have now improved. Distinguishing between malignant lymphoma in paranasal sinuses and sinusitis on diagnostic images is difficult, so it is thought that surgical treatment for biopsy should be performed immediately.
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Nobuyuki Miyahara, Makoto Shirane, Tsutomu Ueda
2006 Volume 2006 Issue Supplement117 Pages
126-129
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Varicella-zoster virus often causes not only vesicles, but also facial and vestibular nerve paralysis (Ramsay Hunt syndrome). This syndrome can affect other cranial nerves. We report a case of unilateral palsy of the V, VII, IX, and X cranial nerves due to varicella-zoster virus infection.
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Masakiyo Takeda, Akira Nagasawa, Naoki Hayashi
2006 Volume 2006 Issue Supplement117 Pages
130-134
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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Myoepithelioma is a rare tumor, mainly arising in the salivary gland. We report a case of myoepithelioma of the nasal septum, provide a comprehensive review of the 10 myoepitheliomas of the nasal cavity described in the literature, and discuss the histopathological features of the tumor. A 63-year-old man consulted our clinic with a smooth mass his on left nasal septum, measuring 1.5 cm in diameter. He experienced a 4-month history of a few minor episodes of epistaxis but no pain. The surgical treatment was successfully performed and the patient has no sign of recurrence to date at 10 months' follow-up. The tumor consisted of a solid growth of plasmacytoid cells. Positive strainings for S-100 protein, cytokeratin, and smooth muscle actin were found to be useful adjuncts to diagnosis. In the literature, the 10 myoepitheliomas of the nasal cavity occurred in individuals from 29 to 69 years of age,9 cases affected females, and most presented epistaxis (in 7 tumors).
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Takashi Satoh, Nobuharu Tagashira, Yoshie Horibe, Tohru Tanigawa, Yosh ...
2006 Volume 2006 Issue Supplement117 Pages
135-139
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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We report a case in which FDG-PET was useful in detecting the primary lesion in carcinoma of unknown primary. The patient was a 53-year-old male with a chief complaint of tumor of the right neck. Visual inspection, palpation, endoscopy, and CT revealed no marked changes in the nasopharynx, oropharynx, or hypopharynx. Carcinoma of unknown primary was strongly suspected from palpation of the neck, CT findings, and high CYFRA level, and FDG-PET was carried out with the aim of identifying the primary lesion. There was significant accumulation of FDG in the right palatine tonsil, and poorly differentiated squamous cell carcinoma, T2N2bMO Stage IV A, was diagnosed from a biopsy of that area.
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Tohru Tanigawa, Hiroyuki Takahashi, Takashi Sato
2006 Volume 2006 Issue Supplement117 Pages
140-142
Published: January 20, 2006
Released on J-STAGE: November 27, 2012
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A 77-year-old man consulted our hospital complaining of discomfort in the throat on September 10,1999. He had diabetes, which was being managed by our hospital. He had no smoking history. By fiberscopic examination, accumulation of yellow sputum was apparent in the lower pharynx. The leukocyte count and C-reactive protein were within normal limits. Suspecting pneumonia lacking systemic inflammatory signs, we performed chest radiography, which disclosed an abnormal shadow in the upper lobe of the right lung. Computed tomography of the chest showed a solitary tumor,35 mm in diameter, in the right S3a segment. Right upper lobectomy was performed under general anesthesia on October 15. The pathologic diagnosis was adenocarcinoma. To our knowledge, lung cancer has not been diagnosed based upon discomfort in the throat, but given our experience, the finding of yellow sputum in the lower pharynx of an elderly patient should be an indication for radiography.
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