Sarcopenia is defined as“age-related loss of skeletal muscle mass and strength”, and has been reported to be a poor prognostic factor in various malignancies. However, the volume of the psoas muscle may be more accurate than the area of the psoas muscle. Thus, the volume of the psoas muscle was measured using 3D-CT and the psoas volume index （PVI） was calculated by the division of the psoas volume by the square of the body height. Thirty patients with metastatic urothelial cancer （18 males and 12 females; mean age, 74.5 years; median follow-up, 10 months） treated with chemotherapy Showa University School of Medicine, Tokyo, Japan, in 2020, were retrospectively studied to determine the impact of sarcopenia on survival after chemotherapy. The patients were divided into two groups: sarcopenia （n＝8） and nonsarcopenia （n＝22） groups. No significant difference in progression-free survival exists between the sarcopenia and the nonsarcopenia groups. However, univariate analysis showed that sarcopenia was associated with poor prognostic factors （P＝0.049）. Moreover, anemia with Hb ＜10 during chemotherapy （P＝0.012） and multivariate analysis showed that anemia with Hb ＜10 during chemotherapy was only associated with poor prognosis （P＝0.029）. Furthermore, the Kaplan-Meier analysis revealed a shorter overall survival in patients with sarcopenia compared with those without （P＝0.049）. The present study suggests that the evaluation of sarcopenia using PVI before chemotherapy may be a useful method to predict the prognosis of patients with metastatic urothelial carcinoma.
Osteomas are benign tumors consisting of mature bone tissue. They occur more frequently in the skull and upper and lower jawbones in the maxillofacial region, but rarely in the maxillary sinus. In this report, we present a case of a 53-year-old woman with an osteoma in the maxillary sinus which was suspected to have arisen because of reactive growth due to chronic inflammatory stimulation of apical periodontitis. The patient had been aware of the mobility of her right upper second molar that had been left unattended. One month previously, she experienced occlusal pain. A panoramic X-ray taken by a local dentist before visiting our department in February 2015 showed a transmission image of the apical part of her right maxillary second molar and an opaque image of her right maxillary sinus. At the first examination, her right maxillary second molar showed mobility and percussion pain, but there was no obvious inflammation in the surrounding gingiva. Computed tomography showed a large （35×29×28 mm） bone-like lesion from the posterior maxillary bone in the right maxillary sinus. There was also a continuous transmission lesion from the apex of the right upper second molar. Under the clinical diagnosis of chronic right maxillary second molar periapical periodontitis and right maxillary tumor, right maxillary second molar extraction and right maxillary tumor resection were performed under general anesthesia in September 2015. Histopathologically, the resected materials showed a lamellar bone consisting of connective tissue covered with multirow ciliated columnar epithelium, mature cancellous bone, and thickened compact bone, which was diagnosed as a cancellous osteoma. To date, five years have passed since the operation, and the patient showed good outcomes with no recurrence.
Most cases of postaxial polydactyly in Japan undergo a primary operation at around the age of 1 year. This time, a metatarsal surgery was performed on a 9-year-old boy who underwent a primary operation for postaxial polydactyly when 1 year old. However, the patient complained of pain when 6 years old due to metatarsal deformity. Polydactyly of the foot is a common congenital malformation of the limbs; however, few metatarsal bone deformities and few reports exist on the appropriate age and surgical method for surgery were reported. This paper reports a case of postaxial polydactyly of the foot whose metatarsal bone deformity was successfully treated by surgery at the age of 9 years.