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Primary hepatic neuroendocrine neoplasm diagnosed by somatostatin receptor scintigraphy:A case report

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World Journal of Clinical Cases 2022年第7期10卷 2222-2228页

作者： Miho Akabane Yuta Kobayashi Keiichi Kinowaki Satoshi Okubo Junichi Shindoh masaji hashimoto Division of Hepatobiliary-pancreatic Surgery Department of Gastroenterological SurgeryToranomon HospitalTokyo 105-8470Japan Department of Diagnostic Pathology Toranomon HospitalTokyo 105-8470Japan

BACKGROUND Primary hepatic neuroendocrine neoplasm(NEN)is a rare condition,and it is difficult to differentiate between primary and metastatic hepatic ***,we report a case of primary hepatic NEN that initially mimicked a hemangioma but showed a gradual increase in size on long-term careful *** SUMMARY A 47-year-old woman was incidentally diagnosed with a 12-mm liver mass,suspected to be a *** then,regular follow-up had been carried *** years later,she was referred to our institute due to the tumor(located in segment 4)having increased to 20 *** imaging studies depicted no apparent extrahepatic *** emission tomography(PET)/computed tomography exhibited significant accumulation in the mass lesion,which made us consider the possibility of *** hepatectomy was *** histopathological diagnosis was neuroendocrine tumor grade 2,with somatostatin receptor 2 a/5 *** somatostatin receptor scintigraphy(SRS)showed no other site,leading to the diagnosis of NEN of primary hepatic *** gradual growth of the hepatic NEN over 10 years suggested that it was likely to be a primary liver *** In this case,positivity on PET and postoperative SRS may have helped determine whether the tumor was primary or metastatic.

关键词： Hepatic neoplasm Scintigraphy Surgery Positron-emission tomography Clinical decision-making Case report

Right hepatectomy for giant cavernous hemangioma with diffuse hemangiomatosis around Glisson's capsule

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World Journal of Gastroenterology 2014年第25期20卷 8312-8316页

作者： Yu Ohkura masaji hashimoto Seigi Lee Kazunari Sasaki Masamichi Matsuda Goro Watanabe Department of Digestive Surgery Hepato Pancreato Billiary Surgery UnitToranomon HospitalTokyo 105-8470Japan

Diffuse liver hemangiomatosis with giant cavernous hemangioma in adult is extremely rare. A 35 year-old woman presented to hospital with main complaint of epigastric pain and abdominal fullness. An enhanced computed tomography scan revealed a massive liver tumor in right lobe about 150 mm in size. There was contrast enhancement at the periphery of the mass consistent with a cavernous hemangioma. She underwent right hepatectomy. Histologically, it was diagnosed as a cavernous hemangioma. And also, hemangiomatous lesions were scattered around the Glisson’s capsule on the back ground liver. These hemangiomatous lesions were not recognized preoperatively. Even if we couldn’t diagnose hemangiomatosis around the main giant hemangioma preoperatively, we need to take enough surgical margins because the giant hemangioma has the potential to have small hemangiomatous lesions around the tumor. We reported right hepatectomy for giant cavernous hemangioma with diffuse hepatic hemangiomatosis without an extrahepatic lesion in an adult.

关键词： Giant cavernous hemangioma Hemangiomatosis Right hepatectomy Around Glisson’ s capsule Surgery

Solid pseudopapillary neoplasm of the pancreas in a young male with main pancreatic duct dilatation: A case report

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World Journal of Clinical Cases 2021年第36期9卷 11382-11391页

作者： Saki Nakashima Yoshiki Sato Tsunao Imamura Daisuke Hattori Tetsuo Tamura Rikako Koyama Junichiro Sato Yuta Kobayashi masaji hashimoto Department of Neurology The University of Tokyo HospitalBunkyo-ku 113-8655TokyoJapan Department of Gastroenterology Toranomon HospitalTokyo 105-0001Japan Department of Pathology Toranomon HospitalTokyo 105-0001Japan Department of Gastrointestinal Surgery Toranomon HospitalTokyo 105-0001Japan

BACKGROUND Solid pseudopapillary neoplasms(SPNs)are rare tumors of the ***,they occur in young females,often have characteristic imaging features,such as cystic components and calcification,and have few effects on the pancreatic *** SUMMARY A 31-year-old man was admitted to our hospital with the chief complaint of epigastric *** was only mild tenderness in his upper abdomen,and blood tests showed only a slight increase in alkaline ***-enhanced computed tomography showed a 40-mm-diameter,hypovascular mass in the head of the pancreas,and the main pancreatic duct upstream of the mass was severely *** resonance imaging showed low intensity on T1-weighted images,with high intensity on T2-weighted image in some *** ductal adenocarcinoma was the primary differential *** vein infiltration could not be ruled out,so this case was a candidate for neoadjuvant ***,endoscopic ultrasound-guided fine needle aspiration was performed,and pathological evaluation and immunostaining suggested a diagnosis of ***,pancreatoduodenectomy was *** year after the operation,the patient is alive with no *** Main pancreatic duct dilatation is usually a finding of suspected pancreatic ***,pancreatic duct dilatation can occur in SPN depending on the location and growth ***,SPN should be considered in the differential diagnosis of tumors with pancreatic duct dilatation,and pathological evaluation by endoscopic ultrasound-guided fine needle aspiration should be actively performed.

关键词： Solid pseudopapillary neoplasm Endoscopic ultrasound-guided fine-needle aspiration Main pancreatic duct dilatation Male Case report

A specific gene-expression signature quantifies the degree of hepatic fibrosis in patients with chronic liver disease

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World Journal of Gastroenterology 2007年第3期13卷 383-390页

作者： Tohru Utsunomiya Masahiro Okamoto Shigeki Wakiyama masaji hashimoto Kengo Fukuzawa Takahiro Ezaki Shinichi Aishima Yasuji Yoshikawa Taizo Hanai Hiroshi Inoue Graham F Barnard Masaki Mori Department of Molecular and Surgical Oncology Medical Institute of Bioregulation Kyushu University Beppu Japan Department of Surgery Iizuka Hospital Iizuka Japan Department of Digestive Surgery Toranomon Hospital and Okinaka Memorial Institute for Medical Research Tokyo Japan Department of Surgery Oita Red Cross Hos-pital Oita Japan Department of Surgery Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital Hiroshima Japan Department of Anatomic pathology Graduate School of Medical Sciences Kyushu University Fukuoka Japan Department of Pathology Medical Institute of Bioregulation Kyushu University Beppu Japan Laboratory for Bioinformatics Graduate School of Systems Life Sciences Kyushu University Fukuoka Japan Division of Gastroenterology University of Massachusetts Medical School Worcester MA United States

AIM： To study a more accurate quantification of hepatic fibrosis which would provide dinically useful information for monitoring the progression of chronic liver disease. METHODS： Using a cDNA microarray containing over 22000 clones, we analyzed the gene-expression profiles of non-cancerous liver in 74 patients who underwent hepatic resection. We calculated the ratio of azanstained： total area, and determined the morphologic fibrosis index （MFI）, as a mean of 9 section-images. We used the MFI as a reference standard to evaluate our method for assessing liver fibrosis. RESULTS： We identified 39 genes that collectively showed a good correlation （r 〉 0.50） between geneexpression and the severity of liver fibrosis. Many of the identified genes were involved in immune responses and cell signaling. To quantify the extent of liver fibrosis, we developed a new genetic fibrosis index （GFI） based on gene-expression profiling of 4 clones using a linear support vector regression analysis. This technique, based on a supervised learning analysis, correctly quantified the various degrees of fibrosis in both 74 training samples （r = 0.76, 2.2% vs 2.8%, P 〈 0.0001） and 12 independent additional test samples （r = 0.75, 9.8% vs 8.6%, P 〈 0.005）. It was far better in assessing liver fibrosis than blood markers such as prothrombin time （r = -0.53）, type IV collagen 7s （r = 0.48）, hyaluronic acid （r = 0.41）, and aspartate aminotransferase to platelets ratio index （APRI）（r = 0.38）. CONCLUSION： Our cDNA microarray-based strategy may help clinicians to precisely and objectively monitor the severity of liver fibrosis.

关键词： Uver fibrosis Hepatitis virus DNA microarray Supervised learning analysis Scoring system

Liver resection for hepatocellular carcinoma using a microwave tissue coagulator: Experience of 1118 cases

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World Journal of Gastroenterology 2015年第36期21卷 10400-10408页

作者： Kazunari Sasaki Masamichi Matsuda masaji hashimoto Goro Watanabe Department of Digestive Surgery Hepato-pancreatobiliary Surgery UnitToranomon Hospital

A I M : To present our extensive experience of hepatectomy for hepatocellular carcinoma using a microwave tissue coagulator to demonstrate the effectiveness of this device. METHODS: A total of 1118 cases(1990-2013) were reviewed,with an emphasis on intraoperative blood loss,postoperative bile leakage and fluid/abscess formation,and adaptability to anatomical resection and hepatectomy with hilar ***: The median intraoperative blood loss was 250 m L; postoperative bile leakage and fluid/abscess formation were seen in 3.0% and 3.3% of cases,respectively. Anatomical resection was performed in 275 cases,including 103 cases of hilar dissection that required application of microwave coagulation near the hepatic hilum. There was no clinically relevant biliary tract stricture or any vascular problems due to heat injury. Regarding the influence of cirrhosis on intraoperative blood loss,no significant difference was seen between cirrhotic and non-cirrhotic patients(P = 0.38),although cirrhotic patients tended to have smaller tumors and underwent less invasive operations. CONCLUSION: This study demonstrated outcomes of an extensive experience of hepatectomy using heat coagulative necrosis by microwave tissue coagulator.

关键词： Hepatectomy Hepatocellular carcinoma Microwave Mic

Surgical approach for hepatitis C virus-related hepatocellular carcinoma

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World Journal of Hepatology 2015年第1期7卷 70-77页

作者： Junichi Shindoh masaji hashimoto Goro Watanabe Hepatobiliary-pancreatic Surgery Division Department of Digestive SurgeryToranomon HospitalTokyo 105-8470Japan Okinaka Memorial Research Center for Adult Diseases Tokyo 105-8470Japan

Hepatitis C is a strong prognostic factor for patients with hepatocellular carcinoma(HCC). Although liver resection and liver transplantation offer the chance of a cure for HCC,adequate management of co-existing infection with hepatitis C virus(HCV) is important to enable better long-term outcomes after surgery for HCV-related HCC. For patients undergoing liver resection,perioperative anti-viral treatment is recommended,since a decreased HCV viral load itself is reportedly associated with a lower tumor recurrence rate and a longer overall survival. For patients undergoing transplanatations for HCC complicated by end-stage liver disease,the post-transplant management of HCV infection is also necessary to prevent progressive graft injury caused by active hepatitis under the immunosuppressive condition that is needed after liver transplantation. Although only a few lines of solid evidence are available for postoperative antiviral treatment because of the limited indication and frequent adverse events caused by conventional high-dose combination interferon therapy,new direct acting anti-viral agents would enable interferon-free anti-viral treatment with a higher virologic response and minimal side effects.

关键词： Hepatocellular carcinoma Hepatitis C Liverresection Liver transplantation Adjuvant therapy

Retroperitoneal cavernous hemangioma resected by a pylorus preserving pancreaticoduodenectomy

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World Journal of Gastroenterology 2013年第28期19卷 4624-4629页

作者： Marie Hanaoka masaji hashimoto Kazunari Sasaki Masamichi Matsuda Takeshi Fujii Kenichi Ohashi Goro Watanabe Department of Digestive Surgery Toranomon Hospital Tokyo 105-8470 Japan Department of Pathology Toranomon Hospital Tokyo 105-8470 Japan Department of Pathology Yokohama City University Graduate School of Medicine Kanagawa 236-0004 Japan

A retroperitoneal hemangioma is a rare disease. We report on the diagnosis and treatment of a retroperitoneal hemangioma which had uncommonly invaded into both the pancreas and duodenum, thus requiring a pylorus preserving pancreaticoduodenectomy (PpPD). A 36-year-old man presented to our hospital with abdominal pain. An enhanced computed tomography scan without contrast enhancement revealed a 12 cm × 9 cm mass between the pancreas head and right kidney. Given the high rate of malignancy associated with retroperitoneal tumors, surgical resection was performed. Intraoperatively, the tumor was inseparable from both the duodenum and pancreas and PpPD was performed due to the invasive behavior. Although malignancy was suspected, pathological diagnosis identified the tumor as a retroperitoneal cavernous hemangioma for which surgical resection was the proper diagnostic and therapeutic procedure. Reteoperitoneal cavernous hemangioma is unique in that it is typically separated from the surrounding organs. However, clinicians need to be aware of the possibility of a case, such as this, which has invaded into the surrounding organs despite its benign etiology. From this case, we recommend that combined resection of inseparable organs should be performed if the mass has invaded into other tissues due to the hazardous nature of local recurrence. In summary, this report is the first to describe a case of retroperitoneal hemangioma that had uniquely invaded into surrounding organs and was treated with PpPD.

关键词： Retroperitoneal tumor Retroperitoneal cavernous hemangioma Cavernous hemangioma Pancreaticoduodenectomy Pylorus preserving pancreaticoduodenectomy