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A case report of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein tumor embolism

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World Journal of Gastroenterology 2009年第2期15卷 248-251页

作者： Yusuke Tanoue nobutaka tanaka Yoshio Suzuki Shoujirou Hata Aya Yokota Department of General Surgery Asahi General Hospital I-1326 Asahi 289-2511 Chiba Japan Author

We report a case of endocrine cell carcinoma in the sigmoid colon with inferior mesenteric vein （IMV） tumor embolism. A 79-year-old woman was admitted to our hospital with narrowing of the stools. We performed colonoscopy, computed tomography and positron emission tomography, which disclosed sigmoid colon cancer with IMV tumor embolism. She underwent sigmoidectomy and lymph node dissection. The tumor was diagnosed as endocrine cell carcinoma （type 4, pSS, med, INFa, v3, n1, stage Ⅲb）. Immunohistochemically, chromographin A, synaptophysin, cytokeratin 20 and mucicarmine showed partial staining, and CD56 was totally reactive. Three months after operation multiple liver metastases appeared. She was treated with chemotherapy of cisplatin （CDDP）＋ irinotecan （CPT11）. This case highlights the aggressiveness of endocrine cell carcinoma with tumor embolism, and it is essential to establish an accurate diagnosis and effective treatment.

关键词： Enteroendocrine cells Tumor embolism Carcinoid tumor Colon cancer, Cisplatin Irinotecan

Spontaneous rupture of splenic hamartoma in a patient with hepatitis C virus-related cirrhosis and portal hypertension:A case report and review of the literature

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World Journal of Gastroenterology 2006年第13期12卷 2133-2135页

作者： Yasuji Seyama nobutaka tanaka Yoshio Suzuki Motoki Nagai Takatoshi Furuya Yukihiro Nomura Jimpei Ishii Masakazu Nobori Department of Surgery Asahi General Hospital ChibaJapan Department of Pathology Asahi General Hospital ChibaJapan

Spontaneous rupture is a rare complication of splenic hamartoma. A review of the literature revealed only four such cases. To the best of our knowledge, this is the first report of spontaneous rupture of splenic hamartoma associated with liver cirrhosis and portal hypertension. A 53-year-old woman, who was followed up for aortic dissection and hepatitis C virus （HCV）-related liver cirrhosis, was referred with sudden left chest and shoulder pain. An abdominal ultrasound showed intraabdominal bleeding, and computed tomography indicated rupture of a splenic tumor. Emergent splenectomy was carried out. The postoperative course was uneventful, and the patient was discharged on the 13th postoperative day. Pathology revealed the tumor to be a ruptured splenic hamartoma. The non-tumorous splenic parenchyma revealed congestive changes. We consider that the presence of liver cirrhosis and portal hypertension are risk factors for spontaneous rupture of the splenic hamartoma.

关键词： Splenic hamartoma Spontaneous rupture Hepatitis C virus Cirrhosis Portal hypertension

Pancreatic insulinoma combined with glucagon positive cell: A case report

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World Journal of Gastrointestinal Surgery 2013年第3期5卷 68-72页

作者： Suguru Yamashita nobutaka tanaka Michiro Takahashi Motoki Nagai Takatoshi Furuya Yoshio Suzuki Yukihiro Nomura Department of Surgery Asahi General Hospital Department of Surgery Kanto Medical Center NTT EC Department of Pathology Asahi General Hospital

We present a 70-year-old man who was referred for surgery with uncontrollable hypoglycemia. Ultrasonography and abdominal contrast computed tomography revealed a hypervascular tumor of 1 cm in diameter in the pancreatic tail. With a diagnosis of insulinoma, we performed a distal pancreatectomy. The patient showed a good postoperative course without any complications. The patient's early morning fasting hypoglycemia disappeared. The respective levels of C-peptide and insulin dropped from 14.9 ng/mL and 4860 μIU/mL preoperatively to 5.3 ng/mL and 553 μIU/mL after surgery. A histopathological examination demonstrated that the tumor was a pancreatic neuroendocrine tumor, grade 1. Immunostaining was negative for insulin and positive for CD56, chromogranin A, synaptophysin and glucagon. These findings suggested that the tumor was clinically an insulinoma but histopathologically a glucagonoma. Among all insulinoma cases reported between 1985 and 2010, only 5 cases were associated with independent glucagonoma. In this report, we characterize and discuss this rare type of insulinoma by describing the case we experienced in detail.

关键词： Hypoglycemia Insulinoma Pancreas Neuroendocrine tumor Glucagon

Laparoscopic surgery for small-bowel obstruction caused by Meckel's diverticulum

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World Journal of Gastrointestinal Surgery 2016年第2期8卷 169-172页

作者： Takatsugu Matsumoto Motoki Nagai Daisuke Koike Yukihiro Nomura nobutaka tanaka Department of Gastroenterological Surgery Dokkyo Medical University Department of Surgery Asahi General Hospital

A 26-year-old woman was referred to our hospital because of abdominal distention and vomiting. Contrastenhanced computed tomography showed a blind loop of the bowel extending to near the uterus and a fibrotic band connecting the mesentery to the top of the bowel,suggestive of Meckel's diverticulum(MD) and a mesodiverticular band(MDB). After intestinal decompression,elective laparoscopic surgery was carried out. Using three 5-mm ports,MD was dissected from the surrounding adhesion and MDB was divided intracorporeally. And subsequent Meckel's diverticulectomy was performed. The presence of heterotopic gastric mucosa was confirmed histologically. The patient had an uneventful postoperative course and was discharged 5 d after the operation. She has remained healthy and symptom-free during 4 years of follow-up. This was considered to be an unusual case of preoperatively diagnosed and laparoscopically treated small-bowel obstruction due to MD in a young adult woman.

关键词： Surgery Human Meckel’s diverticulum Small-bowel obstruction Laparoscopic surgery

Resection of Multiple Neurinomas of the Cauda Equina Improves Normal Pressure Hydrocephalus

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Open Journal of Modern Neurosurgery 2012年第3期2卷 54-57页

作者： Atsuhito Fuse Kenya Nishioka Hideki Shimura Wataru Manabe Ryota tanaka nobutaka Hattori Takao Urabe Department of Neurology Juntendo University Urayasu Hospital Chiba Japan Department of Neurology Jutendo University School of Medicine Tokyo Japan Department of Orthopedic Surgery Jutendo University Urayasu Hospital Chiba Japan

Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by dementia, gait disturbances, and urinary incontinence. This case study aimed to evaluate the effectiveness of surgical intervention in treating NPH associated with spinal cord tumors. A patient suffering with NPH underwent a spinal tap procedure and surgical resectioning of three neurinomas on the cauda equina. The patient exhibited marked improvement in neurological and motor symptoms related to NPH following surgical intervention. These findings suggest that surgical resectioning of neurinomas is an effective intervention for treating NPH associated with spinal cord tumors.

关键词： Normal Pressure Hydrocephalus Spinal Cord Tumor Dementia Neurinoma

KIF3马达分子运送N-cadherin并对发育中的神经上皮的结构起组织作用

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KIF3马达分子运送N-cadherin并对发育中的神经上皮的结构起组织作...