Hachiro Suzuki

Results of Treatment of Laryngeal Cancer

Eighty-one laryngeal cancer patients treated at our clinic during the past ten years were studied clinically. The proportion of patients in their sixties was highest and the number of males was much larger than that of females, at a ratio of 15:1. Laryngeal cancer was classified as glottic, supraglottic, and subglottic in 58, 19, and 4 cases, respectively, and glottic cancer patients accounted for more than half of these. The cumulative 5-year survival rate in all patients was 79.6%, and the rates in glottic and supraglottic cancer patients were 82.2% and 83.3%, respectively. Cumulative 5-year survival rates in patients in Stages I, II, III and IV were 83.7%, 83.9%, 83.3%, and 55.5%, respectively. Recurrence after radiotherapy was controlled by salvage operations satisfactorily in Stages I and II, but the prognosis of recurrent cancer was poor for patients in Stages III and IV. A selective review is given.

End-to-end anastomosis in chronic tracheal stenosis.

OBJECTIVE This study assessed the efficacy and safety of end-to-end anastomosis of the trachea following segmental resection in chronic tracheal stenosis. METHODS End-to-end anastomoses of the trachea were performed in 35 patients with chronic tracheal stenosis; 18 patients with tracheal invasion of thyroid cancer and 17 patients with long-term intubation and blunt injuries of the trachea. RESULTS All operations were successful, except one whose unilateral recurrent nerve had not been identified in the recurrent thyroid cancer invasion with trachea. CONCLUSION This operation provides a one-step cure for the stenosed trachea and can be applied to the resection of less than six tracheal segments.

Sudden deafness in relapsing polychondritis. A scanning electron microscopy study.

The left ear of a 57-year-old female who suffered sudden deafness during the course of relapsing polychondritis was examined under a scanning electron microscope. Marked degeneration of the organ of Corti in all turns and dislocated and encapsulated tectorial membrane were found in the cochlea. Marked decrease in number of the sensory cells in the utricular and saccular maculae and total loss of sensory hair bundles in the ampullary cristae of the semicircular canals were seen in the vestibule. These findings strongly suggest that the cause of sudden deafness in this case might be viral. The usefulness of scanning electron microscopy in human temporal bone pathology is stressed.

Primary non-Hodgkin’s lymphoma of the larynx (Stage IE) diagnosed by gene rearrangement

An extremely rare case of primary non-Hodgkins lymphoma of the larynx (Stage IE) diagnosed by gene rearrangement is reported. The patient was a 76-year-old man with a chief complaint of pharyngeal discomfort. Remission was obtained by excision of the tumour and radiotherapy. Surface phenotypic studies of the laryngeal lesion demonstrated a main population of B-cells expressing L-26, some of the atypical lymphocytes positive with UCHL-1. Genotypic analysis of the specimen disclosed a clonal rearrangement of the immunoglobulin heavy chain with the same rearrangement pattern. These data indicate that this patient had non-Hodgkins lymphoma with diffuse large B-cell type. Gene rearrangement analysis was useful for diagnosis. Diagnostic and therapeutic options are discussed in light of the current literature.

Capillary hemangioma in a patient with pancoast syndrome.

A 34-year-old man was admitted with a two months history of tumor on the left side of the neck and severe pain of the left neck and shoulder. Five years earlier he had had the same symptoms for one month. Angiograms and Computed Tomography revealed a giant left neck tumor with an aneurysm in its central area. At operation, the tumor was found to be adherent to the anterior face of the Processus transversus and to the Rami of the brachial plexus. The pathologic diagnosis of the tumor was capillary hemangioma. Rupture of this thoracic outlet tumor was the cause of Pancoast syndrome. This is a very rare case of a benign tumor producing Pancoast syndrome.