Junichi Wakashima

Sternocleidomastoid Muscle-Clavicle Myoosseous Flap for Single-Stage Reconstruction of Postoperative Tracheal Defects in Patients with Invasive Thyroid Tumor

In this report, we present 3 cases with thyroid carcinoma with tracheal invasion. In all cases, the tracheal defects were simultaneously reconstructed using a sternocleidomastoid muscle-clavicle myoosseous flap. We were able to close the tracheostomas without trouble, and no stenotic lesions or late complications were noted. This myoosseous composite flap has proved itself to be a reliable material for laryngotracheal reconstruction in some cases with thyroid carcinoma.

A case of anaplastic thyroid carcinoma surviving disease free for over 2 years

A 52-year female presented with an enlarged thyroid mass and lump sensation in the throat. The cytologic examination showed class five and she was admitted to the hospital to undergo operation. Total thyroidectomy was done and the tumoral invasion of the trachea was removed. We performed tracheoplasty using a sternocleidomastoid muscle-clavicle myoosseous flap in a single stage operation. Histologic diagnosis revealed anaplastic thyroid carcinoma After upper mediastinal dissection had been performed, systemic chemotherapy using pirarubicin, cisplatin and etoposide was administered. In addition, she was treated with radiochemotherapy using pirarubicin, cisplatin and a total of 58 Gy was administered. No recurrence of the tumor has been noted since the above operation 2 years ago. Immunohistochemical studies of primary and metastatic tissues in this case revealed a positive expression of p53 protein in both.

Wegener's Granulomatosis Presenting as an Orbital Pseudotumor. A Case Report.

A 44-year-old male who complained of left eye pain and double vision consulted our outpatient clinic in July 1996. He was diagnosed as having left orbital pseudotumor 3 years previously. Although steroids and radiotherapy were administered, his ocular symptoms did not remit.A tumorous mass with crust was found in his left nasal cavity. CT findings showed a tumorous legion occupying his left orbita and ethmoid sinus. Microscopic examination of the biopsy specimen from his nasal cavity suggested Wegeners granulomatosis. Cyclophosphamide and prednisolone were administered. The tumor in the nasal cavity and ethmoid sinus shrank and he was discharged in December. Right parapharyngeal mass which was suspected to be recurrence of Wegeners granulomatosis was detected in January 1997. Following re-treatment with cyclophosphamide and prednisolone, a second remission was induced.

A Case of Ulcerative Colitis in which Palatine Tonsillectomy was Remarkably Effective.

Ulcerative colitis is an idiopathic, non-specific inflammatory disorder of the colon, and its etiology remains unknown. We present a case of ulcerative colitis in which clinical symptoms were remarkably improved by palatine tonsillectomy. The patient was diagnosed with severe ulcerative colitis and treated with internal medicine. When pharyngitis and aphthous stomatitis developed, his bowel symptoms worsened. A tonsillar provocation test was performed, and the result was positive. Moreover, bowel symptoms worsened after the tonsillar provocation test and the patient developed a sore throat and fever. Therefore, we suspected tonsillar focal infection and carried out palatine tonsillectomy. In the early postoperative period, bloody diarrhea recovered despite the interruption of sulfasalazopiridine and lymphocyte afferesis. In addition, recurrent pharyngitis and aphtous stomatitis were resolved entirely.