Masanori Iwase

Ruptured retroperitoneal mucinous cystadenocarcinoma with synchronous gastric carcinoma and a long postoperative survival: Case report

We describe an 86‐year‐old woman with a long survival following surgey for a massive retroperitoneal mucinous cystadenocarcinoma and a synchronous gastric carcinoma. Computed tomography showed a huge tumor with septation and calcification. Upper gastrointestinal radiography showed the additional gastric lesion. At operation, the 23 × 20 × 12‐cm retroperitoneal tumor had ruptured. Tumor resection and distal gastrectomy including regional lymph nodes were performed. Mucinous peritoneal implants were removed as completely as possible. Histologically, the mucinous tumor showed limited invasion, whereas the poorly differentiated gastric adenocarcinoma showed no serosal invasion. Among 18 retroperitoneal mucinous cystadenocarcinomas reported in the English literature since 1965, only ours was associated with gastric carcinoma. Despite peritoneal implants, our patient has survived for 6 years without clinical recurrence. As at other sites, retroperitoneal mucinous cystadenocarcinoma often grows slowly. Total removal, even after peritoneal dissemination, can result in long survival. J. Surg. Oncol. 2000;73:26–30.

Successful treatment of Fournier's gangrene with the assistance of preoperative computed tomography in an elderly man: report of a case.

An 87-year-old man presented with inguinal pain and swelling, and was later diagnosed as having Fournier’s gangrene. The information gained from preoperative computed tomography (CT) proved very useful for defining the extent of necrosis, and emergency surgery saved his life. Thus, CT should be performed prior to treatment of Fournier’s gangrene, even in an emergency situation.

A small, incidentally detected pancreatic somatostatinoma: Report of a case

Abstract.We report an asymptomatic 72-year-old woman with a small, incidentally detected, pancreatic somatostatinoma. The tumor, measuring 1 cm in diameter, showed a hypervascular pattern of contrast enhancement on computed tomography, and was found angiographically to receive a blood supply from the posterior superior pancreaticoduodenal artery. The results of preoperative hormonal assays all were normal. No assay for somatostatin was performed. No abnormality in either the pituitary or parathyroid was found. We thus considered the tumor to be a sporadic, nonfunctioning endocrine cell tumor, and enucleation was carried out. As some tumor cells in the resected specimen showed immunoreactivity for somatostatin, a diagnosis of somatostatinoma was made. Therefore, the possibility of somatostatinoma should be kept in mind when making a differential diagnosis of pancreatic endocrine tumors in cases where even a small hypervascular tumor is detected on enhanced computed tomography.

Two cases of duplication of the alimentary tract lined with ciliated columnar epithelium.

線毛円柱上皮よりなる消化管重複症の2例を経験したので報告する.症例1は14歳の男性で無症状.腹部computed tomographyにて偶然発見された.重複胃は胃体上部後壁に強固に結合, 一部筋層を共有していた.大きさは7×4×4cm.病理組織検査で, 重複胃は多列線毛円柱上皮で覆われ, 3層の比較的厚い筋層を有した.症例2は15歳男性で主訴は腹痛と嘔吐.イレウスにて手術.重複腸管は回腸にあり, 大きさは10×6.5×6.5cmで, 回腸の軸捻転を伴っていた.重複腸管は内面を多列線毛円柱上皮で覆われ, 厚い筋層を回腸と共有していた.消化管重複症は種々の発生学的異常に起因するためか, 組織学的にも解剖学的にも多彩である.自験例は食道重複症でしばしばみられるように線毛円柱上皮で覆われており, その解剖学的, 病理組織学的特徴から, 胎生期の前腸に由来する消化管重複症と考えられた.