Michinori Yamamoto

I-123 uptake in nonfunctional struma ovarii

A case of nonfunctional struma ovarii preoperatively diagnosed by scintigraphy of the pelvis using I-123 NaI is reported. US, CT, and MRI revealed a multilobulated mass composed of cystic and solid components. CT showed cystic components with slightly high density and MRI showed various signal intensities on T1- and T2-weighted images. I-123-scintigraphy of the pelvis showed uptake in the pelvic mass. Microscopic examination revealed the histologic appearance of thyroid tissue accompanied by follicular adenoma. I-123 scintigraphy of the pelvis was useful for reaching the correct preoperative diagnosis in this patient with nonfunctional struma ovarii.

Reevaluation of postoperative radiotherapy for thoracic esophageal carcinoma

PURPOSE To reevaluate postoperative radiotherapy for thoracic esophageal carcinoma. METHODS AND MATERIALS Reviewed were the outcome of 89 patients who underwent esophagectomy with systematic dissection of regional lymph nodes between 1988 and 1993. Of the 89 patients, 19 underwent no adjuvant treatment, 22 underwent adjuvant chemotherapy alone, and 48 underwent postoperative radiotherapy. Twelve of the 48 also underwent adjuvant chemotherapy. RESULTS All patients who experienced local-regional recurrence had lymph node metastases at the time of surgery. The actuarial local-regional control rate at 2-year of follow-up was 94% for patients with lymph node metastases at the time of surgery who underwent postoperative radiotherapy alone or plus chemotherapy, and 74% for those who underwent adjuvant chemotherapy alone. The local-regional control rate was significantly better for those who had undergone postoperative radiotherapy (p < 0.01). CONCLUSIONS Postoperative radiotherapy still plays an important role as adjuvant treatment.

MR appearance of adenomatoid tumor of the uterus.

Reports on the radiological findings of adenomatoid tumor of the uterus are rare, and preoperative diagnosis is very difficult. To our knowledge, there have been no reports concerning the MR findings of adenomatoid tumor of the uterus. We report two cases of uterine adenomatoid tumor that showed the characteristic features of leiomyoma on MR images.

Three-dimensional CT imaging in the evaluation of fracture of the jaws

The purpose of this study was to evaluate the diagnostic value of three-dimensional (3-D) image reconstruction of jaw bone fractures in comparison with high-resolution CT scanning. Assessment was made using a simple scoring system and analyzing the effects of factors like slice thickness, fracture site, and displacement of bone fragments. 3-D images proved especially useful in patients with complicated maxillary fractures. Images reconstructed from CT scans obtained with a 2-mm slice thickness were much better than those reconstructed from scans with a 5-mm slice. 3-D images provided very useful data regarding fractures with marked displacement. 3-D images not only outlined the extent of the fractures but revealed differences of the mechanism of injury between the maxilla and the mandible. Although 3-D images do not provide any information that is not already present in the original CT sections, they do present selected volume data in an easily assimilated and familiar anatomical format. The findings suggest that the high-resolution CT scanning and 3-D image reconstruction are complementary procedures.

Sclerosing stromal tumor of the ovary with atypical magnetic resonance imaging findings in a middle-aged woman

We encountered a case of atypical sclerosing stromal tumor of the ovary (SST) in a middle-aged woman. This 52-year-old woman presented with a 2-year history of abdominal distention. Magnetic resonance imaging (MRI) showed a large mass extending from the pelvis to the epigastrium. T2-weighted MRI showed an island-shaped area of slight hyperintensity. Dynamic MRI demonstrated gradual light enhancement of the area in which T2-weighted imaging showed low intensity. The diagnosis of the tumor proved difficult because neither MRI findings nor the age of getting sick were atypical. We report this case with MRI findings and correlated pathology.

Comparison of cisplatin and 5-fluorouracil chemotherapy protocols combined with concurrent radiotherapy for esophageal cancer

PurposeThe optimal chemotherapeutic protocol for the treatment of esophageal cancer has not yet been established. This study was performed to identify the differences in toxicity and completion rates of various chemotherapy protocols with that goal in mind.Materials and methodsA total of 61 patients with esophageal cancer were enrolled in this study between June 2002 and January 2004. The total radiotherapy dose was 64 Gy. Three chemotherapy protocols were used. Arm A comprised daily low-dose cisplatin (CDDP) and 5-fluorouracil (5FU) (CF protocol) (3 mg/m2 and 180 mg/m2, respectively). Arm B was intermediate between arm A and C (CDDP 7 mg/m2 and 5FU 250 mg/m2 on days 1–5, 8–12, 29–33, and 36–40). Arm C comprised two courses of standard CF (CDDP 70 mg/m2 on day 1 and 5FU 600 mg/m2/24 h on days 1–4).ResultsAlthough there were no significant differences in hematological toxicity between the protocols, leukocytopenia was slightly milder in arm A. Nausea was significantly more severe in arm C. The completion rate was higher in arm A. The 3-year survival rates were 40%, 31%, and 62%, respectively.ConclusionThe daily low-dose CF protocol showed a trend of mild toxicity regarding leukocytopenia. However, we could not find statistical difference between arms. It also showed a better completion rate than the other two arms.

2113 The results of radiotherapy for T1 glottic cancers; influence of radiation beam energy

We analyzed the influence of various parameters on the results of radiotherapy for T1 glottic cancer by assessing the outcomes of 60 patients with this cancer who received definitive radiotherapy between 1985 and 1994. Seven patients were treated with a cobalt-60 unit, and the other 53 with a linear accelerator (26 patients at 3-MV, 10 at 6-MV, and 17 at 10-MV). Of the 17 patients treated at 10-MV, 4 also received part of their treatment with a cobalt-60 unit. The total radiation dose ranged from 56 Gy to 70 Gy (mean, 61 Gy). The total radiation dose of 51 patients (85%) was 60 Gy. The factors found to influence local control were the strength of the radiation beam energy and whether or not there was gross tumor invasion of the anterior commissure. The local control rate was 71% in the patients treated with a 10-MV linear accelerator, 56% in those treated with a 6-MV linear accelerator and, 97% in those treated with a cobalt-60 unit or a 3-MV linear accelerator (P = 0.0173). The local control rate was 43% in the patients with gross anterior commissure invasion and 88% in those without (P = 0.0075). We conclude that low energy photon beams are more suitable for the treatment of early glottic cancers, especially if the lesion grossly invades the anterior commissure.