Shujiroh Makino

Three-phase bone scintigraphy and viability of vascularized bone grafts for mandibular reconstruction.

Three-phase bone scintigraphy was undertaken to check the anastomotic patency and monitor the viability of vascularized bone grafts. Ten consecutive patients who underwent vascularized bone grafting of the mandible were reviewed. A successful clinical outcome was achieved in 8 patients. The graft failed in 2 patients. In this series, 3-phase bone scintigraphy of radiolabeled (99m)Tc-methylene-diphosphonate was performed at 7 days, and at 1, 3, 6, and 12 months after reconstruction. Assessments made using 3-phase bone images were compared with the clinical findings. The clinical outcome of the cases presented in our series correlated extremely well with 3-phase bone images. Three-phase bone scintigraphy is a useful method for the assessment of patency and viability of vascularized bone grafts. The use of this method can be very helpful in assessing the anastomotic patency and viability of a graft which for clinical reasons is suspected of being non-viable.

G‑CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report

A 78-year-old male patient was referred to the Department of Oral Surgery, Hokuto Hospital (Obihiro, Japan) for painless swelling on the left neck and tongue. Histopathological examination of a biopsy specimen resulted in a diagnosis of squamous cell carcinoma of the tongue. Imaging examinations revealed cervical lymph node metastases on both sides, along with diffuse uptake of 18F-fluorodeoxyglucose (FDG) in the bone marrow of the spine and pelvis. Hematologic tests revealed an increased white blood cell (WBC) count and serum concentrations of granulocyte colony stimulating factor (G-CSF). These findings suggested a G-CSF producing tumor, with fluctuations of WBC count, serum G-CSF concentration, and FDG uptake in the bone marrow, associated with tumor shrinkage and enlargement, an indicator of tumor status.

Distant metastases in patients with squamous cell carcinoma of oral cavity. Analysis of critical factors that influence development of distant metastasis with locoregional control.

口腔癌の遠隔転移発現に関与する因子を明らかにする目的で, 頸部転移様相をはじめとする臨床的・病理組織学的所見を検討した。1974年から1995年までに根治的治療を行った口腔扁平上皮癌535例中, 原発・頸部制御例は427例であった。頸部転移の有無で遠隔転移の発現率をみると頸部転移群では25/112 (22.3%) , 非転移群では5/315 (1.6%) で両群間に有意差がみられた (p<.001) 。このことより頸部転移群は遠隔転移のハイリスクグループであることが明らかとなった。今回ハイリスクグループである頸部転移群112例を対象に, さらに関連性の高い因子を検討すべく多重ロジスティック解析を行った。その結果, 転移リンパ節レベルのオッズ比が3.960と最も高く, レベルの進展した症例に対する遠隔転移の対策が必要と考えられた。