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Tanaka H.,Mie Prefectural General Medical Center
Asian journal of endoscopic surgery | Year: 2013

A cotyledonoid dissecting leiomyoma is categorized as a leiomyoma with an unusual growth pattern, which is characterized by remarkable extrauterine bulbous growth in continuity with a dissecting myometrial component. A 36-year-old patient was preoperatively diagnosed with a mature cystic teratoma of the left ovary, and according to MRI, the tumor protruded from the uterus into the right broad ligament and was 10 cm in diameter. She underwent laparoscopic surgery to resect ovarian teratoma and the tumor under the right broad ligament. The tumor was almost completely resected and diagnosed as a cotyledonoid dissecting leiomyoma based on intraoperative and pathological findings. Recurrence was not seen for 26 months postoperatively in our case. Gross specimens are often mistaken for malignant lesions, but this was a benign disease. Even if some remnants of the leiomyoma remained postoperatively, recurrence has never been reported. When a cotyledonoid dissecting leiomyoma is resected laparoscopically, intrapelvic structures around it, such as the ureter, uterine artery, bladder, rectum and external iliac vessels, must be given careful attention. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Okano H.,Suzuka General Hospital | Takahashi M.,Jichi Medical University | Isono Y.,Suzuka General Hospital | Tanaka H.,Suzuka General Hospital | And 10 more authors.
Hepatology Research | Year: 2014

Aim: To characterize hepatitis E in Mie prefecture and to investigate whether raw pig liver sold as food in Mie is contaminated with hepatitis E virus (HEV) strains similar to those recovered from patients. Methods: Seventeen patients with sporadic acute hepatitis E treated from 2004 to 2012 were studied. A total of 243 packages of raw pig liver from regional grocery stores were tested for the presence of HEV RNA. The partial genomic sequences of human and swine HEV isolates were determined and subjected to the phylogenetic analyses. Results: The HEV isolates recovered from the 17 patients segregated into genotype 3 (n=15) and genotype 4 (n=2), and 15 genotype 3 isolates further segregated into 3e (n=11) and 3b (n=4). Pig liver specimens from 12 (4.9%) of the 243 packages had detectable HEV RNA. All 12 swine HEV isolates were grouped into genotype 3 (3a or 3b). Although no 3e strains were isolated from pig liver specimens, two 3b swine strains were 99.5-100% identical to two HEV strains recovered from hepatitis patients, within 412-nt partial sequences. Conclusion: The 3e HEV was prevalent among hepatitis E patients. HEV RNA was detected in approximately 5% of pig liver sold as food. The presence of identical HEV strains between hepatitis patients and pig liver indicated that pigs play an important role as reservoirs for HEV in humans in Mie. Further studies are needed to clarify the source of 3e HEV in the animal and environmental reservoirs. © 2013 The Japan Society of Hepatology.

Okugawa Y.,Mie University | Toiyama Y.,Mie University | Inoue Y.,Mie University | Iwata T.,Mie University | And 6 more authors.
Journal of Surgical Research | Year: 2012

Background: E-cadherin expression has been associated with an outcome in patients with colorectal cancer, and serum levels of soluble E-cadherin (sE-cadherin) are significantly elevated in patients with malignant disease. However, the prognostic value of serum sE-cadherin level has not been demonstrated in colorectal cancer. Methods: Serum samples were collected from 186 patients with colorectal cancer and 21 normal volunteers. Serum sE-cadherin levels were measured using an enzyme-linked immunosorbent assay kit. We investigated the relationship between serum sE-cadherin level and clinicopathologic findings. Results: Mean serum sE-cadherin levels were significantly higher in CRC patients than in controls. Mean sE-cadherin levels were significantly correlated with hepatic metastasis, UICC classification, and poor prognosis. Elevated serum sE-cadherin level was an independent risk factor for predicting poor prognosis, and was an independent marker for predicting hepatic metastasis. Among patients with synchronous hepatic metastases, the prognosis was significantly worse in patients with elevated serum sE-cadherin levels than in those with lower levels. Conclusions: Preoperative elevated sE-cadherin level is associated with poor prognosis in colorectal cancer. Measuring serum sE-cadherin may provide valuable information for predicting prognosis in patients with hepatic metastasis. © 2012 Elsevier Inc. All rights reserved.

Tanaka H.,Mie Prefectural General Medical Center
Asian journal of endoscopic surgery | Year: 2011

Follicular variant thyroid-type papillary carcinoma (FVTPC) arising from thyroid tissue in mature cystic teratoma of the left ovary is extremely rare, and it is not easy to diagnose preoperatively. However, with reports of an early postoperative death, we must prudently select the strategy for this lesion. A 50-year-old woman had a uterine fibroid with hypermenorrhea and a left ovarian tumor measuring approximately 8 cm diameter. Serum thyroid-stimulating hormone level was within the normal limit. A laparoscopic hysterectomy and left salpingo-oophorectomy were performed. During surgery, there were no signs of invasion or metastasis, and there was no spillage in the abdomen. On histopathological examination of the left ovary, we diagnosed FVTPC arising from thyroid tissue in mature cystic teratoma of the left ovary. FVTPC in ovarian struma is a rare malignant transformation. We must be aware of the possibility of such a rare malignant disease when treating teratoma laparoscopically. © 2011 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Blackwell Publishing Asia Pty Ltd.

We present a patient with a low-grade appendiceal mucinous neoplasm, resulting in disseminated peritoneal adenomucinosis (pseudomyxoma peritonei) with uterine involvement, and mimicking primary mucinous endometrial adenocarcinoma. On immunohistochemistry, neoplastic glands were cytokeratin 7-negative and cytokeratin 20-positive, indicating a gastrointestinal origin rather than a primary ovarian mucinous neoplasm. A diagnosis of uterine metastasis of appendiceal origin was made, based on the constellation of clinicopathological findings, that is, preceding appendiceal neoplasm, peritoneal involvement, absence of coexisting prototypical endometrioid adenocarcinoma or endometrial hyperplasia. The patient underwent hysterectomy and there was no evidence of disease progression at the 12-month follow up. This suggested the indolent nature of this particular neoplasm, despite its advanced stage. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

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