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T Ohtani

Publications and source records attributed to T Ohtani.

183 records · Page 11Linked to original sources

Dysplastic ganglioneurocytoma with increased glucose metabolism: a heterotopia with unique histopathology.

A 1 year and 7 month old boy was incidentally found to have an intracranial mass lesion at the frontal base. The mass was 45 x 54 x 47 mm in size, contained a calcification, a few small cysts, and extended downward to the sphenoid sinus and upper pharynx. The signal intensity of the lesion on magnetic resonance imaging was iso-high on T1-weighted images, and slightly high on T2-weighted images, and it did not enhance with gadolinium injection. Although there was no obvious mass effect, 18F-fluorode-oxyglucose positron-emission tomography demonstrated increased uptake, and a surgical resection was performed suspecting a neoplastic lesion. Histologically, the lesion consisted of small to large anomalous neurons and glial cells but lacked normal cortical architecture. Cellularity was high in some portion with MIB-1 labeling index of 2%, but there was no cellular atypia suggestive of neoplasm. Therefore, this lesion was considered to be a dysplasia that does not fit into the previously described entity. We suggest this lesion would be better described as dysplastic ganglioneurocytoma.

Ganglioneuroma↗

Pancreaticoduodenectomy for gallbladder cancer with peripancreatic nodal metastases.

The prognosis of patients with advanced gallbladder carcinoma remains dismal. In the English language literature, we found only one 5-year survivor with peripancreatic lymph node metastases. We herein report a patient with marked peripancreatic nodal metastases, who has exhibited the longest survival (6 years) without recurrence after a pancreaticoduodenectomy combined with extended cholecystectomy. This outcome suggests that pancreaticoduodenectomy may be effective for clearance of peripancreatic nodal metastases from gallbladder cancer.

Carcinoma↗

Laparoscopic cholecystectomy may disseminate gallbladder carcinoma.

Laparoscopic cancer surgery has been reported to facilitate tumor dissemination. In our experience with 158 laparoscopic cholecystectomies, we encountered 2 cases (1.3%) of unsuspected gallbladder cancer. We report these 2 cases to illustrate the disadvantages of laparoscopic tumor resection. In Case 1, a 60-year-old woman with symptomatic cholecystolithiasis underwent a laparoscopic cholecystectomy revealing an unsuspected gallbladder cancer (pT2). Five months later, localized peritoneal carcinomatosis developed in the right subphrenic space, and she died from disseminated disease 19 months postoperatively. Laparoscopic manipulation may have caused the unusual, localized seeding. In Case 2, laparoscopic cholecystectomy was initiated for a polypoid lesion of the gallbladder in a 69-year-old man. When laparoscopy revealed a concomitant cancer (pT3), resection was converted to an open radical cholecystectomy. He remains alive without evidence of disease 31 months postoperatively. Conversion to open surgery may have contributed to the favorable outcome. The contrast between the 2 cases suggests that laparoscopic cholecystectomy should be converted to open surgery whenever malignancy is suspected. Surgeons should note that laparoscopic resection may disseminate cancer.

Adenocarcinoma↗