共查询到20条相似文献,搜索用时 984 毫秒
1.
K Sakamoto T Suda K Ide 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2000,48(7):464-467
Direct invasion of a lung cancer into the liver is rare. Here we report a case with a non-small-cell lung cancer invading through the diaphragm into the liver. A 77-year-old woman was admitted to our hospital with a complaint of right chest pain. Chest X-ray showed a 10-cm shadow in the right lower lung field. Chest CT demonstrated a large heterogeneous tumor located in the right lower lobe of the lung. Chest MRI revealed the tumor directly invading through the diaphragm into the liver. Bronchoscopic biopsy revealed squamous cell carcinoma. Surgical resection was performed to prevent intrapulmonary rupture of the necrotic contents. A right lower lobectomy was performed with partial resection of the diaphragm, liver and chest wall. Marlex mesh was used to reconstruct the diaphragm and chest wall. The patient was discharged on the 23rd postoperative day without complications, but died 4 months later from bilateral pulmonary metastases. Invasion to the diaphragm and liver may increase the risk for hematological spread. Although there are limited reports on treatment options, combined resection of the liver should be considered in the case of non-small-cell lung cancer invading the liver, particularly in c-N0M0 case. 相似文献
2.
Hiroshi Yamamoto Kazuo Watanabe Wataru Takayama Shigeru Yamada Ichiro Honda Yoshihiro Fujita Hideki Imura Sadao Obata Teisuke Komatsu 《Surgery today》1994,24(8):744-748
We present herein the case of a 55-year-old man with primary malignant fibrous histiocytoma (MFH) of the diaphragm. He was admitted to our hospital with right anterior chest pain, where diagnostic imaging showed a huge tumor in the right diaphragm with a tumor thrombus in the vena cava, spreading to the left lobe of the liver and the pericardium. Although invasion into the right lung was identified at the time of surgery, the entire tumor was removed. Histopathological examination of the resected specimen revealed the characteristics of MFH. We discuss the clinical features of this patient in comparison with the few previous reports on MFH of the diaphragm. 相似文献
3.
Kataoka D Nonaka M Yamamoto S Fukuzumi M Kunimura T Kaga E Kadokura M Takaba T 《Kyobu geka. The Japanese journal of thoracic surgery》2003,56(12):1025-1028
A 61-year-old man was admitted to Showa University Hospital because of a myasthenia gravis. Chest computed tomography revealed a mediastinal invasive tumor. During surgery, invasion to the pericardium and dissemination on the left visceral pleura and the left diaphragm were observed. Extended thymo-thymectomy and partial resection of the pericardium, left lung, and diaphragm were performed. Incomplete resection was achieved because of the dissemination on the diaphragm. Chemotherapy using ADOC and radiotherapy for mediastinum and left diaphragm were done. Four years after surgery, neither recurrence of the tumor nor myasthenia gravis was observed. 相似文献
4.
Tsuji Y Okada K Fukuoka M Watanabe Y Ataka K Minami R Hanioka K Tachibana S Saito H Sasada A Okita Y 《Surgery today》2001,31(8):735-739
A 59-year-old man was admitted with general fatigue, an epigastric mass, and remittent fever. Radiological examinations disclosed
a huge solid-to-cystic mass in the right lobe of the liver, and the mass severely compressed the right diaphragm, the inferior
vena cava, and the right atrium. In addition, the patient suffered from chronic hepatitis; however, the serum α-fetoprotein,
carcinoembryonic antigen, and PIVKA II levels were all within the normal ranges. The serum C-reactive protein level was 7.71
mg/dl. With a clinical diagnosis of a malignant hepatic tumor invading the right diaphragm, surgery was performed. The tumor
originated from segments IV and VII of the liver, was well defined, and grew extrahepatically. The tumor was resected using
an ultrasonic cavitational aspirator together with the infiltrated right diaphragm. The resected tumor measured 23 × 13 ×
23 cm in size and weighed 3 700 g. Histologically, the tumor was found to consist of hepatocellular carcinomatous component
and sarcomatous component. In the sarcomatous component, spindle-shaped cells which were positive for the immunohistochemical
localization of vimentin, α-smooth muscle actin, and keratin were identified. The postoperative course was uneventful. The
value of the serum C-reactive protein returned to within the normal range, and the patient became afebrile. The patient received
a postoperative combination chemotherapy (etoposide, epirubicin, and cisplatin), and remains well with no signs of recurrence
12 months after the operation.
Received: October 18, 2000 / Accepted: March 6, 2001 相似文献
5.
J P McArdle I Hawley J Shevland T Brain 《The American journal of surgical pathology》1989,13(11):961-965
A 53-year-old male Caucasian presented with a massive liver tumor composed entirely of spindle-shaped cells showing light-microscopic and ultrastructural evidence of rhabdomyoblastic differentiation. No epithelial or other sarcomatous elements were included. Detailed postmortem examination failed to reveal evidence of metastatic tumor or an alternative primary site. There have been only four previous cases of primary rhabdomyosarcoma of the adult liver, all occurring in Japanese men. 相似文献
6.
Doki Y Ishikawa O Kabuto T Hiratsuka M Sasaki Y Ohigashi H Kameyama M Murata K Yamada T Miyashiro I Yokoyama S Imaoka S 《Surgery》2003,133(5):479-485
BACKGROUND: The caudal spread of esophageal squamous cell carcinoma (ESCC) frequently involves the stomach. An extended surgical treatment may provide a tumor-free margin; however, its clinical benefit has not been elucidated. METHODS: Sixty-three of 582 patients with ESCC (11%) had massive gastric involvement and underwent esophagectomy with combined resection of the stomach and other organs. The mode of gastric involvement was classified as direct invasion from primary tumor (PT invasion) or invasion from metastatic lymph nodes (LN invasion). RESULTS: In addition to the removal of either the proximal (83%) or the whole (17%) stomach, 46 patients (73%) underwent the combined resection of adjacent organs, including the diaphragm, pancreas, liver, lung, and pericardium. This surgical treatment resulted in a high rate (83%) of curative resection and a low rate (8%) of operative mortality. Postoperative survival rates were 53%, 33%, and 25% at 1, 2, and 5 years, respectively. The first tumor recurrence was frequently in the abdominal paraaortic lymph nodes (41%) and the liver (28%), followed by the mediastinal lymph nodes, local recurrence, the lung, and other organs. The mode of gastric involvement strongly affected clinical outcome, with a 5-year survival rate of 36% for those with PT invasion but of only 7% with LN invasion (P <.0086). No significant difference was seen in the number and location of metastatic lymph nodes between the 2 groups; however, the size of the largest metastatic lymph node was significantly smaller with PT invasion than with LN invasion (12 mm vs 37 mm in diameter; P <.0001). CONCLUSION: Surgical treatment of ESCC involving the stomach was considered safe and successful. A favorable prognosis can be expected for gastric invasion from the primary tumor but not from metastatic lymph nodes. 相似文献
7.
Inoue T Araki O Karube Y Hayama M Tamura M Kobayashi S Oyaizu T Seki N Ikeda Y Umezu H Nagai S Chida M 《Kyobu geka. The Japanese journal of thoracic surgery》2011,64(9):832-835
We report a case of metastatic diaphragm tumor from uterine corpus cancer. A 72-year-old female had a tumor on right diaphragm 4-years after operation for uterine corpus cancer. After chemotherapy, tumor resection was performed by right lung basal segmentectomy, partial liver resection, and partial diaphragm resection. The pathological examination revealed adenocarcinoma, compatible with uterine corpus cancer, metastasizing in diaphragm and involving lung and liver. After the operation, a local recurrence occurred at parasternal lymph node, which is considered to be present on the efferent route of lymph flow from diaphragm. 相似文献
8.
H Azuma H Ueda M Tani T Sakakibara A Ishikawa S Itoh H Okano N Takasaki A Obashi H Mori 《Hinyokika kiyo. Acta urologica Japonica》1992,38(6):711-714
A 59-year-old male took total cystourethrectomy on July, 1991, since the bladder tumor recurred 2 years and 4 months after transurethral resection. Six months after total cystourethrectomy, an abnormal mass shadow appeared on the right lower lung field. Metastatic lung tumor was strongly suspected from CT scan. Despite chemotherapy, the pulmonary lesion grew rapidly and the patient died. From the autopsy, metastatic lesions were found in the bilateral lung fields, skin (face, head and abdominal wall), pleura, bilateral kidneys, small intestine and lymph nodes (para-aortic and mesenteric). The primary bladder tumor contained histologically transitional cell carcinoma as the epithelial element and sarcomatous changes with osteoid formation as the non-epithelial elements. Thus, the primary lesion was diagnosed as a malignant mesodermal mixed tumor. However, all of the metastatic lesions showed only sarcomatous changes. Only 10 cases of malignant mesodermal mixed tumor of the bladder have been reported in Japan since Fujita's report. In general, total cystectomy is necessary for the treatment of this disease. It has a poor prognosis; 5 of the 10 patients died within one year after operation. 相似文献
9.
Kawamura N Kakuta Y Fukuhara S Imazu T Hara T Yamaguchi S Adachi S 《Hinyokika kiyo. Acta urologica Japonica》2007,53(10):713-716
A 77-year-old man was admitted to our hospital for a scheduled examination after transurethral resection of transitional cell carcinoma of urinary bladder. Tumor reccurence was found in the bladder by cystoscopic examination. Total cystectomy and unilateral cutaneous ureterostomy were performed. Histologically the tumor was composed of epithelial and sarcomatous elements. Therefore, we diagnosed this tumor as sarcomatoid carcinoma. The patient died of lung metastasis three months after operation. Autopsy findings showed lung metastasis and local reccurence which were composed of carcinomatous and sarcomatous elements. About 64 cases of sarcomatoid carcinoma of the urinary bladder have been reported in the Japanese literature and are reviewed briefly here. 相似文献
10.
Takashi Ikebe Kenichi Wakasa Masaomi Sasaki Hiroyuki Hamba Masahiro Kaneko Takatsugu Yamamoto Shinichi Mikami Taichi Shuto Kazuhiro Hirohashi Hiroaki Kinoshita Masami Sakurai 《Journal of Hepato-Biliary-Pancreatic Surgery》1998,5(2):217-220
Hepatocellular carcinoma with chondrosarcomatous variation is very rare. We report a case with the results of pathology examination,
and review the literature. The patient, a 72-year-old may had a very large tumor in the liver revealed during follow-up for
diabetes mellitus. The liver mass, which was 14 cm in diameter, was diagnosed as hepatocellular carcinoma by abdominal ultrasonography.
Anterior segmentectomy and partial liver resection were performed. Histopathology examination revealed that the tumor consisted
of two different components: the major one was hepatocellular carcinoma (HCC), which occupied most of the tumor; and a sarcomatous
component, which occupied a smaller area, and included spindle-shaped cells with chondroscarcomatous variation. Intrahepatic
metastases and tumor thrombi of HCC were also found in portal and hepatic veins. Investigations of the immunohistochemical
localization of keratin (KRT), vimentin (VMT), and S-100 protein (S 100) were performed by the avidin-biotin complex method.
Some of the spindle cells were immunohistochemically positive for both KRT and VMT, and the chondrosarcomatous cells were
positive for S 100. These results strongly suggested that the sarcomatous lesion resulted from a sarcomatous change of HCC.
Received for publication on Aug. 18, 1997; accepted on Dec. 12, 1997 相似文献
11.
Polypoid carcinoma of the esophagus. A unifying term for "carcinosarcoma" and "pseudosarcoma" 总被引:2,自引:0,他引:2
R Y Osamura K Shimamura J Hata N Tamaoki K Watanabe M Kubota S Yamazaki T Mitomi 《The American journal of surgical pathology》1978,2(2):201-208
Polypoid carcinomas with spindle-cell sarcomatous features have been designated either as carcinosarcoma or pseudosarcoma. The distinction between these two tumors has depended on the presence of "intermingling" of the carcinomatous and sarcomatous components in so-called carcinosarcoma. But unlike the carcinosarcoma, the sarcomatous component in pseudosarcoma has been considered benign. A polypoid tumor of the esophagus in a 57-year-old male was predominantly composed of spindle cell, sarcomatous cells. The presence of adjacent intraepithelial epidermoid carcinoma with transitional and ultrastructural features confirmed the epithelial origin of this tumor. Because of the absence of "intermingling," the primary tumor was considered to be a pseudosarcoma. However, our postmortem examination showed metastases composed of both carcinomatous and sarcomatous features. A review of the literature on carcinosarcomas and pseudosarcomas shows that only one case of pseudosarcoma reported by Hughes and Cruickshank showed a similar situation and indicates that the sarcomatous component in pseudosarcomas has the same metastatic potentiality as has been reported in carcinosarcomas. We conclude from these studies a basic similarity of the carcinosarcoma and pseudosarcoma. The term polypoid carcinoma is proposed for both these lesions. 相似文献
12.
13.
Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males. 总被引:3,自引:0,他引:3
This study pertains to an entity characterized by the presence of multiple intrapulmonary nodules, which consist of an admixture of bundles of well-differentiated smooth muscle cells and epithelial-lined spaces. These lesions have been frequently interpreted as a variant of hamartomas. However, in this review of the literature, and careful analysis of nine cases of this entity, we concluded that they should be considered metastases from smooth muscle tumors which incorporate some structures of mature lung parenchyma as they slowly expand. We affirm that the designation "fibroeliomyomatous hamartoma" should be discarded. Our cases occurred in six female and three male patients. In all but one female the primary source for lung metastases was uterus, while the male patients had primary lesions in the saphenous vein, diaphragm, and soft tissues. These lung lesions increase in size and number and are potentially fatal, though this may take many years. Even though the smooth muscle cells of the lung nodules appear bland on light microscopy, we were always able to demonstrate mitotic activity; electron microscopy indicated immaturity of the cells. For these reasons, we believe the tumors to represent metastatic leiomyosarcomas. 相似文献
14.
Itamoto T Asahara T Katayama K Momisako H Dohi K Shimamoto F 《Journal of Hepato-Biliary-Pancreatic Surgery》1999,6(4):422-426
Intrahepatic cholangiocarcinoma (ICC) with a spindle-cell variant is very rare. We report here a surgical patient who had
double cancer — hepatocellular carcinoma (HCC) and ICC with a spindle-cell variant. In this 70-year-old man, who had a history
of hepatic resection for HCC about 2 years previously, two large discrete masses were identified in the right lobe of the
liver. A right lobectomy of the liver was performed. Pathological findings revealed that one tumor was a typical HCC, and
the other was ICC with sarcomatous lesions. Immunohistochemical examinations of the sarcomatous lesions in ICC demonstrated
that some of the spindle cells were positive for keratin, epithelial membrane antigen, and vimentin, but negative for S-100
protein, desmin, and actin. From these findings, we concluded that the sarcomatous lesions of ICC were not a true sarcoma,
but sarcomatous transformation of cholangiocarcinoma cells, that is, a spindle-cell variant of ICC.
Received for publication on April 14, 1999; accepted on June 24, 1999 相似文献
15.
Katsuhiko Uesaka Yuji Nimura Naokazu Hayakawa Shinsuke Iyomasa Satoshi Kondo Masato Nagino Tetsuro Nagasaka 《Journal of Hepato-Biliary-Pancreatic Surgery》1995,2(4):446-450
A rare case of a huge carcinosarcoma of the gallbladder is presented. Despite a tumor thrombus in the portal vein, this tumor
was resected successfully by extended right hepatic lobectomy with right caudate lobectomy and gastroduodenectomy. However,
hepatic metastases developed rapidly, and the patient died only 3 months after surgery. Macroscopically, a whitish tumor filled
the body and neck of the gallbladder and involved the right lobe and left medial segment of the liver, stomach, and duodenum.
Microscopically, the neoplasm consisted of both carcinomatous and sarcomatous components. The former contained adenocarcinoma
and squamous cell carcinoma, which were observed in the wall of the gallbladder. The latter comprised the bulk of the mass
and contained malignant cartilage and osteoid. Immunohistochemically, the sarcomatous cells reacted to antibodies for epithelial
membrane antigen and cytokeratin, but were negative for vimentin antibody, Although stromal differentiation into osteoid and
cartilage was noted, the sarcomatous component was felt to be derived from mesenchymal metaplasia of the carcinomatous cells.
Only 14 cases of carcinosarcoma of the gallbladder have been reported in the English language literature since 1967. 相似文献
16.
We report the case of a 49-year-old woman with a large renal angiomyolipoma that invaded the liver. In some areas, the tumor had the appearance of a typical angiomyolipoma; however, it also had foci where the spindle cells of the lesion showed marked cytologic atypia and mitotic activity, giving it the appearance of a high-grade sarcoma. Immunohistochemical studies demonstrated expression of vimentin, desmin, and muscle-specific actin by the sarcoma cells; these findings were consistent with leiomyosarcoma. A second, small typical angiomyolipoma was also present in the kidney. In addition, the liver exhibited focal nodular hyperplasia. Three weeks after resection of the primary renal tumor, pulmonary metastases were diagnosed by fine-needle aspiration biopsy. This is the first report of a case of angiomyolipoma with sarcomatous transformation and biopsy-proven metastatic disease. 相似文献
17.
The authors present a case of a 2-year-old boy with an abdominal mass, which was later found to be a yolk sac tumor arising from the diaphragm. To the authors’ knowledge there has been only 1 previous report of a germ cell tumor arising from the diaphragm. This case illustrates the imaging findings in this rare tumor and how it could be confused with a primary liver neoplasm. 相似文献
18.
Motohisa Kato Shigetoyo Saji Katsuyuki Kunieda Tatsuhiro Yasue Kimitoshi Nishio Mitsuri Adachi 《Surgery today》1997,27(8):766-768
We experienced a case of mediastinal lipoma, which is considered to be a relatively rare disease. A 3-year-old girl was referred
to Gifu University hospital because of fever and an abnormal shadow on her chest X-ray. The chest X-ray clearly showed a well-delineated
tumor shadow which seemed to oppress the diaphragm and the right atrium in the right lower lung area. A computed tomogram
(CT) of the chest showed a homogeneous mass localized on the right diaphragm and adjoining the right anterior chest wall and
heart. The mass showed a fat density measuring about-100 HU. Magnetic resonance imaging (MRI) showed a high-intensity mass
which was almost the same level as the subcutaneous fat on both the T1-weighted and T2-weighted images. Thoracotomy was performed and a fatty tumor was found. It arose from the right side of the pericardium and
adjoined the diaphragm, the anterior chest wall, and the thymus. There was no adhesion between the tumor and the surrounding
organs. It was resected easily and its contents were yellowish and homogeneous. The patient made an uneventful recovery and
was discharged 10 days after the operation. Light microscopy showed a lipoma consisting of mature adipose tissue and no malignancy
was found. 相似文献
19.
Asahi Sato Masaji Hashimoto Jin Moriyama Marie Hanaoka Kohta Momose Keiichi Kinowaki Sumiyo Ando Takeshi Fujii Kenichi Ohashi Goro Watanabe 《Surgery today》2014,44(2):378-382
This report presents a case of primary pleomorphic rhabdomyosarcoma arising in the duodenum. A 63-year-old male with persistent melena was referred for a solid tumor in his right upper abdomen detected using ultrasonography. Gastrofiberscopy revealed a protrusion in the upper part of the duodenum, with a large ulcer on the top of it. Enhanced computed tomography showed that the tumor extended to the pancreas. Pancreaticoduodenectomy was performed, despite the absence of malignant cells in the biopsy specimen, with a preoperative diagnosis of duodenal cancer. The tumor consisted of multiple cell types, and immunohistochemical staining was positive for desmin, HHF-35 and alpha smooth muscle actin. Electron microscopy revealed primitive Z-band structures in the tumor. The final diagnosis was pleomorphic rhabdomyosarcoma of the duodenum. This is the first report of primary rhabdomyosarcoma occurring in the duodenum, confirmed by immunohistochemical staining and electron microscopy. 相似文献
20.
Xingyang Xue Jun Chen Wei Ma Daxing Zhu Weiguo Zhang Gang Chen Sen Wei Qinghua Zhou 《Surgery today》2009,39(4):332-334
Mediastinal solitary fibrous tumors (SFTs) are rarely found in adults and there are few reports describing primary mediastinal
SFT invading the diaphragm. We report the case of a 47-year-old woman with a large right inferior mediastinal SFT. Magnetic
resonance imaging showed the tumor invading the right lower lobe of the lung and the right hemidiaphragm, with displacement
of the inferior vena cava (IVC) and right lobe of the liver. Angiogram showed IVC stenosis. To our knowledge, this is the
first report of complete resection of the tumor combined with right lower lobectomy of the lung and partial resection and
reconstruction of the right diaphragm with a Dacron flap. 相似文献