A Trigeminal Neuralgia-like Paroxysmal Pain Condition Presumably Due to Buccal Nerve Compression in the Temporalis Muscle

We encountered three patients with trigeminal neuralgia-like paroxysmal pain in the buccal nerve region. In all cases, paroxysmal pain was felt spreading to the receptive field of the ipsilateral buccal nerve, and clear tenderness was observed during intraoral palpation at the inner side of the mandibular ramus where the temporalis muscle runs and attaches. It was assumed that the paroxysmal pain might be caused by nerve compression related to temporalis muscle hyperactivity. To lend support to this hypothesis, we also studied the anatomical relationship between the buccal nerve and the masticatory muscles. In this autopsy study, the buccal nerve pierced the temporalis muscle in six (12%) of 52 specimens from 26 cadavers. These findings support the hypothesis that peripheral buccal nerve compression could be an etiology of paroxysmal neuropathic pain in the unilateral orofacial region.     

Expression of GLUT-1 and GLUT-3 in Xanthogranulomatous Cholecystitis Induced a Positive Result on 18F-FDG PET: Report of a Case

Although several reports have revealed that fluorine-18 fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) is useful for differentiating between benign and malignant lesions in the gallbladder, the positive results of ¹⁸F-FDG PET are not specific for malignancy because ¹⁸F-FDG is also accumulated in inflammatory lesions. It is known that the most important pathway for ¹⁸F-FDG to enter the cell body is mediated by the facilitative glucose transporter-1 (GLUT-1) through GLUT-3. We herein present a case of xanthogranulomatous cholecystitis (XGC) with a positive result on ¹⁸F-FDG PET. In this case, GLUT-1 and GLUT-3 were both positively expressed in inflammatory cells at the gallbladder wall of XGC and this is the first report to reveal GLUT expression in XGC. This report reveals that surgeons should carefully consider the appropriate treatment of gallbladder tumor, even with a positive result on ¹⁸F-FDG PET.     

Tube cavoplasty using autologous vein grafts for resected inferior vena cava reconstruction

Reconstruction of inferior vena cava (IVC) defects after surgical resection of the IVC is associated with significant complications, such as venous thrombosis and graft infection. We herein report a new technique called “tube cavoplasty” that uses only autologous venous grafts to reconstruct IVC defects after resection of leiomyosarcomas of the IVC. The patient’s own left internal jugular and left external iliac veins are procured independently and incised along their axes to create an independent venous patch that is approximated together to make a wider “tube” graft. The size and length of the “tube” graft perfectly matches the IVC defect. In this study, no complications associated with this new procedure were observed except for transient mild edema of the left leg. This new technique could be a valuable tool to reconstruct IVC defects, such as those that occur after resection of IVC tumors or IVC stenosis for Budd–Chiari syndrome.