Publications by authors named "Itsuo Watanabe"

Article Synopsis
  • A multicenter study in Japan compared clinical outcomes for patients with pelvic bone sarcomas treated with surgery versus particle beam therapy (carbon-ion and proton).
  • The study included 116 patients, with 57 receiving surgery and 59 undergoing particle beam therapy, revealing differences in median age at diagnosis and tumor size between the groups.
  • Overall survival, local control, and metastasis-free survival rates were similar between the groups, but in chordoma patients, the particle beam therapy showed significantly better local control rates compared to surgery.
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This case report focuses on a 15-year-old competitive-level high school basketball player who experienced chronic low back pain. Diagnostic imaging revealed osteoid osteoma in the L5 posterior element, causing osteosclerotic deformity of the left lamina and more inferior facet. To return him to the condition of sports activity, less invasive surgery of microscopic tumor resection with autologous bone grafting was planned instead of CT-guided ablation, which can cause thermal injury to nearby tissues.

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Article Synopsis
  • Treatment of spinal metastasis, particularly from breast and prostate cancers, is gaining attention due to its impact on patients' quality of life and surgical interventions.
  • A case study describes a patient with lumbar metastasis who experienced nerve palsy after surgery, but improvement occurred following further bone resection.
  • The study highlights the importance of adequately removing tumor mass during surgery to prevent complications like intervertebral foraminal stenosis and nerve damage.
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A 57-year-old woman underwent cervical implant surgery for a dislocated cervical spine fracture, and she complained of continuous intractable neck pain after surgery. Eight years later, she developed a plantar skin rash, subsequently diagnosed as a metal allergy, and metal dentures were replaced with ceramic ones. The skin rash, however, persisted for four more years after that and was eventually treated with cervical implant removal.

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Introduction: Wrong-site spine surgery is an incident that could result in possible severe complications. In this present spinal surgery, the accurate spinal level is confirmed via preoperative or intraoperative radiographic marking. However, the location of radiographic marking has been determined from the manual palpation on the landmarks of the body surface.

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Article Synopsis
  • This study analyzed the clinical outcomes of 187 patients with pelvic and retroperitoneal bone and soft tissue sarcoma (BSTS) treated at specialized centers in Japan.
  • The 3-year overall survival (OS) rate was 71.7%, while local control (LC) and progression-free survival (PFS) rates were 79.1% and 48.6%, respectively, with osteosarcoma showing significantly worse outcomes.
  • Key poor prognostic factors identified included larger tumor size, soft tissue tumors, presence of distant metastasis, and age, impacting overall survival, local control, and progression-free survival.
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Several reports have compared spinal cord tumor removal techniques but none have clearly described the appropriate site and level of indication for laminectomy or laminoplasty. The approach method for tumor removal depends on the type and localization of the tumor and the surgeon's skill. Therefore, a system that can suggest various surgical techniques is useful for spinal cord tumor surgery.

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Introduction: Denosumab has been shown to be highly effective at suppressing the progression of giant cell tumor of bone (GCTB). However, recent studies have observed a potential increased risk of local recurrence after surgery following the use of denosumab, raising concerns on the use of this agent against GCTB in combination with surgery.

Methods: We retrospectively reviewed the medical records of 234 patients with GCTB who were surgically treated at multiple institutions from 1990 to 2017.

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In spine surgery, instrumentation surgery using augmented reality (AR) and navigation systems have become widespread, while decompression surgery using those applications is not so common. However, we sometimes encounter intraoperative problems such as excessive blood loss or bony resection in decompression surgery. Therefore, a practical navigation system is needed for safer spinal decompression surgery.

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Background: Intracortical chondroma of the metacarpal bone which could be painful is an extremely rare condition and previously only one case has been reported. Due to the similar physical features and appearance on clinical imaging, it is difficult to differentiate between intracortical chondroma and osteoid osteoma. Therefore, pathological examination is usually required to establish a definite diagnosis, which is often carried out only after tumor removal.

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Methotrexate-associated lymphoproliferative disorder is recognized as a lymphoma that occurs following methotrexate administration. The lesion of the spine is extremely rare, and only one case of lesion in the lumbar spine has been reported so far. Here, we present a case of methotrexate-associated lymphoproliferative disorder of the thoracic spine in a 54-year-old woman with rheumatoid arthritis.

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Background: Due to the wide variations in location, size, local invasiveness, and treatment options, the complications associated with surgery for giant cell tumor of bone have been sporadically reported. For quality assessment, fundamental data based on large-scale surveys of complications under a universal evaluation system is needed. The Dindo-Clavien classification is an evaluation system for complications based on severity and required intervention type and is suitable for the evaluation of surgery in a heterogeneous cohort.

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Background: Clear cell chondrosarcoma is an extremely rare chondrosarcoma subtype; thus, its treatment outcomes and associated factors have not been widely studied. Knowing more about it is potentially important because clear cell chondrosarcomas are often misdiagnosed as other benign lesions and subsequently treated and followed inappropriately.

Questions/purposes: (1) What are the patient- and tumor-related characteristics of clear cell chondrosarcoma? (2) What proportion of patients with clear cell chondrosarcoma initially had a misdiagnosis or a misleading initial biopsy result? (3) What is the survivorship of patients with clear cell chondrosarcoma free from death, local recurrence, and distant metastasis, and what factors are associated with greater survivorship or a reduced risk of local recurrence?

Methods: Between 1985 and 2018, 12 Japanese Musculoskeletal Oncology Group (JMOG) hospitals treated 42 patients with a diagnosis of clear cell chondrosarcoma.

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A liposarcoma is extremely rare in the digits. A 73-year-old woman was diagnosed with a lipoma in her middle finger 10 years ago. As this tumor increased in size and presented with imaging findings that were atypical of lipomas, careful marginal resection biopsy outside the pseudo-capsule was performed, and the tumor was diagnosed as a well-differentiated liposarcoma.

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Background: Surgical treatment for renal cell carcinoma metastases can be an effective modality for improving survival and patients' quality of life. However, it is often difficult to decide on the optimal surgical approach due to the lesion's high vascularity and uncertainty regarding postoperative performance status and survival.

Patients And Methods: Blood loss, postoperative performance status, overall survival, postoperative complication and related risk factors for surgical treatment were analysed in 61 renal cell carcinoma patients with bone metastases.

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Solitary metastasis of a carcinoma to carpal bone is extremely rare. Metastases of renal cell carcinoma (RCC) usually occur in a multiple fashion and there has been no report to date of a solitary metastasis to trapezium from RCC. The tumor was excised and reconstructed with iliac bone transplantation.

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Background: Adamantinoma arising in the femur is extremely rare. We report a case of an adamantinoma occurring in the right medial femoral condyle that was diagnosed 5 years after the primary surgery.

Case Presentation: A 74-year-old Asian woman first complained of right knee pain without any cause.

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Objective: The purpose of this study is to identify factors that affect survival of patients with differentiated thyroid carcinoma with bone metastases and to optimize surgical treatment modality for bone metastatic lesion by comparing duration of patient survival and local control.

Methods: We examined 52 bone metastatic lesions from 40 patients with differentiated thyroid carcinoma who were treated surgically between 1994 and 2008 at Keio University Hospital. Median follow-up time was 46 months (range: 4-233 months).

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Introduction: Osteoid osteoma is a benign tumor that usually occurs in the long bones of young adults. Its symptoms can be diverse depending on the location of the tumor and especially difficult to diagnose when occurring in an atypical location. Osteoid osteoma arising in the sacrum is extremely rare, and here, we present a case that was treated successfully in a minimally invasive fashion under computed tomography guidance.

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Desmoplastic fibroma (DF) of the bone is a rare locally aggressive tumor usually occurring in adolescents and young adults. These tumors most commonly occur in the mandibles and metaphyses of long bones but are extremely rare in small bones, often resulting in diagnostic problems. The occurrence of these tumors in the foot is especially limited.

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Aneurysmal bone cyst (ABC) is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

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Mesenchymal chondrosarcoma (MC) is an extremely rare subtype of chondrosarcoma. A tumor specific fusion gene, HEY1-NCOA2 fusion, was recently identified in this tumor. The finding raises the possibility that the diagnosis of MC can be improved by examining the fusion gene.

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