Publications by authors named "Kosuke Tobita"

In this case report, we describe the extremely rare case of a collision tumor comprising cancers of the bile duct and the pancreas. A 70-year-old man was referred to our hospital with a diagnosis of obstructive jaundice. He was diagnosed with pancreatic head cancer, and we performed a pancreaticoduodenectomy with lymph node dissection.

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Objectives: It is difficult to introduce laparoscopic surgery in institutions with a small number of patients, and surgical training relies heavily on mentors to produce well-trained surgeons. The aim of this study was to determine whether implementation of a hands-on mentorship model could provide safe skill transfer for transabdominal preperitoneal (TAPP) repair.

Methods: A trainee who had no experience with TAPP repair underwent operative tutorials until the mentor judged that the trainee could carry out the operation independently.

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Article Synopsis
  • A 31-year-old woman was found to have a huge amebic intra-abdominal tumor after presenting with abdominal fullness.
  • Colonofiberscopy revealed discrete ulcers in the cecum, and biopsy identified Entamoeba histolytica, leading to a diagnosis of asymptomatic amebic colitis.
  • Despite treatment with oral metronidazole, the tumor showed no improvement, necessitating surgical resection, which confirmed the presence of amebic infection and hemorrhagic cyst.
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A 60-year-old man received interferon/ribavirin combination therapy for chronic hepatitis C in 2002 and achieved sustained virological response. In 2008, a hepatocellular carcinoma (HCC) with a diameter of 60 mm appeared and surgical resection was performed. In March 2011, the patient was referred to our hospital because of portal lymph node swelling.

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We have previously classified wall invasion patterns of gallbladder carcinoma (GBC) cases into two groups, i.e., the infiltrative growth type (IG type) and destructive growth type (DG type).

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Objectives: There have been only a few reports on follow-up results of serous cystic neoplasm (SCN) of the pancreas. The frequency of malignancy and surgical indication of SCN are not determined yet.

Methods: In this multi-institutional study of the Japan Pancreas Society, a total of 172 patients with SCN were enrolled.

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An annular pancreas is an uncommon congenital anomaly that usually presents early in childhood. Malignancy in the setting of an annular pancreas is unusual. We herein report a case of annular pancreas with carcinoma of the papilla of Vater.

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Leiomyosarcoma of the pancreas is a rare neoplasm, with only 34 reported cases in the literature. We encountered a rare case of leiomyosarcoma of the pancreas, treated successfully by surgery. A 41-year-old woman was referred to our hospital for further examinations of a pancreatic tumor.

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Pancreatic endocrine tumors (PETs) rarely involve the main pancreatic duct. We report a case of malignant nonfunctioning pancreatic endocrine tumor (NFPET) with prevalent intraductal growth. A 47-year-old woman was referred to us after ultrasonography at a routine health check showed diffuse swelling of the pancreas.

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Objective: The aim of this study was to evaluate the long-term follow-up results of patients with branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) without mural nodules (MNs) at 10 representative institutions in Japan.

Methods: We analyzed 349 follow-up BD-IPMN patients who had no MNs on endoscopic ultrasonography at initial diagnosis.

Results: Observation periods ranged from 1 to 16.

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Objective: The aim of this study was to elucidate the clinicopathological features and prognosis of mucinous cystic neoplasms (MCNs).

Materials And Methods: We performed a multi-institutional, retrospective study on a collected series of patients with MCN pathologically defined by ovarian-type stroma. Clinicopathological features and prognosis were investigated.

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A 35-year-old woman who had visited an other hospital because of epigastralgia and anorexia was found to have a giant abdominal tumor, and was referred to our hospital. On admission, the abdomen was markedly distended. Abdominal CT scan and MRI showed the presence of a retroperitoneal tumor which occupied almost the entire abdominal cavity.

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Background: The surgical decision regarding where to resect the pancreas is an important judgement that is directly linked to the surgical procedure. An appropriate surgical margin to resect intraductal papillary-mucinous neoplasm (IPMN) of the pancreas based on the distance of tumor spread (DTS) in the main pancreatic duct has not been adequately documented. We analyzed the appropriate surgical margin based on the DTS in the main pancreatic duct of IPMN and the positive rate at the pancreatic cut end margin.

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Article Synopsis
  • The study aimed to improve the diagnosis of invasive intraductal papillary-mucinous neoplasm (IPMN) using TSP1 immunohistochemistry as a supplementary diagnostic tool.
  • Eighty patients with resected pancreatic IPMNs were examined for TSP1 expression, among other markers, leading to the classification of the tumors into different categories based on their invasiveness and histological type.
  • The research found that high TSP1 expression correlated with more aggressive forms of IPMN and poorer patient prognoses, suggesting that TSP1 could serve as a valuable marker for assessing the invasiveness of these tumors.
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  • A 37-year-old Japanese man with a pancreatic mass underwent surgery, revealing a 3.0 cm solid and cystic tumor.
  • Histological analysis showed the cyst walls lined with non-atypical columnar cells and solid areas with spindle cells characterized by specific immunohistochemical markers.
  • This case is unique as it presents the first reported instance of a primary pancreatic phyllodes tumor, distinguishing it from other spindle cell tumors.
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Gallbladder carcinomas (GBC) frequently show vascular invasion and metastasis when the carcinoma cells invade the perimuscular connective tissue (pT2 according to the TNM classification) through the muscular layer. In this study, two intramural invasion patterns were defined as (i) infiltrative growth (IG) type, infiltrative growth in the muscle layer without destruction and (ii) destructive growth (DG) type, massive growth with destruction of the muscle layer. Sixty-six surgically resected gallbladder adenocarcinomas invading the perimuscular connective tissue (pT2) and beyond the gallbladder wall, including the visceral serosa, (pT3/pT4) were examined.

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Our previous study demonstrated that the pT2 and pT3-4 gallbladder carcinomas can be classified into two groups, i.e. infiltrative growth type (IG type) and destructive growth type (DG type) and that the DG type is associated with poor differentiation, aggressive infiltration, and decreased postoperative survival.

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  • Pancreatic cancer is considered resectable only when there are no metastases or surrounding organ involvement; in this case, a 61-year-old woman initially diagnosed with advanced pancreatic adenocarcinoma was treated with chemotherapy before surgery.
  • After receiving a combination of gemcitabine and S-1, she showed a partial response, allowing for a successful pancreaticoduodenectomy, where the majority of the tumor was replaced with fibrotic tissue and very few cancer cells remained.
  • This case indicates that a targeted preoperative chemotherapy regimen can improve surgical outcomes and potentially increase resection rates in patients with pancreatic cancer previously deemed inoperable.
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  • Reconstruction by pancreaticoenterostomy is commonly used after medial pancreatectomy, but this report highlights three patients who underwent a less invasive pancreatic end-to-end anastomosis procedure following the same surgery.
  • The patients included two with serous cystadenomas and one with an intraductal papillary mucinous tumor, all located in the pancreatic neck or body, with tumor sizes ranging from 10 to 33 mm.
  • The procedure involved ductal and parenchymal anastomosis, with a pancreatic tube for decompression, resulting in an average surgery time of 3 hours and 31 minutes and minimal complications, with no tumor recurrence or pancreatic duct issues noted in follow-up.
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The calcium-binding protein, S100A4, with an inverse association of E-cadherin, is known to correlate with prognosis in various cancers. In this study, we investigated the expression of the S100A4 and E-cadherin status in relation to the clinicopathological parameters of pancreatic cancer. The expression status of these two proteins was examined in 72 specimens of primary pancreatic carcinoma with immunohistochemistry.

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Hepatorblastoma is an uncommon childhood malignant tumor of hepatic origin and recent progress of treatment strategy resulted in improved prognosis of patients with hepatoblastoma. Although patients within one year of age were considered to have better prognosis than those over that age, the treatment related deaths have been reported to be the only cause of the treatment failure of the infantile hepatoblastoma. We have successfully treated 4 infants including one with spontaneous rupture and the other with recurrence.

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Hepatocellular carcinoma rarely metastasizes to the orbit. We report on a 72-year-old man with a past history of resection for hepatocellular carcinoma and recurrent HCC, who presented with diplopia and left painful proptosis. Head scans revealed a large and irregular mass in the left orbit that caused destruction of the orbital bone superiorly and posterolaterally.

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Hepatocellular carcinoma (HCC) is rarely metastasized to the pharyngeal region. We report the case of a 59-year-old man admitted to our hospital with a complaint of hematemesis. An endoscopic examination revealed a tumor located in the left piriform sinus.

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