A Transposition Flap Reconstruction after Resection of a Soft-Tissue Sarcoma in the Buttock

Introduction: Large defects following resection in the gluteal region are challenging. Of note, there are a limited number of fairly morbid options for reconstruction. Case Report: A 65-year-old female presented with complaints of an enlarging mass in the left buttock over the past several months. A high-grade sarcoma was diagnosed based on a biopsy. The final diagnosis was an undifferentiated pleomorphic sarcoma based on the resected tumor. An 11-cm tumor with surrounding tissues, including the great gluteal muscle, was resected, which resulted in a 17-cm full thickness defect. The defect was reconstructed with a transposition flap elevated from the lateral thorax. A transposition flap can cover large buttock defects without sacrificing other muscles. Conclusion: Moreover, a transposition flap is esthetically acceptable because most of the operative scar is within the buttock area. A transposition flap reconstruction is one of the several options for large defects after soft-tissue sarcoma resection in the buttock

Thoracoabdominal flap reconstruction after resection of superficial soft-tissue sarcomas in the chest wall

The thoracoabdominal flap is a rotation flap, and is well known for reconstruction of defects following resections for breast cancer, but the flap is not well known for reconstructing defects following resections of soft-tissue sarcomas involving the chest wall. Here we present two patients with superficial chest wall sarcomas consisting of a dermatofibrosarcoma protuberans in a 42-year-old man and a recurrent myxofibrosarcoma in a 76-year-old man. The tumors were resected with the surrounding tissue. The defect was reconstructed with a thoracoabdominal flap elevated from the ipsilateral thorax (medially-based flap). Neither case developed necrosis of the flap or reduced shoulder range of motion. The chest wall presents few options for a donor vessel. The thoracoabdominal flap has an axial blood supply and does not require a microsurgical procedure. A thoracoabdominal flap is a suitable reconstruction option for a defect after the resection of a superficial soft-tissue sarcoma in the chest wall

Multifidus muscle retracted and preserved in resection of malignant bone tumor in the sacral ala

Resection of malignant tumors in the posterior pelvis requires multidirectional approaches for the resection and the subsequent spine-pelvic fixation. The multifidus muscle can be scarified during the operation. This is a case report of a 44-year-old male with a secondary chondrosarcoma arising from an osteochondroma in the sacral ala. Recurrence occurred 11 months after the initial operation, and the resected tissue from the recurrence was diagnosed as a chondrosarcoma. In both operations, the multifidus muscle was elevated from its distal attachment to provide an adequate view of the tumor resection and insertion of spine-pelvic instrumentation. An adequate view by elevation of the multifidus muscle is useful for a safe operation. A preserved multifidus muscle covering the instrumentation may reduce the risk of infection. The elevation and preservation of the multifidus muscle is an easy and simple method that contributes to successful resection of a malignant tumor of the pelvis

Preserving the posterior cortex of the sternum during resection of a superficial anterior chest wall sarcoma

Following resection of a sternal tumor, respiratory dysfunction can occur and rigid reconstruction is necessary. An 82-year-old woman noted a mass in the anterior chest wall that was increasing in size. The tumor was located on the left aspect of the sternum at the level of the third rib. A radiation-induced malignant spindle cell tumor was diagnosed because of a history of irradiation for hilar lymph node carcinoma. The tumor was resected with the surrounding tissues of the second-to-fourth ribs and sternum. The posterior sternal cortex was preserved by cutting with a curved chisel under fluoroscopy. The chest wall defect was reconstructed with a 2-mm thick Gore-Tex® sheet and a local transpositional flap. Sternal resection with a chisel under fluoroscopy avoids damage to the internal thoracic artery. Preserving the posterior sternal cortex does not require rigid reconstruction. The procedure is minimally invasive

A comparison of the usefulness of nuclear beta‐catenin in the diagnosis of desmoid‐type fibromatosis among commonly used anti‐beta‐catenin antibodies

Desmoid-type fibromatosis (DF) is a locally aggressive but non-metastatic (myo)fibroblastic neoplasm. A hallmark of the tumor is nuclear positivity for beta-catenin in immunohistochemistry due mostly to CTNNB1 mutations. However, a recent study has reported that even beta-catenin ‘nuclear-negative’ DFs can harbor CTNNB1 mutations and that the positive ratio of nuclear beta-catenin in DF is different among antibodies. Here, we reviewed soft tissue lesions for which the possibility of DF was considered and compared the sensitivity and specificity of nuclear beta-catenin for the diagnosis of DF among commonly used anti-beta-catenin antibodies, i.e., clone beta-catenin 1, 17C2 and 14. We analyzed 26 cases of DF, 28 cases of benign fibroblastic lesions, and 27 cases of other soft tissue tumors. The sensitivity and specificity of nuclear beta-catenin for the diagnosis of DF were different among antibodies; 54% and 98% in clone beta-catenin 1, 85% and 84% in 17C2, and 96% and 62% in 14. IHC of LEF1 showed comparable results with IHC of beta-catenin, with a sensitivity of 88% and specificity of 76%. Additionally, when beta-catenin 1 was used, DFs showed characteristic dotted cytoplasmic staining, often appearing as rings. Our results might be helpful for making a correct diagnosis of DF

Paraplegia Caused by Multifocal Osteosarcoma With Spinal Lesions

Background: Multifocal osteosarcoma is a rare condition that may be either synchronous or metachronous. Spine involvement of multifocal osteosarcoma is very rare. Synchronous multifocal osteosarcoma is typically described as the occurrence of tumors at two or more sites in the absence of pulmonary metastases. Methods: A 55-year-old man initially presented with low back pain. Multiple osteosclerotic lesions were observed, primarily in the spine and pelvis, as well as in soft tissues. Lung lesions were observed, but they were relatively small at reference. Laboratory tests showed a markedly elevated alkaline phosphatase (ALP) level of 36, 416 U/L (normal range, 115-359 U/L). Based upon a diagnosis of osteosarcoma on biopsy, chemotherapy was administered, resulting in a decrease in ALP to 17, 833 U/L. Results: Decompression of the symptomatic compressed spinal cord and posterior spinal stabilization of T8-12 were performed. However, progressive extensions of multiple lesions to the spinal canal led to paraplegia with urinary dysfunction. Eleven months after the first visit to our hospital, the patient died due to multiple organ failure. Conclusions: Multifocal osteosarcoma accompanied by spinal lesions may lead to paraplegia, a clinical problem that negatively affects the quality of activities of daily living. Level of Evidence 4. Clinical Relevance: Multifocal osteosarcoma accompanied by spinal lesions may lead to paraplegia, a clinical problem that negatively affects the quality of life and activities of daily living

The Yuu-yuu Health Circle as a Place for Learning and Playing

The Yuu-yuu Health Circle is a place for students to learn and deepen their understanding and interest by putting into practice the knowledge and skills they have gained in class at the university. This chapter introduces its maintenance and promotion activities for older adults in the community that were participated by students of the Departments of Physical Therapy and Occupational Therapy at Kinjo University before and during the coronavirus pandemic. The activity method and contents changed significantly during the pandemic. However, as a medical and welfare university, its job to develop human resources that deal with people has not changed. As an educational method toward such purpose, the activities helped students, who need to actively communicate with people of different ages and improve their interpersonal communication skills even during the pandemic

Biochemical properties of warm eddies reproduced by western Arctic marine ecosystem model

第2回極域科学シンポジウム/第34回気水圏シンポジウム 11月17日（木） 統計数理研究所 セミナー室