11 research outputs found
Cisplatin-Induced Sonic Hedgehog Signaling Mediates Epithelial-Mesenchymal Transition in Hertwig’s Epithelial Root Sheath Cells.
福岡歯科大学2020年
Giant immature sacrococcygeal teratoma with early recurrence and lung metastases: A case report
Introduction: Neonatal sacrococcygeal teratoma (SCT) results in poor outcomes if it is associated with preterm delivery and an immature histology. Furthermore, some patients experience recurrence, generally one to two years later. We herein present a preterm infant case of an immature SCT with metastatic recurrence within two months of the initial resection. Case presentation: A neonate with prenatally diagnosed SCT was born at 28 weeks’ gestation with a birth weight of 2337 g. The tumor measured 18 × 9 × 8 cm in diameter, and it was predominantly solid and hypervascular. Postnatally, the patient presented with anemia and coagulopathy requiring a massive transfusion presumably due to intratumoral hemorrhage. Surgical resection was performed at 12 days of age. The tumor was histologically diagnosed to be an immature teratoma. The alpha-fetoprotein (AFP) levels decreased but increased thereafter on postoperative day 68. Computed tomography revealed both local recurrence and bilateral lung metastases. During chemotherapy, all secondary lesions were enlarged. We resected the lesion in the right lung, which was histologically diagnosed as mature teratoma. Even after switching chemotherapy protocols, the residual lesions were progressive. We resected the lesion from the left lung. Following another course of chemotherapy, we resected the presacral recurrent tumor, which was histologically confirmed as a mature teratoma. The patient has not shown any signs of a re-recurrence for 6 years. Conclusion: This case highlights the fact that immature sacrococcygeal teratomas can recur and metastasize as early as two months after the initial resection
A Case of Pneumothorax Complicated by Multiple Large Pulmonary Nodules Due to Mycobacterium Kansasii Infection
We report a rare case of pulmonary infection with Mycobacterium kansasii complicated by pneumothorax and multiple large nodules in both lungs. A 68-year-old man presented with sudden right chest pain and dyspnea. He was diagnosed with pneumothorax on the right side and immediately treated by insertion of a chest tube and drainage. After admission, the pneumothorax was cured, but a high fever continued. A chest x-ray and computed tomography scan showed multiple large nodules with and without cavities in both lungs. We suspected malignant disease, inflammatory granulomatosis, or pneumomycosis and subsequently performed bronchofiberscopy. The results of a transbronchial lung biopsy indicated caceous necrosis surrounded by epithelioid cells, without forming distinct granulomas on histology, and the results of acid-fast bacilli smear tests were positive. Mycobacterium could not be detected by polymerase chain reaction. Because the patient\u27s condition was poor, we started him on anti-Mycobacterium therapy: rifampin, isoniazid, and ethambutol. His condition subsequently improved. Bacterial culture confirmed the presence of M. kansasii, so the antibiotic therapy was continued. The patient\u27s temperature decreased to below 37°C, and the nodules in his lungs reduced in size. In this atypical case of M. kansasii infection, the patient presented with severe symptoms. Bronchofiberscopy enabled prompt diagnosis and early treatment