Large-Cell Undifferentiated Carcinoma of the Submandibular Gland

Occurrence of large-cell undifferentiated carcinoma in the submandubular gland is uncommon. A 52-year-old man with a 30-mm tumor underwent radical resection of the left submandibular gland together with selective dissection of enlarged ipsilateral cervical nodes followed by postoperative radiotherapy. After histologic examination identified the submandibular gland mass as large-cell undifferentiated carcinoma, selective dissection of enlarged contralateral cervical nodes was performed. The patient showed no evidence or of distant metastasis at 24 months after initial treatment

Endoscopic Resection of Zenker's Diverticulum

We report an endoscopically assisted total diverticulectomy for Zenker's diverticulum. Skin incisions were made at the anterior axillary line, the center of the sternum, and the neck as portals for endoscopical instruments. The skin was retracted with hooks which provided an excellent view of the working space. The diverticulum was fully exposed and resected by using a multifire endoscopic stapler. This approach is minimally invasive in comparison with the conventional open cervical approach

Prevalence of asthma and wheezes among snow crab workers in western Japan : a cross-sectional study

Objectives : Few reports are available concerning the prevalence of asthma among snow crab workers in Japan. The object of this study was to estimate the prevalence of asthma and wheezes among Japanese snow crab workers and their associations with exhaled nitric oxide (FeNO) and YKL-40. Methods : Forty-nine snow crab workers enrolled in this study, which was cross-sectional by design and was conducted using a translated version of the European Community Respiratory Health Survey questionnaire. The levels of FeNO and serum YKL-40 were measured between September and October 2014. Results : The prevalences of current asthma and wheezes were 10.2% (95% CI, 3.4 to 22.2) and 12.2% (95% CI, 4.6 to 24.8), respectively. There was no association between these prevalences and the duration of snow crab employment. Six subjects’ FeNO levels exceeded 50 ppb, and nine subjects’ levels exceeded 25 ppb. Twelve subjects’ (25.5%) serum YKL-40 levels exceeded 77.2 ng/mL, which was 2 standard deviations above the mean for healthy subjects. However, there were no significant relationships among the prevalences for asthma and wheezes, FeNO, and serum YKL-40. Conclusions : This study provides information concerning the prevalences of asthma and wheezes among Japanese snow crab processing workers

Endolymphatic Sac Tumor, A Patient Report

Endolymphatic sac tumors are rare low malignant neoplasms of the petrous temporal bone, with symptoms referable to auditory, vestibular or facial nerves, which should be strictly discriminated from benign tumors of the temporal bone. Differential diagnosis between both at the early stages of checkup controls the treatment and prognosis. Complete surgical resection is the treatment of choice, which commonly provides long-term control. We have experienced a 48-year-old man with progressive hearing loss, unsteadiness and constant tinnitus. Computed tomography and magnetic resonance imaging (MRI) demonstrated a tumor invading the posterior petrous bone, extending to the posterior fossa. In the course of image diagnosis of his disease, we observed diagnostic efficacy of 3-tesla MRI, which showed excellent lesion visualization even in a small-size endolymphatic sac tumor. The intraoperative pathologic diagnosis was not available

Tumour blood vessel normalisation by prolyl hydroxylase inhibitor repaired sensitivity to chemotherapy in a tumour mouse model

Blood vessels are important tissue structures that deliver oxygen and nutrition. In tumour tissue, abnormal blood vessels, which are hyperpermeable and immature, are often formed; these tissues also have irregular vascularisation and intravasation. This situation leads to hypoperfusion in tumour tissue along with low oxygen and nutrition depletion; this is also called the tumour microenvironment and is characterised by hypoxia, depleted nutrition, low pH and high interstitial pressure. This environment induces resistance to anticancer drugs, which causes an increase in anticancer drug doses, leading to increased side effects. We hypothesised that normalised tumour blood vessels would improve tumour tissue perfusion, resupply nutrition and re-oxygenate the tumour tissue. Chemotherapy would then be more effective and cause a decrease in anticancer drug doses. Here we report a neovascularisation-inducing drug that improved tumour vascular abnormalities, such as low blood flow, blood leakage and abnormal vessel structure. These results could lead to not only an increased chemo-sensitivity and tissue-drug distribution but also an up-regulated efficiency for cancer chemotherapy. This suggests that tumour blood vessel normalisation therapy accompanied by angiogenesis may be a novel strategy for cancer therapy

Squamous Cell Carcinoma Derived from a Skin Flap Used for Reconstruction of the Hypopharynx

Development of a secondary primary cancer in a skin flap is a rare complication. A 70-year-old man underwent partial laryngopharyngectomy, right neck dissection and reconstruction with a radial forearm free flap in 2004. Five years later, an exophytic tumor was found on the hypopharynx reconstructed with the radial forearm free flap. He underwent total laryngopharyngectomy, left neck dissection and reconstruction with a jejunal free flap in June 2009. Pathological findings suggested this was a primary cancer rather than a metastasis. Localization to the epidermis and dermis indicate that the tumor was derived from the surface of the skin flap

Immunohistochemical Features of Primary Pure Squamous Cell Carcinoma in the Thyroid: An Autopsy Case

Primary squamous cell carcinoma (SCC) in the thyroid is extremely rare and has been reported in < 1% of all thyroid cancer cases. Primary SCC in the thyroid was thought to be a transitional form derived from adenocarcinomas; therefore, the majority of reported cases have focused on the conjunction with other histological adenocarcinomas. A 73-year-old male presented to our hospital with bilateral vocal fold palsy and an anterior neck mass. Ultrasound sonography revealed a bulky tumor in the thyroid and bilateral cervical lymphadenopathy. We performed fine-needle aspiration cytology from the thyroid tumor, which revealed SCC. Positron emission tomography/computed tomography showed distant metastases in the lungs, mediastinal lymph nodes, and vertebra. We diagnosed the patient as having stage IVC SCC in the thyroid and administered weekly paclitaxel. Four and a half months after treatment initiation, the tumor progression resulted in aspiration pneumonia, which proved fatal. We performed an autopsy in accordance with the patient’s wishes. Pathological findings revealed that all carcinomas in the thyroid, cervical lymph nodes, and lungs were pure SCCs. Immunohistochemical examinations for PAX8, thyroglobulin, and TTF-1 were all negative. Differentiated thyroid carcinomas have 3 major positive markers – PAX8, thyroglobulin, and TTF-1 –, and PAX8 is also sometimes positive for SCC in the thyroid. PAX8 positivity of SCC in the thyroid might, however, be associated with conjunction with other histological adenocarcinomas such as papillary or follicular thyroid carcinoma; therefore, pure SCC in the thyroid might be negative for PAX8

The potential role of temperate Japanese regions as refugia for the coral Acropora hyacinthus in the face of climate change

As corals in tropical regions are threatened by increasing water temperatures, poleward range expansion of reef-building corals has been observed, and temperate regions are expected to serve as refugia in the face of climate change. To elucidate the important indicators of the sustainability of coral populations, we examined the genetic diversity and connectivity of the common reef-building coral Acropora hyacinthus along the Kuroshio Current, including recently expanded (<50 years) populations. Among the three cryptic lineages found, only one was distributed in temperate regions, which could indicate the presence of Kuroshio-associated larval dispersal barriers between temperate and subtropical regions, as shown by oceanographic simulations as well as differences in environmental factors. The level of genetic diversity gradually decreased towards the edge of the species distribution. This study provides an example of the reduced genetic diversity in recently expanded marginal populations, thus indicating the possible vulnerability of these populations to environmental changes. This finding underpins the importance of assessing the genetic diversity of newly colonized populations associated with climate change for conservation purposes. In addition, this study highlights the importance of pre-existing temperate regions as coral refugia, which has been rather underappreciated in local coastal management