記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：英語  

Although synovial sarcoma is a relatively common soft tissue sarcoma, primary intra-articular cases are extremely rare. Herein, we report a case of primary intra-articular synovial sarcoma arising from the hip joint, that was initially treated with hip arthroscopy. A 42-year-old male presented with a history of pain in the left hip for 7 years. Radiography and magnetic resonance imaging revealed the primary intra-articular lesion and simple excision with an arthroscopy was performed. Histological findings revealed spindle cell proliferation with abundant psammoma bodies. SS18 gene rearrangement was confirmed by fluorescence in situ hybridization, and the tumor was diagnosed as synovial sarcoma. Adjuvant chemotherapy and radiotherapy were performed. Local control without metastasis was achieved 6 months after excision. This is the first case of intra-articular synovial sarcoma of the hip joint excised via hip arthroscopy. When an intra-articular lesion is identified, malignancies such as synovial sarcoma should be included in the differential diagnosis.

DOI： 10.1093/jscr/rjad066

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BackgroundThe active surveillance (AS) has been suggested for the initial treatment of extra-abdominal desmoid fibromatosis (EADF), the percentage of patients who shifted to invasive secondary treatments was significant. Tranilast, an anti-keloid medication, is frequently used in Japan, but there is no detailed report on its efficacy.MethodsWe retrospectively analyzed the medical records of EADF patients treated with tranilast between January 2009 and March 2021. Since EADF has been reported to shrink spontaneously, the effects of all drugs should be compared to AS. Therefore, we compared its clinical course with that under AS (determined by a systematic review) to assess the effect of tranilast. A systematic literature review of AS outcomes was conducted on July 22, 2021, according to PRISMA guidelines. The primary endpoint was the rate of conversion to secondary treatment. Secondary endpoints were progression-free survival, objective response rate (ORR), disease control rate (DCR), and adverse events. The rates of conversion to secondary treatment, ORRs, and DCRs were compared between the two groups using the Fisher's exact test.ResultsEighteen patients who received tranilast as the initial treatment for EADF were included. Two patients (11.1%) underwent surgical resection due to tumor growth and continuous pain. Compared to the secondary treatment conversion rate from the pure AS approach (40.1%), tranilast was shown to significantly reduce the rate (p = 0.01). The ORR and DCR did not different between the two groups.ConclusionsAs initial treatment for EADF, tranilast is preferred over AS.

DOI： 10.1272/jnms.JNMS.2023_90-113

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for malignant musculoskeletal tumor are at an increased risk of thromboembolic events, only few studies have investigated this risk in detail. Therefore, the aim of this study was to determine the prevalence and risk factors for preoperative VTE in malignant musculoskeletal tumors patients. METHODS: We retrospectively reviewed the medical records of 270 patients who underwent surgical procedures, including biopsy for malignant musculoskeletal tumor, have undergone measurements of preoperative D-dimer levels, and were subsequently screened for VTE by lower extremity venous ultrasonography and/or contrast-enhanced computed tomography scans. Statistical analyses were performed to examine the prevalence and risk factors for VTE. Receiver operating characteristic (ROC) analysis was performed to verify the D-dimer cutoff value for the diagnosis of VTE. RESULTS: Overall, 199 patients (103 with primary soft tissue sarcomas, 38 with primary bone sarcomas, 46 with metastatic tumors, and 12 with hematologic malignancies) were included. D-dimer levels were high in 79 patients; VTE was detected in 19 patients (9.5%). Multivariate analysis indicated that age ≥ 60 years (P = 0.021) and tumor location in the lower limbs (P = 0.048) were independent risk factors for VTE. ROC analysis showed that the D-dimer cutoff value for the diagnosis of VTE was 1.53 µg/mL; the sensitivity and specificity were 89.5% and 79.4%, respectively. CONCLUSIONS: Our study indicated that age and tumor location in the lower limbs were independent risk factors for preoperative VTE in malignant musculoskeletal tumors patients. D-dimer levels were not associated with VTE in the multivariate analysis, likely because they are affected by a wide variety of conditions, such as malignancy and aging. D-dimer is useful for exclusion diagnosis because of its high sensitivity, but patients with high age and tumor location in the lower limbs are a high-risk group and should be considered for imaging evaluation such as ultrasonography regardless of D-dimer levels. TRIAL REGISTRATION: Our study was approved by the institutional review board. The registration number is B200600056 . The registration date was July 13, 2020.

DOI： 10.1186/s12959-022-00382-2

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Serum tartrate-resistant acid phosphatase 5b is well known to be increased in giant cell tumors of bone. However, there are only a few studies that analyzed the association with tartrate-resistant acid phosphatase 5b expression in those patients. Therefore, we analyzed the characteristics of patients with giant cell tumors of bone and high tartrate-resistant acid phosphatase 5b expression. METHODS: This retrospective study included 26 patients with giant cell tumors of bone. The correlation between tartrate-resistant acid phosphatase 5b before initial treatment and tumor volume was evaluated. Patients were divided into two groups according to tartrate-resistant acid phosphatase 5b level. Statistical analysis was performed between the two groups. RESULTS: Tartrate-resistant acid phosphatase 5b was elevated in 17/26 patients, and the mean value was 852 mU/dL. There was no correlation with tumor volume (r = 0.034, P = 0.86). The mean age of 34.5 years in the HT group was significantly younger than the mean age of 47.4 years in the LT group (P = 0.040). Pathologically, 19/26 cases showed at least one focal area with features of typical giant cell tumor of bone. Although 11/18 patients in the LT group exhibited relatively noticeable secondary changes, all patients in the HT group exhibited typical features (P = 0.0074). CONCLUSIONS: Tartrate-resistant acid phosphatase 5b levels were not elevated in some giant cell tumors of bone. This study suggested that tartrate-resistant acid phosphatase 5b may be elevated in younger patients and in cases with fewer pathological secondary changes, regardless of tumor volume.

DOI： 10.1272/jnms.JNMS.2022_89-611

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本骨折治療学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本病理学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本病理学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：神奈川整形災害外科研究会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

遠隔転移のない骨・軟部肉腫に対して重粒子線治療(CIRT)を行った48例を対象として、CIRT後の局所再発に関連する因子について検討し、計画的切除術とCIRTを併用した取り組みについて紹介した。経過中局所再発は10例20.8%、遠隔転移は17例35.4%に認め、化学療法は19例39.6%で併用されており、初回局所治療として施行したP群は10例20.8%、切除術後の再発に施行したR群は9例18.8%であった。全体の2年生存率は71.6%、3年生存率は53.7%で、P群とR群の生存率に有意差はなかったが、P群はR群よりも局所制御率が有意に高く、転移制御率が良好な傾向にあり、切除術など既治療後の再発が有意な予後不良因子であった。今回、CIRTの利用価値を高めるための方策の一つとして紹介した計画的切除の併用は、CIRTの成績向上や適応拡大につながると考えられた。

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01133&link_issn=&doc_id=20210805120006&doc_link_id=%2Ffj2ortho%2F2021%2F009507%2F007%2F0495-0504%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffj2ortho%2F2021%2F009507%2F007%2F0495-0504%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本骨折治療学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

63歳女。右手掌の腫脹と疼痛を主訴とした。X線では母指球を中心に遠位方向へ拡大する軟部陰影の腫脹を認めた。MRIでは右手掌橈側の皮下脂肪を中心とし、一部筋層内へ進展する境界不明瞭な腫瘍様病変を認めた。腫瘍はT1強調像で低信号、T2強調像と脂肪抑制像で高信号を示し、分葉状を呈していた。腫瘍は全長12cmで、橈骨茎状突起の約3cm近位から生じ、遠位は母指および示指のMP関節以遠に至る病変であった。短母趾伸筋(EPB)、長母指外転筋(APL)、長母指伸筋の腫瘍内走行を認めた。手術を施行し、橈側のAPLとEPBの腱に接する部分や橈骨神経浅枝の周囲では一部腫瘍内切除となり、手掌側では手掌腱膜と長掌筋の一部、APLの橈側線維の一部をつけて一塊に切除した。エタノール処理した後、切除面を人工真皮で被覆した。病理所見はmyxoinflammatory fibroblastic sarcomaに矛盾しない所見であった。術後1ヵ月で肉芽の新生を認め、全層植皮による再建術を施行した。植皮部に術後感染等の合併は生じず、生着は良好であった。術後8ヵ月の現在、母指のIP関節とMP関節に軽度の屈曲制限が残存するが、再発は認めていない。

researchmap

記述言語：日本語   出版者・発行元：神奈川整形災害外科研究会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：関東整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：東日本整形災害外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)神奈川県医師会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本整形外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap