Publications by authors named "Kosuke Makihara"

13 Publications

  • Page 1 of 1

Malignant Transformation of Giant Cell Tumor of Bone 7 years After Initial Surgery: A Case Report and Literature Review.

JBJS Case Connect 2021 04 20;11(2). Epub 2021 Apr 20.

Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Japan.

Case: A 64-year-old man with a history of giant cell tumor of bone (GCTB) in the fibula 7 years earlier developed a recurrence with histologic features of osteosarcoma. Both the primary GCTB and the secondary osteosarcoma were found to have the H3F3A gene mutation. Despite immediate above-the-knee amputation, the patient died of respiratory failure because of lung metastases 3 months later.

Conclusion: This is the first report of proven H3F3A mutation in both the primary GCTB and the secondary osteosarcoma in the same case. Clinicians should consider secondary malignancy in patients presenting with a lesion at the site of a previously treated GCTB after a long interval.
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http://dx.doi.org/10.2106/JBJS.CC.20.00417DOI Listing
April 2021

Cardiac Tamponade as an Unusual Initial Clinical Manifestation of CIC-DUX4 Sarcoma.

Am J Case Rep 2021 Feb 28;22:e929349. Epub 2021 Feb 28.

Department of Orthopedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Fukuoka, Japan.

BACKGROUND CIC-rearranged sarcoma (CRS) is a recently described subset of undifferentiated small-round-cell sarcomas of bone and soft tissue. DUX4 is the most common gene involved in CRS. CRS usually presents in the soft tissue of the trunk and extremities, and is recognized as being clinically aggressive, with poor prognosis. Our case highlights an unusual presentation of CRS with cardiac tamponade. CASE REPORT A 48-year-old man presented with hypotension caused by hemorrhagic cardiac tamponade. ¹⁸F-fluorodeoxyglucose-positron emission tomography showed increased uptake in multiple lesions, including lesions in the left proximal humerus and several lymph nodes. Biopsy specimens of the humerus revealed proliferation of round-shaped cells. In addition, CIC-DUX4 gene rearrangement was detected by polymerase chain reaction and direct sequencing, leading to a diagnosis of cardiac tamponade caused by CRS. Although the patient received systemic chemotherapy as well as radiotherapy to the mediastinal lesion and left humerus, he died of progressive disease 12 months after diagnosis. CONCLUSIONS Because CRS is a recently proposed entity that is distinct from Ewing sarcoma, the clinical presentation and outcome of CRS has not been well documented in the literature. This is the first case report of CRS presenting as cardiac tamponade. Although cardiac tamponade due to metastatic sarcoma is extremely rare, CRS can be included in the differential diagnosis.
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http://dx.doi.org/10.12659/AJCR.929349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931773PMC
February 2021

Nuclear expression of MDM2 in hibernoma: a potential diagnostic pitfall.

Virchows Arch 2021 Mar 20;478(3):527-534. Epub 2020 Aug 20.

Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, 807-8555, Japan.

Hibernoma is a rare benign adipocytic tumor composed of a proliferation of brown and white fat cells varying in their proportions. The tumor may also contain fat cells resembling lipoblasts, which makes it difficult to distinguish it from atypical lipomatous tumor/well differentiated liposarcoma (ALT/WDLS). Although nuclear expressions of murine double minute 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) are widely used as immunohistochemical surrogate markers for ALT/WDLS, the utility of these proteins in distinguishing between hibernoma and ALT/WDLS still remains to be elucidated. We evaluated immunohistochemical expressions of MDM2 and CDK4 in 10 hibernomas expressing uncoupling protein-1 (UCP-1), a mitochondrial protein transporter consistently expressed in brown fat cells, and lacking MDM2 gene amplification, which was analyzed by fluorescence in situ hybridization (FISH). In contrast to the data previously obtained, nuclear expression of MDM2 was observed in 100% (10/10 cases) of the hibernomas irrespective of the proportion of brown fat cells, whereas no cases were positive for CDK4. The tumors also showed almost concurrent expression of p53 (in 9/10 cases) and ubiquitin-specific-processing protease 7 (USP7) (in 10/10 cases), which deubiquitinates and stabilizes MDM2, potentially resulting in its nuclear expression without MDM2 gene amplification. MDM2 expression may thus be a diagnostic pitfall for hibernoma particularly in differentiating it from ALT/WDLS.
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http://dx.doi.org/10.1007/s00428-020-02914-5DOI Listing
March 2021

Desmoplastic Fibroblastoma Invading the Humerus.

Case Rep Orthop 2020 23;2020:9780263. Epub 2020 May 23.

Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Japan.

Desmoplastic fibroblastoma (DFB) is an uncommon, benign, soft tissue tumor. The tumor most often presents as a slowly growing, painless soft tissue mass and is usually small. There have been only a few reports of patients with DFB who presented with bone invasion. Herein, we report the case of a 66-year-old woman with DFB with bone invasion in her left axilla. A lump under the left axilla was detected and was associated with pain and limited range of motion (ROM) of the shoulder. Computed tomography showed a soft tissue mass with invasion of the adjacent left humerus. Magnetic resonance imaging revealed a lesion with low signal intensity on T1- and T2-weighted images, and weak internal enhancement on postcontrast T1-weighted images with fat suppression. Histologic evaluation of a preoperative needle biopsy revealed DFB with FOSL1 expression. The tumor was marginally excised. Postoperative outpatient follow-up demonstrated a significant improvement in pain and ROM of the shoulder and no recurrence after 1 year. Even though DFB with bone invasion can cause pronounced clinical symptoms with pain and limited ROM, we conclude that simple excision is an adequate treatment.
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http://dx.doi.org/10.1155/2020/9780263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271290PMC
May 2020

Mucosal incision-assisted biopsy versus endoscopic ultrasound-guided fine-needle aspiration with a rapid on-site evaluation for gastric subepithelial lesions: A randomized cross-over study.

Dig Endosc 2019 Jul 2;31(4):413-421. Epub 2019 Apr 2.

Department of Medicine and Bioregulatory Science, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Objectives: This study aimed to compare the diagnostic yield of mucosal incision-assisted biopsy (MIAB) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a rapid on-site evaluation (ROSE) for gastric subepithelial lesions (SEL) suspected of being gastrointestinal stromal tumors (GIST) with an intraluminal growth pattern.

Methods: This was a prospective randomized, cross-over multicenter study. The primary outcome was the diagnostic yield of EUS-FNA and MIAB. The secondary outcomes were the technical success rate, complication rate, procedure time and biopsy frequency.

Results: A total of 47 patients were randomized to the MIAB group (n = 23) and EUS-FNA group (n = 24). There was no significant difference in the diagnostic yield of MIAB and EUS-FNA (91.3% vs 70.8%, P = 0.0746). The complication rates of MIAB and EUS-FNA did not differ to a statistically significant extent. The mean procedure time in the MIAB group was significantly longer than that in the EUS-FNA group (34 vs 26 min, P = 0.0011).

Conclusions: The diagnostic yield of MIAB was satisfactorily as high as EUS-FNA with ROSE for gastric SEL with an intraluminal growth pattern.
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http://dx.doi.org/10.1111/den.13367DOI Listing
July 2019

[INVASIVE BLADDER CANCER PRODUCING GRANULOCYTE-COLONY STIMULATING FACTOR: A CASE REPORT].

Nihon Hinyokika Gakkai Zasshi 2018 ;109(3):144-149

Department of Surgical Pathology, Kyushu Rosai Hospital.

A 72-year-old man presented with the chief complaint of asymptomatic macroscopic hematuria. Cystoscopy revealed a non-papillary sessile tumor in the left bladder wall. Computed tomography revealed a large invasive tumor in the bladder and left hydronephrosis; no metastases were observed. Laboratory examination showed leukocytosis (27,600 /μl) and a high serum level of granulocyte-colony stimulating factor (G-CSF; 158 pg/ml). A diagnosis of locally advanced bladder cancer producing G-CSF was made; therefore, the patient underwent a total cystectomy and urinary diversion with an ileal conduit. Histopathological examination of the surgical specimen revealed a urothelial carcinoma with squamous differentiation (pT3a, pN0, ly1, v1). In terms of their immunohistochemistry, the tumor cells were shown to express G-CSF. After surgery, the leukocyte count and serum level of G-CSF decreased to normal values. No recurrence was observed in the 41 months after surgery without adjuvant therapy. We reviewed 73 cases of bladder cancer producing G-CSF reported in the literature in Japan.
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http://dx.doi.org/10.5980/jpnjurol.109.144DOI Listing
January 2018

[Rapid Progression in Early-Stage Primary Glioblastoma Multiforme:A Case Report].

No Shinkei Geka 2016 Nov;44(11):945-950

Department of Neurosurgery, Kyushu Rosai Hospital.

The signs and features of early-stage primary glioblastoma multiforme(GBM)are not well-characterized. Here, we report a case of GBM that was presented at an early stage and showed extremely rapid progression within a short period. A 63-year-old woman was incidentally revealed to have a tiny lesion in her right parietal lobe. Magnetic resonance imaging(MRI)showed a hyperintense signal on T2WI, with a ring-enhancement on gadolinium(Gd)-enhanced T1WI. Two weeks later, she was admitted to our hospital for neurosurgical intervention;the MRI at that time showed rapid tumor growth, immediately followed by progressive neurological deterioration. The tumor was urgently removed;its histopathological diagnosis was GBM. This case indicates that primary GBM, even at an early stage, can rapidly progress within an extremely short period. Scheduling prompt neuroradiological assessments and neurosurgical interventions in possible cases of early-stage GBM are important, especially if a Gd-enhancement is seen on MRI.
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http://dx.doi.org/10.11477/mf.1436203405DOI Listing
November 2016

[A Forensic Autopsy Case Applied for Asbestos-Related Disease].

J UOEH 2016 Mar;38(1):65-9

Department of Surgical Pathology, Kyushu Rosai Hospital, Japan.

We had a forensic autopsy case that required additive pathological examination for the asbestos-related lung disease compensatory application afterwards. A man in his sixties with a history of occupational asbestos inhalation who had neither visited a hospital nor received a physical examination received forensic autopsy because of his death from unknown cause. An inmate said, "He developed cough and dyspnea, and died in the progression of the symptoms." The autopsy revealed widespread pleural plaques on both sides of the parietal pleura and multiple tumors in both sides of the lungs. The cause of death was diagnosed as lung cancer. Additional pathological examination was asked by his family to certify that he had suffered from asbestos-related lung disease in order to apply to the Asbestos-related Damage Relief Law. The Japanese criteria of the compensation law of asbestos-related lung cancer is the detection of more than 5,000 asbestos bodies per gram of dry lung tissue, while his number of asbestos bodies was 4,860. Asbestos bodies were reported to be accumulated in the distal lung parenchyma with no pathological changes. The present lung samples were collected from proximal section around the tumor, which might have made the number of asbestos bodies less than the criteria. Both the number of patients suffering from asbestos-related lung disease and the number of forensic autopsy cases have increased in Japan. Collecting lung samples from the appropriate lung section is essential and should be noted when the lung cancer is suspected at forensic autopsy in order to apply for asbestos-related lung disease compensation.
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http://dx.doi.org/10.7888/juoeh.38.65DOI Listing
March 2016

[Brain Abscess due to Infection with Dematiaceous Fungi Cladophialophora bantiana Associated with Hypogammaglobulinemia Following Gastrectomy: A Case Report].

No Shinkei Geka 2016 Jan;44(1):59-66

Department of Neurosurgery, Kyushu Rosai Hospital.

Dematiaceous fungi have melanin-like pigment in the cell wall and usually cause a variety of dermal infections in humans. Infections of the central nervous system(cerebral phaeohyphomycosis)are rare but serious, since they commonly occur in immunocompromized patients. A 76-year-old man was admitted with mild motor aphasia and underwent total excision of a mass in the left frontal lobe. With the postoperative diagnosis of brain abscess due to infection with dematiaceous fungi (C. bantiana) associated with hypogammaglobulinemia following gastrectomy, intravenous antifungal drugs including amphotericin B and fluconazole were administered. Regrowth of the abscess with intraventricular rupture was noted at about the 88th day after the initial surgery, and the patient underwent neuroendoscopic aspiration of the pus and placement of a ventricular drain. Following intraventricular administration of miconazole through ventricular drainage or an Ommaya reservoir, neuroradiological findings improved, but general and neurological conditions worsened. Further treatment was discontinued and the patient died 9 months after onset. The poor outcome in this patient is attributed to 1)intractability of dematiaceous fungi, 2)development of ventriculitis and the need for intraventricular administration of antifungal drugs, and 3)untreatable hypogammaglobulinemia following gastrectomy.
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http://dx.doi.org/10.11477/mf.1436203208DOI Listing
January 2016

[Synchronous gastrointestinal stromal tumors of the rectum and duodenum: a case report].

Nihon Shokakibyo Gakkai Zasshi 2015 Nov;112(11):1991-7

Department of Gastroenterology, Kyushu Rosai Hospital.

An 85-year-old woman with anemia underwent colonoscopy, which revealed a 25-mm submucosal tumor with ulceration in the lower rectum. Histological examination of a biopsy showed that the lesion was a gastrointestinal stromal tumor (GIST). Subsequent esophagogastroduodenoscopy revealed a submucosal tumor in the duodenum, and examination of a biopsy obtained by endoscopic ultrasound-guided fine-needle aspiration also confirmed that this lesion was a GIST. The rectal lesion was surgically resected to control bleeding and was confirmed as a GIST histologically. Simultaneous development of GISTs in the rectum and duodenum is extremely rare.
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http://dx.doi.org/10.11405/nisshoshi.112.1991DOI Listing
November 2015

Primary lung sebaceous carcinoma.

Intern Med 2015 ;54(3):351-2

Department of Respiratory Medicine, Kyushu Rosai Hospital; Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.

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http://dx.doi.org/10.2169/internalmedicine.54.3339DOI Listing
June 2015

[Patients with intractable epilepsy who achieved good seizure control after craniotomy instead of vagal nerve stimulation].

No Shinkei Geka 2014 Dec;42(12):1137-46

Department of Neurosurgery, Kyushu Rosai Hospital.

Vagal nerve stimulation(VNS)is an effective adjunctive therapy for medically intractable epilepsy. However, VNS is a palliative therapy, and craniotomy should preferably be performed when complete seizure remission can be expected after craniotomy. We report here three patients who were referred for VNS therapy, but underwent craniotomy instead of VNS based on the results of a comprehensive preoperative evaluation, and achieved good seizure control. Case 1 was a 48-year-old woman with left temporal lobe epilepsy and amygdalar enlargement. Even though no left hippocampal sclerosis was observed on magnetic resonance imaging, she underwent left anterior temporal lobectomy and hippocampectomy. Case 2 was a 36-year-old woman with multiple bilateral subependymal nodular heterotopias, who underwent resection of the left medial temporal lobe including subependymal nodular heterotopias adjacent to the left inferior horn. Case 3 was a 25-year-old man with posttraumatic epilepsy. As the right hemisphere was most affected, multiple subpial transections were performed on the left frontal convexity. These three patients were referred to us for VNS therapy because there was a dissociation between the interictal electroencephalogram and magnetic resonance imaging findings, or because they had multiple or extensive epileptogenic lesions. Comprehensive preoperative evaluation including ictal electroencephalography can help to identify patients who are suitable candidates for craniotomy.
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http://dx.doi.org/10.11477/mf.1436200049DOI Listing
December 2014

Lymphoepithelioma-Like Carcinoma of the Stomach with Epithelioid Granulomas.

Case Rep Gastroenterol 2010 Sep 18;4(3):361-368. Epub 2010 Sep 18.

Department of Surgery Fukuoka Sannou Hospital, Fukuoka, Japan.

An 83-year-old Japanese man was admitted to our hospital for gastric adenocarcinoma mimicking a submucosal tumor in the gastric body. Considering his general condition, partial resection of the stomach and dissection of regional lymph nodes were performed; a dome-shaped tumor that was largely covered by normal mucosa and having a shallow central stellate ulcer was removed. Histopathologically, the carcinoma cell nests were surrounded by prominent lymphoid stroma. Sarcoid-like epithelioid granulomas were noted both in the tumor stroma and in the regional lymph node with metastasis. Epstein-Barr virus (EBV)-encoded RNA (EBER) in situ hybridization showed an intense and diffuse positive reaction in the carcinoma cells and no reaction in the surrounding gastric and lymphoid tissues. While the presence of lymphoid stroma is a characteristic finding in EBV-associated lymphoepithelioma-like carcinoma, sarcoid-like epithelioid granulomas might be associated with latent EBV infection.
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http://dx.doi.org/10.1159/000320671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975000PMC
September 2010