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Faculty of Medicine School of Medicine Department of Surgery, Thoracic and Breast Surgery |
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Associate Professor |
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MAEDA Ryo
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Papers 【 display / non-display 】
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Primary pulmonary colloid adenocarcinoma: A case report of a rare subtype Reviewed
Yamada R., Oguri N., Kawano F., Inomata M., Sato Y., Maeda R.
International Journal of Surgery Case Reports 123 110260 2024.10
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction and importance: Pulmonary colloid adenocarcinoma is an extremely rare subtype of lung adenocarcinoma. Owing to its rarity, the detailed clinical features of colloid adenocarcinoma remain largely unknown. This report describes a case of early-stage colloid adenocarcinoma that recurred soon after resection, including its radiological findings. Case presentation: During a routine checkup, a chest roentgenogram revealed an abnormal shadow in the right upper lung field of an asymptomatic 68-year-old man. Computed tomography (CT) showed a well-defined, low-attenuation nodule in the right upper lobe. Right upper lobectomy with mediastinal lymph node dissection was performed. The postoperative histopathological diagnosis indicated pulmonary colloid adenocarcinoma. The pathological stage was classified as T1bN0M0 (stage IA2). Follow-up CT 1 year after the resection revealed an enlarged supraclavicular lymph node and pulmonary nodule in the right lower lobe. Both lesions appeared as well-defined solitary hypoattenuated tumors with minimal enhancement on CT images. Excisional biopsies of both tumors were performed to obtain a definitive diagnosis. Both tumors consisted of abundant mucin in which some tumor cells were floating and were diagnosed as colloid adenocarcinoma recurrences. Clinical discussion: Although colloid adenocarcinoma is generally considered to have indolent clinical behavior, it can recur even in early-stage cases. Conclusion: Colloid adenocarcinoma is a distinct variant of lung adenocarcinoma, characterized by well-circumscribed mucinous lesions with alveolar wall destruction caused by mucin pools and scant tumor cells. The treatment strategy for colloid adenocarcinoma should follow the guidelines for primary lung cancer.
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Radiological features and diagnostic pitfalls of idiopathic azygos vein aneurysm: A case report Reviewed
Inomata M., Kawano F., Yamada R., Maeda R.
International Journal of Surgery Case Reports 122 110094 2024.9
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction and importance: We present a case of idiopathic azygos vein aneurysm (AVA) and describe its radiological features. Clinicians should be aware of the imaging findings to avoid the risk of bleeding caused by biopsy. Case presentation: An asymptomatic 46-year-old woman was found to have an abnormal shadow on a chest computed tomography (CT) scan during a medical checkup. Plain CT revealed a well-defined, homogeneous mass on the posterior side of the right main bronchus. Contrast-enhanced CT revealed a mass with marked enhancement pointing to a vascular structure. Three-dimensional reconstruction showed that the mass was connected to the azygos arch, and inflow to and outflow from the azygos vein was detected. Subsequently, video-assisted thoracic surgery was performed. Clinical discussion: Patients with idiopathic AVA often present with accidental findings of a mediastinal or lung mass on a chest radiographs or CT scans, which can be mistakenly diagnosed as a paratracheal tumor, bronchial cyst, or posterior mediastinal tumor. Needle biopsy should be avoided due to the risk of massive bleeding. During the evaluation of thoracic malignancies, AVAs should be considered in the differential diagnosis, especially in area of the right tracheobronchial angle or right upper or posterior mediastinum. Three-dimensional reconstruction can help surgeons to clarify the disease diagnosis. Conclusion: Imaging findings combined with enhanced CT and three-dimensional reconstruction are useful for diagnosing AVAs.
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Kawano F., Inomata M., Yamada R., Maeda R.
International Journal of Surgery Case Reports 121 110018 2024.8
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction and importance: Bronchial foreign body aspiration is a life-threatening emergency. Largely, the published literature focuses on the removal of foreign bodies by bronchoscopy, while the surgical removal of endobronchial foreign bodies is rarely reported on. Thus, we presented a case of a bronchial foreign body that was successfully removed by a video-assisted thoracoscopic surgical (VATS) bronchotomy, after multiple failed bronchoscopic attempts. Case presentation: A 77-year-old male patient presented with a 2-month duration of a persistent cough and low-grade fever after undergoing dental treatment. Bronchoscopy revealed a dental crown surrounded by granulation tissue in the right basal bronchus. The patient was referred to our department for open surgery after undergoing multiple unsuccessful extractions. The bronchial foreign body was removed by a VATS bronchotomy. The postoperative course was uneventful, and the patient was discharged 2 days postoperatively without any complications. Clinical discussion: Most aspirated tracheobronchial foreign bodies can be removed through bronchoscopy; nonetheless, certain aspirated foreign bodies may require surgical intervention. Furthermore, the indications for bronchotomies encompass the failure to remove the foreign body despite repeated attempts, due to immobility, with or without distal bronchial placement. Thoracoscopy is beneficial in providing superior visualization, with an increased likelihood of post-bronchotomy recovery. Conclusion: VATS bronchotomy is a safe and effective alternative for the removal of bronchial foreign bodies without sacrificing the functioning of the lung parenchyma.
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Kuroki S., Inomata M., Matsuo A., Kawano F., Ayabe T., Maeda R.
International Journal of Surgery Case Reports 111 108887 2023.10
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction and importance: We presented an extremely rare case of lung abscess following bronchoscopy associated with lung cancer that extended directly into the chest wall. Case presentation: A 49-year-old man with adenocarcinoma underwent bronchoscopy. Eight days after the biopsy, the patient presented with chills and anterior chest wall pain. Chest computed tomography (CT) scan revealed a gas-containing lung abscess, measuring 10 cm in the left upper lobe and subcutaneous emphysema. The coronal view of the CT indicated a continuous passage of air from the lung abscess to the subcutaneous emphysema beneath the pectoralis muscle. Surgical debridement of the subcutaneous abscess was performed, resulting in drainage of a large volume of purulent material. We confirmed that the lung abscess had directly extended to the chest wall, leading to a decision to perform segmentectomy of the upper division of the left lung. Clinical discussion: Lung abscess associated with lung cancer is a rare, life-threatening complication, which may lead to significant delays in the commencement of oncological treatment and potentially worsen long-term outcomes. In the present case, surgical findings confirmed a lung abscess extending directly to the chest wall. Surgical therapy is the treatment of choice for this rare condition, providing rapid focus control. Therefore, prompt initiation of surgical therapy is essential when conservative measures prove ineffective. Conclusion: Lung abscesses may extend into the chest wall during differential diagnosis of infectious diseases of the chest wall. Successful treatment of this rare condition depends on prompt surgical intervention.
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Radiological features of intrathoracic chronic expanding hematoma: A case report
Inomata M., Kuroki S., Nakada H., Kawano F., Maeda R.
International Journal of Surgery Case Reports 110 108767 2023.9
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
Introduction and importance: We present a relatively rare case of intrathoracic chronic expanding hematoma (CEH) after thoracic surgery for lung cancer. CEH is often difficult to distinguish from malignant tumors because of its large size and slow progressive enlargement. In this report, we describe the radiological features of CEH in detail. Case presentation: A 67-year-old man who underwent a left upper lobectomy for lung cancer at 46 years of age presented with hemosputum. Computed tomography revealed a large mass with central low attenuation. Calcification was detected in peripheral lesions of the mass. T2-weighted magnetic resonance imaging (MRI) revealed a mass with mixed low and high signal intensities. Based on the clinical course, the patient was diagnosed with an intrathoracic CEH. A left posterolateral thoracotomy was performed with the patient in the lateral position, and a mass encased in a tough capsule was resected. The postoperative histopathological findings were consistent with CEH. Clinical discussion: CT of intrathoracic CEH shows a lesion with heterogeneous content, a thick wall, and calcifications. However, differentiation from malignant tumors is difficult using CT alone. MRI is a good diagnostic modality for CEH and often shows a mixture of low- and high-intensity areas on T2-weighted images. In addition, the patient's medical history is important because most cases of CEH have a history of trauma or surgery. Conclusion: To diagnose intrathoracic CEH, it is essential to consider the patient's clinical course and MRI findings.
Presentations 【 display / non-display 】
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原発不明の肺門リンパ節転移癌の2切除例
落合貴裕、前田亮、綾部貴典、鈴木康人、富田雅樹、中村都英
第52回日本胸部外科学会九州地方会総会
Event date： 2019.8.29 - 2019.8.30
Language：Japanese Presentation type：Oral presentation (general)
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胸痛にて発見された自然縮小した胸腺腫の1例
千代反田顕、前田亮、富田雅樹、綾部貴典、佐藤勇一郎、中村都英
第52回日本胸部外科学会九州地方会総会
Event date： 2019.8.29 - 2019.8.30
Language：Japanese Presentation type：Oral presentation (general)
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異所性縦隔内甲状腺腫の1切除例
鈴木康人、前田亮、綾部貴典、中村都英、富田雅樹
第52回日本胸部外科学会九州地方会総会
Event date： 2019.8.29 - 2019.8.30
Language：Japanese Presentation type：Oral presentation (general)
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外科医療における患者第一の医療安全と臨床倫理のスキルとエッセンス
綾部貴典、富田雅樹、前田亮、宗像駿、櫻原大智、中村都英
第１１８回日本外科学会定期学術集会
Event date： 2019.4.18 - 2019.4.20
Language：Japanese Presentation type：Oral presentation (general)
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MRSA アウトブレイク発生・収束後の長期アウトカムと産業界品質管理手法による感染制御の質改善の試み
綾部貴典、富田雅樹、前田亮、宗像駿、緒方祥吾、中村都英
第71 回日本胸部外科学会定期学術集会
Event date： 2018.10.4 - 2018.10.6
Language：Japanese Presentation type：Poster presentation