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医学部 医学科 臨床神経科学講座脳神経外科学分野 |
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A Rare Case of a Solid Variant Aneurysmal Bone Cyst of the Medial Sphenoid Bone: Clinical Features, Diagnostic Points, and Treatment 査読あり
YAMASHITA Shinji, MATSUMOTO Fumitaka, OKUYAMA Hironobu, OGASAWARA Natsuki, TAMURA Mitsuru, KAWANO Tomoki, YOKOGAMI Kiyotaka, KIWAKI Takumi, FUKUSHIMA Tsuyoshi, SATO Yuichiro, TOMONAGA Takumi, OKITA Yoshiko
NMC Case Report Journal 12 ( 0 ) 369 - 375 2025年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本脳神経外科学会
A 5-year-old boy presented to our hospital with ptosis and an abnormal ocular position. Magnetic resonance imaging showed a well-defined mass measuring 20 mm in diameter in the medial sphenoid bone extending to the orbit and compressing the external ocular muscle. The patient underwent total surgical excision and was subsequently diagnosed with a solid variant of aneurysmal bone cyst via molecular integrated diagnosis. Solid variant of aneurysmal bone cyst is an extremely rare subtype of aneurysmal bone cyst, accounting for 0.2% of all primary bone tumors. It is characterized by the absence of a solid cystic component, which is difficult to diagnose via conventional hematoxylin and eosin staining. Molecular analyses revealed that this subtype is also characterized by the rearrangement of <i>USP6</i> and the absence of the H3F3A mutation. This report discusses the clinical features of this extremely rare neoplastic lesion, the importance of an integrated diagnosis, and treatment options.
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Arita H., Ikawa T., Kanayama N., Morimoto M., Umehara T., Yoshizawa H., Kodama Y., Okita Y., Kinoshita M., Konishi K.
Acta Neurochirurgica 167 ( 1 ) 163 2025年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Acta Neurochirurgica
Background: Recent advances in cancer treatment have prolonged survival after the onset of brain metastasis (BM), increasing the incidence of local progression (LP) following radiotherapy. However, no standard approach exists for managing LP. We aimed to evaluate the outcomes of salvage surgery in a clinical setting. Methods: The clinical data were retrospectively collected from the medical records of 49 patients who underwent their first salvage surgery for LP of BM at a single institution between April 2014 and March 2024. Overall survival (OS) and LP-free survival (LPFS) were evaluated using the Kaplan–Meier method. Results: Most patients (47/49, 96%) had a history of stereotactic radiosurgery (n = 34) and/or stereotactic radiotherapy (n = 14). The histopathological examination of surgical specimens confirmed tumor recurrence in 33 patients and radiation necrosis (RN) in 16 patients. The interval from prior radiotherapy to salvage surgery was longer in patients with RN than in those with recurrence (median: 42.3 vs. 9.3 months, respectively). OS was longer in the RN group compared with the recurrent group (median: 68.5 months and 21.8 months, respectively). In the recurrent group, shorter OS was associated with preoperative poor KPS (< 70), the presence of active extracranial lesions, and RPA classes 2–3. The extent of resection, postoperative chemotherapy, and local irradiation had no significant effect on OS. After salvage surgery, further LP was observed in 20 patients (61%), with a median LPFS of 7.0 months in the recurrent group. No significant association was found between LPFS and the extent of tumor removal, postoperative chemotherapy, and RT. Conclusions: This study highlights a relatively prolonged survival period following salvage surgery for local progression of BM after irradiation. Salvage surgery is a treatment option in patients with good extracranial control and performance status. The high recurrence rate following salvage treatment underscores the need for developing additional treatment approaches.
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Dysembryoplastic neuroepithelial tumor in an atypical location without epilepsy: a case report 査読あり
Masato Hidaka, Shinji Yamashita, Tsuyoshi Fukushima, Natsuki Ogasawara, Mitsuru Tamura, Tomoki Kawano, Fumitaka Matsumoto, Hironobu Okuyama, Nei Fukasawa, Junko Hirato, Yuichiro Sato, Yoshiko Okita
Acta Scientific Neurology 8 ( 5 ) 89 - 94 2025年4月
担当区分：最終著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
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Takenaka T., Nishida T., Takagaki M., Okita Y., Kijima N., Hirayama R., Matsui Y., Yamada S., Fukuda T., Nakagawa R., Matsumura T., Nakamura H., Kagawa N., Kishima H.
World Neurosurgery 194 123463 2025年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：World Neurosurgery
Background: N-butyl cyanoacrylate (n-BCA) is often used for preoperative transarterial embolization (TAE) of meningiomas. However, factors affecting the embolization effect with n-BCA remain unclear. This study aimed to clarify the factors associated with the embolization rate after TAE using n-BCA in meningioma, from the aspect of feeder architecture. Methods: We retrospectively analyzed 62 patients with meningioma who underwent preoperative TAE with n-BCA between 2016 and 2021. Patient variables, including characteristics, intraoperative findings, and outcomes, were collected. Feeder architecture was classified into 7 groups: 1) internal maxillary artery, 2) occipital artery, 3) ascending pharyngeal artery, 4) posterior meningeal artery, 5) infraclinoidal internal carotid artery, 6) ophthalmic artery (OphA), and 7) pial feeder group, based on preoperative angiography. We set primary outcome as the embolization rate, representing the reduction rate of the gadolinium-enhanced lesion volume observed on contrast-enhanced magnetic resonance imaging. Angiographic findings following n-BCA injection were classified as feeder occlusion or intratumoral embolization. We analyzed the factors associated with the embolization rate. Results: The OphA feeder group showed a decrease in the embolization rate (P = 0.008). The number of feeder groups with intratumoral embolization showed a robust positive correlation (r = 0.557). The OphA feeder group showed an increase in the number of feeder groups (P < 0.001) and larger tumor volume (P = 0.005). Conclusions: The OphA feeder group was associated with a lower embolization rate. Our study suggested that the vascular architecture in meningioma affected the efficacy of TAE with n-BCA.
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When machines start examining tissue specimens on their own. 査読あり
Kinoshita M, Okita Y, Kishima H
Neuro-oncology 2025年1月
科研費（文科省・学振・厚労省）獲得実績 【 表示 ／ 非表示 】
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膠芽腫に対する新規治療法の探索を可能とするデジタルツインの基盤技術開発
研究課題/領域番号：25K22913 2025年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費基金 挑戦的研究（萌芽）
担当区分：研究分担者
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膠芽腫におけるシングルセルラマン分光法の確立による腫瘍細胞特性の解明
研究課題/領域番号：24K12261 2024年04月 - 2027年03月
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
担当区分：研究代表者
寄附金・講座・研究部門 【 表示 ／ 非表示 】
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臨床神経科学講座脳神経外科学分野研究奨学金
2025年01月
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臨床神経科学講座脳神経外科学分野研究奨学金
2024年11月
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臨床神経科学講座脳神経外科学分野研究奨学金（潤和ﾘﾊﾋﾞﾘﾃｰｼｮﾝ振興財団）
2024年09月
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臨床神経科学講座脳神経外科学分野研究奨学金
2024年06月
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臨床神経科学講座脳神経外科学分野研究奨学金（潤和ﾘﾊﾋﾞﾘﾃｰｼｮﾝ振興財団）
2024年05月