著者

Ryuta Shigefuku Kyoko Yoshikawa Mone Tsukimoto Hirono Owa Yasuyuki Tamai Masahiko Tameda Suguru Ogura Ryosuke Sugimoto Hideaki Tanaka Akiko Eguchi Kazushi Sugimoto Hiroshi Hasegawa Motoh Iwasa Hayato Nakagawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.9701-22, (Released:2022-06-21)

参考文献数

14

被引用文献数

5

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A 70-year-old man was diagnosed with hepatocellular carcinoma (HCC) with portal vein invasion and lung metastases, for which atezolizumab plus bevacizumab (ATZ/BEV) was initiated. After two months, computed tomography revealed tumor growth accompanied by ascites, right ventricular invasion, exacerbation of the lung metastases, and main portal vein invasion. However, continuation of ATZ/BEV caused remarkable size reductions in all lesions, finally resulting in the disappearance of the vascular invasion and lung metastases after nine cycles of treatment. The tumor growth was considered to reflect pseudoprogression, which is difficult to distinguish from hyperprogression. We herein report a remarkable HCC case of pseudoprogression on ATZ/BEV.

著者

Yoshiyuki Kojima Susumu Yokoya Noriaki Kurita Takayuki Idaka Tetsuo Ishikawa Hideaki Tanaka Yoshiko Ezawa Hitoshi Ohto

出版者

THE FUKUSHIMA SOCIETY OF MEDICAL SCIENCE

雑誌

FUKUSHIMA JOURNAL OF MEDICAL SCIENCE (ISSN:00162590)

巻号頁・発行日

vol.65, no.3, pp.76-98, 2019 (Released:2020-01-09)

参考文献数

116

被引用文献数

9

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Cryptorchidism (undescended testes) is among the most common congenital diseases in male children. Although many factors have been linked to the incidence of cryptorchidism, and testicular androgen plays a key role in its pathogenesis, the cause remains unknown in most cases. Recently, a Japanese group published a speculative paper entitled, “Nationwide increase in cryptorchidism after the Fukushima nuclear accident.” Although the authors implicated radionuclides emitted from the Fukushima accident as contributing to an increased incidence of cryptorchidism, they failed to establish biological plausibility for their hypothesis, and glossed over an abundance of evidence and expert opinion to the contrary. We assessed the adequacy of their study in terms of design setting, data analysis, and its conclusion from various perspectives. Numerous factors must be considered, including genetic, environmental, maternal/fetal, and social factors associated with the reporting of cryptorchidism. Other investigators have established that the doses of external and internal radiation exposure in both Fukushima prefecture and the whole of Japan after the accident are too low to affect testicular descent during fetal periods;thus, a putative association can be theoretically and empirically rejected. Alternative explanations exist for the reported estimates of increased cryptorchidism surgeries in the years following Japan’s 2011 earthquake, tsunami, and nuclear crisis. Data from independent sources cast doubt on the extent to which cryptorchidism increased, if at all. In any case, evidence that radionuclides from the Fukushima Daiichi Nuclear Power Plant could cause cryptorchidism is lacking.