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1.
Hinyokika Kiyo ; 70(2): 39-43, 2024 Feb.
Artículo en Japonés | MEDLINE | ID: mdl-38447943

RESUMEN

Radical prostatectomy is the treatment of choice for localized prostate cancer. In our institution, preoperative cystoscopy is performed routinely to clarify the prostate anatomy, including the median lobe and position of ureteral orifices. We conducted a retrospective analysis of 721 patients, from January 2008 to December 2022, our aim being to assess the clinical course of bladder cancer discovered incidentally through cystoscopy prior to radical prostatectomy. We found that bladder cancer was detected in eight of these patients (1.1%), seven of whom had low-grade, non-invasive, papillary urothelial carcinomas ; the remaining patient had a high-grade lesion. Notably, the pathological stage was Ta in all cases. The median duration of follow-up of patients with bladder cancer was initially set at 21 months (12-24 months). During the follow-up period, bladder cancer recurrence was identified in three patients. Patients who remained recurrence-free beyond the follow-up period underwent radical therapy. Importantly, no evidence of prostate cancer progression was detected throughout the follow-up period. Thus, incidental bladder cancer detected prior to radical prostatectomy is predominantly non-invasive, ensuring safe treatment of both the bladder and prostate cancers. Our findings suggest that cystoscopy could be omitted.


Asunto(s)
Carcinoma in Situ , Carcinoma de Células Transicionales , Neoplasias de la Próstata , Neoplasias de la Vejiga Urinaria , Masculino , Humanos , Próstata , Cistoscopía , Estudios Retrospectivos , Prostatectomía , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Próstata/cirugía
2.
BMC Infect Dis ; 23(1): 849, 2023 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-38049729

RESUMEN

BACKGROUND: The severity of coronavirus disease 2019 (COVID-19) infections has led to the development of several therapeutic agents, with tocilizumab becoming increasingly used to treat patients with COVID-19-related pneumonia. This study compared the use of tocilizumab treatment with the standard of care (SOC) to determine its efficacy against severe COVID-19-related pneumonia in Japan. METHODS: This retrospective cohort study was designed to evaluate the efficacy of tocilizumab in two different databases: the JA42434 single-arm study and COVID-19 Registry Japan (COVIREGI-JP), with a synthetic control group from the COVIREGI-JP cohort as a benchmark for the tocilizumab group. The study's primary objective was to evaluate the efficacy of tocilizumab in treating severe COVID-19-related pneumonia compared to the SOC among patients included in the above two databases. The SOC group was extracted as the synthetic control group using exact matching and a propensity score matching in sequence per subject. As a secondary objective, the efficacy of tocilizumab compared to the SOC was evaluated exclusively among patients included in the COVIREGI-JP database. In each objective, the primary endpoint was defined as the time to discharge or the status of awaiting discharge. RESULTS: For the primary endpoint, the hazard ratio (HR) of the tocilizumab group against the SOC group was 1.070 (95% confidence interval [CI]: 0.565-2.028). The median time from Study Day 1 to discharge or the state of awaiting discharge was 15 days in the tocilizumab group and 16 days in the SOC group. The HRs for the secondary endpoints, namely, time to improvement in the clinical state, time to clinical failure, and time to recovery, were 1.112 (95% CI: 0.596-2.075), 0.628 (95% CI: 0.202-1.953), and 1.019 (95% CI: 0.555-1.871), respectively. Similarly, the HR of the primary endpoint for the secondary objective was 0.846 (95% CI: 0.582-1.230). CONCLUSIONS: Tocilizumab did not demonstrate a positive effect on time to discharge or the state of awaiting discharge. Furthermore, no statistically significant differences in other clinical outcomes, such as time to improvement in the clinical state, time to clinical failure, and time to recovery, were observed among the groups.


Asunto(s)
COVID-19 , Humanos , SARS-CoV-2 , Estudios Retrospectivos , Datos de Salud Recolectados Rutinariamente , Resultado del Tratamiento , Tratamiento Farmacológico de COVID-19
3.
Hinyokika Kiyo ; 69(5): 131-135, 2023 May.
Artículo en Japonés | MEDLINE | ID: mdl-37312493

RESUMEN

A 59-year-old man presented with high blood pressure, hypokalemia and muscle weakness. His aldosterone/renin ratio was high and plasma renin activity was low. Computed tomography (CT) showed a heterogeneous left adrenal mass. Primary aldosteronism was diagnosed and laparoscopic left adrenalectomy was performed. The pathological diagnosis was adrenocortical carcinoma with positive surgical margins. He underwent radiotherapy and mitotane as adjuvant therapies. Subsequently, CT revealed multiple metastases, in the liver and retroperitoneum. After six courses of EDP (a combination of etoposide, doxorubicin and cisplatin), CT showed widespread metastases in the retroperitoneum and he chose to receive the best supportive care. Aldosterone-producing adrenocortical carcinoma is exceedingly rare. To the best of our knowledge, only67 cases have been reported. Complete resection is needed to improve prognosis and this was not achieved in our case. We therefore recommend careful selection of the operative procedure.


Asunto(s)
Neoplasias de la Corteza Suprarrenal , Carcinoma Corticosuprarrenal , Masculino , Humanos , Persona de Mediana Edad , Carcinoma Corticosuprarrenal/diagnóstico por imagen , Carcinoma Corticosuprarrenal/cirugía , Aldosterona , Renina , Mitotano , Neoplasias de la Corteza Suprarrenal/diagnóstico por imagen , Neoplasias de la Corteza Suprarrenal/cirugía
4.
Hinyokika Kiyo ; 68(5): 149-153, 2022 May.
Artículo en Japonés | MEDLINE | ID: mdl-35748233

RESUMEN

A 78-year-old man was treated with Bortezomib, Lenalidomide, and Dexamethasone, for multiple myeloma. Two years after the start of treatment, the patient came to our department with a complaint of gross hematuria. Cystoscopy revealed a tumor on the left wall of the bladder. Urine cytology was negative. Magnetic resonance imaging (MRI) of the lower abdomen showed a slightly high signal on the T2-weighted image, indicating an intravesical mass lesion invading outside the bladder. Contrast-enhanced computed tomography (CT) also showed an intravesical mass and enlarged left external iliac lymph node swelling. Transurethral resection of bladder tumor was performed. The resection specimen showed tumor cells. The pathological examination revealed CD138 (+) and light-chain restriction. The patient was diagnosed with plasmacytoma. The patient was treated with radiation therapy for plasmacytoma of the bladder and surrounding lymph nodes, and then with daratumumab and dexamethasone for multiple myeloma for one year; however, the patient died because of worsening of multiple myeloma.


Asunto(s)
Mieloma Múltiple , Plasmacitoma , Neoplasias de la Vejiga Urinaria , Anciano , Dexametasona/uso terapéutico , Humanos , Masculino , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/terapia , Plasmacitoma/diagnóstico por imagen , Plasmacitoma/terapia , Vejiga Urinaria , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/terapia
5.
Hinyokika Kiyo ; 68(10): 327-331, 2022 Oct.
Artículo en Japonés | MEDLINE | ID: mdl-36329381

RESUMEN

A 48-year-old man presented with a painless nodule on the right ventral aspect of the penile shaft root. The patient visited the hospital and complained that the mass was growing. On physical examinations, a 5 cm mass without tenderness was palpated. An isoechoic mass about 4 cm in size was observed on ultrasonography. Inhomogeneous high signal intensity was observed on T2-weighted magnetic resonance imaging. A needle biopsy revealed schwannoma. During surgery for excision of the tumor, another small tumor was detected both tumors were resected. Both tumors were diagnosed as schwannoma by pathological examination. Out of 40 cases of penile schwannoma reported, eight were of multiple tumors. In our case, it was difficult to detect the other small tumor by preoperative diagnosis. Therefore, we recommend careful observation during surgery.


Asunto(s)
Neurilemoma , Neoplasias del Pene , Masculino , Humanos , Persona de Mediana Edad , Neurilemoma/diagnóstico por imagen , Neurilemoma/cirugía , Neoplasias del Pene/diagnóstico por imagen , Neoplasias del Pene/cirugía , Imagen por Resonancia Magnética , Ultrasonografía , Pene/patología
6.
Hinyokika Kiyo ; 67(1): 1-6, 2021 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-33535289

RESUMEN

Robot-assisted laparoscopic radical prostatectomy (RARP) is becoming the standard treatment procedure for localized prostate cancer. The main complications associated with RARP include urinary incontinence and sexual dysfunction. In addition, acute urinary retention (AUR) after urethral catheter removal is sometimes seen. Early catheter removal is a risk factor for AUR, and administration of alphablockers before catheter removal reduces the occurrence of AUR. However, the ideal management of AUR after RARP is not known. Here we report the clinical course and treatment after AUR. We performed 279 RARPs at our institution, and AUR developed in 11 cases. In all cases, urination status was improved after placement of a urinary catheter or intermittent catheterization. Later, urethral stricture was seen in 2 out of 11 cases. Ourstudy suggests that when AUR is observed afterRARP, catheterur ination should be initially performed. If urinary retention recurs, a urinary catheter should be placed with administration of alpha-blockers. The catheter is removed after about 3 days, and administration of analgesics is effective for reducing the pain on urination. If urination status is not improved, evaluation of the urethral stricture should be considered.


Asunto(s)
Laparoscopía , Neoplasias de la Próstata , Robótica , Retención Urinaria , Humanos , Masculino , Recurrencia Local de Neoplasia , Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Cateterismo Urinario/efectos adversos , Retención Urinaria/etiología , Retención Urinaria/terapia
7.
Hinyokika Kiyo ; 67(9): 413-417, 2021 Sep.
Artículo en Japonés | MEDLINE | ID: mdl-34610706

RESUMEN

A 69-year-old man presented with left flank pain and underwent a computed tomographic scan, which revealed a large left renal mass of 16×9×5 cm. A left nephrectomy was performed. Pathological analysis revealed that the tumor was consistent with angiosarcoma of the left kidney with a negative surgical margin. He received combination therapy with radiation therapy and four courses of chemotherapy with doxorubicin and ifosfamide. However, he died 10 months after surgery because of pleural dissemination and peritoneal dissemination. Primary renal angiosarcoma is an extremely rare and highly aggressive tumor with a dismal survival rate, and a satisfactory surgical margin is necessary for its successful treatment. If primary renal angiosarcoma is suspected, biopsy may be considered before surgery. Primary renal angiosarcoma treatment with combination therapy of surgery, radiotherapy, and chemotherapy by a specialist multidisciplinary team with experience and expertise in sarcoma is preferable. Development of therapy for angiosarcoma is awaited.


Asunto(s)
Hemangiosarcoma , Neoplasias Renales , Anciano , Biopsia , Terapia Combinada , Hemangiosarcoma/cirugía , Humanos , Neoplasias Renales/cirugía , Masculino , Nefrectomía
8.
Hinyokika Kiyo ; 66(12): 421-426, 2020 Dec.
Artículo en Japonés | MEDLINE | ID: mdl-33435651

RESUMEN

We compared the perioperative and oncological outcomes of radical nephroureterectomy for renal pelvic and ureteral cancer between octogenarians and younger patients. We examined 146 patients attending our hospital from January 2012 to December 2019. The octogenarian group included 48 patients and the control group (younger patients) 98 patients. The median body mass index (BMI) (21.2 vs 23.4 kg/m^2, p<0.001), American Society of Anesthesiologists (ASA) score (p=0.044), preoperative albumin concentration (p=0.04) and operation time (287 vs 314 min, p=0.029) differed significantly between the two groups. However, there were no significant differences in perioperative complications between the two groups. According to multivariable analysis of overall survival, pT3 or higher pathology was a significant indicator of poor prognosis in all patients. In the octogenarian group alone, perioperative transfusion was the only other factor significantly associated with prognosis, whereas anti-CD55 monoclonal antibody (RM1) was a significant factor in the control group. There were significant differences between the octogenarian and control groups with respect to overall survival in those with pT2 or below stage disease (60.2% vs 87.5%, p=0.049), but not to cancer-specific survival (≤pT2 : 73.5% vs 94.2%, p=0.202 ≥pT3 : 72.2% vs 63.8%, p=0. 87). Our findings indicate that nephroureterectomy is a safe and efficient procedure for selected octogenarian patients.


Asunto(s)
Nefroureterectomía , Neoplasias Ureterales , Anciano de 80 o más Años , Humanos , Pronóstico , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias Ureterales/cirugía
9.
Anaerobe ; 60: 102107, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31647977

RESUMEN

BACKGROUND: The optimal and practical laboratory diagnostic approach for detection of Clostridioides difficile to aid in the diagnosis of C. difficile infection (CDI) is controversial. A two-step algorithm with initial detection of glutamate dehydrogenase (GDH) or nucleic acid amplification test (NAAT) alone are recommended as a predominant method for C. difficile detection in developed countries. The aim of this study was to compare the performance of enzyme immunoassays (EIA) detecting toxins A and B, NAAT detecting the toxin B gene, and GDH compared to toxigenic culture (TC) for C. difficile as the gold standard, in patients prospectively and actively assessed with clinically significant diarrhea in 12 medical facilities in Japan. METHODS: A total of 650 stool specimens were collected from 566 patients with at least three diarrheal bowel movements (Bristol stool grade 6-7) in the preceding 24 h. EIA and GDH were performed at each hospital, and NAAT and toxigenic C. difficile culture with enriched media were performed at the National Institute of Infectious Diseases. All C. difficile isolates recovered were analyzed by PCR-ribotyping. RESULTS: Compared to TC, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of EIA were 41%, 96%, 75% and 84%, respectively, and for NAAT were 74%, 98%, 91%, and 92%, respectively. In 439 specimens tested with GDH, the sensitivity, specificity, PPV, and NPV were 73%, 87%, 65%, and 91%, and for an algorithm (GDH plus toxin EIA, arbitrated by NAAT) were 71%, 96%, 85%, and 91%, respectively. Among 157 isolates recovered, 75% of isolates corresponded to one of PCR-ribotypes (RTs) 002, 014, 018/018", and 369; RT027 was not isolated. No clear differences in the sensitivities of any of EIA, NAAT and GDH for four predominant RTs were found. CONCLUSION: The analytical sensitivities of NAAT and GDH-algorithm to detect toxigenic C. difficile in this study were lower than most previous reports. This study also found low PPV of EIAs. The optimal method to detect C. difficile or its toxins to assist in the diagnosis of CDI needs further investigation.


Asunto(s)
Técnicas Bacteriológicas , Clostridioides difficile/genética , Infecciones por Clostridium/diagnóstico , Infecciones por Clostridium/microbiología , Toxinas Bacterianas/genética , Técnicas Bacteriológicas/métodos , Técnicas Bacteriológicas/normas , Clostridioides difficile/clasificación , Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/epidemiología , Femenino , Humanos , Japón/epidemiología , Masculino , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Ribotipificación , Sensibilidad y Especificidad
10.
Anaerobe ; 60: 102011, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30872073

RESUMEN

Clostridioides (Clostridium) difficile is the leading cause of healthcare-associated infectious diarrhea in the developed world. Retrospective studies have shown a lower incidence of C. difficile infection (CDI) in Japan than in Europe or North America. Prospective studies are needed to determine if this is due lack of testing for C. difficile or a true difference in CDI epidemiology. A prospective cohort study of CDI was conducted from May 2014 to May 2015 at 12 medical facilities (20 wards) in Japan. Patients with at least three diarrheal bowel movements (Bristol stool grade 6-7) in the preceding 24 h were enrolled. CDI was defined by positive result on enzyme immunoassay for toxins A/B, nucleic acid amplification test for the toxin B gene or toxigenic culture. C. difficile isolates were subjected to PCR-ribotyping (RT), slpA-sequence typing (slpA-ST), and antimicrobial susceptibility testing. The overall incidence of CDI was 7.4/10,000 patient-days (PD). The incidence was highest in the five ICU wards (22.2 CDI/10,000 PD; range: 13.9-75.5/10,000 PD). The testing frequency and CDI incidence rate were highly correlated (R2 = 0.91). Of the 146 isolates, RT018/018″ was dominant (29%), followed by types 014 (23%), 002 (12%), and 369 (11%). Among the 15 non-ICU wards, two had high CDI incidence rates (13.0 and 15.9 CDI/10,000 PD), with clusters of RT018/slpA-ST smz-02 and 018"/smz-01, respectively. Three non-RT027 or 078 binary toxin-positive isolates were found. All RT018/018" isolates were resistant to moxifloxacin, gatifloxacin, clindamycin, and erythromycin. This study identified a higher CDI incidence in Japanese hospitals than previously reported by actively identifying and testing patients with clinically significant diarrhea. This suggests numerous patients with CDI are being overlooked due to inadequate diagnostic testing in Japan.


Asunto(s)
Clostridioides difficile , Infecciones por Clostridium/epidemiología , Infecciones por Clostridium/microbiología , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Clostridioides difficile/clasificación , Clostridioides difficile/efectos de los fármacos , Clostridioides difficile/genética , Geografía Médica , Humanos , Incidencia , Japón/epidemiología , Pruebas de Sensibilidad Microbiana , Tipificación Molecular , Vigilancia en Salud Pública , Estudios Retrospectivos , Ribotipificación
11.
Hinyokika Kiyo ; 64(6): 271-275, 2018 Jun.
Artículo en Japonés | MEDLINE | ID: mdl-30064166

RESUMEN

Distant metastasis is rare in patients with non-muscle invasive bladder cancer (NMIBC). We describe two cases of NMIBC with distant metastasis diagnosed in the follow-up period after transurethral resection (TUR), with neither intravesical recurrence nor progression to muscle-invasive disease. Case 1 : A 77-yearold man was referred to our hospital for treatment of a bladder tumor with the complaint of asymptomatic gross hematuria. TUR of the bladder tumor was performed. Pathological examination revealed high grade urothelial carcinoma pT1. Second TUR was performed and pathological examination confirmed high grade urothelial carcinoma pT1 with lymphovascular invasion. The patient received standard BCG therapy and subsequently developed left leg pain and lumbago 10 months after initial diagnosis. Magnetic resonance imaging, computed tomography, and bone scintigraphy demonstrated no local recurrence, but revealed multiple bone and liver metastases. The patient died 15 months after initial diagnosis. Case 2 : A 70-year-old man was referred to our hospital for treatment of an incidental bladder tumor. TUR of the bladder tumor was performed and pathological examination confirmed high grade urothelial carcinoma pT1. Second TUR was performed and pathological examination revealed no residual tumor cells. 18Fflurodeoxyglucose (FDG) positron emission tomography/computed tomography confirmed increasing uptake of 18F-FDG in the retroperitoneal lymph nodes, 18 months after initial diagnosis. The patient underwent laparoscopic lymphadenectomy. Pathological examination demonstrated metastasis of the bladder cancer. Combined chemotherapy was initiated with gemcitabine and cisplatin consecutively. To date the patient survives without progression or new distant metastases after four cycles of chemotherapy.


Asunto(s)
Neoplasias de la Vejiga Urinaria/cirugía , Anciano , Hematuria/etiología , Humanos , Masculino , Invasividad Neoplásica , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Neoplasias de la Vejiga Urinaria/complicaciones , Neoplasias de la Vejiga Urinaria/patología
12.
Hinyokika Kiyo ; 64(11): 445-450, 2018 Nov.
Artículo en Japonés | MEDLINE | ID: mdl-30543744

RESUMEN

We describe two cases of inflammatory myofibroblastic tumor (IMT) of the urinary bladder. Case 1 : A 55-year-old man complained of urinary frequency. Transurethral biopsy of the bladder tumor was performed ; pathological examination revealed IMT. After steroid therapy for 1 year, the tumor was markedly reduced in size. Laparoscopic partial cystectomy was performed. The patient has now been free from recurrence for 3 years after the surgery. Case 2 : A 61-year-old man presented with gross hematuria. Transurethral biopsy of the bladder tumor revealed IMT. Despite steroid therapy for 6 months, the tumor size increased. Laparoscopic partial cystectomy and vesicoureteroneostomy were performed. The patient has now been free from recurrence for 1 year and 11 months after the surgery. IMT of the urinary bladder often responds well to steroid therapy. We experienced two cases of IMT. One showed a good response to steroid therapy and the other showed a poor response to steroid therapy. In both cases, we performed laparoscopic partial cyctectomy and the patients have remained free from recurrence IMT of the urinary bladder may have a good prognosis after complete surgical resection.


Asunto(s)
Granuloma de Células Plasmáticas , Neoplasias de la Vejiga Urinaria , Cistectomía , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/cirugía
13.
Hinyokika Kiyo ; 64(9): 359-363, 2018 Sep.
Artículo en Japonés | MEDLINE | ID: mdl-30369226

RESUMEN

We investigated the prostatic anterior fat pad (PAFP) for the presence of lymph nodes and lymph node metastases after excision during radical prostatectomy for the treatment of prostate cancer. From November 2013 to May 2017, 215 patients underwent radical prostatectomy for localized prostate cancer at our institution. PAFP was removed and sent for pathological analysis routinely to evaluate the presence of lymph nodes and lymph node metastases. Of the 215 patients, 20 (9.3%) had lymph nodes in the PAFP. Among the 20 patients with lymph nodes in the PAFP, 2 patients (10.0% ; 0.9% of all patients) were positive for metastatic prostate cancer. These patients did not have positive nodes elsewhere among the pelvic lymph nodes. There was no significant difference in the clinicopathological features between the patients with lymph nodes in the PAFP and those with no lymph nodes in the PAFP. The present findings are similar to those in the Western population. Considering the very low rate of lymph node metastasis in PAFP, it is necessary to discuss which patients should be selected for pathological analysis of PAFP.


Asunto(s)
Tejido Adiposo/cirugía , Neoplasias de la Próstata/cirugía , Tejido Adiposo/patología , Anciano , Humanos , Escisión del Ganglio Linfático , Ganglios Linfáticos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Prostatectomía , Neoplasias de la Próstata/patología
14.
Int Cancer Conf J ; 13(1): 49-53, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38187184

RESUMEN

Renal cell carcinoma often metastasizes to the adrenals; however, bilateral adrenal metastases are rare. We here report a patient with bilateral adrenal metastases from renal cell carcinoma after robot-assisted partial nephrectomy and review relevant published reports. A 64-year-old man underwent robot-assisted partial nephrectomy for a left renal tumor. During follow-up, he was diagnosed with bilateral adrenal metastases. He underwent left adrenalectomy followed by right partial adrenalectomy to preserve adrenal function. The renal tumor later metastasized to other parts of the body. He continues to receive systemic treatment and remains in partial remission. Patients with pT1aN0M0 renal cell carcinoma generally have a favorable prognosis. However, occasional such patients develop multiple metastases. To the best of our knowledge, this is the first reported case of bilateral adrenal metastases after partial nephrectomy. Clinicians should keep this rare scenario in mind.

15.
Urol Case Rep ; 54: 102719, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38595728

RESUMEN

Breast cancer is a major contributor to cancer-related morbidity and mortality in women, which is primarily attributed to metastases. Common metastatic sites include the lungs, liver, and bone, whereas bladder metastasis is rare. We report a case of bladder metastasis from breast cancer in a 61-year-old woman, highlighting the challenges in diagnosis and treatment. The patient, previously diagnosed with invasive lobular carcinoma, presented with renal failure and underwent transurethral resection of bladder tumor. Pathological analysis confirmed metastasis from breast cancer. Bladder metastasis from breast cancer demands vigilance and prompt intervention because of its potential prognostic impact.

16.
IJU Case Rep ; 7(4): 329-332, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38966769

RESUMEN

Introduction: 17α-Hydroxylase deficiency is a very rare disease reported to be associated with a risk of gonadal malignancy. We herein report a rare case of seminoma in a 46, XY patient with 17α-hydroxylase deficiency. Case presentation: A 52-year-old woman presented with a 9-cm pelvic tumor. At age 14, she had been identified as having the XY karyotype and 17α-hydroxylase deficiency. However, she was not informed and did not consult the urology department. Laparoscopic gonadectomy was performed at the latest consultation, and seminoma was diagnosed. Conclusion: This is the third reported case of testicular tumor and the first of germ cell tumor in a 46, XY patient with 17α-hydroxylase deficiency. Given the rarity and the risk of gonadal malignancy associated with 17α-hydroxylase deficiency, the involvement of multidisciplinary specialists and prophylactic gonadectomy is considered crucial in its management.

17.
IJU Case Rep ; 6(3): 181-184, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37144080

RESUMEN

Introduction: Myopericytomas usually occur in the extremities of older individuals; however, they also rarely occur in the penis. We report a case of myopericytoma in the corpus cavernosum of the penis and review the relevant literature. Case presentation: A 76-year-old man presented with a slow-growing painless nodule on the left side of the penis. On physical examination, a non-tender, 7-mm mass was palpable. This tumor showed inhomogeneous low signal intensity on T2-weighted magnetic resonance imaging. The mass was excised and a myopericytoma diagnosed by pathological examination of the operative specimen. Conclusion: We here report a rare case of myopericytoma in the corpus cavernosum of the penis. To the best of our knowledge, this is the second reported case of a myopericytoma in the penis and the first in the corpus cavernosum of the penis. Clinicians should keep this rare possibility in mind when investigating a mass in the penis.

18.
Hinyokika Kiyo ; 58(8): 421-4, 2012 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-23052266

RESUMEN

A 49-year-old man presented with elevated serum creatinine. He had histories of pancreatic pseudocyst caused by alcoholic pancreatitis and right nephrectomy due to renal cell carcinoma. Computed tomographic scan demonstrated that a subcapsular renal cyst appeared adjacent to the pancreatic pseudocyst and compressed the parenchyma of the left kidney. Since the renal subcapsular cyst was suspected to directly communicate with the pancreatic pseudocyst, endoscopic ultrasound-guided transgastric drainage of pancreatic pseudocyst was performed. After the intervention, the renal subcapsular cyst disappeared without formation of a pancreatic fistula and renal dysfunction was promptly improved. He remains free of relapse for more than 1 year.


Asunto(s)
Drenaje/métodos , Endosonografía/métodos , Enfermedades Renales Quísticas/etiología , Seudoquiste Pancreático/cirugía , Humanos , Masculino , Persona de Mediana Edad , Seudoquiste Pancreático/complicaciones
19.
Hinyokika Kiyo ; 57(6): 309-13, 2011 Jun.
Artículo en Japonés | MEDLINE | ID: mdl-21795833

RESUMEN

A 66-year-old man presented with multiple bilateral renal nodular lesions demonstrated by enhanced computed tomographic scan. He had a history of autoimmune pancreatitis and renal cell carcinoma, which had been treated with partial nephrectomy. We performed renal biopsy under ultrasound guidance. Pathological examination revealed plasma cell infiltration to the renal interstitium. Serum IgG4 level was high and we diagnosed as IgG4-related tubulointerstitial nephritis. After one month of oral steroid therapy the multiple nodular lesions disappeared.


Asunto(s)
Inmunoglobulina G/análisis , Riñón/patología , Nefritis Intersticial/inmunología , Anciano , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulina G/sangre , Masculino , Nefritis Intersticial/diagnóstico , Nefritis Intersticial/patología , Células Plasmáticas/patología , Prednisolona/uso terapéutico , Tomografía Computarizada por Rayos X
20.
IJU Case Rep ; 4(4): 239-242, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34258538

RESUMEN

INTRODUCTION: Horseshoe kidney is a renal fusion anomaly often associated with ectopia, malformation, and vascular changes. Robot-assisted partial nephrectomy is selected for patients with T1a renal cell carcinoma; however, there are few reports of renal cell carcinoma in horseshoe kidney. We present a case of robot-assisted partial nephrectomy via a retroperitoneal approach in a patient with horseshoe kidney with a brief literature review. CASE PRESENTATION: An 84-year-old woman presented with a 2-cm mass in horseshoe kidney. She underwent robot-assisted laparoscopic partial nephrectomy via a retroperitoneal approach. CONCLUSION: The use of robot-assisted laparoscopic partial nephrectomy in patients with horseshoe kidney is very rare, and only four cases have been reported. Because of the unique anatomical structure, surgeons need to consider surgical strategy more carefully, considering tumor location, vascular anatomy, and past history of abdominal surgery.

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