Short schedule intravesical mitomycin preceding transurethral resection for recurrent Ta-T1, G1-G2 bladder cancer.

AIMS AND BACKGROUND: Intravesical instillations commonly follow resection, when all visible lesions have been removed, making impossible any direct assessment of efficacy. The study was conceived to evaluate the ablative effect on the tumor and the efficacy in reducing the risk of recurrence of short schedule intravesical chemotherapy administered before endoscopic resection. STUDY DESIGN: Four weekly intravesical instillations of mitomycin C followed by transurethral resection (TUR) were administered to 31 patients with recurrent small volume superficial bladder cancer. RESULTS: At TUR no evidence of disease was found in 22 patients (70.9%) and residual disease in the remaining 9 (29.1%). At a median follow-up of 15 months (range, 3-33) 16 of 31 patients (51.6%) had recurrence of disease. The treatment was well tolerated. CONCLUSIONS: Short-schedule intravesical chemotherapy can completely ablate small volume recurrent superficial bladder cancer in a relevant number of patients but is probably not sufficient to obtain long-term prophylaxis.

[Immunotherapy with subcutaneous recombinant IL-2 and interferon combined with surgery in advanced stage carcinoma of the kidney]. / Immunoterapia con IL-2 sottocutanea ricombinante ed interferone associata a chirurgia nel carcinoma del rene in stadio avanzato.

Twelve consecutive patients with metastatic renal cell carcinoma were submitted to an integrate treatment plan of immunotherapy with subcutaneous IL-2 and IFN and radical surgery in a pilot study. Partial response were observed in 2 patients, stable disease in 5 patients and progression of disease under treatment were observed in 5. Two RP were maintained for 12 and 18+ months and 1 SD is maintained at 12+ months. Treatment was well tolerated without significant toxicity. Integrated radical surgery and immunotherapy with s.c. IL-2 and IFN can produce occasionally protracted clinical responses.

[Extrarenal angiomyolipoma: vascular, lymphonodal, and perirenal localization. Report of 4 cases]. / Angiomiolipomi extrarenali: localizzazioni vascolari, linfonodali e perirenali. Descrizione di 4 casi.

Angiomyolipomas are rare renal tumors considered benign even though evidences of occurrence of the disease in lymphnodes and vascular structures as well as in a variety of distant sites, such as the liver, the uterus, the nasal cavity and others, have occasionally been reported. We describe one case of late lesion of angiomyolipoma within the wall of the inferior bronchial artery, two cases of lymphnodes involvement and one case of angiomyolipoma extending into the perirenal fat.

[Calcifying giant-cell Sertoli tumor: description of a case with atypical echographic presentation]. / Il tumore a cellule giganti del Sertoli calcificante: descrizione di un caso a presentazione ecografica atipica.

Large cell calcifying Sertoli cell tumor of the testis is an extremely rare type of sex cord tumor with low malignant potential that occurs in the first and second ecades of life. Twenty-eight cases have been reported in the literature and, to our knowledge, only 2 had an aggressive behaviour. Patient age, tumor size, histological malignant patterns such as pleomorphism and high mitotic rate seem to heavy influence the future neoplasm malignancy. Ultrasonography imaging of the large cell calcifying has described in only 6 cases. We report an experience with a large cell calcifying Seroli cell tumor of the testis and point out the unusual sonographic findings. Moreover, if histologic examination suggests no malignant features, we suggest local excision as ideal therapy for the preservation of testicular parenchyma.

Changes of renal resistive index in response to hydration and diuretic administration in normal subjects and in patients with small ureteral stone.

The renal resistive index has been measured before and after hydration and administration of diuretics in persons with normal kidneys and in kidneys with small ureteral stone, either obstructing or nonobstructing, to assess induced flow changes and to identify features differentiating obstructing from nonobstructing stones. In normal kidneys the resistive index was normal (mean, 0.62+/-0.03); no changes in the resistive index occurred within 15 to 60 min after hydration alone, whereas the resistive index rose within 15 min after hydration plus administration of diuretics and then returned to initial values within 30 min. In both cases the resistive index decreased below basal values after 75 to 90 min. Similar changes were observed in kidneys with a nonobstructing ureteral stone. In kidneys with an obstructing ureteral stone the resistive index was higher than in normal subjects (mean, 0.73+/-0.02, P<0.01), increased further within 15 min after hydration and administration of diuretics (P<0.01), and remained higher than basal values during the following 90 min. In conclusion, different resistive index changes have been observed in response to hydration and diuretics in normal and obstructed kidneys. Duplex Doppler sonography and diuresis duplex Doppler sonography seem promising diagnostic tools to identify obstructing stones.