[Extracorporeal partial nephrectomy and auto-transplantation after presurgical targeted therapy with tyrosine kinase inhibitors for renal cell cancer].

A 74-year-old woman who had previously undergone left nephrectomy because of calculi was referred to our department with a right renal mass that was detected by computed tomography (CT) during treatment for pyelonephritis. Repeated CT showed a contrast-enhanced 4.7 cm tumor close to the renal sinus, and no metastatic lesion was detected. Sunitinib was administered as a presurgical therapy ; however, the patient experienced grade 3 neutropenia and thrombocytopenia, and sunitinib was discontinued. Sorafenib was administered 7 days after discontinuation of sunitinib ; however, the patient experienced febrile neutropenia and rash, and sorafenib was discontinued. Extracorporeal partial nephrectomy and auto-transplantation were performed 24 days after discontinuation of sorafenib. Though peri-graft abscess was suspected to be present and resolved by antibacterial therapy, severe complications were not experienced, and the patient did not require dialysis therapy after surgery. There was no evidence of recurrence at 30 months after the surgery.

[Primary signet ring cell carcinoma of the bladder: a case report].

A 71-year-old man complained of dyspnea and general fatigue. His blood tests showed severe renal dysfunction. Computed tomographic scan, bone scintigram, and cystoscopy revealed primary signet ring cell carcinoma of the urinary bladder with multiple bone metastases (cT2N0M1). As the general condition of the patient was poor, nephrostomy was performed. He died one month after the diagnosis due to cancer progression. The prognosis of signet ring cell carcinoma of the bladder is poor because many cases presented at an advanced stage. Fifty cases of signet ring cell carcinoma in the urinary bladder reported in Japan are reviewed.