Nephrosphere-Derived Cells Are Induced to Multilineage Differentiation when Cultured on Human Decellularized Kidney Scaffolds.

In end-stage chronic kidney disease, the option of organ transplantation is limited because of the scarce availability of kidneys. The combination of stem cell research, regenerative medicine, and tissue engineering seems a promising approach to produce new transplantable kidneys. Currently, the possibility to repopulate naturally obtained scaffolds with cells of different sources is advancing. Our aim was to test, for the first time, whether the nephrosphere (NS) cells, composed by renal stem/progenitor-like cells, were able to repopulate different nephron portions of renal extracellular matrix scaffolds obtained after decellularization of human renal tissue slices. Our decellularization protocol enabled us to obtain a completely acellular renal scaffold while maintaining the extracellular matrix structure and composition in terms of collagen IV, laminin, and fibronectin. NS cells, cultured on decellularized renal scaffolds with basal medium, differentiated into proximal and distal tubules as well as endothelium, as highlighted by histology and by the specific expression of epithelial cytokeratin 8.18, proximal tubular CD10, distal tubular cytokeratin 7, and endothelial von Willebrand factor markers. Endothelial medium promoted the differentiation toward the endothelium, whereas epithelial medium promoted the differentiation toward the epithelium. NS cells seem to be a good tool for scaffold repopulation, paving the way for experimental investigations focused on whole-kidney reconstruction.

Major Action of Endogenous Lysyl Oxidase in Clear Cell Renal Cell Carcinoma Progression and Collagen Stiffness Revealed by Primary Cell Cultures.

Human clear cell renal cell carcinoma (ccRCC) is therapy resistant; therefore, it is worthwhile studying in depth the molecular aspects of its progression. In ccRCC the biallelic inactivation of the VHL gene leads to stabilization of hypoxia-inducible factors (HIFs). Among the targets of HIF-1α transcriptional activity is the LOX gene, which codes for the inactive proenzyme (Pro-Lox) from which, after extracellular secretion and proteolysis, derives the active enzyme (Lox) and the propeptide (Lox-PP). By increasing stiffness of extracellular matrix by collagen crosslinking, Lox promotes tumor progression and metastasis. Lox and Lox-PP can reenter the cells where Lox promotes cell proliferation and invasion, whereas Lox-PP acts as tumor suppressor because of its Ras recision and apoptotic activity. Few data are available concerning LOX in ccRCC. Using an in vitro model of ccRCC primary cell cultures, we performed, for the first time in ccRCC, a detailed study of endogenous LOX and also investigated their transcriptomic profile. We found that endogenous LOX is overexpressed in ccRCC, is involved in a positive-regulative loop with HIF-1α, and has a major action on ccRCC progression through cellular adhesion, migration, and collagen matrix stiffness increment; however, the oncosuppressive action of Lox-PP was not found to prevail. These findings may suggest translational approaches for new therapeutic strategies in ccRCC.

Healing at implant sites prepared conventionally or by means of Sonosurgery ®. An experimental study in dogs.

OBJECTIVE: To compare peri-implant tissue healing at implants installed in sites prepared with conventional drills or a sonic device. MATERIAL AND METHODS: In six Beagle dogs, the mandibular premolars and first molars were extracted bilaterally. After 3 months, full-thickness muco-periosteal flaps were elevated and recipient sites were prepared in both sides of the mandible. In the right side (control), the osteotomies were prepared using conventional drills, while, at the left side (test), a sonic device (Sonosurgery(®)) was used. Two implants were installed in each side of the mandible. After 8 weeks of non-submerged healing, biopsies were harvested and ground sections prepared for histological evaluation. RESULTS: The time consumed for the osteotomies at the test was more than double compared to the conventional control sites. No statistically significant differences were found for any of the histological variables evaluated for hard and soft tissue dimensions. Although not statistically significant, slightly higher mineralized bone-to-implant contact was found at the test (65.4%) compared to the control (58.1) sites. CONCLUSIONS: Similar healing characteristics in osseointegration and marginal hard tissue remodeling resulted at implants installed into osteotomies prepared with conventional drills or with the sonic instrument (Sonosurgery(®)).

Chromosomal imbalances in human bladder urothelial carcinoma: similarities and differences between biopsy samples and cancer stem-like cells.

BACKGROUND: The existence of two distinct groups of tumors with different clinical characteristic is a remarkable feature of transitional cell carcinomas (TCCs) of the bladder. More than 70% are low-grade (LG) non-infiltrating (NI) cancers at diagnosis, but 60-80% of them recur at least one time and 10-20% progress in stage and grade. On the other hand, about 20% of tumors show muscle invasion (IN) and have a poor prognosis with <50% survival after 5 years. This study focuses on the complexity of the bladder cancer genome, and for the first time to our knowledge, on the possibility to compare genomic alterations of in vitro selected cancer stem-like cells (CSCs), and their original biopsy in order to identify different genomic signature already present in the early stages of tumorigenesis of LG and HG tumors. METHODS: We initially used conventional chromosome analysis on TCC biopsies with different histotypes (LG vs HG) in order to detect rough differences between them. Then, we performed array comparative genomic hybridization (aCGH) on 10 HG and 10 LG tumors providing an overview of copy number alterations (CNAs). Finally, we made a comparison of the overall CNAs in 16 biopsies and their respective CSCs isolated from them. RESULTS: Our findings indicate that LG and HG bladder cancer differ with regard to their genomic profile even in the early stage of tumorigenesis; moreover, we identified a subgroup of LG samples with a higher tendency to lose genomic regions which could represent a more aggressive phenotype. CONCLUSIONS: The outcomes not only provide valuable information to deeper studying TCC carcinogenesis, but also could help in the clinic for diagnosis and prognosis of patients who will benefit from a more aggressive therapy.

Osseointegration of implants with dendrimers surface characteristics installed conventionally or with Piezosurgery®. A comparative study in the dog.

AIM: The first aim of the present experiment was to compare bone healing at implants installed in recipient sites prepared with conventional drills or a piezoelectric device. The second aim was to compare implant osseointegration onto surfaces with and without dendrimers coatings. MATERIAL AND METHODS: Six Beagles dogs were used in this study. Five implants with two different surfaces, three with a ZirTi(®) surface (zirconia sand blasted, acid etched), and two with a ZirTi(®)-modified surface with dendrimers of phosphoserine and polylysine were installed in the right side of the mandible. In the most anterior region (P2, P3), two recipient sites were prepared with drills, and one implant ZirTi(®) surface and one coated with dendrimers implants were installed at random. In the posterior region (P4 and M1), three recipient sites were randomly prepared: two sites with a Piezosurgery(®) instrument and one site with drill and two ZirTi(®) surface and one coated with dendrimers implants installed. Three months after the surgery, the animals were sacrificed for histological analysis. RESULTS: No complications occurred during the healing period. Three implants were found not integrated and were excluded from analysis. However, n = 6 was obtained. The distance IS-B at the buccal aspect was 2.2 ± 0.8 and 1.8 ± 0.5 mm, while IS-C was 1.5 ± 0.9 and 1.4 ± 0.6 mm at the Piezosurgery(®) and drill groups, respectively. Similar values were obtained between the dendrimers-coated and ZirTi(®) surface implants. The BIC% values were higher at the drill (72%) compared to the Piezosurgery(®) (67%) sites. The BIC% were also found to be higher at the ZirTi(®) (74%) compared to the dendrimers-coated (65%) implants, the difference being statistically significant. CONCLUSION: This study has revealed that oral implants may osseointegrate equally well irrespective of whether their bed was prepared utilizing conventional drills with abundant cooling or Piezosurgery(®). Moreover, the surface coating of implants with dendrimers phosphoserine and polylysine did not improve osseointegration.

The edentulous ridge expansion (ERE) technique an experimental study in the dog.

OBJECTIVE: To compare the healing and bony crest resorption at implants installed conventionally or applying an edentulous ridge expansion (ERE) technique in the maxilla. MATERIAL AND METHODS: In six Labrador dogs, the first and second maxillary incisors were extracted bilaterally. In the left side of the maxilla (Test), the flaps were elevated and the buccal plate of the alveoli and septa was removed. After 3 months of healing, partial-thickness (split) flaps were dissected and the residual alveolar bone was exposed. In the right side of the maxilla, an implant was installed conventionally (Type IV; Control) while, in the left side, the ERE technique was adopted. Hence, an expansion of the buccal bony crest was obtained, and the implant was subsequently installed (Test). After 3 months of healing, biopsies were obtained and ground sections were prepared for histological analyses. RESULTS: A buccal vertical resorption of the bony crest of 2.2 ± 1.2 mm and 1.6 ± 0.7 mm was found at the test and control sites, respectively. The difference, however, did not reach statistical significance. The coronal level of osseointegration at the buccal aspect was located at 3.1 ± 1.0 mm and 2.2 ± 0.7 mm from the implant shoulder at the test and control sites, respectively, the difference being statistically significant. The mean values of the mineralized bone-to-implant contact (MBIC%) ranged from 43% to 48% at the buccal and lingual sites. No differences reached statistical significance. CONCLUSIONS: Implants installed by applying an ERE technique may osseointegrate similarly to conventional implant installation. However, vertical and horizontal resorption of the displaced buccal bony wall occurred as well.

PKH(high) cells within clonal human nephrospheres provide a purified adult renal stem cell population.

The existence and identification of adult renal stem cells is a controversial issue. In this study, renal stem cells were identified from cultures of clonal human nephrospheres. The cultured nephrospheres exhibited the activation of stem cell pathways and contained cells at different levels of maturation. In each nephrosphere the presence of 1.12-1.25 cells mirroring stem cell properties was calculated. The nephrosphere cells were able to generate three-dimensional tubular structures in 3D cultures and in vivo. In clonal human nephrospheres a PKH(high) phenotype was isolated using PKH26 epifluorescence, which can identify quiescent cells within the nephrospheres. The PKH(high) cells, capable of self-renewal and of generating a differentiated epithelial, endothelial and podocytic progeny, can also survive in vivo maintaining the undifferentiated status. The PKH(high) status, together with a CD133(+)/CD24(-) phenotype, identified a homogeneous cell population displaying in vitro self-renewal and multipotency capacity. The resident adult renal stem cell population isolated from nephrospheres can be used for the study of mechanisms that regulate self-renewal and differentiation in adult renal tissue as well as in renal pathological conditions.

DNA copy number alterations and PPARG amplification in a patient with multifocal bladder urothelial carcinoma.

BACKGROUND: Bladder cancer is the seventh most common cancer worldwide and over 90% are transitional cell carcinoma (TCC). At the first time of diagnosis at least 70% of TCC present as superficial bladder cancer. Because the clinical outcome of superficial bladder tumors is relatively unpredictable, there is a pressing need to identify markers that may predict tumor recurrence and progression and new treatment strategies. CASE PRESENTATION: We present a unique case of a 67-year old male who underwent total cystectomy after repeated trans-urethral resections of the bladder for multifocal non-muscle invasive bladder cancer. The first and the third tumor were diagnosed as high grade non-infiltrating (HGNI), while the second as carcinoma in situ (CIS). We performed both array comparative genomic hybridization and a targeted chromosomal profile by UroVysion in order to detect copy number variations (CNVs) that may be involved with tumor recurrence and progression. The overall data from this study provide new evidence for the monoclonal origin of urothelial tumor multifocality as several genetic changes were found in different tumors of the same patient. From the analysis of shared CNVs two gained regions emerged at 3p25.2 and 12q23.2, including PPARG and ASCL1 genes, respectively. The copy number level of these genes would seem inversely mutually correlated and highly dependent on histological grade, because the highest level of amplification at 3p25.2 was evidenced in the two HGNI samples, while the highest level of copy number gain at 12q23.2 was reported in the CIS. CONCLUSION: We provide new evidence on the role of PPARG in initiation and maintenance of bladder cancer. For the first time we also suggest a possible explanation for the elevated expression of PPARG in this type of tumor through a focal high level amplification at 3p25.2. Furthermore, a new gene, ASCL1, emerged as a potential candidate to assist PPARG in bladder carcinogenesis.

Healing outcomes at implants installed in grafted sites: an experimental study in dogs.

AIM: To evaluate the integration of implants installed using a surgical guide in augmented sites with autologous bone or deproteinized bovine bone mineral (DBBM) blocks, concomitantly with a collagen membrane. MATERIAL AND METHODS: Mandibular molars were extracted bilaterally in six Labrador dogs, the buccal bony wall was removed, and a box-shaped defect was created. After 3 months, flaps were elevated, a bony graft was harvested from the ascending ramus, and secured to the lateral wall of the defect by means of screws. In the left mandibular side, a DBBM block was fixed into the defect. A resorbable membrane was applied at both sides, and the flaps were sutured. After 3 months, flaps were elevated, and a customized device was used as surgical guide to prepare the recipient sites in the interface between grafts and parent bone. One implant was installed in each side of the mandible. After 3 months, biopsies were harvested, and ground sections were prepared for histologic evaluation. RESULTS: One autologous bone block graft was lost before implant installation. The width of the alveolar crest at the test sites (DBBM) was 5.4 ± 1.2 mm before, 9.4 ± 1.2 mm immediately after grafting, and 9.3 ± 1 mm at implant installation. At the control sites (autologous bone), the corresponding values were: 5.2 ± 1, 9 ± 1.2, and 8.7 ± 0.9 mm, respectively. All implants installed were available for histologic evaluation (n = 5). The autologous bone grafts, rich in vessels and cells, were integrated in the parent bone, and only little non-vital bone was found. The BIC% was 56.7 ± 15.6% and 54.2 ± 13.2% at the buccal and lingual aspects, respectively. At the test sites, the DBBM appeared to be embedded into connective tissue, and very little newly formed bone was encountered within the grafts. The BIC% was 5.8 ± 12.3% and 51.3 ± 14.2% at the buccal and lingual aspects, respectively. CONCLUSIONS: Autologous bone blocks used to augment the alveolar bony crest horizontally allowed the complete osseointegration of implants installed after 3 months of healing. However, similar blocks of DBBM did not promote osseointegration, although the installed implants were stable owing to the osseointegration in the sites of the parent bone.

Chromosomal aberrations in bladder cancer: fresh versus formalin fixed paraffin embedded tissue and targeted FISH versus wide microarray-based CGH analysis.

Bladder carcinogenesis is believed to follow two alternative pathways driven by the loss of chromosome 9 and the gain of chromosome 7, albeit other nonrandom copy number alterations (CNAs) were identified. However, confirmation studies are needed since many aspects of this model remain unclear and considerable heterogeneity among cases has emerged. One of the purposes of this study was to evaluate the performance of a targeted test (UroVysion assay) widely used for the detection of Transitional Cell Carcinoma (TCC) of the bladder, in two different types of material derived from the same tumor. We compared the results of UroVysion test performed on Freshly Isolated interphasic Nuclei (FIN) and on Formalin Fixed Paraffin Embedded (FFPE) tissues from 22 TCCs and we didn't find substantial differences. A second goal was to assess the concordance between array-CGH profiles and the targeted chromosomal profiles of UroVysion assay on an additional set of 10 TCCs, in order to evaluate whether UroVysion is an adequately sensitive method for the identification of selected aneuploidies and nonrandom CNAs in TCCs. Our results confirmed the importance of global genomic screening methods, that is array based CGH, to comprehensively determine the genomic profiles of large series of TCCs tumors. However, this technique has yet some limitations, such as not being able to detect low level mosaicism, or not detecting any change in the number of copies for a kind of compensatory effect due to the presence of high cellular heterogeneity. Thus, it is still advisable to use complementary techniques such as array-CGH and FISH, as the former is able to detect alterations at the genome level not excluding any chromosome, but the latter is able to maintain the individual data at the level of single cells, even if it focuses on few genomic regions.

Biological heterogeneity of putative bladder cancer stem-like cell populations from human bladder transitional cell carcinoma samples.

Transitional cell carcinoma (TCC) is the most common type of bladder cancer. Emerging evidence has suggested that the capability of a tumor to grow and propagate is dependent on a small subset of cells, the cancer stem-like cells (CSCs) or tumor initiating cells. We report on the isolation and biological characterization of putative bladder CSC populations from primary TCCs. Isolated cells were induced to proliferate in stem cell culture conditions (serum-free medium containing mitogenic growth factors). The proliferating cells formed spheroids (urospheres) and their abilities for extensive proliferation and self-renewal were assayed. Their positivity for several stem cell markers (CD133, Oct-3/4, nestin, and cytokeratins) was also assessed by immunofluorescence tests and they could have the potential to differentiate in the presence of serum. In stem cell culture conditions they gradually showed loss of proliferation, adherence to the substrate, and morphological changes, which might reflect their progressive acquisition of differentiative capacity and loss of self-renewal ability. To evaluate if effective cell selection occurred after isolation, conventional cytogenetic studies on fresh chromosome spreads immediately after isolation and after culture were carried out. In addition, a molecular cytogenetic study by UroVysion assay was carried out on paraffin-embedded tissue sections and on fresh and after culture nuclei preparations. The data collected indicated important karyotype changes and a positive selection for hypo- or near-diploid cells, losing the complexity present in fresh tumors.

Defunctioning stoma in high ASA grade, aged patients, with bowel occlusion due to advanced cancer: is it still worthwhile?

PURPOSE: The aim of this study was to assess the role of defunctioning stoma (DS) in elderly high-risk patients with bowel obstruction from advanced colorectal cancer, by exploring consistent variables of outcome, because every other procedure was unfeasible. MATERIALS AND METHODS: A 6-year survey in a single surgery unit (between 1999 and 2004) was retrospectively evaluated, allowing to collect a cohort of 75 patients, aged over 65, who overall presented such critical condition. Pre-operatively, American Society of Anaesthesiologist grade classification was used. Post-operative course was monitored by focusing on gauging symptom relief. So, a validated assessment scale was employed to evaluate physical distress symptoms, graduated on a Likert scale and compared at baseline and day 7, on days 7 and 30, post-operatively. Length of hospital stay (LHS), morbidity, in-hospital (within 30 days) and overall mortality (within 6 months) were also assessed. Paired t test was used as statistical analysis to ascertain improvement of symptoms. RESULTS: All symptoms improved significantly (range, p < 0.05 to p < 0.01) within the surveyed time, with exception of vomiting on day 30 (p = 0.14). Average LHS was 22.8 (standard deviation, +/-3.856) days. Overall morbidity was detected in 68 (91%) patients. In-hospital and overall mortality rates accounted for 27 (35.8%) patients and for 48 (100%) patients, respectively. CONCLUSIONS: The role of DS was effective to improve symptom relief but was poor in terms of morbidity and mortality control. So, ethical concerns have to be addressed, and medical treatment or stenting for left-side obstructions only should be considered as alternative procedures.

Splenic rupture after colonoscopy. A case report and review of the literature.

Rupture of the spleen after colonoscopy is a rare but dangerous complication; up to now only a few cases have been reported in the literature. This complication is more frequent in patients who have previously undergone abdominal surgery and after operative colonoscopies. This case report describes a 64-year-old man who complained of abdominal pain and dyspnoea some hours after a colonoscopy. Laboratory exams showed anaemia; the patient also developed hypotension and tachycardia; a CT scan revealed a splenic laceration with haemoperitoneum. A laparotomic splenectomy was successfully carried out.

Complete genital prosthetization in patients treated with bilateral orchiectomy for metachronous testicular cancer.

UNLABELLED: Testicular malignant tumours represent 1% of neoplasms. The probability of developing a contralateral tumour is between 3% and 7%. We report two cases of complete genital prosthetization in two patients treated with bilateral orchiectomy for metachronous testicular cancer. In our knowledge no previous case is reported in literature. CASE REPORTS: A 46-year-old patient and a 49-year-old patient underwent bilateral radical orchiectomy for metachronous cancers of the testis. The first patient complained the complete loss of libido and complete impotence. For this reason he began a substitutive hormonal therapy with testosterone esters obtaining re-establishment of the masculine phenotype. With the reappearance of the libido and physical efficiency, the patient showed the intention to recover sexual activity and he was treated first by phosphodiesterase type 5 (PDE-5) inhibitors and then he began a cycle of prostaglandin El1(PGE1) but unfortunately without a satisfactory sexual performance. The second man maintained libido, lost sexual efficiency and showed hypogonadism. Substitutive therapy with testosterone enanthate obtained normalization of testosterone values. A psychosexual assessment highlighted a depressive state related to the absence of sexual performance due to an erectile deficit, that was treated first by PDE-5 inhibitors and then by intracavernous injections of PGEI without benefits. After individual and couple counselling both of the patients submitted both semirigid mono component penile prosthesis and bilateral testicular prostheses implantation by means of a single penile-scrotal incision. Both the patients regained sexual activity and were satisfied with the cosmetic appearance. CONCLUSION: We underline the importance of the collaboration between the andrologist and the psycho-sexologist and the on-going collaboration with the patient. This allows the clinician to appraise the situation completely and to work out a common solution built around the patient to obtain a full recovery of his identity.

Giant renal cyst complicated with acquired crossed renal ectopia, hypertension and renal cell carcinoma: case report and review of the literature.

Simple renal cysts are acquired kidney lesion that are described as spherical, smoothed surfaced, with a serous, sub-yellow content. They are generally considered as a harmless anomaly, however cases of complicated renal cysts have been reported. We present a case of an enormous renal cyst (the biggest ever described) containing more than 25 L of fluid mimicking ascites, complicated with controlateral displacement of ipsilateral functional kidney and intra-abdominal organs, renal cell carcinoma and hypertension. Particular attention is carried in the analysis of the literature about different aspects of giant renal cysts like the ability to grow to a very giant size, the association with hypertension and renal cell carcinoma, the sensibility of the most important examinations to reveals malignancy and management.

Numb chin syndrome: the presenting symptom of a metastatic prostate carcinoma.

Numb chin syndrome is a sensory neuropathy characterized by numbness involving the distribution of the mental nerve that could be an uncommon manifestation of metastatic malignancy. Bony metastases are common in patients with advanced prostate carcinoma and involving preferentially vertebrae, sternum, pelvic bones, ribs and femurs. We report a case in an 82-year-old man presenting a history of mental neuropathy as the isolated presenting symptom of a widespread metastatic prostate cancer Numb chin syndrome was describe in some reviews as a late component of a previously diagnosed disease but this report underline the importance of this neuropathy as the isolated presenting symptom of a widespread metastatic prostate cancer. This event is very rare and enumerates four cases in the world literature.

A 7-year history of an intratesticular mass: patient description and review of the literature about dermoid cysts of the testis.

A dermoid cyst is a particular form of a cystic teratoma. In the testis, it is very rare, with only a few cases reported in world literature. A 19-year-old patient come to our attention with a 7-year history of an intratesticular cystic mass. Sonography showed a large hypoechoic solid mass. The tumour markers alpha-fetoprotein, beta-human chorionic gondatotrophin, and lactate dehydrogenase were negative. Chest X-ray was negative. He underwent surgical exploration of the right testis and enucleation of the mass with testis preservation. At 14 month of follow-up, the patient had no complications and no recurrence of the lesion. Surgical enucleation is the treatment of choice in consideration of hormonal, psychological, and reproductive aspects. Orchiectomy should have been the treatment of choice, if the mass had substituted all testicular parenchyma and if there had been some malignant transformations.

Sequence analysis of the JC virus transcriptional control region detected in urine from HIV-positive patients.

OBJECTIVE: To investigate the correlation between transcriptional control region (TCR) types and virus replication and the role of decreased host immunity in inducing TCR changes. STUDY DESIGN: In a previous study, urine specimens from 78 unselected HIV-positive patients were independently evaluated by cytology, immunohistochemistry and nested polymerase chain reaction (n-PCR) to detect the presence of polyomaviruses. The JC virus (JCV) large T region was positive in 44/78 (56%) urine specimens by n-PCR. In the current study, these cases further underwent to n-PCR to detect TCR, and the amplified products were sequenced. The JCV types identified were compared using: (1) morphologic evidence of replication (decoy cells and/or immunohistochemical staining of cells detected using anti-SV 40 antiserum), and (2) patients' immune status (CD4+ cell counts). RESULTS: TCR was successfully amplified in 30/44 cases (68%). TCR sequence analysis disclosed 6/30 archetype (20%) and 24/30 archetypelike sequences, the latter distributed as follows: 4 G2 (4/30, 13%) with G-->A substitutions in the C sequence (nt 9), and 20 CY (20/30, 67%) with A-->G substitutions in the F sequence (nt 19). There were no correlations with morphologic evidence of viral replication or immune status. CONCLUSION: The present study indicated that TCR in urine samples from PML-free HIV-positive subjects are archetypes or archetypelike. Immune suppression does not seem to influence minor changes in the TCR genome, and single by mutations do not change JCV replication activity.

Leiomyoma of the seminal vesicles.

We report the case of a 37-year-old man suffering from dysuria, frequency, acute renal failure followed by bowel distress with rectal tenesmus. PSA was 6.19 ng/ml. CT of abdomen and pelvis revealed a probable prostatic-related pelvis mass. TRUS was not carried out due to intolerance. The patient underwent laparotomy through a lower midline incision that confirmed a firm, even if not involving the adjacent organs, considerable pelvic mass adhering to the left seminal vesicle and involving the right one. Therefore the right seminal vesicle and the mass originating from it were removed. Three months follow-up showed a clinically recovered patient, free of voiding and intestinal symptoms, back to normal working activity.