[A case of idiopathic retroperitoneal fibrosis accompanied by asynchronous bilateral urinoma].

The patient was a 68-year-old female with the complaint of left flank pain. On examination, hydronephrosis of the left kidney and the urinoma of left retroperitoneal space were disclosed by abdominal computed tomographic (CT) scan. The urinoma disappeared spontaneously, but 4 months later right hydronephrosis and the urinoma of ipsilateral retroperitoneum emerged. Enhanced CT scan revealed aneurysm of bilateral common iliac arteries and perianeurysmal fibrotic mass. After steroid therapy under the diagnosis of idiopathic retroperitoneal fibrosis (IRPF), the fibrotic mass reduced in size and the urinoma disappeared. We should be aware that urinomas, which are thought to be caused by sudden obstruction of the upper urinary tract, could be brought about by IRPF.

[A case of seminal vesicle cyst due to the obstruction of the ejaculatory duct: possible association with prostate cancer].

We report a case of a seminal vesicle cyst supposed to be associated with prostate cancer in a 79-year-old Japanese man presenting with urinary retention. A fist-sized soft mass was palpated at the anterior wall of the rectum and serum prostate-specific antigen (PSA) was elevated to 59.8 ng/ml. Transrectal ultrasonography, computed tomography and magnetic resonance imaging revealed a retrovesical cystic mass measuring 7 cm in diameter and the absence of bilateral seminal vesicles. On vasography the lumen of the cystic lesion was visualized immediately, but the radiopaque fluid did not flow into the urethra. Transperineal prostate biopsy revealed moderately differentiated adenocarcinoma and puncture of the cyst revealed bloody fluid including sperm with a low PSA level. These findings strongly suggested that the mass was a seminal vesicle cyst caused by ejaculatory duct obstruction associated with prostate cancer. He has received endocrine therapy with goserelin acetate and bicalutamide for 6 months with no enlargement of the cystic lesion.

[A case of idiopathic retroperitoneal fibrosis with a marked thickening of the urinary bladder wall].

The patient was a 49-year-old male with the chief complaint of right lower extremity edema. Ultrasonography showed a right hydronephrosis and a thickening of the right side of bladder wall. No bladder tumor was found by cystoscopy. The right renal pelvis and ureter were not visualized by drip infusion pyelography (DIP). Computed tomography (CT) demonstrated a soft tissue mass surrounding the bilateral common iliac artery and extending to thickened bladder wall. After the echo-guided needle biopsy, steroid therapy was performed under the diagnosis of the idiopathic retroperitoneal fibrosis. Prednisolone was administered for 10 weeks, resulting in the complete disappearance of thickening of the bladder wall.