Primary Yolk Sac Tumor of the Prostate: A Case Report and Review of the Literature.

Endodermal sinus (yolk sac) tumors (ESTs) are rare neoplasms that most commonly arise in the ovaries or testis. Only six cases of prostatic ESTs have been reported in the literature. We report a case of prostatic EST, the first case in which the patient had a history of previous testis cancer. Treatment included cisplatin-based chemotherapy and radical prostatectomy. Previous cases of primary ESTs and use of cisplatin-based therapy as well as metastatic tumors to the prostate are discussed.

Percutaneous nephrolithotomy in spinal cord neuropathy patients: a single institution experience.

BACKGROUND AND PURPOSE: Patients with spinal neuropathy are at an increased risk for urolithiasis. Data on percutaneous nephrolithotomy (PCNL) in this population are limited. Our objective is to review our experience in managing stones with PCNL in patients with spinal neuropathy. PATIENTS AND METHODS: Twenty-one patients with spinal neuropathy underwent PCNL at our institution between January 2005 and August 2011. Their medical records were reviewed retrospectively to collect data relating to stone characteristics, treatment outcomes, and complications. RESULTS: Forty-two PCNL were performed on 26 kidneys. Five patients had bilateral stones. They were 14 (66.7%) patients with spinal cord injury, 5 (23.8%) with spina bifida, and 2 (9.5%) with other neurologic abnormalities. There were 90.5% of patients with preoperative bacteriuria and 47.6% with severe scoliosis, making positioning for PCNL challenging. Complete staghorn stones occurred in 46.2% of kidneys, and 50% of stones were struvite. Only 53.8% of kidneys were stone free after the first PCNL. The success rate increased to 80.8% after the second and 88.5% after the third PCNL. Urosepsis developed in three (14.3%) patients, necessitating admission to the intensive care unit postoperatively. Six (28.6%) patients needed blood transfusion. One patient had a pneumothorax and another had a perforation of the collecting system. CONCLUSIONS: Based on our experience, PCNL in patients with spinal neuropathy had a stone clearance rate comparable with that of the general population. These patients, however, needed multiple PCNLs to be stone free and had a higher incidence of complications (especially infectious).

Primary Ewing's sarcoma of the kidney with caval involvement: a case report.

Ewing sarcoma, also referred to as primitive neuroectodermal tumor (PNET), is a malignancy, histologically characterized by Homer-Wright rosettes and small round cells, that presents most commonly in bone or soft tissue in the pediatric and adolescent populations. We report the case of a patient that presents with intermittent gross hematuria, abdominal mass and elevated blood pressure. After surgical excision of the renal mass, the rare finding of a primary renal Ewing's sarcoma was discovered. After surgery the patient was additionally treated with chemotherapy. After presenting this case, we briefly discuss the unique case of isolated renal Ewing's sarcoma, including incidence and treatment.

Primary carcinoid tumor of the ileal efferent limb of an ileovesicostomy: a case report.

We report on the evaluation and management of a 47-year-old white male found to have primary carcinoid tumor of the ileal segment of his diverting ileovesicostomy thirty-five months after initial creation. Subsequent to presentation with intermittent gross hematuria, CT urogram highlights an 8 mm enhancing lesion near the enterovesical junction of urinary diversion. Office cystoscopy confirms presence of a lesion that was later endoscopically resected and found to be a well-differentiated carcinoid tumor. Evaluation with serum markers, direct visualization utilizing endoscopy, and imaging was without finding of alternate primary or metastatic lesions. The patient ultimately had the proximal ileal portion of his ileovesicostomy excised and the distal portion converted into an ileal conduit. After briefly discussing the carcinoid tumor and the carcinoid syndrome it may cause, we review the literature on the incidence of carcinoid tumors in a population requiring the use of intestine in the urinary tract.

Angiotensin II-induced hypertrophy is potentiated in mice overexpressing p22phox in vascular smooth muscle.

Increased reactive oxygen species (ROS) are implicated in several vascular pathologies associated with vascular smooth muscle hypertrophy. In the current studies, we utilized transgenic (Tg) mice (Tg(p22smc)) that overexpress the p22(phox) subunit of NAD(P)H oxidase selectively in smooth muscle. These mice have a twofold increase in aortic p22(phox) expression and H(2)O(2) production and thus provide an excellent in vivo model in which to assess the effects of increased ROS generation on vascular smooth muscle cell (VSMC) function. We tested the hypothesis that overexpression of VSMC p22(phox) potentiates angiotensin II (ANG II)-induced vascular hypertrophy. Male Tg(p22smc) mice and negative littermate controls were infused with either ANG II or saline for 13 days. Baseline blood pressure was not different between control and Tg(p22smc) mice. ANG II significantly increased blood pressure in both groups, with this increase being slightly exacerbated in the Tg(p22smc) mice. Baseline aortic wall thickness and cross-sectional wall area were not different between control and Tg(p22smc) mice. Importantly, the ANG II-induced increase in both parameters was significantly greater in the Tg(p22smc) mice compared with control mice. To confirm that this potentiation of vascular hypertrophy was due to increased ROS levels, additional groups of mice were coinfused with ebselen. This treatment prevented the exacerbation of hypertrophy in Tg(p22smc) mice receiving ANG II. These data suggest that although increased availability of NAD(P)H oxidase-derived ROS is not a sufficient stimulus for hypertrophy, it does potentiate ANG II-induced vascular hypertrophy, making ROS an excellent target for intervention aimed at reducing medial thickening in vivo.