[A primary adenocarcinoma of the seminal vesicles. Case report of a rare malignancy]. / Primäres Adenokarzinom der Samenblasen. Fallbericht einer seltenen onkologischen Entität.

Primary malignancies of the seminal vesicles are extremely rare. They must be strictly differentiated from surrounding malignancies that may infiltrate the seminal vesicles from outside (e.g. prostate, rectum, and bladder carcinoma). MEDLINE and CANCERLIT review showed about 50 documented cases of primary seminal vesicle carcinoma so far worldwide in men between 19 and 90 years of age. Early diagnosis may be difficult due to lack of specific symptoms. Especially with a history of voiding dysfunction, haemospermia and/or haematuria, investigators should consider it. Primary diagnostic steps include digital rectal examination, transrectal ultrasound, and transrectal biopsy of the tumour. Additionally, CT and MRT scans show tumour masses corresponding to the seminal vesicles. Adenocarcinoma of seminal vesicles shows no expression of prostate-specific antigen or prostate-specific acid phosphatase, but there may be expression of carcinoembryonic antigen and cancer antigen 125. Radical surgery including radical prostatectomy and/or cystoprostatectomy including pelvic lymph node dissection offers a curative treatment pathway. Adjuvant or inductive medical treatment is of unproven worth, but a combination of hormonal deprivation and radiotherapy seems to be more effective than any chemotherapy.

[Spontaneous renal angiomyolipoma rupture. Rare differential diagnosis of renal ruptures]. / Spontane Nierenruptur bei Angiomyolipom. Seltene Differentialdiagnose bei Nierenrupturen.

Spontaneous renal rupture is a rare but nevertheless life-threatening complication in cases of benign and malignant space-occupying lesions in the kidneys. A precise preoperative differentiation often turns out to be difficult because of the formation of a hematoma. We report on a 50-year-old female patient with a retroperitoneal hematoma due to a spontaneous renal rupture for which an angiomyolipoma could only by diagnosed after the nephrectomy with histological work-up. In search of the cause, sonography, abdominal computed tomography, and digital subtraction angiography were conducted, which could provide findings suggestive of a space-occupying lesion, but because of the distinct hemorrhagic infarction could not determine whether it was benign or malignant. As shown in this case, when the radiological result is ambiguous, renal exposure is indicated from both a diagnostic and therapeutic standpoint.

Pentoxifylline prevents endothelial damage due to ischemia and reperfusion injury.

BACKGROUND: Endothelial injury after ischemia and reperfusion is characterized by an increase in permeability, cellular edema, and loss of acetylcholine-mediated vasorelaxation. Three hours of ischemia followed by 2 hr of reperfusion in the New Zealand white rabbit hindlimb has been shown to result in loss of acetylcholine-induced superficial femoral artery vasorelaxation. The purpose of this study was to evaluate the effect of intraarterial pentoxyfylline (PTX) on this endothelial injury. METHODS: New Zealand white rabbits underwent 3 hr of complete hindlimb ischemia followed by 2 hr of reperfusion. Twenty milliliters of either 100 microM PTX or normal saline was infused over 20 min via the circumflex iliac artery at initiation of reperfusion. Superficial femoral artery rings were then evaluated in vitro for endothelial cell-mediated relaxation. Rings were exposed to standardized incremental doses of acetylcholine after norepinephrine-induced contraction and percentage relaxation was measured. Sections of arteries were also sent for hematoxylin and eosin staining. RESULTS: Similar contraction responses following NE stimulation were observed between control and PTX-treated rings. Control rings relaxed a mean of 14.97 +/- 3.64, 23.17 +/- 5.61, and 31.84 +/- 8.43% in response to acetylcholine doses of 6 x 10(-8), 1 x 10(-7), and 1.5 x 10(-7) M, respectively. In contrast, PTX-treated segments relaxed a mean of 47.52 +/- 8.88, 62.32 +/- 6.83, and 76.73 +/- 4.91% to the same doses of acetylcholine. Differences in relaxation between control and PTX-treated vessels were significantly different at each dose (P < 0.05, Student's t test). Histologic examination of the PTX-treated and control arteries revealed an intact endothelium without morphologic differences between the two groups. CONCLUSION: In this model of rabbit hindlimb ischemia, endothelial cell-mediated vasorelaxation was preserved with the administration of intraarterial PTX during reperfusion compared to controls. The different relaxation responses could not be attributed to altered arterial contractility in response to norepinephrine, or explained by histologic changes in the arterial wall. These studies demonstrate a potential modality for therapeutic intervention to reduce reperfusion injury after acute limb ischemia.