Accessory spleen after splenectomy mimicking adrenal tumor: a case report.

Accessory spleen is a congenital anomaly, those asymptomatic generally do not need surgical intervention. Retroperitoneal heterotopic accessory spleens are often misdiagnosed, especially in cases that have undergone splenectomy for various reasons. In these cases, most patients are received unnecessary resection for misdiagnosed as adrenal gland tumors, ganglioblastomas or paragangliomas preoperatively. We report on a case of accessory spleen mimicking a left adrenal tumor. A 47-year-old man who had undergone splenectomy 25 years ago was referred to our department because of hypertension, CT scan revealed a mass about 4 cm in the left adrenal gland. The mass was confirmed nonfunctional through hormonal evaluation of the adrenal gland. We found the mass was not originated from the adrenal gland intraoperation even they were close together. Histopathologic examination of the surgical specimen revealed an accessory spleen. The differences between the case and other accessory spleen patients include a history of hypertension, the location of the mass and a history of splenectomy, and these also are the main reasons for our misdiagnosis. This case remind us that an accessory spleen should be considered for the biochemically inactive mass in left adrenal area, even the splenectomy has been performed before.

Re-transurethral resection treatment for non-invasive bladder tumor.

The objective of this study was to compare surgical treatments for non-invasive bladder tumor. Hundred and forty patients with non-invasive bladder tumor were studied. Seventy-three patients were treated by transurethral resection of bladder tumor (TURBT) and Repeated-Transurethral Resection of Bladder Tumor (R-TURBT), while 67 by partial cystectomy. Operation time, blood loss, postoperative complications, and postoperative recurrence rate were better in the TURBT+R-TURBT group compared with the partial cystectomy group. Further, TURBT+R-TURBT offers advantages, such as simple surgical manipulation, less trauma, faster recovery, repeatedly performable procedure, and safety. In conclusion, this is an optimal therapy for treatment of non-invasive bladder tumor.

The transurethral seminal vesiculoscopy in the diagnosis and treatment of the seminal vesicle disease.

To develop a transurethral endoscopy technique of the transurethral seminal vesiculoscopy to examine and treat seminal vesicle disease. A total of 61 patients with seminal vesicle disease were diagnosed and treated with the transurethral seminal vesiculoscopy through the distal seminal tracts and vesicles. 58 cases were successfully treated using transurethral seminal vesiculoscopy via the seminal vesicles. The operation took 25 ~ 85 min, with an average of (35.6) mins. In this group, seven cases were diagnosed as ejaculatory orifice cyst, 14 cases had blood clots in the seminal vesicles, and nine patients had stones in the seminal vesicles. All patients were treated properly. Follow-up occurred at 3 months, with two cases showing post-operative discomfort in perineal region. One patient had recurrence with seminal vesiculitis, which improved with treatment. Four infertile patients had a significant increase in sperm count and ejaculation volume and two of these patients were able to naturally inseminate within seven to 18 months post-surgery. This approach enables a new endoscopic technique with the transurethral seminal vesiculoscopy to diagnose and treat seminal vesicle disease through the normal anatomic pathway which can be easily performed with few post-operative complications.