[Pelvic Reconstruction in Abdominal Trachelectomy and Bilateral Salpingo-Oophorectomy for Occult Uterine Endometrial Cancer Found in Specimens Removed in the Context of Laparoscopic Sacrocolpopexy].

In the patients undergoing pelvic organ prolapse (POP) repairs, the incidence of occult uterine endometrial cancer is low and there is no established management procedure for preoperative cancer screening. We report a case of pelvic reconstruction in abdominal trachelectomy and bilateral salpingo-oophorectomy for occult uterine endometrial cancer found in specimens removed in the context of laparoscopic sacrocolpopexy (LSC). A 70-year-old woman presented to our center with cystocele. She underwent LSC and laparoscopic supracervical hysterectomy. She had no atypical genital bleeding; and, transvaginal ultrasound, pelvic plane magnetic resonance imaging and cervical cytology showed no evidence of malignancy. However, the pathological examination showed uterine endometrial cancer. She underwent trachelectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. A part of mesh was removed with a cervical stamp, but the remaining mesh was sewn together. At 5 months after the operation, no recurrence of uterine endometrial cancer and POP was seen.

[Renal Artery Stenting for Spontaneous Renal Artery Dissection with Renal Infarction].

Spontaneous renal artery dissection (SRAD) is extremely rare and the management procedures have not been established. We report a case of endovascular stent placement for SRAD with renal infarction. A 53-year-old man visited a hospital with the complaint of lumbago. Contrast enhanced computed tomography images showed right renal artery dissection and renal infarction. He was transferred to our hospital for further treatment. We consulted our department of endovascular surgery. As 16 hours had passed from the onset, stent placement was performed on the next day as a wait and see procedure. He was discharged 11 days after the stenting. At 14 months after the procedure, he is free from lumbago and his serum creatine levels are within the normal range.

[A Case of Urachal Carcinoma Treated with Laparoscopic Resection of Urachal Remnants with Partial Cystectomy that was Difficult to Diagnose Preoperatively by Transurethral Biopsy].

A 42-year-old male was referred to our hospital with the main complaint of gross hematuria. A submucosal tumor was found on top of the bladder dome. A cystoscopy and magnetic resonance image also revealed a urachal cyst at the position of the urachus. We performed a transurethral biopsy and the pathological examination was negative for malignancy. We executed laparoscopic urachal resection and partial cystectomy as well. The final pathological diagnosis was urachal carcinoma. It is difficult to diagnose urachal carcinoma accuratelyprior to the operation. Therefore, it is controversial whether a transurethral biopsyis necessaryor not. Surgical procedures should be planned with the suspicion of a malignant tumor.