Primary prostate cancer synchronous with renal cell carcinoma: clinical experience and literature review.

The objective of this study was to report the diagnosis and treatment results of primary prostate adenocarcinoma (PRAD) concurrent in a patient with renal cell carcinoma (RCC), and to review the relative literature. A 62-year-old man was admitted to our hospital with chief complaint of a painless, incidentally found renal mass for one year. RCC was initially found by computed tomography (CT) scan, but prostate cancer was incidentally found by abnormal prostate-specific antigen (PSA) level results. The post-nephrectomy pathology assay reported clear RCC with positive staining of vimentin, cluster of differentiation 10 (CD10), carbonic anhydrase IX (CA-IX), paired box 8 (Pax-8), epithelial membrane antigen (EMA), and Ki67 labeling index (Ki67 LI). Magnetic resonance imaging (MRI) revealed uneven signals in the right peripheral zone of the prostate. Both prostate biopsy and post-prostatectomy pathology examination revealed prostate acinar adenocarcinoma with positive staining of P504S and Ki67 LI. The patient has been in periodic follow-up and has remained in good general condition without any evidence of recurrence to date. To the best of our knowledge, the present report is the only case of systematically described pre- and post-therapy laboratory, pathology, and imaging examination results. Our report together with published studies suggest that increased awareness of synchronous PRAD risk will enable early detection and prompt therapies in patients with RCC.

Adipose-derived stem cells modified by BDNF gene rescue erectile dysfunction after cavernous nerve injury.

Cavernous nerve injury is the main cause of erectile dysfunction following radical prostatectomy. The recovery of erectile function following radical prostatectomy remains challenging. Our previous studies found that injecting adipose-derived stem cells (ADSCs) into the cavernosa could repair the damaged cavernous nerves, but the erectile function of the treated rats could not be restored to a normal level. We evaluated the efficacy of ADSCs infected with a lentiviral vector encoding rat brain-derived neurotrophic factor (lenti-rBDNF) in a rat model of cavernous nerve injury. The rats were equally and randomly divided into four groups. In the control group, bilateral cavernous nerves were isolated but not injured. In the bilateral cavernous nerve injury group, bilateral cavernous nerves were isolated and injured with a hemostat clamp for 2 minutes. In the ADSCGFP and ADSCrBDNF groups, after injury with a hemostat clamp for 2 minutes, rats were injected with ADSCs infected with lenti-GFP (1 × 106 in 20 µL) and lenti-rBDNF (1 × 106 in 20 µL), respectively. Erectile function was assessed 4 weeks after injury by measuring intracavernosal pressures. Then, penile tissues were collected for histological detection and western blot assay. Results demonstrated that compared with the bilateral cavernous nerve injury group, erectile function was significantly recovered in the ADSCGFP and ADSCrBDNF groups, and to a greater degree in the ADSCrBDNF group. Neuronal nitric oxide synthase content in the dorsal nerves and the ratio of smooth muscle/collagen were significantly higher in the ADSCrBDNF and ADSCGFP groups than in the bilateral cavernous nerve injury group. Neuronal nitric oxide synthase expression was obviously higher in the ADSCrBDNF group than in the ADSCGFP group. These findings confirm that intracavernous injection with ADSCs infected with lenti-rBDNF can effectively improve erectile dysfunction caused by cavernous nerve injury. This study was approved by the Medical Animal Care and Welfare Committee of Wuhan University, China (approval No. 2017-1638) on June 20, 2017.

Neural-like cells from adipose-derived stem cells for cavernous nerve injury in rats.

Although the remaining nerve tissue can regenerate and partly restore erectile function when the cavernous nerve is compressed/severed and function lost, the limited regenerative ability of these nerve tissues often fails to meet clinical needs. Adipose-derived stem cells are easy to obtain and culture, and can differentiate into neural cells. Their proliferation rate is easy to control and they may be used to help restore injured cavernous nerve function. Sprague-Dawley male rats (n = 45) were equally randomized into three groups: fifteen rats as a sham-operated group, fifteen rats as a bilateral nerve crush (BINC) group (with no further intervention), fifteen rats as a BINC with intracavernous injection of one million neural-like cells from adipose-derived stem cells (NAS) (BINC + NAS) group. After 4 weeks, erectile function was assessed by stimulating the cavernous body. The number of myelinated axons in the dorsal cavernous nerve was determined by toluidine blue staining. The area of neuronal nitric oxide synthase-positive fibers in the dorsal penile nerve was measured by immunohistochemical staining. Masson staining was used to analyze the ratio of smooth muscle to collagen in penile tissue. The results demonstrate that maximal intracavernous pressure, the ratio of maximal intracavernous pressure to mean arterial pressure, the numbers of myelinated axons and neuronal nitric oxide synthase-positive fibers in the dorsal penile nerve, and the ratio of smooth muscle to collagen could be increased after cell transplantation. These findings indicate that neural-like cells from adipose-derived stem cells can effectively alleviate cavernous nerve injury and improve erectile function. All animal experiments were approved by the Animal Ethics Committee of Huazhong University of Science and Technology, China (approval No. 2017-1925) on September 15, 2017.