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Introduction: We aim to present a rare case of a patient who developed a late testicular metastasis of PCa after radical prostatectomy.Case description: A 78 years old man presenting for left testicular swelling slowly increasing of size over the last 2 months. He underwent a retropubic radical prostatectomy and extended bilateral lymphadenectomy in 2007 for prostatic adenocarcinoma. At the time of the presentation the last PSA was 0.91 ng/mL. The patient underwent a standard left orchifunicolectomy in April 2019 without intra- or perioperative complications. The pathological analysis showed a testicular metastasis of acinar adenocarcinoma.Conclusions: In conclusion, testicular metastasis from PCa are uncommon conditions. PSA evaluation and physical examination of all sites of metastasis and accurate evaluation of all signs/symptoms during the clinical visit remains crucial to the diagnosis of recurrence.

BPH patients may be asymptomatic or symptomatic and the latter with or without obstruction. Symptoms may be independent of the obstruction. The endoscopic or surgical ablation of the enlarged gland has a percentage of failure in all reports. The urodynamics study including uroflowmetry, pressure flow study with application of nomogram for the obstruction provides a certain diagnosis of obstruction in the majority of cases.

After having outlined the approaches for radical nephrectomy and after some critical considerations, the authors dwell upon the current indications for conservative surgery of renal cell carcinoma. They discuss the problems related to such therapy, emphasizing the advantages and possible risks. In particular, the problems connected with multifocal lesions and peritumoral spread are examined, the real clinical meaning of which is at present unknown, as shown by the discrepancy between experimental and clinical data. Then the authors present their own experience concerning 11 cases of renal carcinoma who underwent conservative surgical treatment between January 89 and September 92. None had relapses nor further progression. The conclusion is that, although the results of such surgery are very encouraging, nonetheless prospective studies and a wider selection of cases are required in order to define its role in the treatment of renal carcinoma.

Between 1980 and 1990, 135 patients underwent nephrectomy in our Department for renal cell carcinoma. Two groups were identified: Group 1 (72 patients) had the adrenal gland removed; group 2 (63 patients) did not undergo removal of the gland. In group 1 only one patient had ipsilateral adrenal gland neoplastic involvement. This patient also had hepatic metastasis and died 4 months after surgery. Differences in the time of survival after surgery were not statistically significant between groups. In the light of present findings and on the basis of data reported in literature, the problem of systematic adrenalectomy as part of radical nephrectomy is discussed.

Several different parameters, both clinical and pathological are used to prognosticate renal parenchymal carcinoma (RPC). In the present report we have analyzed prognosis according to our experience, based upon the pathological staging of disease performed at the time of nephrectomy, early diagnosis, nuclear grading, the infiltration of blood vessels and metastases.

Sixty-nine patients with localised prostatic cancer, who could not undergo radical prostatectomy due to loco-regional lymph node metastasis or anaesthesiological counter-indications, were subjected to a combined treatment, radiation therapy and androgen deprivation. All patients underwent pelvio-lymphadenectomy and those with cervico-urethral obstruction, endoscopic resection of the prostate. There was a progression of the disease in 33% of patients with lymph node metastasis (median time of progression 33 months) and in 27% of those without (median time of progression 22 months). Stable disease in 67% of patients (median follow-up over 3 years).

— The Authors describe a new software for prostate transrectal ultrasound biopsy (TRUSB) patient management.