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Several types of nephrological side-effects can occur during treatment with targeted therapy: high blood pressure, proteinuria, thrombotic microangiopathy, kidney failure, etc. Screening and treatment for high blood pressure, proteinuria and kidney failure are recommended during treatment with molecular targeted therapy (mainly for anti-VEGF). If BP is greater than 140/90mmHg on two measurements, it must be treated before the start of treatment. Self-measurement or ambulatory measurement of blood pressure is recommended. All antihypertensive drugs may be used apart from those, which interfere with cytochrome P450 (verapamil and diltiazem). Specialist advice (cardiology or nephrology) is recommended in the event of uncontroled hypertension. It is essential to monitor proteinuria with a urine strip test: if proteinuria is less than 2+ (grade 1), maintain treatment with molecular targeted therapy; if proteinuria is greater or equal to 2+ (grade2 or 3, confirmed by weight assay), specialist advice is required. Persisting proteinuria of grade2 or 3 requires nephrological monitoring. Thrombotic microangiopathy must be investigated in the event of hypertension greater than grade2 and/or proteinuria greater than 2+., (Copyright © 2011 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Primary neuroectodermal tumours (PNET) are very aggressive malignant tumours, rapidly progressing to metastasis and death. They rarely involve the kidney, as only 23 cases have been described in the literature. Renal tumours, regardless of their histology, spread to the inferior vena cava (IVC) in 4% to 10% of cases. Invasion of the inferior vena cava wall by tumour thrombus is rare and, when it occurs, is often limited to the ostium of the renal vein. The authors report a case of primary neuroectodermal tumour of the kidney with thrombus in the inferior vena cava ascending to the right atrium (level IV), invading the wall of the IVC and associated with a non-infiltrating papillary urothelial tumour of the ureter. They describe the surgical management of this tumour and present a review of the literature.

Cystic prostate cancer is a rare entity. Ductal adenocarcinoma, formerly known as endometrioid adenocarcinoma, is a clinical and histological variant of prostatic carcinoma. The authors report two cases of cystic prostate cancer, in which histological examination demonstrated the predominance of a ductal carcinoma contingent. A review of the literature revealed 8 cases of cystic prostate cancer, including 3 cases that also presented a ductal contingent. The cystic appearance of the peripheral prostatic zone appears to be a distinct clinical and morphological entity of ductal carcinomas. This entity has never been previously reported.

This article reviews cell therapy for muscle diseases and describes the development of a treatment for urethral sphincter insufficiency by muscle precursor cell (MPC) autograft. These studies were conducted in several successive steps, comprising: 1) comparative study of the cellular mechanisms of regeneration of skeletal striated muscle and urethral striated sphincter and development of a method of extraction of MPC; 2) creation of an animal model of sphincter injury reproducing chronic denervation lesions and fibrosis responsible for sphincter insufficiency in human; 3) study of the biology of intrasphincteric transplantation of MPC extracted from peripheral muscle, taking into account the interactions between these cells and the peripheral nervous system.

Objective: To assess the value of scrotal ultrasound to guide the diagnosis of torsion of the spermatic cord., Material and Methods: Retrospective study from January 1995 to June 2001. One hundred and sixty eight patients were admitted to the emergency department with an empirical diagnosis of torsion of the spermatic cord. Scrotal ultrasound was performed when there was a doubt about the diagnosis or in the presence of atypical clinical features. All patients underwent surgical exploration of the scrotum. Two groups were distinguished: torsion and no torsion. We evaluated the contribution of ultrasound signs., Results: Scrotal ultrasound was performed in 66 cases (39%) and suggested the diagnosis of torsion in 30 cases and showed no signs of torsion in 36 cases. Seven of these 36 cases actually presented torsions confirmed by surgical exploration (false-negative), corresponding to a sensitivity of 79% and a specificity of 88%. The interval between arrival of the patient in the emergency department and scrotal exploration was 2.6-fold longer when scrotal ultrasound was performed (p < 0.001). Surgical exploration identified 99 torsions (59%). Orchidectomy had to be performed in 15 cases (15% of torsions). However, the need for orchidectomy was not significantly different according to whether or not scrotal ultrasound was performed (p = 0.08)., Conclusion: As scrotal ultrasound gave false-negative results in 10% of cases and delayed surgery, we do not recommend this examination as an emergency investigation. Systematic surgical exploration of the scrotum in all cases of painful testis must be performed urgently without preoperative morphological assessment.

The authors report the case of a patient presenting with bladder haemangiomas in the context of Klippel-Trenaunay syndrome treated by Neodymium:YAG laser. Klippel-Trenaunay syndrome consists of a combination of hypertrophy of a limb, cutaneous angiomas and varicose veins. Bladder haemangioma is a benign congenital vascular tumour associated with Klippel-Trenaunay syndrome in 3 to 6% of cases, especially affecting children and young adults. Its most frequent clinical manifestation is haematuria. The diagnosis is based on endoscopy. Endoscopic treatment by Neodymium:YAG (Nd:YAG) laser photocoagulation appears to be a satisfactory treatment option.

Malakoplakia is a granulomatous inflammatory disorder occurring rarely in the prostate. We report our experience with three patients aged from 54 to 75 years old. Clinical presentations were unspecific. All patients presented with a past history of urinary tract infection. Ultrasound study revealed hypoechoic peripheral zone lesions. Histological examination showed a diffuse granulomatous inflammation with numerous histiocytes containing Michaelis-Gutmann bodies. In the prostate, malakoplakia is a histological variant of granulomatous chronic prostatitis following urinary infections. Clinically and radiologically, the differential diagnosis with adenocarcinoma is difficult. The symptoms disappear with a prolongated antibiotic treatment.