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A case of ipsilateral transitional cell carcinoma of left renal pelvis and left-renal cell carcinoma is presented. A 75-year-old male consulted our hospital with the complaint of painless gross-hematuria which had persisted for four years. Excretory urography revealed left non-visualized kidney. Retrograde pyelography demonstrated the filling defect, which had an irregular border, in the left renal pelvis. The selective left renal arteriography revealed the hypervascular region in the left renal cortex. Intraarterial chemotherapy with CDDP, MTX and ADR was performed preoperatively. Then, total left nephroureterectomy and segmental resection of the bladder was done. The surgical specimen was pathologically diagnosed as transitional cell carcinoma of the renal pelvis and renal cell carcinoma of the left kidney. This case is the 23rd reported case of ipsilateral synchronous renal malignancy in Japan.

A 17-year-old woman consulted our clinic with the complaint of gross hematuria and lower abdominal pain. Blood examination showed severe anemia and renal failure. Emergent hemodialysis and blood transfusion were performed. CT scanning revealed left retroperitoneal hematoma, right severe hydronephrosis and loss of uterus shadow. Under diagnosis of left renal rupture, left nephrectomy and removal of retroperitoneal hematoma were performed. The area of rupture in the left renal pelvis was identified on its posterior wall. Postoperatively renal function did not improve and periodic hemodialysis has been done.

A case of postpartum spontaneous rupture of angiomyolipoma in a 27-year-old woman with the chief complaints of right flank pain and fever was reported. Physical examinations revealed an infant-head sized, hard elastic mass with a smooth surface in the right flank. Laboratory studies showed a decrease of Hb to 9.0 g/dl and Ht to 26.5%, and elevated LDH (2914 IU/l). Angiomyolipoma was suspected with ultrasonography, CT scan and angiography. Transperitoneal right nephrectomy was performed. The right kidney and tumor weighed 1,870 g. Pathological diagnosis also confirmed angiomyolipoma of the kidney. Discussion of the case and a brief review of the literature on spontaneous rupture of angiomyolipoma in the intra- and postpartum are made.

A case of blind-ending bifid ureter is presented. A 65-year-old man was admitted with the complaint of dysuria. He had no past episode of left flank pain or pyelonephritis. Digital examination and urethrography suggested benign prostatic hypertrophy. Drip infusion pyelography showed an abnormal cavity at the lower portion of the left ureter. He was diagnosed as benign prostate hypertrophy and left blind-ending bifid ureter. During suprapubic prostatectomy, the bifid ureter was resectd. The related reports are reviewed in the Japanese literature.

Herein we report a case of perirenal encysted hematoma secondary to renal cell adenocarcinoma. A 57-year-old woman was hospitalized because of a palpable mass in the left flank. She had had an episode of left flank pain. X-ray studies demonstrated a tumor in the left kidney and a large cystic mass beneath the left kidney. The cyst was excised by nephrectomy. Histological examination of the large cyst revealed perirenal encysted hematoma secondary to renal cell adenocarcinoma. Six months postoperatively, she is now free from left lumbar pain, and alive with lung and liver metastasis.

A case of pure, primary testicular carcinoid tumor in a 27-seven-year-old male is reported. The patient presented with a painless enlargement of the right testis but the serum markers for testicular cancer, including alpha-fetoprotein, beta-human chorionic gonadotropin and lactate dehydrogenase, were not elevated. Right orchiectomy was performed. Histologically, the tumor showed a typical appearance of carcinoid tumor. Further examinations such as barium studies, computed tomographic scan and Ga scintigraphy, showed no other lesions, and he received an adjuvant chemotherapy of cyclophosphamide, 5-fluorouracil and adriamycin. He is well and free from symptoms 17 months after surgery.

A case of leiomyosarcoma of the urinary bladder in a 33-year-old female is reported. She was admitted with the complaint of gross hematuria. Cystoscopic examination showed a thumb-tip sized mass, located at the dome. CT showed a wide-based tumor at the dome (CT number was 60.2 H.U.). Segmental resection of bladder was performed, followed by radiation and chemotherapy (VCR, ACT-D, CPM and ADM). She is alive without evidence of disease 13 months after surgery. A case report and review of the literature are presented.