Search

Ureteral stent encrustation is sometimes encountered, especially in cases in which a ureteral stent has been forgotten. An 84-year-old female patient with malignant myeloma underwent metallic ureteral stent insertion to treat malignant ureteral obstruction. At the time of scheduled ureteral stent exchange, the stent was heavily encrusted and could not be removed on either side. We performed endoscopic lithotripsy to remove the encrusted ureteral stents. The bilaterally encrusted metallic ureteral stents were successfully removed using Ho:YAG laser lithotripsy after inserting another ureteral stent placement besides the encrusted metallic ureteral stents. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) accounts for around 3% of all cases of skin metastasis. In these patients, solitary metastasis from RCC shows a favorable prognosis. A 68-year-old woman was found to have a right renal tumor in 2009, and the pathological diagnosis was pathological T3 and grade 3 right clear cell RCC. Left-sided RCC developed and was resected in 2018. She subsequently noticed a cutaneous nodule on her abdomen. We performed surgical resection, and the pathological diagnosis was skin metastasis of RCC. We herein report a case of skin metastasis of RCC that developed 11 years after the initial diagnosis that was successfully treated by surgical resection. [ABSTRACT FROM AUTHOR]

A 65-year-old man was referred to our hospital for his right adrenal adenoma. Adrenal vein blood sampling revealed primary hyperaldosteronism, and he was referred to our department for surgical resection of his right adenoma. During the operation, a small nodule was discovered in addition to the adrenal tumor. The pathological diagnosis of this nodule was ganglioneuroma. We herein report a rare case of ganglioneuroma incidentally discovered by laparoscopic right adrenalectomy. [ABSTRACT FROM AUTHOR]

A 70-year-old Japanese woman was referred to our department due to general fatigue and a persistent low fever. We performed percutaneous nephrostomy and administered antibiotics for the pyelonephritis due to her left staghorn calculus. After the infection had been brought under control and her general condition improved, we performed nephrectomy. A pathologic examination revealed renal squamous cell carcinoma (SCC) in addition to xanthogranulomatous inflammation. Seventeen days after the operation, computed tomography demonstrated local recurrence of the tumor; therefore, she received palliative care. Two months after her operation, she died of renal SCC. [ABSTRACT FROM AUTHOR]

Background: Automated bone scan index (aBSI) change (ΔBSI) after treatment and survival in men with prostate cancer remains unclear. We evaluated the correlation between ΔBSI after cabazitaxel and overall survival (OS) in men with bone metastatic castration-resistant prostate cancer (CRPC). Methods: We retrospectively enrolled 32 men with bone metastatic CRPC who had received cabazitaxel. The correlation between ΔBSI from baseline to 16 weeks after starting cabazitaxel and OS was analyzed by multivariate analysis. Results: Median age and time to CRPC were 70.7 years and 9.5 months, respectively. The median cycles of docetaxel before cabazitaxel were eight. Ten (31.2%) patients had visceral metastases at baseline. Median baseline prostate-specific antigen (PSA) was 123.0 ng/mL. The median aBSIs at baseline and 16 weeks after cabazitaxel were 3.2 and 4.4%, respectively. Improvements in aBSI and PSA after 16 weeks of cabazitaxel occurred in 7 (21.9%) and 12 patients (37.5%), respectively. There were no correlations between ΔBSI and OS (p = 0.55), but PSA change was significantly correlated with OS (p = 0.03) by multivariate analysis. Conclusions: This study demonstrated that ΔBSI from baseline to16 weeks after starting cabazitaxel was not correlated with OS among men with bone metastatic CRPC. Further prospective studies may be warranted to confirm the limited utility of aBSI in this setting. [ABSTRACT FROM AUTHOR]

Castleman's disease was first reported in 1954 by Castleman et al. and identified as an uncommon lymphoproliferative disorder. In most cases, Castleman's diseases are detected in the chest, head, and neck. A 71-year-old man was referred to our hospital due to a retroperitoneal tumor in the para-aortic area by computed tomography (CT). Positron emission tomography-CT revealed an uptake in this tumor, suggesting malignant diseases. Laparoscopic tumorectomy was performed, and the pathological diagnosis was Castleman's disease, hyaline vascular type. No evidence of recurrence was observed 20 months after surgery. We herein report a rare case of retroperitoneal Castleman's disease. [ABSTRACT FROM AUTHOR]

IgG4-related disease is diagnosed when both the elevation of the serum IgG4 level and invasion of IgG4-positive interstitial cells and sclerosis to a tumor are noted. Some cases have demonstrated malignant disease. In the head and neck lesion in particular, IgG4-producing mucosa-associated lymphoid tissue (MALT) lymphoma has arisen during the treatment of IgG4-related disease. We herein report the first case of IgG4-producing MALT lymphoma during the treatment of IgG4-related disease in the renal hilum. A 79-year-old man was being followed for autoimmune pancreatitis and IgG4-related sclerosing cholangitis. During follow-up, magnetic resonance cholangiopancreatography detected a mass in the renal hilum, so he was referred to our department for a further examination. Positron emission tomography-computed tomography detected a standard uptake of 9.7, and the tumor size was gradually increasing. Due to these findings, laparoscopic nephro-ureterectomy was performed. A pathological examination revealed IgG4-producing marginal zone B cell lymphoma. We herein report a rare case of IgG4-producing B cell lymphoma in the renal hilum. [ABSTRACT FROM AUTHOR]

GnRH antagonist and GnRH agonist are widely used as androgen deprivation therapy for metastatic prostate cancer. A previous report demonstrated that patients with PSA levels of >20 ng/mL using GnRH antagonists showed favorable outcomes in comparison to those using GnRH agonists. An 82-year old male patient with edema, a stony hard nodule on his prostate, and an initial PSA level of 6,717 ng/mL was referred to our hospital due to suspected prostate cancer. He received prostate needle biopsy and was diagnosed with prostate cancer with bone metastasis, with a Gleason Score of 4 + 4 = 8. He was then treated with a GnRH agonist (leuprorelin acetate) and bicalutamide from July 2015. Although his PSA level decreased to 582.0 ng/mL in December 2015, his PSA level gradually increased and CRPC developed. He indicated that he did not wish to take 2nd generation anti-androgen drugs or receive systemic chemotherapy. We introduced a GnRH antagonist (degarelix) in February 2015; his PSA level did not change and his CRPC was controlled. We herein report a case in which changing a GnRH agonist to a GnRH antagonist contributed to CRPC control. [ABSTRACT FROM AUTHOR]

Granulocyte colony-stimulating factor (G-CSF)-producing bladder cancer is rare, with only 75 cases reported in Japan. A 67-year-old woman was referred to our institution for the further examination of gross hematuria. Cystoscopy revealed a 7-cm bladder tumor. The initial white blood cell count was 17,100/μL, and a transurethral resected specimen showed G-CSF expression. CT revealed that the tumor had invaded the colon. As the patient had uncontrollable schizophrenia, radical cystectomy was abandoned. We herein report a case of G-CSF-producing bladder tumor. [ABSTRACT FROM AUTHOR]

Dysgeusia is an adverse effect caused by enzalutamide said to affect 1–5% of patients. The reported management strategies include a temporary drug holiday, the prescription of herbal medicine, and changing the timing of enzalutamide intake from morning to before sleep at night. Case 1: A 72-year-old man developed castration-resistant prostate cancer (CRPC) and was administered enzalutamide. After six weeks of enzalutamide installation, he showed taste alternation, and consequently his dysgeusia increased to grade 2; we therefore changed the medicine intake time from morning to night just before sleep without dose reduction. Four weeks after changing the timing, his dysgeusia had improved. Case 2: A 63-year-old man had developed bone metastatic CRPC, so the combination of Ra-223 and enzalutamide (160 mg/body) was introduced. His serum PSA level had gradually decreased, but dysgeusia appeared, so we changed the timing of enzalutamide intake from morning to night just before sleep without dose reduction. One month after changing the timing, his dysgeusia had improved. We herein report two cases of enzalutamide-induced dysgeusia successfully treated by changing the timing of drug intake from morning intake to just before sleep. [ABSTRACT FROM AUTHOR]

While the overall survival of patients with castration-resistant prostate cancer (CRPC) has been prolonged by enzalutamide, a considerable number of patients suffer from enzalutamide-induced nausea and fatigue. An 86-year-old male patient who started enzalutamide (160 mg) for CRPC treatment, experienced nausea and vomiting approximately 2 weeks after the start of treatment. Enzalutamide treatment was stopped for two weeks, then restarted enzalutamide at a half-dose (80 mg); the dose was then increased to 120 mg. He remained free from any adverse events and showed good CRPC control for 53 months. We herein report the case of a patient with enzalutamide-induced nausea and vomiting, whose symptoms were overcome and in whom long-term CRPC control was achieved following a temporary drug holiday. [ABSTRACT FROM AUTHOR]

Introduction: Nivolumab has been introduced for metastatic renal cell carcinoma (mRCC) as a second-line therapy for years. However, despite widespread evidence of its utility, few reports have described the efficacy of nivolumab for mRCC patients on hemodialysis. Case Presentation: A 68-year-old man with a 20-year history of dialysis due to chronic glomerulotubular nephritis was referred to our department for bilateral renal tumors in 2015. In February 2015, contrast-enhanced CT revealed findings suggestive of RCC, so we performed right nephrectomy. The pathological diagnosis was clear cell carcinoma and papillary renal cell carcinoma. In July 2015, we consequently performed left nephrectomy, and the pathological diagnosis was metastatic RCC. In February 2016, because follow-up CT revealed a right adrenal tumor with time-dependent growth, sunitinib (25 mg/body) was introduced. In January 2017, although sunitinib had controlled the adrenal metastasis for 9 courses (11 months), liver metastasis was observed, so nivolumab was introduced as a second-line chemotherapy in March 2017. Nivolumab was able to control the mRCC for 15 months (32 courses). While CT showed no metastatic sites except for the liver and adrenal glands, his general condition gradually decreased, and he died in October 2018. Conclusion: We herein report a patient with RCC on hemodialysis with long-term cancer control by nivolumab. [ABSTRACT FROM AUTHOR]

Pembrolizumab has been used as a second-line systemic therapy for urothelial carcinoma. We herein report a case of cisplatin-resistant renal-pelvic urothelial carcinoma that was successfully resected after pembrolizumab treatment. A 74-year-old woman was referred to our hospital for further examination for gross hematuria and a renal-pelvis tumor. Retrograde pyelography showed a defect lesion in her renal pelvis and urinary cytology of the renal pelvis showed class V. Because staging CT could not deny lung metastasis, we planned to perform nephro-ureterectomy after evaluating the response to neoadjuvant chemotherapy. After three courses of gemcitabine and cisplatin chemotherapy, the original site showed progression; thus, nephro-ureterectomy was cancelled. We introduced pembrolizumab as a second-line therapy. After four courses of pembrolizumab treatment, the size of the original lesion was significantly decreased. During these therapies the lung tumor size was unchanged; thus, we determined that the lung tumor was not metastatic and performed nephro-ureterectomy. A pathological examination demonstrated that the tumor was completely resected with a negative surgical margin. We described the first case in which cisplatin-resistant renal pelvic tumor was successfully resected after pembrolizumab treatment. [ABSTRACT FROM AUTHOR]

For the treatment of internal ureteral orifice invasion of bladder cancer, percutaneous nephrostomy is usually attempted initially. However, percutaneous nephrostomy reduces patients' quality of day life. A 65-year-old man showed bilateral hydronephrosis due to locally advanced bladder cancer, and right percutaneous nephrostomy was created. After dilating the percutaneous nephrostomy, we inserted a metallic ureteral stent via an antegrade approach. We herein report a case of metallic ureteral stent insertion via an antegrade approach after initial creation of a nephrostomy, thus freeing the patient from nephrostomy. [ABSTRACT FROM AUTHOR]

COMPARZ study revealed no marked differences in terms of the progression free survival and overall survival between sunitinib and pazopanib treatment. Regarding the quality of life and early tumor shrinkage, pazopanib showed more favorable results than sunitinib treatment. A 70-year-old man underwent right nephrectomy in 2015. In 2017, iliac bone metastasis was found and consequently lung metastasis was developed. Pazopanib (200 mg × 4 tablets) was introduced. He showed no abnormal liver function markers during pazopanib treatment for more than two years and the size and number of lung metastases decreased. We herein report a case of successful control of metastatic renal cell carcinoma for more than two years using pazopanib treatment. [ABSTRACT FROM AUTHOR]

Introduction: Low-molecular-weight protein tyrosine phosphatase (LMW-PTP) expression affects carcinogenesis in various cancers and has been associated with determining the overall survival among men with metastatic hormone-naïve prostate cancer (mHNPC). In this study, we analyzed the value of LMWPTP for prediction of time to castration-resistant prostate cancer (CRPC) for men with mHNPC. Materials and Methods: We retrospectively enrolled 45 men with mHNPC who were diagnosed from 2003 to 2009. All patients had received androgen deprivation therapy as first-line treatment. Prostate cancer tissues (pre-treatment needle biopsies) were immunohistochemically stained for LMW-PTP. Multivariate analyses (Cox proportional hazard model) were used to correlate baseline clinical factors of age, prostate-specific antigen (PSA), Gleason scores, T stage, N stage, extent of disease on bone scan (EOD), LMW-PTP expression and time to CRPC. Continuous variables were classified as dichotomous. Results: Median age and PSA were 70.0 years and 87.8 ng/mL respectively. Median time to CRPC was 40.2 months. Median time to CRPC was significantly shorter in the high LMW-PTP group (14.8 months) than that in the low LMW-PTP group (86.3 months, p < 0.01). In multivariate analysis, age ≥70 years and high LMW-PTP expression were significant predictors of time to CRPC. [ABSTRACT FROM AUTHOR]

A 59-year-old man was referred to our hospital complaining of asymptomatic gross hematuria. Cystoscopy revealed a papillary tumor 8 cm in diameter filling the bladder. The patient underwent transurethral resection of the bladder tumor. The pathological findings revealed the sarcomatoid variant of urothelial carcinoma with a heterologous osteosarcomatous element. He had no metastasis according to our imaging analyses; thus, we planned radical cystectomy after two courses of neoadjuvant chemotherapy (gemcitabine and cisplatin). Following chemotherapy, enlarged pelvic lymph nodes were noted, and extremely aggressive local progression of the bladder tumor was confirmed. The patient ultimately died 6 months after his initial visit to our hospital. [ABSTRACT FROM AUTHOR]

Introduction: We evaluated bone scan index (BSI) as a predictive biomarker for time to castration-resistant prostate cancer (CRPC) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Materials and Methods: We identified 85 consecutive mHSPC patients treated with first-line androgen deprivation therapy. We analyzed the correlations between time to CRPC and clinicopathological characteristics, including age, prostate-specific antigen (PSA) level, Gleason score, clinical TNM stage, hemoglobin, lactate dehydrogenase, C-reactive protein, and BSI. Results: The median BSI was 2.7%. Progression to CRPC occurred in 55 (64.7%) patients and the median time to CRPC was 12.9 months. In multivariate analysis, 3 significant risk factors for time to CRPC were identified: age (>73 vs. ≤73 years; hazard ratio [HR] 0.53), p = 0.038, PSA level (>270 vs. ≤270 ng/mL; HR 0.53, p = 0.038), and BSI (>2.7 vs. ≤2.7%; HR 2.97, p < 0.001). Conclusion: Age, PSA level, and BSI were found to be significant predictive factors for time to CRPC in patients with mHSPC. [ABSTRACT FROM AUTHOR]

Ductal adenocarcinoma is an unusual variant of adenocarcinoma of the prostate. A 73-yearold male was referred to our hospital for the further examination of an elevated prostatespecific antigen level of 23.4 ng/mL. Radical prostatectomy (RP) was performed based on the diagnosis obtained by a prostate needle biopsy. The RP specimen revealed ductal adenocarcinoma of the prostate with positive capsular penetration. We herein report a rare case of ductal adenocarcinoma of the prostate. [ABSTRACT FROM AUTHOR]

A 36-year-old male was referred to our department for further examination of asymptomatic gross hematuria emanating from a bladder tumor. Cystoscopy revealed a broad-based tumor 40 mm in diameter. Urinary cytology was negative. Preoperative magnetic resonance imaging suggested a muscle invasive tumor. Transurethral resection was performed, and the pathological findings revealed an inflammatory myofibroblastic tumor. We herein report a rare case of bladder inflammatory myofibroblastic tumor. [ABSTRACT FROM AUTHOR]

A 73-year-old male was referred to our department for further treatment of a right retroperitoneal tumor. Contrast CT showed a tumor mass measuring 33 × 26 mm in size with poor contrast enhancement. Because we were unable to rule out tumor malignancy, we planned an operation. The tumor was easily separated and removed without nephrectomy. Histological study revealed a schwannoma. It is rare for this kind of tumor to arise from the retroperitoneum (approximately 0.7% of all cases), in particular at the renal hilum. We herein report a rare case of retroperitoneal schwannoma arising from the renal hilum. [ABSTRACT FROM AUTHOR]

Introduction: Retroperitoneal tumor is often seen in urology clinical practice. To diagnose the tumor, tumor specimens must be obtained. However, in some cases, the tumor is penetrated by vessels around the ureter, and it may be difficult to detect the optimal spot for obtaining a specimen, even when performing open surgery. Case Presentation: A 53-year-old male patient was referred to our hospital for further examination of left back pain due to hydronephrosis. Enhanced computed tomography demonstrated ureter stenosis in front of the ilium, which was surrounded by a retroperitoneal tumor. The tumor was penetrated by blood vessels; therefore, we performed an open surgical biopsy on the suspicion of a retroperitoneal tumor using ureteroscopic assistance. The diagnosis of idiopathic retroperitoneal fibrosis was made according to the biopsy. Conclusion: We herein report the first case of a ureteroscopy-assisted biopsy for the pathological diagnosis of a retroperitoneal tumor. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: We developed a method for ureteral stent exchange in female patients under fluoroscopic guidance using a crochet hook technique (CHEX). Patients and Methods: A total of 45 female patients (51 stents) underwent exchange of ureteral stents. In these patients, 21 ureteral stents were exchanged using CHEX. All procedures were carried out with the patients under conscious sedation. At the time of the procedures, we extracted the ureteral stent from the external urethral orifice using CHEX under fluoroscopic guidance and inserted the new stent under fluoroscopic guidance without cystoscopy. Results: 20 of the 21 stents (95.2%) were successfully exchanged. Ureteral stent exchange using CHEX was unsuccessful in 1 patient, including migration to the ureter. Conclusions: Ureteral stent exchange using a crochet hook is easy, safe and cost-effective. This technique was also easy to learn. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: The ureteral stent is now a fundamental part of many urological procedures. To decrease ureteral stent-related symptoms, loop type ureteral stent was developed. However the most important factor to decrease urinary symptoms is choosing the optimal length of a ureteral stent. We investigated the relationship between the actual ureteral length and the loop type ureteral stent position. Materials and Methods: A total of 226 loop type polyurethane ureteral stents (156 patients) were inserted with four options for stent length (20, 22, 24 and 26 cm). The ureteral length was measured using a ruled 5-Fr ureteral catheter. The appropriateness of stent position was defined into three groups based on kidney-ureter-bladder films. Results: Nine stents (3.9%) migrated, 171 stents (75.7%) were in the appropriate position and 46 stents (19.5%) were overlong. The rate of migration rate and overlong stents closely correlated with the ureteral length when the proximal end of the stent was in the renal pelvis. Conclusions: It is appropriate to choose a loop type ureteral stent that is the same or 1 cm less than the length of the ureter when the proximal end of the stent will be in the renal pelvis. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Nonsteroidal anti-inflammatory drugs (NSAIDs) induce expression of NSAID-activated gene 1 (NAG-1). NAG-1 expression in prostate cancer has previously been detected by microarray and immunohistochemical analyses. We examined the mRNA expression of NAG-1 by quantitative real-time polymerase chain reaction using 51 human prostate cancer tissue specimens. The level of NAG-1 expression was higher in prostate cancer than in normal prostate tissues (p = 0.025). The level of NAG-1 expression was also significantly higher in well-differentiated prostate cancer than in moderately (p = 0.04) and poorly differentiated adenocarcinomas (p = 0.03). These data suggest that NAG-1 may be a new biomarker for evaluating the grade of malignancy in prostate cancer. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: In the present study, we compared 12- with 8-core biopsy in patients with prostate-specific antigen (PSA) levels of 4.0–20.0 ng/ml. We also examined whether the free/total (F/T) PSA ratio is useful for cancer detection in 12-core biopsy. Methods: A total of 419 men with PSA level between 4.0 and 20.0 ng/ml underwent transrectal ultrasound-guided transperineal needle biopsies of the prostate. Of these men, 235 underwent 8-core biopsy and 184 underwent 12-core biopsy. We compared the cancer detection rate between the 8- and 12-core biopsy groups by analyzing the PSA value, and especially the F/T PSA ratio. Results: The cancer detection rate in the 12-core group (35.9%) was significantly higher than in the 8-core group (23.8%). In cases of PSA level of 4.0–20.0 ng/ml with F/T PSA ratio less than 0.11, the cancer detection rate was 53.1% in the 12-core biopsy group. Performing 12-core biopsy resulted in a marked difference of cancer detection rate between men with F/T PSA ratio less than 0.11 and those with more than 0.12 in gray zone PSA (48.2% and 17.5%, respectively). Conclusions: Twelve-core biopsy can achieve a higher detection rate of prostate cancer than 8-core biopsy using F/T PSA ratio. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We examined the significance of a pathologic ‘fused gland’ according to the WHO-Mostofi classification for predicting prognosis in hormonally treated prostate cancer. Of 284 newly diagnosed patients receiving hormone therapy, 60 patients had specimens with no ‘medullary’ or ‘column-cord’ elements. Twenty-five of these had a ‘fused gland’, while 35 did not. Survival of these patients was analyzed. Cause-specific survival of the patients with no medullary or column-cord elements showed a significantly better prognosis compared to others. Furthermore, the patients whose specimens contained a ‘fused gland’ component had significantly poorer survival than those without that component, suggesting that the ‘fused gland’ component is a poor prognostic factor for survival in patients with hormonally treated prostate cancer.Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

No abstract available [ABSTRACT FROM AUTHOR]