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Metastatic spermatic cord tumors are relatively rare, and gastric, colorectal, and pancreatic cancers have been reported as the primary lesion [1, 2]. We experienced a case of metastasis to the spermatic cord 1 year after surgery for gastric cancer. A 68-year-old male developed a painful right inguinal mass 1 year after surgery for gastric cancer and tubular adenocarcinoma was diagnosed by aspiration biopsy cytology from the right inguinal mass. A solitary inguinal metastasis was suspected by FDG-PET, and laparoscopic tumor resection was performed for definite diagnosis. Postoperatively, spermatic cord metastasis of gastric cancer was diagnosed pathologically by hematoxylin and eosin staining and immunohistochemistry (CK7+ and CK20−) of the resected samples. As to the metastasis route to the spermatic cord, development from minimal peritoneal disseminated nodules was suspected. Metastatic routes were speculated by comprehensive analysis of clinical information such as laparoscopic findings and a pathohistological approach including immunohistochemistry.

A rare case of epididymal spindle cell sarcoma in a 68-year-old man is described. The patient was admitted to our hospital with a painless, left intrascrotal mass that had been present for 3 months. Computed tomography revealed a left paratesticular tumor and inguinal lymph node swelling. With a diagnosis of a paratesticular malignant tumor, left high inguinal orchiectomy and lymphadenectomy were performed. Histopathological and immunohistochemical examinations revealed spindle cell sarcoma with a positive surgical margin of the lymph node. The patient was treated with 54 Gy of external beam radiation therapy to the scrotum and the inguinal lymph node. Since the patient’s general condition was poor after recurrence, systemic chemotherapy could not be performed. The patient died 10 months after initial diagnosis.

In this study, hemoglobin vesicle (HbV), a type of artificial oxygen carrier, was infused in a hemorrhagic shock model, and the findings were compared with those of red blood cell (RBC) transfusion to evaluate the effects on blood pressure and renal function. In rats maintained in hemorrhagic shock for 30 min under general anesthesia, either irradiated stored RBCs from the same strain or HbVs were used for resuscitation. Blood pressure, serum creatinine concentration, and creatinine clearance 24 h after shock were measured. At 2 and 24 h after shock, the kidneys were removed, and the heme oxygenase-1 (HO-1) mRNA level was measured. A histopathology study was performed 24 h after shock. In both the RBC and HbV group, blood pressure recovered significantly immediately after fluid resuscitation, and blood pressure 24 h after shock did not differ significantly between the two groups. Serum creatinine concentration and creatinine clearance 24 h after shock did not differ significantly between the two groups. After 24 h, there was no significant difference in HO-1 mRNA between the groups. In the renal histopathology samples taken at 24 h after shock, there were no obvious differences between the two groups. In conclusion, HbV transfusion improved blood pressure in a manner equivalent to RBC transfusion when administered during hemorrhagic shock, and no renal dysfunction was apparent after 24 h.

We report a staghorn renal calculus case with squamous cell carcinoma of the renal pelvis producing granulocyte colony-stimulating factor. A 77-year-old woman was followed-up at our institution for 3 years for lower right ureter stone and right staghorn calculus. She was admitted to our hospital complaining of right flank pain and a discharging abscess in her lower back 2 months after a bicycle accident. Radiological evaluations lad to the diagnosis of a large right renal abscess. Although daily percutaneous drainage had previously been performed, her general condition did not improve. Diagnosing a renal abscess, we performed nephro-ureterectomy and retroperitoneal irrigation. Pathological examination revealed squamous cell carcinoma of the renal pelvis producing granulocyte colony-stimulating factor. Although three courses of cisplatin and fluorouracil (5FU) chemotherapy were administered, the patient had a remarkable degree of leukocytosis despite no obvious focus of infection, with aggravated local recurrence of the tumor. The patient died 6 months after surgery. A summary of our case and a review of the literature are presented.

To investigate associations between dual-specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) expression and survival in T1 high-grade or T2 bladder cancer patients treated with neoadjuvant chemotherapy. The cohort under investigation comprised 44 patients who underwent neoadjuvant chemotherapy for pT1 high-grade or pT2N0M0 bladder cancer at our institution between 2002 and 2011. Immunohistochemical analysis was used to determine expression of DYRK2 in bladder cancer specimens obtained by transurethral resection before chemotherapy. Relationships between DYRK2 expression and both response to chemotherapy and survival in these patients were analyzed. DYRK2 expression was positive in 21 of 44 patients (47.7 %) and negative in 23 patients (52.3 %). In total, 20 of 21 DYRK2-positive cases showed complete response to neoadjuvant chemotherapy, whereas 11 of 23 DYRK2-negative cases did not show complete response. Sensitivity and specificity were 62.5 % and 91.7 %, respectively (P = 0.0018). In addition, disease-specific survival rate was significantly higher for DYRK2-positive patients than for DYRK2-negative patients (P = 0.017). In multivariate analysis, DYRK2 expression level was identified as an independent prognostic factor for disease-specific survival (P = 0.029). We also showed that DYRK2 mRNA expression was significantly higher in DYRK2-positive samples by immunohistochemistry than DYRK2-negative samples (P = 0.040). DYRK2 expression level may predict the efficacy of neoadjuvant chemotherapy for T1 high-grade and T2 bladder cancer.

Background Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common. Case presentation A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the perirenal fat, and vascular involvement was strongly positive. Thirty months after partial nephrectomy, an enhanced computed tomographic scan showed local recurrence of the renal cell carcinoma extending into the inferior vena cava without renal mass. Hence, we performed right radical nephrectomy and intracaval thrombectomy. Microscopic examination revealed a clear cell carcinoma grade 2, stage pT3a + b. The patient is still alive with no evidence of recurrence 10 months post-procedure. Conclusion To our knowledge, local recurrence of renal cell carcinoma extending into the inferior vena cava after partial nephrectomy has not been reported in the literature. Our case report emphasizes the importance of strict surveillance of patients after partial nephrectomy, especially for those with renal cell carcinoma positive for microvessel involvement.

Background Neoadjuvant chemotherapy has been shown to have benefit in T1 high-grade or T2 bladder cancer. However, neoadjuvant chemotherapy fails in some patients. Careful patient selection for neoadjuvant chemotherapy is therefore needed. Several reports show that Snail is associated with resistance to chemotherapy. We hypothesized that Snail expression could predict survival in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy. Methods The participants were 44 patients with T1 high-grade and T2 bladder cancer receiving neoadjuvant chemotherapy. Immunohistochemical analysis was used to determine Snail expression in specimens of bladder cancer obtained by transurethral resection before neoadjuvant chemotherapy. The relationships between Snail expression and patients’ outcomes were analyzed. Results Snail expression was positive in 15 of the 44 patients (34.1%) and negative in 29 (65.9%). Disease-free survival was significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.014). In addition, disease-specific survival was also significantly shorter for the Snail-positive group than for the Snail-negative group (p = 0.039). In multivariate analysis, Snail expression level was identified as an independent prognostic factor for disease-specific survival (p = 0.020). Conclusions The results indicate that Snail expression may predict poor outcome in T1 high-grade and T2 bladder cancer patients treated with neoadjuvant chemotherapy.