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Here, we report an adult case of intra-abdominal testicular cancer after surgical treatment of an undescended testis in infancy. A 36-year-old male patient was accidentally diagnosed with a tumor in the pelvic cavity by ultrasonographic examination. He had hematuria and the human chorionic gonadotropin beta subunit level was slightly elevated. T2-weighedmagnetic resonance imaging revealed a well-defined and highly intense mass. Since these findings suggested intra-abdominal testicular cancer, laparoscopic surgery was performed to remove the mass. Laparoscopy revealed an intra-abdominal tumor accompanied by a looping vas deferens entering the left inguinal canal. The distal part of the looping vas had already been removed from the external inguinal ring. The pathological findings revealed a pT1 seminoma. The patient has been recurrence-free for 12 months. The present case implies the importance of careful investigation and treatment for intra-abdominal testicular cancer, since intra-abdominal testis might have been overlooked at the time of surgery for undescended testis.

We report a case of primary mucosa-associated lymphoid tissue (MALT)-type lymphoma of the urinary bladder, which temporarily regressed after antibiotic therapy and progressed 1 year after the treatment. The patient was a 72-year-old female with a history of recurrent cystitis. She was referred to our hospital for microscopic hematuria. Urinalysis also showed microscopic pyuria and cystoscopy revealed an erythematous and edematous submucosal lesion in the right side wall of the bladder. She was diagnosed with acute cystitis and treated with antibiotics. Cystoscopy after 2 months was normal. However, she presented with macroscopic hematuria and fever 1 year after the treatment. Computed tomography (CT) scan showed a solitary mass measuring 25×40 mm above the right ureteric orifice and right hydronephrosis. Transurethral resection was performed, and the histopathological findings were consistent with MALT-type lymphoma. No evidence of lymphoma was found on positron emission tomography-CT scan and bone marrow biopsy, and she was diagnosed with primary MALT-type lymphoma of the bladder. She was successfully treated with a combination of rituximab and radiotherapy. Since MALT-type lymphoma of the bladder sometimes regresses temporarily after antibiotic therpy, it should be followed carefully.

We studied the short-term efficacy of alendronate, an oral bisphosphonates, on bone mineral density (BMD) during androgen deprivation therapy (ADT) in 45 nonmetastatic prostate cancer patients at the beginning of ADT (treatment group). All received alendronate five mg daily from the initiation of ADT. Lumber BMD was evaluated by dual energy X-ray absorptiometry, at baseline and after six months of treatment. Historical data on 24 patients with prostate cancer who received ADT without bisphosphonate administration were studied as controls (control group). BMD decreased in 13.9 and 45.8% of the patients in the treatment and control groups, respectively. Mean BMD changes in the lumber spine were +1.6 +/- 3.0% in the treatment group and -1.1 +/- 2.7% in the control group (p = 0.006). No pathological fractures occurred during the study period. No severe adverse effects were observed, but three patients could not continue alendronate treatment because of adverse events. Despite the short-term of this evaluation, our results showed that oral alendronate is an effective and safe treatment for preventing bone loss and increasing BMD in patients receiving ADT for prostate cancer., 目的:アンドロゲン除去療法は骨塩減少とそれに伴う病的骨折の潜在的な危険因子である。点滴ビスフォスフォネート製剤はアンドロゲン除去療法を受けている前立腺がん患者に対する骨塩量の減少を予防することが示されているが経口ビスフォスフォネート製剤については評価されていない。今回, われわれは経口ビスフォスフォネート製剤の1つであるアレンドン酸を骨転移を有しない前立腺がん患者に投与して骨塩量を測定し短期間での効果を検討した。対象と方法:治療群として45人の骨転移を有しない前立腺がん患者について検討した。アレンドロン酸を1日5mg経口投与し治療前, 治療半年後に腰椎の骨塩量を測定し比較検討した。対照群として24人の骨転移を有しない前立腺がん患者についても同様に検討を行った。結果:骨塩量の減少は治療群で13.9%, 対照群で45.8%に見られた。腰椎における骨塩量の変化は治療群で平均1.6%, 対照群で-1.1%であった(p=0.006)。治療期間内において病的骨折は認められず, 有害事象として重篤なものは認めなかったが副作用のため3例が内服継続困難であった。結語:短期間の検討であるにもかかわらず経口ビスフォスフォネート製剤であるアレンドロン酸は前立腺がん患者に対するアンドロゲン除去療法による骨塩量減少を予防するのに有効で安全な治療法であることが示唆された。(著者抄録)

Additional file 1. Charlson Comorbidity Score, Kaplanâ Meier of all-cause mortality and analyses predicting death in nocturic patients with Charlson Comorbidity Score 0-2.

60代男.約5年前, 全身倦怠感と食思不振の精査で左後腹膜腫瘍が指摘され, 左腎合併経腹的後腹膜腫瘍切除術が施行された.病理学的に悪性線維性組織球症(MFH)と診断された.術後4年目に左下肺に腫瘤を認め, 肺部分切除術を施行した.病理学的にMFHの肺転移と診断された.術後外来経過観察中に腹部CTで左後腹膜腔に腫瘤を認め, 精査加療目的で入院となった.画像検査よりMFHの局所再発と診断し, 経胸腹式到達法にて再発腫瘍に対して切除術を施行した.病理組織所見により高分化型硬化性脂肪肉腫と診断した.術後, 膵液漏を認めたが, 保存的治療にて1ヵ月後に治癒した.組織学的には切除断端陽性であったが, 脂肪肉腫には高い奏功率を示す化学療法・放射線療法がないため, 術後補助療法は施行しなかった.現在術後9ヵ月が経過し, 明らかな再発は認めていない, We report a case of retroperitoneal tumor which turned out to be liposarcoma by the histological evaluation of its recurrent tumor, although the initial tumor was diagnosed as malignant fibrous histiocytoma (MFH). A retroperitoneal tumor in a 62-year-old man was removed and pathologically diagnosed as MFH. Five years after the initial surgery, computed tomography (CT) demonstrated a recurrent tumor near the spleen. The tumor was resected together with the spleen, tail of pancreas, and connective tissue due to adhesion and diagnosed as well-differentiated liposarcoma with sclerosing component. Generally dedifferentiated liposarcoma is difficult to distinguish from MFH and the presence of a well-differentiated liposarcoma component in the adjacent adipose tissue leads to the diagnosis of dedifferentiated liposarcoma. The clinical course of the present case indicated that the initial tumor was dedifferentiated liposarcoma and the recurrent tumor developed from the surrounding well-differentiated liposarcoma.

60歳代男。患者は右陰嚢内無痛性腫瘤を主訴とした。40歳代から腫瘤が触知され、2～3ヵ月前から増大傾向を認めたため受診となった。血液検査、腫瘍マーカー、尿検査では異常は認められなかったものの、MRIでは右精索に沿って腫瘤を認め、腫瘤尾側にも脂肪の信号を示す部分があった。高分化型の脂肪肉腫が疑われ、腫瘤は細胞成分に富む腫瘍が2次的に発生したものと推測された。高位精巣摘除術に準じて手術を施行したところ、腫瘤周囲の癒着はなく腫瘤、脂肪性病変、精巣を一塊に摘除し得た。術後経過は順調で、1年4ヵ月現在、再発は認められていない。尚、本症例はlipoma-like type とscrelosing typeが並存しており、炎症性成分は主にscrelosing typeに認められた。発生部位としては精巣実質に浸潤を認めず、精索由来と考えられた。, Well-differentiated inflammatory liposarcoma is an unusual variant of liposarcoma, accounting for only about 2% of all liposarcomas. We report a case occurring in a 68-year-old male. An elastic soft mass, apart from the testis, was palpated in the right scrotum. Magnetic resonance imaging showed a 4 cm mass along the right spermatic cord. High orchiectomy was performed. Histologically, the mass was composed of lymphocytic aggregates, and paucicellular stroma with multinucleated cells. The adjacent lipoma-like lesion was clearly defined, and the mass was pathologically diagnosed as well-differentiated inflammatory liposarcoma.

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