Inflammatory Myofibroblastic Bladder Tumor in a Patient with Von Recklinghausen's Syndrome

Myofibroblastic tumor, also known as inflammatory pseudotumor or pseudosarcoma, is a benign tumor with mesenchymal origin. Bladder location is very uncommon. We report the case of a 58-year-old man with a history of von Recklinghausen's disease who complained for painless macroscopic hematuria 5 months after suprapubic prostatectomy. The radiograph evaluation revealed a bladder tumor, and the pathologic examination following a transurethral resection showed inflammatory myofibroblastic tumor of the bladder. The patient finally underwent a radical cystectomy due to the uncertain pathogenesis of inflammatory myofibroblastic tumor as well as the rarity of cases published on bladder tumors in Von Recklinghausen's patients

Inhibin B serum levels as biomarker of spermatogenesis in cancer patients treated by chemotherapy

Objective: This study was conducted to assess the effects of the taxanes based chemotherapy on the male reproductive-axis that reflects its impact on spermatogenesis and fertility. Material and Methods: Fourty cancer patients of reproductive age with solid tumor at diagnosis, scheduled to receive taxanes based chemotherapy, were included in the study. Patients were treated with docetaxel (taxotere) (70-80mg/m²) or paclitaxel (Taxol) (130-200mg/m²) combined with gemcitabine (Gemzar) (1000mg/m²) or Carboplatin (400mg/m²). In all patients serum levels of inhibin B, FSH, Lh and in half of patients bilateral testicular volume (BTV) were measured before (baseline) and after the completion of chemotherapy. Results: Median age of patients was found 53 years (range 28-60). Serum inhibin B was decreased statistically significant (p0.005). Bilateral testicular volume was decreased statistically significant (p≤0.001) after completion of chemotherapy from a median of 27.6 ml to 23.5 ml. As it was expected we found a significant inverse correlation between serum inhibin B and FSH concentrations (r = -0.4827, p≤0.001). Finally, FSH was statistically inverse correlated significant (r = -0.3166, p0.005). Τέλος, στατιστικά σημαντική (p≤0.001) ήταν η μείωση της μέσης τιμής του αμφοτερόπλευρου όγκου των όρχεων από 27.6 ml σε 23.5 ml. Όπως αναμενόταν υπήρχε στατιστικά αρνητική συσχέτιση μεταξύ ινχιμπίνης Β και FSH (r = -0.4827, p≤0.001). Τέλος, διαπιστώθηκε στατιστικά σημαντική αρνητική συσχέτιση μεταξύ της FSH και του όγκου των όρχεων (r = -0.3166, p<0.05). Οι συγκεντρώσεις της ινχιμπίνης Β και της LH δεν εμφάνισαν συσχέτιση με τον αμφοτερόπλευρο όγκο των όρχεων. Συμπέρασμα: Η χημειοθεραπεία βασισμένη σε ταξάνες έχει ως αποτέλεσμα τη μείωση της ινχιμπίνης Β και την αντίστροφη αύξηση της FSH, οι οποίες σχετίζονται με σημαντική γοναδοτοξικότητα στα αρχικά στάδια μετά τη χημειοθεραπεία

High-Risk Laparoscopic Urologic Surgery

Currently, the majority of operations in the urologic field can be performed laparoscopically. Even in experienced hands, some operations are considered of increased risk either because of increased surgical difficulty of the specific case or because the patient per se is at risk due to associated comorbidities. Scope of this review is to present the existent experience regarding difficult laparoscopic urologic cases, along with points of technique, the product of the experience collected by performing such difficult laparoscopic cases. Knowledge of anticipated difficulties allows both patients and their surgeons to be better prepared. Patients have their expectations from laparoscopy realistically set, whereas urologists, especially those new to laparoscopy, realize their abilities and properly set their indications to achieve the best for their patients

Effects of taxane-based chemotherapy on inhibin B and gonadotropins as biomarkers of spermatogenesis

Objective: To assess the effects of taxane-based chemotherapy on the male reproductive axis, and, therefore, its impact on spermatogenesis and fertility. Design: Controlled clinical study. Setting: Patients with cancer in an academic research environment. Patient(s): Forty male patients of reproductive age with cancer with solid tumor at diagnosis, who had been scheduled to receive taxane-based chemotherapy. Intervention(s): The patients were given treatment with docetaxel or paclitaxel combined with gemcitabine or carboplatin. Blood sampling and testicular ultrasonography were performed before and after completion of chemotherapy. Main Outcome Measure(s): In all patients, serum levels of inhibin B, FSH, and LH were measured, and, in half of the patients, bilateral testicular volume was also measured. Result(s): There was a statistically significant decrease in serum inhibin B and increase in serum FSH in all patients after the completion of the taxane-based chemotherapy. The median LH levels did not exhibit a statistically significant increase after the last cycle. Bilateral testicular volume exhibited a statistically significant decrease in 19 out of 20 patients (95%) after completion of chemotherapy. Conclusion(s): Taxane-based chemotherapy induces the reduction of inhibin B and the reciprocal elevation of FSH, which are associated with significant gonadal damage in the early stages after completion of chemotherapy. (Fertil Steril(R) 2010;94:558-63. (C) 2010 by American Society for Reproductive Medicine.