Villous adenoma of female urethra: An investigation of the mechanism of development regarding glandular neoplasms in the urinary tract

Villous adenomas are rare in the urinary tract. We herein report the fifth known such case while also making a review of the literature. A 54-year-old woman noticed a mass in her external genitalia and a tumor located on her external urethral orifice. The tumor was excised and pathologically confirmed to be a villous adenoma. Up to now, no sign of recurrence has been observed. However, we should be careful for malignant formation, because villous adenomas in the urinary tract frequently coexist with either adenocarcinoma or urothelial carcinoma

前立腺癌治療中の酢酸リュープロレリンによる肉芽腫

Luteinizing hormone-releasing hormone (LH-RH)analogues have become the main focus of androgen deprivation therapy for prostatic cancer. The occurrence of injection-site granulomas due to the administration of LH-RH analogues has been thought to be a rare reaction. We herein report a rare case presenting injection-site granuloma due to the administration of leuprorelin acetate,mimicking metastatic nodule. A 90-year-old man presented with subcutaneous nodules at the injection-site of leuprorelin acetate11.25mg (for 3-month use). Ultrasound examination and computed tomography (CT) revealed two nodules in the bilateral abdominal walls mimicking metastatic nodule. Although he was surgically treated because of the possibility of malignancy, in the end, no evidence of malignancy was found. We should keep in mind that LH-RH analogues may cause injection-site granulomas mimicking metastatic nodule, and therefore we must inform patients undergoing the administration of leuprorelin acetate that it may cause injection-site granuloma and thus when a patient demonstrates a subcutaneous nodule it is essential to confirm whether or not he has received an injection of the LH-RH analogue at the site of nodule.黄体化ホルモン放出ホルモン（LH-RH）アナログは，前立腺癌のホルモン療法において重要な役割を担っている．これまで，LH-RH アナログによる注射部位肉芽腫は，稀な副作用と考えられてきた．われわれは，このたび，転移性腫瘍と紛らわしい腫瘤を呈した酢酸リュープロレリンによる肉芽腫を経験したので報告する．症例は，90歳男性．酢酸リュープロレリン11.25mg（３ケ月製剤）の注射部位に硬結を認めた．超音波検査，CT にて転移性腫瘍が疑われ，腫瘤摘除術が行われたが，悪性所見はなかった．われわれは，LH-RH アナログにより転移と紛らわしい注射部位肉芽腫を生じる可能性があることを知っておくべきである．また，LH-RH アナログによる治療を受ける患者に対しそのことを周知し，皮下腫瘤を呈した患者を診察した際には，その部位にLH-RH アナログの注射を受けていないか確認すべきである