Xanthogranulomatous Pyelonephritis with Incomplete Double Ureter

Introduction. Xanthogranulomatous pyelonephritis (XGP) is a type of chronic renal inflammation that usually occurs in immunocompromised middle-aged women with chronic urinary tract infection or ureteral obstruction induced by the formation of ureteral stones. XGP with an incomplete double ureter is extremely rare. Case Presentation. A 76-year-old woman was referred to our department to undergo further examination for a left renal tumor that was detected by ultrasonography. Dynamic contrast computed tomography (CT) revealed an enhanced tumor in the upper renal parenchyma. Laparoscopic radical nephrectomy was performed based on a preoperative diagnosis of renal cell carcinoma. Histological sections showed the aggregation of foam cells; thus, XGP was diagnosed. Conclusion. We herein report a rare case of XGP in the upper pole of the kidney, which might have been associated with an incomplete double ureter

Enterogenous cyst of pediatric testis: a case report

Abstract Background An enterogenous cyst is a rare entity categorized as an intestinal cyst. In most cases, enterogenous cysts are seen in the mediastinum, peritoneal cavity, spinal canal, subarachnoid space, and cerebral ventricle. Case presentation A 14-year-old Asian (Japanese) boy reported feeling pain in his left groin, and a mass was found. We did not perform orchiectomy because intraoperative frozen sections showed no malignant findings. On histological examination the resected specimens contained columnar epithelium surrounded by smooth muscle. Based on these findings, an enterogenous cyst was diagnosed. Few cases of enterogenous cysts of the testis have been described. Conclusion We encountered a case of an enterogenous cyst of a pediatric testis

Ureter metastatic castration-resistant prostate cancer: a case report

Abstract Background In most cases, prostate cancer metastasizes to the lymph nodes, bone, and liver. In very rare cases, it metastasizes to the ureter. Due to the difficulty in making a preoperative diagnosis, ureteral metastasis from prostate cancer is typically diagnosed after nephroureterectomy. Case presentation A 77-year-old Asian Japanese man with right hydronephrosis and hydroureter was referred to our hospital to undergo further examination due to the suspicion of ureteral cancer. He had been diagnosed 2 years previously with prostate cancer with a Gleason score of 4+5=9. He received radiotherapy and androgen deprivation therapy. A nephroureterectomy was performed for suspected right ureteral cancer. On the basis of a histopathological examination, poorly differentiated adenocarcinoma was suspected, and the tumor cells were positive for prostate-specific antigen immunohistochemically. Conclusions We herein report a rare case of ureteral metastasis in castration resistant prostate cancer

Adrenal Hemangioma: A Case of Retroperitoneal Tumor

Introduction. Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens. Case Presentation. A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous nephropathy. Computed tomography revealed a mass around his left hilum. Magnetic resonance imaging (MRI) and positron-emission tomography (PET)-CT were unable to confirm or deny malignancy, and tumor markers, including CEA and CA19-9, showed slight elevation. His tumor grew from 38 mm to 54 mm in diameter in 7 months of follow-up. We therefore planned retroperitoneal tumor resection with left nephrectomy. Histopathologically, hyperplastic small vessels with hemorrhaging and denaturation were seen. The endothelial cells showed no variants or division of the nucleus. Based on this diagnosis, no further therapy was performed. He has had no recurrence in the eight months since the surgery. Conclusion. We herein report a rare case of adrenal hemangioma

アリルエストレノールによる前立腺肥大症の治療中断後, PSA値の回復に必要な期間についての検討

Decrease in serum prostate specific antigen (PSA) concentration is inevitably associated with antiandrogen therapy for benign prostatic hyperplasia (BPH), and might mask the presence of prostate cancer or delay its diagnosis. To determine the appropriate timepoint for determination of correct PSA value, we sequentially measured serum PSA and testosterone levels after discontinuation of antiandrogen therapy for BPH. With informed consent, 12 patients (72.8 +/- 12.2* years old) with BPH were treated with allylestrenol 50 mg/day for 4 months. Serum testosterone and PSA concentrations were determined before and just after treatment, as well as every month after treatment up to 3 months. After treatment with allylestrenol for 4 months, mean serum testosterone and PSA levels were significantly decreased from 408 +/- 136* to 87.9 +/- 76.2* ng/dl, and from 2.81 +/- 0.87* to 2.04 +/- 0.82* ng/ml, respectively. The mean serum PSA level recovered to the pretreatment level within 2 months and mean serum testosterone concentration within one month after discontinuation of administration. In conclusion, during treatment of BPH with antiandrogen allylestrenol, a two-month washout is adequate for determination of correct PSA value (*: M +/- SD).前立腺肥大症をアンチアンドロゲン剤にて治療するとテストステロンの低下にともないPSAが低下する.これにより前立腺癌の診断が遅れることが危惧されている.しかしながら, アンチアンドロゲン剤の中断後4ヵ月で, 両者とも完全に前値に復することをすでに報告した.PSA4.0ng/ml以下の前立腺肥大症の症例においてアンチアンドロゲン剤中断後のテストステロンとPSAの変化を経時的に観察し, 治療前値に復するまでに要する期間につき検討した.症例は平均72.8±2.2歳前立腺肥大症(前立腺体積:36.7±7.9ml)患者でアンチアンドロゲン剤による治療およびテストステロン, PSAの経時的採血に文書同意を得た12症例である.アリルエストレノール50mg/dayを4ヵ月間投与した.これを中断後1ヵ月ごとに採血してテストステロンとPSAを経時的に観察した.アリルエストレノールの投与4ヵ月でテストステロンは低下し, これに伴いPSAも有意に低下した.治療の中断後1ヵ月でテストステロンは前値に復し, PSAは中断後2ヵ月でほぼ前値に復した.以上より, 前立腺肥大症のアリルエストレノールによる治療中に正確なPSA値を知るために必要なアリルエストレノールのwashout期間は, ほぼ2ヵ月であることが示唆された(著者抄録

Efficacy of Immediate Switching from Bicalutamide to Flutamide as Second-Line Combined Androgen Blockade

We determined whether prostate specific antigen (PSA) would decrease with immediate antiandrogen switching from bicalutamide (BCL) to flutamide (FLT) in patients receiving combined androgen blockade for advanced prostate cancer. From 2002 to 2006, 20 patients who showed PSA failure after first-line hormonal therapy with a luteinizing hormone-release hormone (LH-RH) agonist and BCL were enrolled. All patients were immediately switched from BCL to FLT, administered with an LH-RH agonist, as second-line combined androgen blockade (CAB). We evaluated the PSA response to second-line CAB. Eight patients (40%) were responsive, showing PSA decreases of at least 50%. The median (range) duration of the PSA response was 18.4 (3–26) months. Second-line CAB using FLT was effective in 40% of patients who received first-line CAB using BCL. The lower Gleason scores at the initial prostate biopsy probably reflect the response to second-line CAB. Responders showed significantly better OS and CSS in the determination of any PSA decline and 40% PSA decline. The median OS duration in nonresponders and responders (40% PSA decline) was 1433 days versus 3617 days. It is concluded that an immediate switch from BCL to FLT is effective for some CRPC patients after first-line CAB using BCL

Skene duct adenocarcinoma in a patient with an elevated serum prostate-specific antigen level: a case report

Abstract Background Female urethral carcinoma is a very rare disease that accounts for 0.02% of malignant diseases in female patients. Case presentation A 70-year-old Asian Japanese woman with a urethral tumor was referred to our hospital to undergo further examination. Biopsy specimens showed urethral adenocarcinoma that was positive for prostate-specific antigen. Her serum prostate-specific antigen level before surgery was 34.4 ng/ml. Urethral tumor resection with pelvic lymph node resection was performed. Her serum prostate-specific antigen level decreased to < 0.01 ng/ml after surgery. Conclusions We report a very rare case of Skene duct adenocarcinoma in a female patient with serum prostate-specific antigen elevation