Giant Retroperitoneal Mucinous Tumor Supportively Diagnosed as a Dedifferentiated Liposarcoma by Fluorescence In Situ Hybridization of MDM2 Gene

Surgical resection was performed on a 47-year-old woman for a retroperitoneal mass that weighed 8.5 kg. Histological examination revealed a myxoid sarcomatous tumor. Because diagnosis could not be determined by immunohistochemistry, attention was focused on MDM2 (murine double minute) gene amplification by fluorescence in situ hybridization (FISH) analysis. The tumor was finally determined to be a dedifferentiated liposarcoma. We experienced a case of a giant retroperitoneal dedifferentiated liposarcoma. FISH analysis was useful for the diagnosis and determination of the therapeutic strategy

根治的前立腺全摘例の臨床病理学的検討 : 少数例施設の妥当性

A total of 161 patients underwent radical retropubic prostatectomy at our 11 institutions in the three-year period from January 2001 to December 2003. The numbers per institution ranged from 1-36, with 5 institutions conducting 20 or more (131 cases), and 6 performing less than 15 (30 cases). Here we examined the differences in operation parameters and patient outcome between these two groups. Time for surgery, associated loss of blood, lymphadenectomy, preservation of neurovascular bundles, time for removal of indwelling catheters, post-operation complications, and subsequent urinary incontinence, were assessed. There were no differences between the two groups of hospitals, except with regard to surgery time and incontinence, where the period to 'pad-free' was an average of more than 40 days longer in institutions undertaking only a small number of operations. From our experience with radical retropubic prostatectomy, series of hospitals, there is no reduction in safety with such intervention performed by institutions undertaking only a small number of operations.われわれの関連病院における, 根治的前立腺全摘例での少数例施設の妥当性についてレトロスペクティブに検討した。2001年1月から2003年12月までの3年間に施行した11施設, 161例の根治的前立腺全摘例を対象とした。1施設あたりの症例数は1例から36例で, 20症例以上の5施設131例と, 14例以下の6施設30症例で2群間での比較検討を行った。手術時間, 出血量, リンパ節郭清の有無, 神経温存の有無, カテーテル留置期間, 術後合併症, 術後尿失禁の状態について検討した。その結果, 手術時間の有意な延長と, パットフリーになるまでの期間が少数例の施設において平均で40日以上長くかかった。他のすべての項目においては有意な差はなかった。以上の結果から, われわれの関連病院における根治的前立腺全摘術は, 少数例の施設においては術後尿失禁の程度はやや劣るものの, 安全に施行されていることが示唆された。(著者抄録

Combination of robot‐assisted laparoscopic pyeloplasty for lower moiety ureteropelvic junction obstruction in a partial duplex system and percutaneous endoscopic surgery for renal calculi reusing the port for robotic pyeloplasty

Introduction Ureteropelvic junction obstruction is often associated with renal calculus formation. However, there is no report of using robot‐assisted laparoscopic pyeloplasty combined with percutaneous endoscopic surgery for ureteropelvic junction obstruction and renal calculi in a partial duplex system. Case presentation A 19‐year‐old female patient with lower moiety ureteropelvic junction obstruction and renal calculi in a partial duplex system was referred to our hospital because of left lumbar pain, left acute pyelonephritis, and an increase in left renal calculi during follow‐up at the referral hospital. To prevent the complication of percutaneous nephrolithotripsy following pyeloplasty, robot‐assisted laparoscopic pyeloplasty combined with percutaneous endoscopic surgery was performed. Two years after surgery, the patient reported no left lumbar pain. Conclusion The combination of robot‐assisted laparoscopic pyeloplasty and percutaneous endoscopic surgery can be proposed as a safe and less‐invasive treatment option for ureteropelvic junction obstruction and renal calculi in a partial duplex system

Long-Term Survival of a Patient with Invasive Signet-Ring Cell Carcinoma of the Urinary Bladder Managed by Combined S-1 and Cisplatin Adjuvant Chemotherapy

Primary signet-ring cell carcinoma of the urinary bladder is extremely rare and patient survival is very poor. The disease usually presents at advanced stages because the cancer progresses rapidly. The only option for effective treatment is radical cystectomy, and no effective chemotherapy has been established for this variant. We report a case of signet-ring cell carcinoma of the urinary bladder with a long-term survival of 90 months owing to radical cystectomy and combination adjuvant chemotherapy with S-1 and cisplatin. To our knowledge, this is the first report to demonstrate the long-term therapeutic activity of combination S-1 and cisplatin adjuvant chemotherapy against invasive signet-ring cell carcinoma of the urinary bladder