Association between gefitinib and hemorrhagic cystitis and severely contracted bladder: a case report

<p>Abstract</p> <p>Background</p> <p>Gefitinib remains an excellent treatment option for patients with a variety of cancers, including non small cell lung cancer (NSCLC). However, clinicians must be aware of the potential of gefitinib to cause an inflammatory reaction in the skin, lungs and bladder.</p> <p>Case Presentation</p> <p>We present a case on hemorrhagic cystitis and severaly contracted bladder in a patient with NSCLC on gefitinib.</p> <p>Conclusions</p> <p>Further studies are needed to substantiate the association of gefitinib therapy with hemorrhagic cystitis and contracted bladder.</p

Inflammatory pseudotumors of the kidney and the lung presenting as immunoglobulin G4-related disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>It has been reported that immunoglobulin G4-related systemic disease can spread to nearly every organ, and often presents as an inflammatory mass or masses at those sites. In the kidney, this disease is often diagnosed after a radical or partial nephrectomy following the discovery of an inflammatory mass which is often suspected to be a malignant tumor. Here, we present a rare case of inflammatory pseudotumors of the kidney and the lung presenting as immunoglobulin G4-related disease, which were diagnosed by computed tomography-guided biopsies.</p> <p>Case presentation</p> <p>A 54-year-old Japanese man was referred to our hospital with suspected bilateral renal cancer, multiple lung metastases and autoimmune pancreatitis. His serum immunoglobulin G4 level was high. We used computed tomography-guided biopsies and histopathological examinations of the biopsied specimens to diagnose the tumors as immunoglobulin G4-related bilateral renal and lung inflammatory pseudotumors. Our patient was treated with oral prednisolone, and after one month of treatment, contrast-enhanced computed tomography demonstrated a general improvement, as noted by a reduction in size of the masses.</p> <p>Conclusion</p> <p>Renal masses that are formed due to immunoglobulin G4-related disease require comprehensive diagnosis to prevent unnecessary surgical resections from being performed. Further consideration should be paid to immunoglobulin G4-related diseases in the future.</p

A rare case of metastatic renal carcinoid

<p>Abstract</p> <p>Background</p> <p>Carcinoid is an endocrine cell tumor with low-grade atypia, which is generally a low-grade malignant cancer with a good prognosis. Metastatic renal carcinoid is even rarer than primary carcinoids.</p> <p>Case presentation</p> <p>We present our experience of a patient with metastatic renal carcinoid from the gastrointestinal tract.</p> <p>Conclusions</p> <p>The carcinoid tumor of the kidney in our patient, who had a history of liver metastasis from rectal carcinoid, was considered metastatic based on the pathological findings.</p

Positive surgical margins at radical prostatectomy: importance of intra-operative bladder neck frozen sections

OBJECTIVE: To determine if intraoperative frozen sections of the bladder neck during radical prostatectomy (RP) could decrease the incidence of final positive surgical margins at the bladder neck. MATERIALS AND METHODS: This prospective cohort study included 51 consecutive men who underwent anatomic RP at University of Florida &amp; Shands Jacksonville. All patients had intraoperative frozen section of bladder neck sent for analysis. Preoperative, operative, and postoperative data were collected and analyzed. Main Outcome Measures: Outcome measures were intraoperative bladder neck margin status, final pathologic bladder neck margin status, and postoperative urinary complications. Median follow-up for the 51 patients was 22 months. RESULTS: The final positive surgical margin rate was 20% (10 patients). An additional three patients had positive surgical margins at the bladder neck intraoperatively. These patients then had a wider resection of the affected bladder neck until the frozen sections were negative for cancer or prostatic tissue. Final pathologic evaluation of bladder neck margin was negative for tumor or persistent prostatic tissue in all 51 men. CONCLUSION: With intra-operative frozen sections, we were able to obtain a negligible positive bladder neck margin rate. Surgeons who are still on the learning curve for RP should consider intra-operative frozen section of the bladder neck

酸性尿酸アンモニウム結石の1例

32歳女.右肺部痛, 膿尿を主訴とした.plain radiograph, drip infusion pyelographyにて右腎結石症, 右水腎症と診断され, 体外衝撃波腎結石砕石術を施行した.結石の成分は, 酸性尿酸アンモニウム結石98%以上であった.症例は3年前より過度の拒食症に罹患し低栄養状態が続いていた時期があり, 本結石の原因として過度の拒食による低カロリー食と推測されたA 32-year-old woman complained of right back pain and pyuria. The plain radiograph (KUB) and drip infusion pyelography (DIP) demonstrated a right renal stone and hydronephrosis. The stone was successfully treated using extracorporeal shock wave lithotripsy. Infrared spectrophotometry revealed that the stone was composed of pure ammonium acid urate. The patient had a 3-year history of excessive anorexia. The low-caloric diet was considered to have caused the disease

原発性尿管腺癌の1例: Primary adenocarcinoma of the ureter

The patient was a 66-year-old man who presented with asymptomatic hematuria. Left hydronephrosis was observed on drip infusion pyelography (DIP), and retrograde pyelography (RP) was performed because the image of the ureter was poor. On RP, stenosis was observed in the left ureter at the L5 vertebral level. The same findings were obtained by antegrade pyelography in combination with nephrostomy. A white-colored tumor was observed at the site ofstenosis by flexible pyeloscopy, and biopsy was performed. Adenocarcinoma was identified by histopathological examination. Total left renal nephroureterectomy was performed after its diagnosis as primary adenocarcinoma of the ureter (T2, NO, MO). To our knowledge, this is the 12th case reported in Japan.患者は66才, 男性。無症候性肉眼的血尿を主訴に受診, DIPでは左水腎症を認めたが尿管の抽出が不良であったため, retrograde pyelography(RP)を施行した。RPでは, 第5腰椎レベルで左尿管の狭窄を認め, 腎瘻増設を兼ねて行ったantegrade pyelographyではRPと同様に, 第5腰椎レベルで狭窄を示していた。同時に施行した軟性腎盂鏡では狭窄部位に一致して白色の腫瘍を認めたため, 生検を施行した。病理組織検査の結果はadenocarcinomaであった。原発性尿管腺癌(T2, N0, M0)の診断にて左腎尿管全摘除術を施行した。本症例はわれわれが調べえた限りでは本邦12例目であった。(著者抄録