The Prognostic Significance of Blood and Lymphatic Vessels Invasion of Upper Urinary Tract Transitional Cell Carcinoma / 대한비뇨기과학회지

The prognostic significance of vascular (blood and lymphatic vessels) invasion was evaluated in a retrospective review of 27 patients with upper urinary tract transitional cell carcinoma from January 1985 to December 1993, who underwent a nephroureterectomy with bladder cuff resection. Vascular invasion was found in 10 patients (37%). The incidence of vascular invasion was well correlated with tumor grade and stage. The incidence of postoperative metastases was significantly higher in the patients with (70%) than without (17.6%) vascular invasion (p<0.05). The survival rate of the patients with vascular invasion was significantly lower than in those without vascular invasion (p<0.01). In multivariate Cox`s regressional analysis the prognostic value of vascular invasion was independent of tumor grade and stage. These results indicate that vascular invasion should predict a more unfavorable outcome in patients with upper urinary tract transitional cell carcinoma as an independent morphological indicator.

Renal Angiomyolipoma, 7 Cases / 대한비뇨기과학회지

Renal angiomyolipomas are uncommon benign neoplasms composed of mature fat tissue, thick-walled blood vessels and smooth muscle in varying proportions, which art often associated with tuberous sclerosis. During the last 5 years, 7 patients of renal angiomyolipoma were managed at Hanyang University Medical College. All cases were unilateral and were not associated with tuberous sclerosis. One patient was managed by radical nephrectomy because we could not distinguish from renal cell carcinoma. In 6 patients preoperative diagnosis were possible and one of them was managed by nephrectomy due to spontaneous rupture with severe bleeding and 5 patients were managed by conservative treatment. One patient was managed by enucleation of angiomyolipoma, and 2 patients were successfully managed with selective renal angioinfarct. Another 2 patients were incidentally found, small sized asymptomatic cases, so they were managed byobservation. All 7 patients were free of recurrence for follow up.

Prognostic Value of Pathological Parameters in Renal Cell Carcinoma / 대한비뇨기과학회지

We conducted a retrospective study of 41 cases of clinically localized renal cell carcinoma (RCC) treated with radical nephrectomy by our department between January 1987 and December 1993. The prognostic pathological parameters considered were tumor extension (pT stage), nuclear grading, histological grading, cell type, histologic growth pattern and tumor size. In the univariate analysis by log-rank test, three parameters showed prognostic significance, including pT stage, nuclear grading and tumor size. However, in the multivariate analysis using Cox's regressional hazard model, only two parameters including pT stage (p0.05). We think that nuclear grading cannot predict the outcome of patients at the same surgical stage. These results suggest that pathological stage of RCC may be the most important prognostic factor and the nuclear grade of tumor may provide additional important prognostic information.

Mesothelioma of the Tunica Vaginalis of the Spermatic Cord with Coincidental Finding of Renal Cell Carcinoma / 대한비뇨기과학회지

Malignant mesothelioma of the tunica vaginalis is an externally rare tumor arising from the serosal surface of the pleural, pericardial, peritoneal cavities. The pathologic diagnosis was based upon the clinical, gross and microscopic findings and immunohistochemical studies. Appropriate treatment of malignant mesothelioma consists of inguinal orchiectomy with close follow up. Treatment of locally recurrent and distant metastasis have not been standardized. We report a case of metastatic malignant mesothelioma from the tunica vaginalis of the right spermatic cord with coincident finding of left renal cell carcinoma, that was metastasis to the abdominal wall, 17months after right radical orchiectomy and left radical nephrectomy.