Large Cell Calcifying Sertoli Cell Tumor of the Testis: A Case Study and Review of the Literature

A 24-year-old man was admitted due to an incidentally detected mass in his left testis, which showed radiopaque calcification on plain X-ray film. Left orchiectomy was performed, and the resected testis contained a well-demarcated, hard mass measuring 1.1 cm. Histological analysis revealed that the tumor was composed of neoplastic cells, fibrotic stroma, and laminated or irregularly shaped calcific bodies. The individual cells had abundant eosinophilic or clear cytoplasm with round nuclei, each of which contained one or two conspicuous nucleoli. They were arranged in cords, trabeculae, clusters, and diffuse sheets. There were several foci of intra-tubular growth patterns, with thickening of the basal lamina. Immunohistochemically, the neoplastic cells were positive for S-100 protein and vimentin, focally positive for inhibin alpha, and negative for cytokeratin, CD10, and Melan-A. In addition to reporting this rare case, we also review the relevant literature regarding large cell calcifying Sertoli cell tumors.

Short-term Prostate-Specific Antigen Velocity Measurement before Prostate Biopsy

PURPOSE: We investigated whether a short-term follow-up prostate-specific antigen (PSA) measurement before prostate biopsy is useful in predicting the presence of prostate cancer. MATERIALS AND METHODS: From January 2004 to May 2008, 670 patients underwent transrectal ultrasound-guided prostate biopsy. The initial PSA (PSA1) was measured at the first outpatient visit. The second PSA (PSA2) was measured the evening before prostate biopsy. Only the patients with a PSA1 between 2.5 and 20 ng/ml and an interval between PSA1 and PSA2 of between 7 and 90 days were included in this study. The short-term PSA velocity (PSAVm) was defined as {(PSA2-PSA1/interval (days)}x30. Prostate volume (PV), PSA1, PSA2, and PSAVm were compared between the patients with prostate cancer and those with benign histology. RESULTS: Of the 362 patients who fulfilled the entry criteria, 365 prostate biopsies were performed. The PSAVm differed significantly between patients with prostate cancer and those with benign histology (p=0.021). In patients with a PSA1 of 10-20 ng/ml, age, PV, PSA1, PSA2, and PSAVm were significantly different between patients with prostate cancer and those with benign histology, whereas in patients with a PSA1 of 2.5-10 ng/ml, only PV was significantly different. In multivariate logistic regression analysis excluding PSA1 and PSA2, PSAVm was a significant predictor of prostate cancer overall and in patients with a PSA1 of 10-20 ng/ml, but not in patients with a PSA1 of 2.5-10 ng/ml. CONCLUSIONS: PSAVm was significantly different between the benign group and the prostate cancer group. But, this difference was mainly the result of a falsely elevated PSA, and PSAVm was not a significant predictor of prostate cancer when the PSA1 was 2.5-10 ng/ml.

Spontaneous Perinephric Urinoma in a Patient with Neurogenic Bladder

Spontaneous rupture of the renal pelvis or ureteropelvic juction area with extravasation of urine into the perinephric space is an uncommon pathologic condition (1). We report a case of 72-year-old woman who suffered 2 days of left loin pain. The patient has got residual urine sensation and weak urine stream since she has gone through a radical hysterectomy 17 years before. Because of these symptoms of voiding difficulty, the patient had abdominal straining during her urination. A CT scan exhibited renal pelvis rupture with perirenal extravasation of urine due to severe hydronephrosis, that was exacerbated by hidden neurogenic bladder disease. Moreover, the patient has detrusor underactivity and high intravesical pressure at voiding trial in the urodynamic study. One month after the percutaneous nephrostomy insertion into the left renal pelvis, the patient was successfully treated. The size of renal pelvis decreased. Moreover, urinoma disappeared in follow up CT scan image.

Secondary Polycythemia Caused by Giant Hydronephrosis due to Ureteropelvic Junction Obstruction / 대한비뇨기과학회지

Secondary polycythemia is a condition for which the red blood cell count is increased due to the physiologic response to hypoxia, autonomous erythropoietin production or deliberate erythropoietin administration. Hydronephrosis and postrenal obstruction have rarely been reported as the causes of secondary polycythemia. We report here on a case of a 30-year- old man with secondary polycythemia that was caused by giant hydronephrosis due to ureteropelvic junction obstruction, and this patient was successfully treated by nephrectomy.

Solitary Fibrous Tumor of the Renal Peripelvis / 대한비뇨기과학회지

A solitary fibrous tumor(SFT) is a rare spindle cell neoplasm that arises most commonly in the pleura but has recently been described in various extrapleural sites. SFTs occurring in the renal pelvis or peripelvis are extremely rare, and only 3 cases have been reported. We report here on a 71-year-old woman who presented with an incidentally detected left renal mass and underwent radical nephroureterectomy under the suspicion of renal pelvis cancer. The pathological examination of the tumor revealed a SFT occurring in the renal peripelvis. The patient has no evidence of disease 1 year after the surgery. Most SFTs appear to pursue a benign course, although, because some of them have the potential to recur or metastasize, careful long-term follow-up is necessary.