A case report of prostate cancer with ureteral metastasis / 中华泌尿外科杂志

Prostate cancer is a common malignancy in men, but rarely metastases to the ureter. A 68-year-old patient with ureteral metastases of prostate cancer was admitted to the hospital due to left lumbar and abdominal pain one month. Enhanced CT examination of urinary system after admission: mass in the middle of left ureter; multiple enlarged pelvic, retroperitoneal and left groin lymph nodes. After admission, the patient's PSA was 69.4 ng/ml, a prostate transrectal needle biopsy showed acinar adenocarcinoma. Under ureteroscopy, a smooth hard mass was seen 15 cm from the left ureteral orifice and completely obstructed the left ureter, the biopsy pathology showed infiltration of heteromorphic cell mass, and tumor could not be excluded. Laparoscopic ureteral tumor resection + end to end ureteral anastomosis was planned and intraoperative freezing was performed to determine the nature of the tumor. Due to severe adhesion around the tumor, partial nephrectomy, ureter and cystectomy were performed. The postoperative pathological diagnosis was ureteral metastasis of prostate cancer. The patient was treated postoperatively with abiraterone and goseririn for prostate cancer. CT examination 6 months after surgery showed multiple pelvic and retroperitoneal lymph node enlargement disappeared.

Breast reconstruction after mastectomy for breast cancer / 中华医学美学美容杂志

Objective To explore the technique of breast reconstruction after mastectomy. Methods 30 cases of patients with breast cancer who were not suitable for breast conservative surgery were sum-marized. Among them, immediate breast reconstruction with prosthetic implants after mastectomy was used in 16 patients, transverse rectus abdominis musculocutaneous flap (TRAM flap) in 10 patients, and latissimus dorsi musculocutaneous flap in 4 patients. There were 27 patients who underwent immediate breast reconstruction, while 3 patients underwent delayed breast construction. Results The appearance was good in 16 cases of breast reconstruction with prosthetic implants and no complications were found. Two out of the ten patients who had the transevarse rectus abdominis musculocutaneous flap (TRAM flap) breast reconstruction had partly necrosis of skin flap, and one lateral ventral syndrome. The appear-ance of the 7 cases after the TRAM flap breast reconstruction evaluated well, 2 cases moderate, and one case less satisfactory. The appearance of 4 patients who had breast reconstruction with latissimus dorsi musculocutaneous flap evaluated well. Conclusion Breast reconstruction is an important part of combined therapy for the breast cancer, especially for the patients who have strong desire to conserve breast, while incompetence for breast conserving surgery. In such a case breast reconstruction is a good choice. Imme-diate breast reconstruction is better than delayed breast construction. The appropriate method of breast reconstruction depends on each individual patient. Patients with locally advanced breast carcinoma can se-lectively choose immediate breast reconstruction.

Clinical Application of Electron Beam Computed Tomography in the Diagnosis of Aortic Disease / 实用放射学杂志

Objective To evaluate the value of electron beam computed tomography (EBCT) angiography and three-dimensional reconstruction in the diagnosis of aortic aneurysm.Methods 31 patients(24 male,7 female) with aortic aneurysm were performed scanning by EBCT . The scanning methods were contrast enhanced single slice volume scanning(SVS) and continuous volume scan(CVS); the 3D reconstruction methods were multiple planar reconstruction (MPR), maximum intensity projection(MIP), shaded surface display(SSD) and volume rendering(VR).Results Of 31 aortic disease, 7 cases were aortic aneurysm, 19 cases were aortic dissection and 5 cases pseudoaneurysm. 9 patients were performed operation and the diagnosis of EBCT coincided well with the operative findings in all cases. Conclusion EBCT angiography can obtain high quality images. EBCT angiographic findings and 3D imagings are in helpful accurate diagnosis and direct surgical operation. The 3D images can directly show the shape and range of aortic aneurysm and the tears of the dissection of pseudoaneurysm. It may substitute conventional aortic angiography in the diagnosis of aortic disease.