ABSTRACT
We reviewed the surgical specimen from 142 men undergoing radical prostatectomy for prostate cancer detected because of an elevation in serum prostate specific antigen alone. No patient had a palpable abnormality suggestive of cancer. One patient had no identifiable tumor in the radical prostatectomy specimen, 8 (6%) had only a few high power microscopic fields showing cancer, 40 (28%) had an estimated tumor volume of less than 1 cc and 93 (65%) had a tumor volume of greater than 1 cc. Surgical margins were positive in 37 patients (26%) and negative in 105 (73%). Most patients with cancer detected because of modest elevation in prostate specific antigen, even without palpable abnormalities, have a clinically significant tumor volume and are good candidates for radical prostatectomy.
Subject(s)
Adenocarcinoma/diagnosis , Biomarkers, Tumor/blood , Prostate-Specific Antigen/blood , Prostate/pathology , Prostatic Neoplasms/diagnosis , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Biopsy, Needle , Humans , Male , Neoplasm Staging , Prostatectomy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgeryABSTRACT
Chemotherapy with cis-platinum, vinblastine and bleomycin for germ cell tumors of the testis has been highly effective but it also has been associated with acute and chronic vascular damage. We report the development of hypertension in a 38-year-old man after chemotherapy that was shown to be owing to nonatherosclerotic partial occlusion of the major branches of the left renal artery. Vascular complications following combination chemotherapy for germ cell tumors are reviewed.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Hypertension, Renovascular/chemically induced , Neoplasms, Germ Cell and Embryonal/drug therapy , Testicular Neoplasms/drug therapy , Adult , Bleomycin/adverse effects , Cisplatin/adverse effects , Humans , Male , Radiography , Renal Artery Obstruction/chemically induced , Renal Artery Obstruction/diagnostic imaging , Vinblastine/adverse effectsABSTRACT
Epididymitis is an uncommonly recognized complication of systemic necrotizing vasculitis. We report 2 cases in which epididymitis heralded the onset of more severe visceral organ involvement. Early biopsy of atypical epididymitis in patients with hypertension or constitutional symptoms is important if effective therapy is to be instituted before irreversible organ damage occurs.
Subject(s)
Epididymitis/etiology , Polyarteritis Nodosa/complications , Adult , Humans , MaleABSTRACT
An ileal segment was interposed between the renal collecting system and bladder in 4 cases. The surgical technique is outlined, with emphasis on the pyelo-infundibulocalico-ileal anastomosis and other technical aspects. The ileal ureter is recommended in selected cases of recurrent renal calculi and nephrocalcinosis with associated nephrolithiasis.
