[A retroperitoneal cyst with elevated level of CA19-9 in its content].

A 52-year-old man, who had been treated for left mega-hydronephrosis (5.6L) 25 years ago in our hospital, recently complained of left lumbago and fever. An abdominal CT scan revealed a cystic mass partially surrounded by calcification in the retroperitoneal space, which appeared to be a hydronephrosis. Percutaneous puncture of the cystic mass was performed and 670 ml, brownish-yellow purulent fluid containing a high level of CA19-9 (over 10,000 U/ml) was obtained. Cytologic diagnosis of the fluid revealed class II cells. Within 7 months after the puncture, recurrence developed twice. Percutaneous instillation of 95% ethanol or Minocycline hydrochloride was instilled, but neither of them prevented recurrence. Ultimately, excision of the cystic mass was performed. Histopathological findings of the cystic mass showed no evidence of malignancy. The patient is follow-up with periodic CT scan showed no evidence of recurrence for more than 3 years.

[Hyperbaric oxygen therapy in the successful treatment of two cases of radiation-induced hemorrhagic cystitis].

Hemorrhagic cystitis resulting from radiation to pelvic visceral malignant lesions often might be incurable and there have been established no definitive treatment. We experienced 2 cases with radiation-induced severe hemorrhagic cystitis refractory to conventional therapy. The treatment with hyperbaric oxygen to control hematuria was performed and obtained successful results. Gross hematuria was disappeared and cystoscopic figure was remarkably improved. No remarkable side-effect was observed in both patient. This experience suggested that hyperbaric oxygen could be considered the primary treatment for patient with radiation-induced hemorrhagic cystitis instead of usual treatment.

[Outpatient ESWL in 500 kidneys].

Between March 1989 and January 1992, 600 cases (636 kidneys) with upper urinary tract stones were treated with ESWL, using a Lithostar. Of these, 78.6% were carried out in our outpatient service, and in the last two years approximately 90% of cases have been treated as outpatient. We evaluated first 500 kidneys, treated with ESWL as outpatient. There were 481 cases involving 500 kidneys (19 bilateral cases). The ages of the 367 men and 114 women ranged from 16 to 77 years. There were 227 kidney stones and 273 ureter stones. Most of the stones were less than 20 mm. The average number of sessions and shock waves for each patient were 1.4 times and 6,988 waves, respectively. While 74% of the patients could be treated in only one session, 9% of them needed 3 sessions or more. Auxiliary measures were needed in 23 cases (D-J stent insertion in 5 cases and ureteral catheterization in 18 cases) and 474 cases (94.8%) were treated by in-situ procedures. At 3 months after treatment, 470 cases were evaluated and the stone-free rates of kidney stones and ureter stones were 70.3% and 84.5%, respectively with an overall stone-free rate of 78.1%. With regard to complications, the rate of the clinic visit because of pain after treatment was observed in 4.6% and higher than 38 degrees C in 2.5%. However, no serious perioperative complications occurred. From these results, outpatient ESWL was considered to be safe and efficient without serious complications.(ABSTRACT TRUNCATED AT 250 WORDS)