ABSTRACT
A 72-year-old Japanese man presented to the hospital with complaints of gross hematuria. Contrast enhanced com-puted tomography revealed a broad-based, approximately 3-cm bladder tumor near the right ureteral orifice and a 5-cm mass located between the prostate and rectum. The patient underwent transurethral resection of the bladder tumor and a transrectal biopsy of the lesion. Histological examination of the specimens suggested that the patient had a muscle invasive adenocarcinoma from transurethral resection and a rectal gastrointestinal stromal tumor in TRUS biopsy. Patient underwent total pelvic exenteration and ileal and colonic stomas to divert urine and faeces. Final pathology report of the resected specimen revealed a rectal gastrointestinal stromal tumor and prostatic ad-enocarcinoma, which had invaded the urinary bladder and seminal vesicles. Synchronous gastrointestinal stromal tumor in rectum and prostate cancer treated with total pelvic exenteration has not been reported before in literature.
Subject(s)
Adenocarcinoma/surgery , Gastrointestinal Stromal Tumors/surgery , Neoplasms, Multiple Primary/surgery , Prostatic Neoplasms/surgery , Rectal Neoplasms/surgery , Aged , Humans , MaleABSTRACT
ABSTRACT A 69-year-old man presented at the hospital with complaints of prolonged stomach pain extending from the week prior. Enhanced computed tomography (CT) revealed a low density area in the retroperitoneal space. A radiologist diagnosed the patient with retroperitoneal fibrosis. One week later, an enhanced CT revealed an exponential increase of the low density area and slight right hydronephrosis. Upon admission, prednisolone administration was initiated at a dose of 40mg/day. The size of the retroperitoneal soft tissue mass decreased gradually. Although the dose of prednisolone was tapered to 5mg, the patient is doing well without any sign of recurrence.
Subject(s)
Humans , Male , Aged , Retroperitoneal Fibrosis/drug therapy , Prednisolone/therapeutic use , Glucocorticoids/therapeutic use , Retroperitoneal Fibrosis/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 69-year-old man presented at the hospital with complaints of prolonged stomach pain extending from the week prior. Enhanced computed tomography (CT) revealed a low density area in the retroperitoneal space. A radiologist diagnosed the patient with retroperitoneal fibrosis. One week later, an enhanced CT revealed an exponential increase of the low density area and slight right hydronephrosis. Upon admission, prednisolone administration was initiated at a dose of 40mg/day. The size of the retroperitoneal soft tissue mass decreased gradually. Although the dose of prednisolone was tapered to 5mg, the patient is doing well without any sign of recurrence.
Subject(s)
Glucocorticoids/therapeutic use , Prednisolone/therapeutic use , Retroperitoneal Fibrosis/drug therapy , Aged , Humans , Magnetic Resonance Imaging , Male , Retroperitoneal Fibrosis/diagnostic imaging , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The patient was a 34-year-old man presenting with the right intra-scrotal painless mass. With a diagnosis of right intrascrotal tumor, the patient underwent right high orchiectomy. The pathological diagnosis of pleomorphic rhabdomyosarcoma arisen from the right spermatic cord was made. Computed tomography revealed a single metastasis in the para-vena cava lymph node. Systemic chemotherapy with vincristine, actinomycin D, plus cyclophosphamide (VAC therapy), and etoposide plus cisplatin (EP therapy) were made according to Intergroup Rhabdomyosarcoma Study (IRS)-IV Regimen 45. But the chemotherapy was ineffective and a retoroperitoneal lymphadenectomy (RPLND) was therefore performed. After 3 months following RPLND, the tumor relapsed in a pelvic lymph node involved in right ureter and ileocaecal valve. Resection of the tumor with ileocaecum was performed and then intraoperative radiotherapy (15 Gy) against the tumor bed was performed to ensure the curative effects. After his recovery, he received a total of 6 courses of systemic chemotherapy consisting of vincristin, ifosphamide, etoposide (IRS-IV Regimen 47). The patient was rigorously followed up for 42 months after the final chemotherapy, with no tumor recurrence.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Genital Neoplasms, Male/therapy , Lymph Node Excision , Orchiectomy , Radiotherapy, Adjuvant , Rhabdomyosarcoma/therapy , Scrotum , Follow-Up Studies , Genital Neoplasms, Male/diagnostic imaging , Genital Neoplasms, Male/pathology , Humans , Lymphatic Metastasis , Male , Neoplasm Recurrence, Local/therapy , Radiography , Rhabdomyosarcoma/diagnostic imaging , Rhabdomyosarcoma/secondary , Treatment OutcomeABSTRACT
A case of mycotic aneurysm secondary to septicemia is reported. A 59-year-old man with end-stage renal failure underwent renal transplantation from a living donor. On the fifteenth postoperative day, he was febrile and his arm around an entry wound of the drip infusion had infectious signs. Cultures of the blood and pus discharge grew Methicillin-resistant Staphylococcus aureus. Vancomycin was administered intravenously for 30 days. Then the existence of a mycotic aneurysm on the transplant artery was not suspected by computed tomography. After his infectious signs disappeared, examinations revealed a pseudoaneurysm measuring 4 cm in diameter at the site of anastomosis between the renal transplant and external iliac arteries by computed tomography. He has been carefully followed up with a conservative management. This is the first case of a mycotic aneurysm treated conservatively and displaying an uneventful course without rupture.
Subject(s)
Aneurysm, Infected/microbiology , Aneurysm, Infected/therapy , Kidney Failure, Chronic/surgery , Kidney Transplantation , Renal Artery , Staphylococcus aureus , Aneurysm, Infected/diagnostic imaging , Aneurysm, Infected/etiology , Anti-Bacterial Agents/administration & dosage , Asian People , Humans , Iliac Artery/diagnostic imaging , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/microbiology , Male , Middle Aged , Monitoring, Physiologic/methods , Renal Artery/diagnostic imaging , Renal Artery/microbiology , Tomography, X-Ray Computed , Vancomycin/administration & dosageABSTRACT
BACKGROUND: Up-regulation of epithelial vascular endothelial growth factor (VEGF) expression was recently reported at an early stage of bladder carcinogenesis in rats. Subsequently, clotrimazole (CLT) was reported to exert an inhibitory effect on the in vitro proliferation of vascular endothelial cells stimulated by VEGF. The present study was performed to evaluate the effect of CLT on the initial stage of N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN)-induced carcinogenesis of the urinary bladder in rats. METHODS: Seven-week-old-female Wistar rats were divided into both a control group and the other four groups that were allowed free access to drinking water containing 0.05%BBN. Two groups of rats (10-CLT and 20-CLT) received CLT (100 mg/kg per day) once daily by gavage for 10 and 20 weeks, respectively. The other two groups of rats (10-BBN and 20-BBN) were maintained on the same BBN-containing drinking water for 10 and 20 weeks, respectively, without receiving CLT. After removing the urinary bladder of each rat, expression of VEGF and VEGF receptor FLT1, and new capillaries were examined by immunohistochemical staining. VEGF mRNA was detected by the reverse transcription polymerase chain reaction. RESULTS: The ratio of VEGF-positive cells and the expression of VEGF mRNA were lower in the 20-CLT group than in the 10-BBN group. Newly formed capillaries in the 20-CLT group were significantly decreased compared with those in the 10-BBN group. CONCLUSION: These quantitative data suggested that CLT can inhibit VEGF expression in vivo and hence inhibit angiogenesis in the early stages of bladder carcinoma.
