[Granulocytic sarcoma of the prostate].

A 71-year-old man with dysuria was referred to our hospital. The level of serum prostate specific antigen was slightly elevated (4.66 ng/ml), and digital rectal examination revealed a stony hard prostate mass. We performed a transrectal prostate biopsy because malignancy was suspected. Histological examination revealed leukemia-like cells, and bone-marrow examination (aspiration) was performed to determine the location of the original lesion. However, no leukemia-like cells or any other form of malignant cells were identified. Clinical imaging confirmed the absence of any other lesions, and granulocytic sarcoma of the prostate was subsequently diagnosed. We treated the cancer with radiotherapy at a dose of 40 Gy and dysuria improved. Furthermore, significant reduction in prostate volume was confirmed. Four months after initial presentation, the patient developed acute myeloid leukemia [M2 by French-American-British classification]. Induction chemotherapy was initiated, and the patient was successfully induced to complete remission. Twenty months later, the patient showed relapse. Despite salvage chemotherapy, he died of brain hemorrhage twenty-four months after complete remission.

[A case of laparoscopic radical nephrectomy in right renal cell carcinoma with left inferior vena cava].

We present a case of laparoscopic radical nephrectomy in right renal cell carcinoma with left inferior vena cava in a 65-year-old male. Abdominal contrasted CT scan revealed that the left inferior vena cava crossed the aorta at the level of third lumbar vertebra. Laparoscopic radical nephrectomy was performed transperitoneally. A right gonadal vein drained into the right renal vein. We indentified a right renal vein easily with tracing the right gonadal vein. Left inferior vena cava is a very rare congenital anomaly among malformation of inferior vena cava. Recognition of such venous anomalies and making a detailed strategy before operation is important especially in laparoscopic surgery.