ABSTRACT
Case 1 : A 60-year-old man presented with right flank pain. A computed tomography (CT) scan revealed a large right renal tumor, multiple lung metastases, multiple liver metastases, and tumor thrombus of the right renal vein. These findings were strongly suggestive of renal cell carcinoma. The patient suddenly complained of dyspnea at night due to bilateral pulmonary embolism, and the patient died 11 days after onset. Needle necropsy showed that the tumors were squamous cell carcinomas of the renal pelvis. Case 2 : A 66-year-old man presented with macrohematuria. An abdominal CT scan revealed a right renal mass and liver metastasis. The differential diagnosis was between renal cell carcinoma and urothelial carcinoma. A renal biopsy revealed urothelial carcinoma of the renal pelvis. The patient died of the disease 3 months after initiation of chemotherapy with gemcitabine and cisplatin. We report these 2 cases to emphasize the importance of renal biopsy and thorough histological analysis for the determination of treatment strategies against unresectable renal tumors.
Subject(s)
Carcinoma, Renal Cell/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Kidney Pelvis , Biopsy , Carcinoma, Renal Cell/pathology , Humans , Kidney Neoplasms/pathology , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
We report a case of fibrosarcoma of the spermatic cord detected with an inguinal tumor. A 45-year old man was admitted to our hospital for further examination of a right inguinal tumor. Computed tomography (CT) and magnetic resonance imaging revealed a right spermatic cord tumor,45 mm in size, and a retroperitoneal tumor in proximity to the right external iliac artery,55 mm in size. He was clinically suspected as having malignant lymphoma. As the differential diagnosis, liposarcoma and leiomyosarcoma were considered. High orchidectomy was performed for the purpose of diagnosis. The histopathological examination suggested fibrosarcoma, with a positive surgical margin. Six days after high orchidectomy, retroperitoneal tumor extirpation was performed. Total resection was difficult because the adhesion with the external iliac vein was strong. The tumor was extirpated as much as possible. The result of the histopathological examination showed fibrosarcoma. Adjuvant radiotherapy (54 Gy) was performed. After radiotherapy, local recurrence was detected by CT. He underwent systemic chemotherapy with adriamycin (60 mg/m2). After 3 courses, there was a slight reduction in tumor size. However, his general condition rapidly deteriorated with marked cachexy and he died six months from the first medical examination.
Subject(s)
Fibrosarcoma/pathology , Genital Neoplasms, Male/pathology , Spermatic Cord , Abdominal Neoplasms/diagnosis , Fibrosarcoma/diagnosis , Fibrosarcoma/surgery , Genital Neoplasms, Male/diagnosis , Genital Neoplasms, Male/surgery , Humans , Inguinal Canal , Male , Middle Aged , OrchiectomyABSTRACT
We report a case of bilateral pheochromocytoma which was incidentally discovered by ultrasonography at a health check-up. A 46-year-old female was admitted to our hospital for further examination of a right adrenal tumor. Computed tomography and magnetic resonance imaging revealed a right adrenal tumor, 5 cm in size, and a left adrenal tumor, 1.5 cm in size. High serum noradrenaline and urine noradrenaline levels were noted. 131I-MIBG scintigraphy revealed an abnormal accumulation of 131 I in the tumors. Thus, our clinical diagnosis was bilateral pheochromocytoma. Laparoscopic right adrenalectomy was performed. The histopathological examination revealed pheochromocytoma, no capsule injury and no malignancy. We decided to continue watchful waiting of the left adrenal tumor, because the serum and urine levels of catecholamine were within the normal range after the operation. She has been well with no clinical symptoms, no increase in tumor size, and no elevation of catecholamine for 20 months.
Subject(s)
Adrenal Gland Neoplasms/surgery , Adrenalectomy , Pheochromocytoma/surgery , Adrenal Gland Neoplasms/diagnosis , Female , Humans , Laparoscopy , Middle Aged , Pheochromocytoma/diagnosis , Treatment OutcomeABSTRACT
We assessed the diagnostic value of procalcitonin (PCT) in urosepsis on 54 patients with urinary tract infections (UTI), suspected of having urosepsis. The results of urine culture, blood culture, and serum concentrations of PCT were analyzed. Overall, the sensitivity and specificity of PCT for bacteremia were as follows : 100 and 31.6% at concentrations of >0.5 ng/ml and 75.0 and 78.9% at concentrations of >10 ng/ml. we concluded that the PCT level could be a reliable early marker suggestive of urosepsis, and may be helpful when deciding whether to perform immediate urological intervention or not.
Subject(s)
Calcitonin/blood , Protein Precursors/blood , Sepsis/diagnosis , Urinary Tract Infections/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Calcitonin Gene-Related Peptide , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Sepsis/etiology , Urinary Tract Infections/complicationsABSTRACT
We report a case of tubercular prostatic abscess in a male patient who had undergone intravesical Bacillus Calmette-Guerin therapy for bladder carcinoma in situ. The abscess was successfully treated with transurethral resection of the prostate for drainage and subsequent antituberculous regime of chemotherapy.
