[A case of metastatic paratesticular rhabdomyosarcoma in an adult successfully treated with multidrug combination chemotherapy].

A 20-year-old man was referred to our hospital with the complaint of a mass in the left scrotum. Computed tomography showed retroperitoneal lymph node metastases and multiple lung metastases. He underwent left high orchiectomy and was diagnosed with paratesticular embryonal rhabdomyosarcoma. He received combination chemotherapy consisting of cyclophosphamide, vincristine, doxorubicin, and dacarbazine. After four cycles of chemotherapy, lung metastases disappeared and lymph nodes decreased dramatically. He was alive without recurrence 31 months after the operation.

[Estramustine phosphate withdrawal syndrome in relapsed prostate cancer: two case reports].

The decrease of the level of serum prostate specific antigen (PSA) after discontinuation of estramustine phosphate (EMP) has rarely been reported. We report 2 cases in whom EMP withdrawal syndrome was encountered. Case 1 was a 68-year-old man with a complaint of paresis of lower limbs. He was diagnosed with prostate cancer with multiple bone metastases. The serum PSA level was 9,300 ng/ml. He was treated with luteinizing hormone-releasing hormone agonist (LH-RHa) and bicalutamide (BCL). Six months later, EMP was started against PSA failure. During the 3-year treatment with EMP, PSA decreased to the nadir of 0.7 ng/ml and gradually increased to 14 ng/ml. After withdrawal of EMP, PSA decreased to 0.3 ng/ml (97.9% decline) and remained at this level for 4 months. Case 2 was a 61-year-old man who visited our hospital with gross hematuria. Transurethral bladder biopsy and transrectal prostate biopsy were performed. The diagnosis was moderately differentiated adenocarcinoma of the prostate that invaded to the bladder. Computed tomography (CT) showed a lymph node metastasis. He was treated with LH-RHa and BCL. The treatment was changed to EMP after PSA failure. EMP was withdrawn when PSA was 30 ng/ml. Then PSA decreased to less than 0.2 ng/ml (99% decline) and remained at this level for 9 months. We consider that in patients with EMP-resistant progression, EMP withdrawal syndrome should be checked.

[A case of adenocarcinoma of the urinary bladder arising 45 years after ileal replacement of ureter for tuberculous ureteral stricture].

We report a case of adenocarcinoma arising in the urinary bladder 45 years after ileal replacement of ureter for tuberculous ureteral stricture. A 65-year-old man was admitted with gross hematuria. Cystoscopic examination demonstrated a broadbased non-papillary tumor on the left posterior wall of the bladder and a papillary tumor at the anastomotic site between the bladder and ileal segment. Total cystectomy and construction of ileal conduit were performed. The histopathological examination demonstrated well differentiated adenocarcinoma of the bladder and ileal ureter. Intestinal metaplasia widely infiltrated into the bladder epithelium around the anastomotic site.