[A Case of Dedifferentiated Liposarcoma of the Spermatic Cord].

A 52-year-old man was referred to our hospital for evaluation of painless right scrotal swelling persisting for 3 months. Palpation detected swelling and induration centered on the head of the upper epididymis, and ultrasonography revealed a blood-filled nodular mass at the same site continuing to the spermatic cord. No abnormalities were observed in the bilateral testes. Blood tests were negative for tumor markers such as α fetoprotein and human chorionic gonadotropin-ß. Right radical inguinal orchiectomy was performed, and the pathological diagnosis was dedifferentiated liposarcoma of the spermatic cord. Although the spermatic cord stump was negative, the peri-spermatic cord stump, which had an exfoliated surface, was positive. No residual tumor was found on magnetic resonance imaging, but the tumor was suspected to remain. Thus, after approximately 1month, the tissue around the spermatic cord was resected. Eight months after the initial operation, no recurrence was observed. Here, we report a case of dedifferentiated liposarcoma of the spermatic cord, which is relatively rare, and review the related literature.

Increased neutrophil-to-lymphocyte ratio is associated with disease-specific mortality in patients with penile cancer.

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), a simple marker of the systemic inflammatory response, has been demonstrated to correlate with patient outcomes for various solid malignancies. We investigated the utility of the pretreatment NLR as a prognosticator in patients who presented with penile cancer. METHODS: A total of 41 patients who underwent complete blood count with differential and subsequent radical penectomy from 1988 to 2014 were analyzed. We assessed the correlation between the NLR and the prognosis of penile cancer. RESULTS: The median and mean (± SD) NLRs in 41 penile cancer patients were 3.42 and 5.03 ± 4.99, respectively. Based on the area under receiver operator characteristic curve, the cut-off value of NLR was determined to be 2.82. Patients with a high NLR (≥2.82) showed a significantly poorer cancer-specific survival (p = 0.023) than those with a low NLR. CONCLUSIONS: The pretreatment NLR may function as a biomarker that precisely predicts the prognosis in patients with penile cancer.

Presurgical downstaging of vena caval tumor thrombus in advanced clear cell renal cell carcinoma using temsirolimus.

A 63-year-old man presenting with a 7.2-cm right renal mass, an inferior vena cava tumor thrombus, and pulmonary metastases underwent renal mass biopsy that revealed clear cell renal cell carcinoma. Temsirolimus (25 mg weekly) was given because of the extent of the disease and poor performance status, which resulted in a marked reduction in the tumor thrombus (from level III to level I) after 20 weeks of treatment. Subsequently, radical nephrectomy and tumor thrombectomy were carried out. Final pathological analysis confirmed the diagnosis of high-grade clear cell carcinoma (pT4N0M1). One year after initiation of temsirolimus therapy, the patient remained alive despite the presence of disease.

Early ultrasonographic evaluation of tumor thrombus level during sunitinib therapy for renal cell carcinoma.

A 72-year-old man presenting with a 14-cm left renal mass, an inferior vena cava (IVC) tumor thrombus, and pulmonary metastases underwent renal mass biopsy that revealed clear cell renal cell carcinoma. Because of metastases and the extent of the tumor thrombus, sunitinib was administered, which resulted in a marked reduction in the tumor thrombus (from level III to level II after 11 weeks of treatment). Ultrasonography, preceding computed tomography, showed a slight shrinkage of the tumor thrombus level in the first 2 weeks. Therefore, ultrasound may be advantageous to monitor the IVC tumor thrombus level during the early phase of targeted therapy.