Like a Rolling Stone: Year-Over-Year Growth of a Rectal Fecalith.

The inability to pass stool for a prolonged period can lead to the formation of fecaliths, which occurs most often in the colon or rectum. Although large fecaliths can lead to serious or life-threatening complications, the detailed process of their formation is unknown. This report describes a 65-year-old woman who presented with melena due to ischemic proctitis caused by a large fecalith. On computed tomography, the fecalith showed a unique multilayered calcification sign. We successfully dismantled and removed the fecalith transanally, assisted by a traction method using a balloon catheter. A review of imaging studies from 6 years ago revealed the growth of the fecalith over the previous year and provided an insight into the mechanism underlying the development of large fecaliths.

[A report of two cases of priapism with metastatic penile tumor].

We report two cases of priapism with metastases to the penis. The first case was a 52-year old man, diagnosed as suffering from gastric cancer by endoscopic biopsy five years previously, but for whom no treatment was performed. He visited our office due to priapism with a duration of 11 days. Physical examination showed two palpable mass lesions on the glans. A glansocavernosum shunt (Winter shunt) was performed, but this was not effective. Radiotherapy was also ineffective. Pathological analysis revealed gastric cancer metastasis to the penis and this was diagnosed as the cause of the priapism. He died of respiratory failure on postoperation day 28. The second case was a 64-year old man with kidney cancer. Hemodialysis had been performed due to chronic renal failure for 20 years and visited our office due to priapism from which he had suffered for 30 days. Computed tomography (CT) demonstrated a left renal cell cancer and metastasized to the retroperitoneal lymph nodes. A Winter shunt was performed on the penis and then a cavernosospongiosum anastomosis was done. The priapism improved about 40%. Pathological analysis confirmed that the renal cell cancer had metastasized to the penis and this was concluded to be responsible for the priapism.