Syndrome of inappropriate antidiuretic hormone secretion as a side effect of chemotherapy for testicular cancer: A case report.

INTRODUCTION: Inappropriate antidiuretic hormone secretion syndrome can be a serious adverse event of cisplatin-based chemotherapy. Cisplatin had to be changed to other drugs or chemotherapy completely discontinued in earlier reported cases. CASE PRESENTATION: Three cycles of bleomycin, etoposide, and cisplatin chemotherapy were planned for a 40-year-old man with a diagnosis of lymph node recurrence of testicular cancer. On day 9, he suffered from vomiting and mental disturbance. Severe hyponatremia (110 mEq/L) with low plasma osmolality led to a diagnosis of a syndrome of inappropriate antidiuretic hormone secretion, and infusions of hypertonic saline and salt intake were prescribed. Second and third courses of bleomycin, etoposide, and cisplatin chemotherapy could then be given with careful electrolyte management. CONCLUSION: Continuation of cisplatin administration with precise electrolyte adjustment can be a treatment option in regimens where cisplatin is essential for achieving optimal antitumor efficacy.

[DRUG-INDUCED INTERSTITIAL LUNG DISEASE DURING COMBINED ANDROGEN BLOCKADE WITH BICALUTAMIDE AND LEUPRORELIN ACETATE FOR PROSTATE CANCER].

We report a case of drug-induced interstitial lung disease as a result of combined androgen blockade. A 75 year-old male was receiving bicalutamide and reuprorelin acetate treatment for advanced prostate cancer. Two weeks after starting therapy, the patient developed dyspnea due to interstitial lung disease. Based on the clinical diagnosis of drug-induced interstitial lung disease, bicalutamide was withdrawn and steroid therapy was initiated. The patient succumbed 6 days later due to respiratory failure. Drug-induced interstitial lung disease following combined androgen blockade is a rare, but potentially serious adverse effect that requires close attention.

[Long-term disease stabilization by docetaxel plus estramustine for castration-resistant prostate cancer : report of a case].

Chemotherapy with docetaxcel (DTX) plus estramustine (EMP) for castration-resistant prostate cancer (CRPC) was started 30 months after the patient, a 65-year-old man, was diagnosed as having advanced prostate cancer cT3aN1M1 (OSS) with an initial PSA of 490 ng/ml. Prostate biopsy specimens revealed moderately differentiated adenocarcinoma, Gleason's sum 4＋5. He was treated with DTX 30 mg/m2 on day 2 and oral EMP 560 mg/day days 1-3 weekly for 3 out of 4 weeks. PSA at start of DTX plus EMP was 81.7 ng/ml, and that after 59 months was 66.6 ng/ml. No objective change in computed tomography and bone scan were observed. He also had no cancer-related symptoms and activity of daily life was good. Chemotherapy was interrupted twice because of pleural effusion and dyspnea by DTX, at 3 and 4 months, respectively, long-term disease stabilization was obtained by this treatment. Other adverse events including interstitial pneumonia, cardiovascular disorders and myelosuppression were not observed. He was maintained on the same chemotherapy. DTX plus EMP chemotherapy is an effective treatment for CRPC patients. Continuing this therapy it is important to survey and control adverse events caused by DTX and EMP carefully.

[Ureteral cancer occurred in megaureter].

A 58-year-old man visited our hospital with a complaint of asymptomatic gross hematuria for three weeks. The urine cytology at another clinic had indicated Papanicolaou class V. A physical examination revealed soft abdominal distention in lower abdomen. Ultrasonography demonstrated an extremely dilated left pelvis, calyx and ureter in which a round mass was detected. Enhancement CT showed a mass 2 cm in diameter in the middle part of the dilated left ureter. These findings suggested the diagnosis of left ureteral cancer having developed in the megaureter. Neither VUR nor UVJ stenosis were identified by VCG and RP. MR-urography showed a severely dilated left pelvis and tortuous megaureter. On the diagnosis of left ureteral cancer left nephroureterectomy with cuff of bladder was performed. Gross findings showed a 2 cm sized papillary tumor in the extremely dilated ureter, and pathological findings showed grade 2, papillary transitional cell carcinoma and non-specific ureteritis in the dilated ureter. Postoperative course was non-eventful. Postoperative 3 months later multiple bladder tumors were detected all over the bladder, and so TUR-Bt and intravesical instillation therapy with pirarubisin was performed. However multiple bladder tumors had been relapsed and so finally radical cystectomy and right cutaneous ureterostomy were undergone postoperative 6 months later. He has been well 48 months postoperatively.

[Self-catheterizable urinary re-diversion using the appendix for urethral recurrence after ileal neobladder].

A 68-year-old man underwent urinary re-diversion due to urethral recurrence 2 years after radical cystectomy with ileal neobladder reconstruction. Computed tomography, magnetic resonance imaging and cystoscopy revealed anastomotic recurrence between bladder and urethra with a tendency of urinary retention. Transurethral resection of bladder tumor was performed and pathological findings showed transitional cell carcinoma (TCC), papillary invasive G3, pT1 or more. Finally, we performed total urethrectomy and partial resection of bladder neck with self-catheterizable urinary rediversion using appendix. Pathological findings showed TCC, G3, pT1. Self-catheterizable urinary re-diversion using the appendix can be an option for urethral recurrence after ileal neobladder reconstruction.