[Incomplete self-castration by the patient with gender identify disorder: a case report].

A 29-year-old man with gender identify disorder presented to our hospital complaining of scrotal pain. Two hours before the consultation, he tried to do self-castration by himself, but he stopped due to bleeding and scrotal pain. His testes were not removed, and his scrotal wound was closed at the emergency operation under spinal anesthesia. After the operation, he never repeated the same act.

Neonatal exposure to estrogen in the Wistar rat decreases estrogen receptor-beta and induces epithelial proliferation of the prostate in the adult.

BACKGROUND/AIMS: The effects of environmental endocrine disruptors on the male reproductive system have received much attention. We attempted to assess the responsible reproduction period vulnerable to decrease in ER beta mRNA by exposing neonate rats to disruptors. METHODS: Each of 64 male Wistar rats was given an injection of estradiol at a dose of 25 mug or oil on days 1, 3 and 5 after birth. These rats were sacrificed on days 80, 120, 160 and 180 and then subjected to measurements of both serum and tissue testosterone levels. Real-time quantitative polymerase chain reaction (PCR) was used to measure the levels of androgen receptor (AR) and estrogen receptor-beta (ER beta) mRNA of the ventral prostate. Histological compositions were analyzed by quantitative morphometry. Immunohistochemical analysis of proliferating cell nuclear antigen (PCNA) was determined. RESULTS: The incidence of epithelial components by histomorphometry and the expression of PCNA was significantly higher in the estrogen group in the mature adult (day 160). Levels of AR and ER beta mRNAs in the estrogen group were significantly lower in middle-aged rats (day 180). CONCLUSION: Estrogen exposure in the neonatal period to Wistar rats decreases the number of ER beta in the mature adult and accelerates cell proliferation.

Chronic pyelonephritis presenting as multiple tumor-like renal lesions.

We encountered a 49-year-old Japanese man in whom tumor-like renal lesions developed as a result of chronic Staphylococcus aureus pyelonephritis. The patient complained of general fatigue, weight loss, and anorexia for 6 months. Contrast-enhanced computed tomography (CT) of the abdomen revealed multiple low-density lesions in both kidneys and paraaortic lymphadenopathy. A strong uptake of Ga67 citrate in the lesions and elevation of serum soluble interleukin-2 receptor and thymidine kinase activity were strongly suggestive of primary renal lymphoma; however, histologic examination of renal biopsy specimens revealed severe tubulointerstitial change, consistent with chronic pyelonephritis. Following systemic antibiotic treatment, multiple tumor-like lesions regressed 4 months later. This case suggested that chronic pyelonephritis could present as bilateral renal tumors.

Histologically benign but telomerase positive adrenal pheochromocytoma.

Adrenalectomy was performed on a 37-year-old woman with right adrenal pheochromocytoma. Although the histological diagnosis was benign, telomerase repeat amplification protocol (TRAP) demonstrated positive telomerase activity. Thirty-five months after adrenalectomy, a recurrent tumor was found. Forty-seven months after adrenalectomy, bone metastases also appeared. Malignant pheochromocytoma was clinically diagnosed. Our experience suggests that telomerase-positive tumor cells are highly likely to repeat cell proliferation when they are left in the patient's body, and lead to recurrence. Therefore, telomerase-positive tumors should be clinically treated as malignant even if they have been histologically diagnosed as benign.