Renal cell carcinoma with intraluminal spread of the entire upper urinary tract.

We describe an unusual case of renal cell carcinoma (RCC) involving the entire upper urinary tract. A 51-year-old female was referred to us because of macroscopic hematuria. Computed tomography revealed a renal tumor filling renal pelvis and ureter, which turned to be a clear cell RCC after nephroureterectomy.

Liquid sclerotherapy for posttraumatic arteriovenous fistula of the radialis indicis artery.

We report the case of a 40-year-old woman with posttraumatic arteriovenous fistula of the right radialis indicis artery. The patient was admitted because a pulsatile lesion appeared on her hand after blunt trauma. Liquid sclerotherapy using 3% polidocanol in combination with distal protection using the rubber band technique was undertaken, which resulted in complete disappearance of the arteriovenous fistula. At 1 year after the endovascular therapy, the arteriovenous fistula had completely disappeared, and no further complications had occurred.

[Efficacy of FEC and trastuzumab/docetaxel combination therapy for metastatic breast cancer].

A 56-year-old female visited our department due to bleeding from a mass in her left breast in November 2007. There was a tumor (diameter, 5 cm) accompanied by ulcer formation and fixation to the pectoral muscle, centering on the left breast Carea. CT examination showed multiple lung metastasis and liver metastasis. Core needle biopsy demonstrated scirrhous carcinoma. The tumor was positive for ER and strongly positive for HER2. After 4 courses of FEC100, 10 courses of trastuzumab / docetaxel combination therapy were performed for a total of 30 weeks. After the therapy, the breast tumor decreased in size, and the lung and liver metastatic lesions disappeared, showing a partial response (PR). FDG-PET examination revealed no abnormal accumulation. In February 2009, left mastectomy was performed. Pathological examination revealed Grade 2b and only a slight residue of cancer cells. This patient with advanced breast cancer accompanied by distant metastasis responded to trastuzumab/docetaxel combination therapy.

Magnetic resonance imaging of the metal clip in a breast: safety and its availability as a negative marker.

PURPOSE: This study assesses magnetic resonance (MR) safety of the stainless-steel clip inserted after stereotactic-guided directional vacuum-assisted biopsy (DVAB) of the breast, and evaluates its imaging value. METHODS: We used a sausage as a substitute breast and inserted the clip into it. The MR images of the substitute were scanned using a breast coil, and it was then dissected. After the substitute experimentation, MR scanning of the breast was performed using a dynamic contrast enhanced technique, in which a clip was placed after DVAB for suspicion of ductal carcinoma was seen as grouped amorphous calcifications on mammography. RESULTS: On every magnetic resonance image of the substitute, the clip was seen as a spotty signal void, with no surrounding artifact. There was no movement and no evidence of increased clip temperature on dissected of the substitute, confirming the safety of breast MR with a clip in place. There was no patient complaint of feeling heat or pain during the MRI examination and there were only biopsy scars on the surgically excised breast specimen material. On the breast MR images, a spreading region of the tumor adjoining the position of the signal void was identified as an early enhancing lesion. CONCLUSIONS: The safety and reliability of breast MR examination using a mammotome clip was demonstrated by both the mock examination and the breast examination. It is possible to localize of tumor spread regions based on the marker position using the clip as a negative signal marker.

Computed tomography-guided transarterial chemoembolization as the initial therapy for hepatocellular carcinoma: experience of 75 cases in a single institute.

We present the survival rates of 75 nonruptured hepatocellular carcinoma cases initially treated with computed tomography-guided transarterial chemoembolization in a single institute. The 1-, 3-, and 5-year survival rates were 93.9%, 74.7%, and 47.4% in 50 Child's A cases; 75.0%, 43.6%, and 6.8% in 20 Child's B cases; and 60.0%, 40.0%, 0.0% in 5 Child's C cases, respectively. The 1-, 3-, and 5-year survival rates of the 38 estimated resectable hepatocellular carcinoma cases (Child's A, tumors limited in a single lobe) were 94.7%, 82.0%, and 44.6%, respectively. The 1-, 3-, and 5-year survival rates of the 41 cases with estimated indication for percutaneous ethanol injection therapy (tumors less than 3 cm in diameter and three or fewer in number) were 96.8%, 84.6%, and 55.5% in 31 Child's A cases; and 90.0%, 46.7%, and 0% in 10 Child's B cases, respectively. In conclusion, computed tomography-guided transarterial chemoembolization is an excellent primary therapy for hepatocellular carcinoma.

Correlation among intratumoral blood flow in breast cancer, clinicopathological findings and Nottingham Prognostic Index.

BACKGROUND: The purpose of this study was to evaluate the correlation among intratumoral blood flow as assessed by color Doppler ultrasonography, clinicopathological findings and the Nottingham Prognostic Index (NPI). METHODS: Twenty-seven patients with breast cancer were examined. All patients received surgical treatment. Color Doppler ultrasonography was performed prior to surgery to detect arterial blood flow signals within the tumors. The lowest resistance index (RI) was recorded. Formalin-fixed, paraffin-embedded slides were reviewed by senior pathologists to evaluate the size of tumor, histological size, lymph node status and histological grade. Estrogen and progesterone receptor levels were measured by enzyme immunoassay. The Nottingham Prognostic Index was calculated using the equation NPI = 0.2 x tumor size (cm) + grade (I-III) + lymph node score (1-3). RESULTS: The lowest RI correlated well with NPI and histological grade (grade II:III = RI 1.037:0.816, P = 0.0035). Regression analysis revealed a linear relationship between the lowest RI and NPI (correlation coefficient = 0.475; P = 0.0153). CONCLUSIONS: Intratumoral blood flow analysis assessed by color Doppler ultrasonography correlates well with histological grade and NPI. Preoperative assessment using color Doppler ultrasonography provides useful information and may contribute to the determination of prognosis.