Post-kidney transplantation lymphocele is a common complication, usually managed with percutaneous drainage, lymphangiography, or surgical fenestration. We report a refractory case successfully treated with percutaneous balloon fenestration into the peritoneal cavity using interventional radiology.
Case Presentation
A woman in her 60s with end-stage renal disease from diabetic nephropathy underwent living-donor kidney transplantation. Two weeks later, a lymphocele developed with a predominant subcutaneous component and a smaller peritransplant retroperitoneal collection, requiring repeated percutaneous aspiration. At 2 months, lymphangiography did not demonstrate an active leak. At 3 months, CT-guided puncture and dilation were used to create a passage between the lymphocele and the peritoneal cavity, with placement of a 10-Fr catheter. The catheter was removed after 3 weeks, and no recurrence has been observed for 2.5 years.
Conclusion
Interventional radiology-based percutaneous balloon fenestration into the peritoneal cavity may be an effective alternative to surgical fenestration in refractory post-transplant lymphocele.
{"title":"A Case of Refractory Lymphocele Following Living Donor Kidney Transplantation Treated With Percutaneous Balloon Fenestration Into the Peritoneal Cavity Using Interventional Radiology","authors":"Naoki Akagi, Shojiro Oka, Shigeshi Kohno, Atsushi Igarashi, Yuto Hattori, Noboru Shibasaki, Mutsushi Kawakita, Toshinari Yamasaki","doi":"10.1002/iju5.70130","DOIUrl":"10.1002/iju5.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Post-kidney transplantation lymphocele is a common complication, usually managed with percutaneous drainage, lymphangiography, or surgical fenestration. We report a refractory case successfully treated with percutaneous balloon fenestration into the peritoneal cavity using interventional radiology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A woman in her 60s with end-stage renal disease from diabetic nephropathy underwent living-donor kidney transplantation. Two weeks later, a lymphocele developed with a predominant subcutaneous component and a smaller peritransplant retroperitoneal collection, requiring repeated percutaneous aspiration. At 2 months, lymphangiography did not demonstrate an active leak. At 3 months, CT-guided puncture and dilation were used to create a passage between the lymphocele and the peritoneal cavity, with placement of a 10-Fr catheter. The catheter was removed after 3 weeks, and no recurrence has been observed for 2.5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Interventional radiology-based percutaneous balloon fenestration into the peritoneal cavity may be an effective alternative to surgical fenestration in refractory post-transplant lymphocele.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acquired factor V (FV) deficiency is a rare bleeding disorder requiring careful management, especially in hemodialysis (HD) patients who regularly receive anticoagulants. We present a case of recurrent acquired FV deficiency in a dialysis patient.
Case Presentation
A 76-year-old man on HD with a history of acquired FV deficiency developed third-degree burns and persistent bleeding. Lab tests confirmed the recurrence of the deficiency. Initial treatments with rituximab and cyclophosphamide were ineffective. When prednisolone was rechallenged, the activity of coagulation FV was rapidly improved, and coagulation function was confirmed to have returned to normal. HD was managed without anticoagulants during critical periods. No major bleeding events were observed during HD.
Conclusion
This case underscores the complexities of managing acquired FV deficiency in patients on HD. It highlights the importance of individualized anticoagulation strategies and close monitoring of coagulation profiles to prevent bleeding complications and ensure the safety of HD.
{"title":"A Case of Acquired Factor V Deficiency in a Hemodialysis Patient: A Case Report With Literature Review","authors":"Akihiko Sugino, Yoshiyuki Miyazawa, Shugo Harashima, Yusaku Shimizu, Mikiya Kajita, Yuri Miyazawa, Yoshiyuki Ogawa, Hiroshi Handa, Yoshitaka Sekine, Kazuhiro Suzuki","doi":"10.1002/iju5.70129","DOIUrl":"10.1002/iju5.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Acquired factor V (FV) deficiency is a rare bleeding disorder requiring careful management, especially in hemodialysis (HD) patients who regularly receive anticoagulants. We present a case of recurrent acquired FV deficiency in a dialysis patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 76-year-old man on HD with a history of acquired FV deficiency developed third-degree burns and persistent bleeding. Lab tests confirmed the recurrence of the deficiency. Initial treatments with rituximab and cyclophosphamide were ineffective. When prednisolone was rechallenged, the activity of coagulation FV was rapidly improved, and coagulation function was confirmed to have returned to normal. HD was managed without anticoagulants during critical periods. No major bleeding events were observed during HD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case underscores the complexities of managing acquired FV deficiency in patients on HD. It highlights the importance of individualized anticoagulation strategies and close monitoring of coagulation profiles to prevent bleeding complications and ensure the safety of HD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoichiro Tohi, Kana Kohashiguchi, Kenichi Tanaka, Mari Jinno, Takuma Kato, Rikiya Taoka, Nobufumi Ueda, Reiji Haba, Yoshihiro Nishiyama, Mikio Sugimoto
Introduction
We present a technique that combines a fluorescent ureteral catheter with Firefly near-infrared fluorescence imaging to identify the ureter and avoid injury during robot-assisted resection of a retroperitoneal cystic tumor.
Case Presentation
Computed tomography revealed a 6-cm retroperitoneal cystic mass anterior to the abdominal aorta near the lower pole of the left kidney that adhered to the left ureter in a 53-year-old man. A fluorescent ureteral catheter was placed preoperatively, and robot-assisted transperitoneal resection was performed. Firefly imaging enabled clear visualization of the ureter, allowing safe dissection and tumor identification. The tumor was excised without cyst rupture. The console time was 4 h 13 min, with minimal blood loss. Pathology confirmed schwannoma.
Conclusion
We demonstrated the feasibility and clinical benefits of integrating a fluorescent ureteral catheter with Firefly fluorescence imaging for intraoperative ureteral identification during robot-assisted surgery. This fluorescence-guided approach improves dissection accuracy and helps prevent ureteral injury.
{"title":"Successful Robot-Assisted Resection of a Retroperitoneal Cystic Tumor With Fluorescent Ureteral Stent and Firefly Imaging","authors":"Yoichiro Tohi, Kana Kohashiguchi, Kenichi Tanaka, Mari Jinno, Takuma Kato, Rikiya Taoka, Nobufumi Ueda, Reiji Haba, Yoshihiro Nishiyama, Mikio Sugimoto","doi":"10.1002/iju5.70125","DOIUrl":"https://doi.org/10.1002/iju5.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We present a technique that combines a fluorescent ureteral catheter with Firefly near-infrared fluorescence imaging to identify the ureter and avoid injury during robot-assisted resection of a retroperitoneal cystic tumor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Computed tomography revealed a 6-cm retroperitoneal cystic mass anterior to the abdominal aorta near the lower pole of the left kidney that adhered to the left ureter in a 53-year-old man. A fluorescent ureteral catheter was placed preoperatively, and robot-assisted transperitoneal resection was performed. Firefly imaging enabled clear visualization of the ureter, allowing safe dissection and tumor identification. The tumor was excised without cyst rupture. The console time was 4 h 13 min, with minimal blood loss. Pathology confirmed schwannoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrated the feasibility and clinical benefits of integrating a fluorescent ureteral catheter with Firefly fluorescence imaging for intraoperative ureteral identification during robot-assisted surgery. This fluorescence-guided approach improves dissection accuracy and helps prevent ureteral injury.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Enfortumab vedotin is a standard therapy for advanced urothelial carcinoma, but its efficacy may be limited by acquired resistance and spatial heterogeneity of Nectin-4 expression.
Case Presentation
We report the case of a 76-year-old woman with cT3N2M0 left renal pelvic urothelial carcinoma that was treated with first-line chemotherapy, followed by pembrolizumab, and subsequently enfortumab vedotin. After 16 cycles of enfortumab vedotin, lymph node metastases remained shrunk, but isolated progression of the primary tumor occurred. Salvage nephroureterectomy was therefore performed, and the patient has remained recurrence-free for one year postoperatively. Immunohistochemistry showed a marked decline in Nectin-4 expression in the resected tumor compared with at the time of the initial biopsy.
Conclusion
This case highlights the potential role of surgery for localized progression during enfortumab vedotin therapy. Nectin-4 reassessment may be considered selectively at decision-changing junctures when results are likely to alter management.
{"title":"Salvage Surgery for Primary Renal Pelvic Urothelial Carcinoma After Enfortumab Vedotin: A Case of Durable Remission With Nectin-4 Loss","authors":"Takahito Wakamiya, Yuya Iwahashi, Hiroki Kawabata, Satoshi Muraoka, Shimpei Yamashita, Fumiyoshi Kojima, Yasuo Kohjimoto","doi":"10.1002/iju5.70122","DOIUrl":"https://doi.org/10.1002/iju5.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Enfortumab vedotin is a standard therapy for advanced urothelial carcinoma, but its efficacy may be limited by acquired resistance and spatial heterogeneity of Nectin-4 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We report the case of a 76-year-old woman with cT3N2M0 left renal pelvic urothelial carcinoma that was treated with first-line chemotherapy, followed by pembrolizumab, and subsequently enfortumab vedotin. After 16 cycles of enfortumab vedotin, lymph node metastases remained shrunk, but isolated progression of the primary tumor occurred. Salvage nephroureterectomy was therefore performed, and the patient has remained recurrence-free for one year postoperatively. Immunohistochemistry showed a marked decline in Nectin-4 expression in the resected tumor compared with at the time of the initial biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the potential role of surgery for localized progression during enfortumab vedotin therapy. Nectin-4 reassessment may be considered selectively at decision-changing junctures when results are likely to alter management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foley catheterization is a routine urologic procedure, yet complications may arise, particularly in patients with long-term indwelling catheters.
Case Presentation
We present a rare case of iatrogenic ureteral obstruction caused by inadvertent Foley catheter insertion into the right ureter in a 55-year-old male nursing home resident. The condition led to right-sided hydronephrosis and recurrent urinary tract infections. Diagnosis was established using computed tomography, which confirmed the catheter's entry into the ureter, and cystoscopy revealed polypoid lesions around the right ureteral orifice. After management with an antegrade Double-J stent, Foley catheter reinsertion, and antibiotic therapy, the patient's condition improved. Follow-up cystoscopy during hospitalization demonstrated a marked reduction in the size of the polypoid lesions, with the right ureteral orifice located within a cellule between two gate-like trabeculations.
Conclusion
This case highlights the importance of vigilance in long-term catheter management and imaging in recurrent urinary tract infections.
{"title":"Iatrogenic Ureteral Obstruction With Ureteral Orifice Polyp Secondary to Foley Catheter Misplacement: A Case Report With Cystoscopic and Imaging Findings","authors":"Cheng-Chieh Yang, Jane-Dar Lee, Jing-Dung Shen","doi":"10.1002/iju5.70131","DOIUrl":"https://doi.org/10.1002/iju5.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Foley catheterization is a routine urologic procedure, yet complications may arise, particularly in patients with long-term indwelling catheters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We present a rare case of iatrogenic ureteral obstruction caused by inadvertent Foley catheter insertion into the right ureter in a 55-year-old male nursing home resident. The condition led to right-sided hydronephrosis and recurrent urinary tract infections. Diagnosis was established using computed tomography, which confirmed the catheter's entry into the ureter, and cystoscopy revealed polypoid lesions around the right ureteral orifice. After management with an antegrade Double-J stent, Foley catheter reinsertion, and antibiotic therapy, the patient's condition improved. Follow-up cystoscopy during hospitalization demonstrated a marked reduction in the size of the polypoid lesions, with the right ureteral orifice located within a cellule between two gate-like trabeculations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the importance of vigilance in long-term catheter management and imaging in recurrent urinary tract infections.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michinori Shimizu, Jun Kamei, Daisuke Yamada, Satoru Taguchi, Daiji Watanabe, Atsushi Kondo, Masako Ikemura, Jimpei Miyakawa, Sigenori Kakutani, Aya Niimi, Yuta Yamada, Haruki Kume
Introduction
We report two cases of ectopic prostate tissue exhibiting fluorescence during photodynamic diagnosis using 5-aminolevulinic acid.
Case Presentation
The first case involved a 57-year-old man with a 9-mm papillary tumor on the right side of the bladder neck. The second case involved a 75-year-old man with a history of left renal pelvic cancer who presented with a 2-mm papillary tumor in the bladder trigone. In both cases, the tumors fluoresced red under blue light during photodynamic diagnosis-assisted transurethral resection. Histopathological examination revealed ectopic prostate tissue in both cases. No recurrence was observed, and a slight decrease in serum prostate-specific antigen levels was noted at 12 and 5 months of follow-up in cases 1 and 2, respectively.
Conclusion
Ectopic prostate tissue in the bladder is a rare benign tumor that may exhibit false-positive fluorescence during photodynamic diagnosis, making it difficult to distinguish from bladder cancer even with this technique.
{"title":"Ectopic Prostate Tissue in the Bladder Exhibiting Fluorescence on Photodynamic Diagnosis: A Report of Two Cases","authors":"Michinori Shimizu, Jun Kamei, Daisuke Yamada, Satoru Taguchi, Daiji Watanabe, Atsushi Kondo, Masako Ikemura, Jimpei Miyakawa, Sigenori Kakutani, Aya Niimi, Yuta Yamada, Haruki Kume","doi":"10.1002/iju5.70126","DOIUrl":"https://doi.org/10.1002/iju5.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We report two cases of ectopic prostate tissue exhibiting fluorescence during photodynamic diagnosis using 5-aminolevulinic acid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>The first case involved a 57-year-old man with a 9-mm papillary tumor on the right side of the bladder neck. The second case involved a 75-year-old man with a history of left renal pelvic cancer who presented with a 2-mm papillary tumor in the bladder trigone. In both cases, the tumors fluoresced red under blue light during photodynamic diagnosis-assisted transurethral resection. Histopathological examination revealed ectopic prostate tissue in both cases. No recurrence was observed, and a slight decrease in serum prostate-specific antigen levels was noted at 12 and 5 months of follow-up in cases 1 and 2, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ectopic prostate tissue in the bladder is a rare benign tumor that may exhibit false-positive fluorescence during photodynamic diagnosis, making it difficult to distinguish from bladder cancer even with this technique.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case of adult vesicoureteral reflux (VUR), in which video-urodynamics was employed to facilitate both diagnosis and treatment planning.
Case Presentation
A 65-year-old man with a history of recurrent pyelonephritis and progressive renal dysfunction was referred to our hospital with a dilated right ureter observed on computed tomography. Video-urodynamics demonstrated generally preserved bladder storage and voiding functions, accompanied by bilateral VUR. Given the severity of the VUR despite normal bladder capacity and compliance, primary VUR was suspected. Anti-reflux surgery using the Cohen method was performed, resulting in complete resolution of the bilateral reflux.
Conclusion
Video-urodynamics are particularly valuable for diagnosing VUR and guiding optimal management in older adults, who may present with underlying urinary dysfunction.
{"title":"Adult Vesicoureteral Reflux Diagnosed and Managed Using Video-Urodynamics","authors":"Sakiko Teramoto, Shingo Nagai, Kazumasa Murase, Hiroki Hoshino, Yasuaki Kubota","doi":"10.1002/iju5.70121","DOIUrl":"10.1002/iju5.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We present a case of adult vesicoureteral reflux (VUR), in which video-urodynamics was employed to facilitate both diagnosis and treatment planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 65-year-old man with a history of recurrent pyelonephritis and progressive renal dysfunction was referred to our hospital with a dilated right ureter observed on computed tomography. Video-urodynamics demonstrated generally preserved bladder storage and voiding functions, accompanied by bilateral VUR. Given the severity of the VUR despite normal bladder capacity and compliance, primary VUR was suspected. Anti-reflux surgery using the Cohen method was performed, resulting in complete resolution of the bilateral reflux.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Video-urodynamics are particularly valuable for diagnosing VUR and guiding optimal management in older adults, who may present with underlying urinary dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tumor lysis syndrome (TLS) arises from the rapid breakdown of tumor cells during oncological treatment. Although TLS is rarely observed in solid tumors, few studies have documented instances of TLS associated with pembrolizumab. This report presents a case involving pembrolizumab-induced TLS.
Case Presentation
A 76-year-old male patient with advanced renal pelvis cancer (T3N2M1) was treated with pembrolizumab as second-line therapy. Four days after the initiation of therapy, the patient developed TLS. Despite intensive therapeutic interventions, he succumbed to the condition on the 10th day.
Conclusion
This case highlights a fatal TLS episode after pembrolizumab. Given its poor prognosis, blood monitoring and prophylaxis are warranted in intermediate-risk patients, particularly when multiple non-renal risk factors are present.
{"title":"Fatal Tumor Lysis Syndrome Induced by Pembrolizumab in Advanced Renal Pelvis Cancer","authors":"Takashi Asakura, Toshiaki Shinojima, Shinnosuke Hiruta, Hirotaka Asakura","doi":"10.1002/iju5.70097","DOIUrl":"10.1002/iju5.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Tumor lysis syndrome (TLS) arises from the rapid breakdown of tumor cells during oncological treatment. Although TLS is rarely observed in solid tumors, few studies have documented instances of TLS associated with pembrolizumab. This report presents a case involving pembrolizumab-induced TLS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 76-year-old male patient with advanced renal pelvis cancer (T3N2M1) was treated with pembrolizumab as second-line therapy. Four days after the initiation of therapy, the patient developed TLS. Despite intensive therapeutic interventions, he succumbed to the condition on the 10th day.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights a fatal TLS episode after pembrolizumab. Given its poor prognosis, blood monitoring and prophylaxis are warranted in intermediate-risk patients, particularly when multiple non-renal risk factors are present.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cellular angiofibroma is a rare, benign mesenchymal tumor that affects middle-aged adults. It most frequently arises in the vulvovaginal or inguinoscrotal region. It is characterized by a slow clinical progression with no known potential for recurrence or metastasis.
Case Presentation
In this case, we report a 78-year-old man presenting with obstructive lower urinary tract symptoms. Transrectal ultrasonography revealed a prostate volume of approximately 150 cc. The patient underwent an open retropubic prostatectomy (Hryntschak) to relieve symptoms. Histopathological evaluation revealed a proliferation of bland, spindle-shaped cells within a collagenous stroma interspersed with dilated, thick-walled blood vessels. Immunohistochemical analysis showed positivity for smooth muscle actin, desmin, and CD34 and negative staining for S100. Fluorescence in situ hybridization revealed a deletion at chromosome 13q14. These morphological and molecular findings support the diagnosis of cellular angiofibroma.
Conclusion
To our knowledge, this is a rare case of cellular angiofibroma originating in the prostate.
{"title":"Cellular Angiofibroma of the Prostate","authors":"Fien Janssens, Celia Perdaens, Isabelle Vanden Bempt, Raf Sciot, Hans Vandendriessche","doi":"10.1002/iju5.70113","DOIUrl":"10.1002/iju5.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cellular angiofibroma is a rare, benign mesenchymal tumor that affects middle-aged adults. It most frequently arises in the vulvovaginal or inguinoscrotal region. It is characterized by a slow clinical progression with no known potential for recurrence or metastasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>In this case, we report a 78-year-old man presenting with obstructive lower urinary tract symptoms. Transrectal ultrasonography revealed a prostate volume of approximately 150 cc. The patient underwent an open retropubic prostatectomy (Hryntschak) to relieve symptoms. Histopathological evaluation revealed a proliferation of bland, spindle-shaped cells within a collagenous stroma interspersed with dilated, thick-walled blood vessels. Immunohistochemical analysis showed positivity for smooth muscle actin, desmin, and CD34 and negative staining for S100. Fluorescence in situ hybridization revealed a deletion at chromosome 13q14. These morphological and molecular findings support the diagnosis of cellular angiofibroma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To our knowledge, this is a rare case of cellular angiofibroma originating in the prostate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fumihiro Ito, Koki Kobayashi, Gaku Hayashi, Shunsuke Kamijo, Takashi Fujita
Introduction
Enfortumab vedotin (EV), a Nectin-4–targeted antibody–drug conjugate, is active in previously treated urothelial carcinoma. Cavitation of pulmonary metastases is classically linked to squamous histology or anti-angiogenic/cytotoxic regimens; rarely reported under EV.
Case Presentation
A 69-year-old woman with upper-tract urothelial carcinoma developed pulmonary and hepatic metastases. During EV, multiple lung nodules rapidly cavitated into thin-walled lesions while liver disease shrank. No infectious symptoms; overall survival was 12 months from EV start.
Discussion
Cavitation likely reflects treatment-related necrosis once infection and EV-related pneumonitis are excluded. Diameter-based criteria can misjudge response when solid nodules cavitate; short-interval re-imaging is advisable. Pulmonary response may not ensure systemic control.
Conclusion
Recognizing EV-associated cavitation as a response pattern may prevent premature discontinuation of effective therapy and unnecessary antibiotics.
{"title":"Cavitation of Pulmonary Metastases During Enfortumab Vedotin for Metastatic Ureteral Urothelial Carcinoma","authors":"Fumihiro Ito, Koki Kobayashi, Gaku Hayashi, Shunsuke Kamijo, Takashi Fujita","doi":"10.1002/iju5.70120","DOIUrl":"10.1002/iju5.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Enfortumab vedotin (EV), a Nectin-4–targeted antibody–drug conjugate, is active in previously treated urothelial carcinoma. Cavitation of pulmonary metastases is classically linked to squamous histology or anti-angiogenic/cytotoxic regimens; rarely reported under EV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 69-year-old woman with upper-tract urothelial carcinoma developed pulmonary and hepatic metastases. During EV, multiple lung nodules rapidly cavitated into thin-walled lesions while liver disease shrank. No infectious symptoms; overall survival was 12 months from EV start.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Cavitation likely reflects treatment-related necrosis once infection and EV-related pneumonitis are excluded. Diameter-based criteria can misjudge response when solid nodules cavitate; short-interval re-imaging is advisable. Pulmonary response may not ensure systemic control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recognizing EV-associated cavitation as a response pattern may prevent premature discontinuation of effective therapy and unnecessary antibiotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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