Pembrolizumab is the standard therapy for urothelial carcinoma treatment; however, adverse events have been noted. Here, we report a rare case of vision loss as an immune-related adverse event of pembrolizumab therapy in a patient with metastatic renal pelvic cancer.
Case presentation
A 69-year-old man treated with pembrolizumab for lung and lymph node metastases of renal pelvic cancer experienced significant vision loss in both eyes after 11 treatment cycles. Without magnetic resonance imaging confirmation owing to an MRI-unsafe pacemaker, his clinical features suggested immune checkpoint inhibitor-associated optic neuritis. Pembrolizumab was discontinued, and the patient received steroid pulse and immunoglobulin therapy. His vision in the right eye improved, but that in the left eye remained unchanged. He maintained a partial response for 36 months despite pembrolizumab discontinuation.
Conclusion
Despite its rarity, vision loss is a potential irAE in patients treated with ICIs, including pembrolizumab.
{"title":"A case of severe visual loss related to treatment with pembrolizumab for metastatic renal pelvic cancer","authors":"Naoki Inoue, Mihoko Iitzuka, Hiroki Tanaka, Yudai Ishikawa, Naoko Kawamura, Tetsuo Okuno","doi":"10.1002/iju5.12784","DOIUrl":"10.1002/iju5.12784","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pembrolizumab is the standard therapy for urothelial carcinoma treatment; however, adverse events have been noted. Here, we report a rare case of vision loss as an immune-related adverse event of pembrolizumab therapy in a patient with metastatic renal pelvic cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 69-year-old man treated with pembrolizumab for lung and lymph node metastases of renal pelvic cancer experienced significant vision loss in both eyes after 11 treatment cycles. Without magnetic resonance imaging confirmation owing to an MRI-unsafe pacemaker, his clinical features suggested immune checkpoint inhibitor-associated optic neuritis. Pembrolizumab was discontinued, and the patient received steroid pulse and immunoglobulin therapy. His vision in the right eye improved, but that in the left eye remained unchanged. He maintained a partial response for 36 months despite pembrolizumab discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite its rarity, vision loss is a potential irAE in patients treated with ICIs, including pembrolizumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"484-486"},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577286","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}
Horseshoe kidney is characterized by midline fusion of the lower poles of both kidneys. We report a case where robot-assisted pyeloplasty was performed for hydronephrosis complicating horseshoe kidney.
Case presentation
A 31-year-old man repeatedly developed fever since childhood. He visited a local clinic for fever and left back pain, where he was diagnosed and treated for acute pyelonephritis. Abdominal computed tomography led to a diagnosis of horseshoe kidney and associated left ureteropelvic junction obstruction. He was referred to our hospital for pyeloplasty because of persistent left back pain. Robot-assisted left pyeloplasty was performed using the Anderson–Hynes technique with four ports because crossing vessels were discovered intraoperatively. Isthmusectomy was not performed. The postoperative course was favorable. Computed tomography performed approximately 2 years post-surgery showed improvement in hydronephrosis. No left back pain was reported.
Conclusion
Our case experience suggests the utility of robot-assisted pyeloplasty for patients with horseshoe kidney.
{"title":"Robot-assisted pyeloplasty for ureteropelvic junction obstruction complicating horseshoe kidney","authors":"Toshinori Nishikimi, Tomoyoshi Ohashi, Hiroshi Yamada, Hiroko Morikami, Yuriko Nagasaka, Hideki Mizuno","doi":"10.1002/iju5.12774","DOIUrl":"10.1002/iju5.12774","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Horseshoe kidney is characterized by midline fusion of the lower poles of both kidneys. We report a case where robot-assisted pyeloplasty was performed for hydronephrosis complicating horseshoe kidney.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 31-year-old man repeatedly developed fever since childhood. He visited a local clinic for fever and left back pain, where he was diagnosed and treated for acute pyelonephritis. Abdominal computed tomography led to a diagnosis of horseshoe kidney and associated left ureteropelvic junction obstruction. He was referred to our hospital for pyeloplasty because of persistent left back pain. Robot-assisted left pyeloplasty was performed using the Anderson–Hynes technique with four ports because crossing vessels were discovered intraoperatively. Isthmusectomy was not performed. The postoperative course was favorable. Computed tomography performed approximately 2 years post-surgery showed improvement in hydronephrosis. No left back pain was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our case experience suggests the utility of robot-assisted pyeloplasty for patients with horseshoe kidney.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"442-447"},"PeriodicalIF":0.0,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577313","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}
Neuroendocrine prostate cancer is an aggressive histological subtype of prostate cancer with a poor prognosis. Neuroendocrine prostate cancer is traditionally treated with cisplatin-based chemotherapy, similar to that used in treating small-cell lung cancer. However, the therapeutic effectiveness of chemotherapy for neuroendocrine prostate cancer has been limited. This case report describes a response to triplet therapy using darolutamide, androgen deprivation therapy, and docetaxel, which was administered in a patient with mixed neuroendocrine prostate cancer.
Case presentation
A 77-year-old man was newly diagnosed with mixed neuroendocrine prostate cancer. Serum prostate-specific antigen, neuron-specific enolase, and progastrin-releasing peptide levels were 62.2, 40.6, and 60.6 pg/mL, respectively. Multiple lymph node metastases were identified on a computed tomography scan, and bone scintigraphy revealed multiple bone metastases. The clinical stage was determined to be cT3bN1M1b. Ultimately, tumor size and serum markers decreased with triplet therapy.
Conclusion
We demonstrated the first case in which triplet therapy had been effective in the treatment of neuroendocrine prostate cancer.
{"title":"A case of mixed neuroendocrine carcinoma–acinar adenocarcinoma: Utilization of triplet therapy for prostate cancer","authors":"Junichi Ikeda, Hisanori Taniguchi, Hiroki Takayama, Yuki Masuo, Takahiro Nakamoto, Katsunori Uchida, Hidefumi Kinoshita","doi":"10.1002/iju5.12778","DOIUrl":"10.1002/iju5.12778","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neuroendocrine prostate cancer is an aggressive histological subtype of prostate cancer with a poor prognosis. Neuroendocrine prostate cancer is traditionally treated with cisplatin-based chemotherapy, similar to that used in treating small-cell lung cancer. However, the therapeutic effectiveness of chemotherapy for neuroendocrine prostate cancer has been limited. This case report describes a response to triplet therapy using darolutamide, androgen deprivation therapy, and docetaxel, which was administered in a patient with mixed neuroendocrine prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 77-year-old man was newly diagnosed with mixed neuroendocrine prostate cancer. Serum prostate-specific antigen, neuron-specific enolase, and progastrin-releasing peptide levels were 62.2, 40.6, and 60.6 pg/mL, respectively. Multiple lymph node metastases were identified on a computed tomography scan, and bone scintigraphy revealed multiple bone metastases. The clinical stage was determined to be cT3bN1M1b. Ultimately, tumor size and serum markers decreased with triplet therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrated the first case in which triplet therapy had been effective in the treatment of neuroendocrine prostate cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"459-462"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577361","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 report a case of troubleshooting against bleeding from an inferior vena cava injury using a gelatin–thrombin matrix.
Case presentation
A 58-year-old man underwent robot-assisted partial adrenalectomy for a right adrenal adenoma causing subclinical Cushing's syndrome. During the surgery, while dissecting between the adrenal gland and the inferior vena cava, bleeding occurred secondary to an inferior vena cava injury. Despite attempts at hemostasis, applying a human fibrinogen–thrombin patch and suturing were both difficult because of poor vision secondary to the bleeding. Hemostasis was ultimately achieved using a gelatin–thrombin matrix, which was accurately placed on the bleeding point using gauze. Open conversion was hence avoided, allowing the completion of the surgery as planned.
Conclusion
Gelatin–thrombin matrix may be effective for managing relatively small inferior vena cava injuries.
{"title":"A case report of troubleshooting against bleeding from inferior vena cava injury","authors":"Tadamasa Shibuya, Toru Inoue, Tadasuke Ando, Toshitaka Shin","doi":"10.1002/iju5.12782","DOIUrl":"10.1002/iju5.12782","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We report a case of troubleshooting against bleeding from an inferior vena cava injury using a gelatin–thrombin matrix.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 58-year-old man underwent robot-assisted partial adrenalectomy for a right adrenal adenoma causing subclinical Cushing's syndrome. During the surgery, while dissecting between the adrenal gland and the inferior vena cava, bleeding occurred secondary to an inferior vena cava injury. Despite attempts at hemostasis, applying a human fibrinogen–thrombin patch and suturing were both difficult because of poor vision secondary to the bleeding. Hemostasis was ultimately achieved using a gelatin–thrombin matrix, which was accurately placed on the bleeding point using gauze. Open conversion was hence avoided, allowing the completion of the surgery as planned.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gelatin–thrombin matrix may be effective for managing relatively small inferior vena cava injuries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"476-479"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577288","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}
Atazanavir, an anti-HIV drug, induces urinary stone formation. We herein report a case of atazanavir-induced bilateral ureteral stones treated with endourological procedures.
Case presentation
A 47-year-old male patient on atazanavir was admitted with right flank pain. The patient's serum creatinine level was 3.60 mg/dL. Plain computed tomography showed bilateral hydronephrosis. The left upper ureter was obstructed by a 13 × 12 × 9-mm mass, which had very low CT attenuation values. The lower part of the right ureter was obstructed, but no mass was observed. Given his medical history, we suspected bilateral ureteral obstruction caused by drug-induced stones. A ureteral stent was successfully inserted on the right side, but not on the left side. Thereafter, a bilateral ureteroscopic lithotripsy was performed. Infrared spectrophotometry revealed that the stone component was atazanavir.
Conclusion
Understanding the characteristics of these rare drug-induced stones will aid in the proper early diagnosis and treatment.
{"title":"Successful endourological treatment for a rare case of atazanavir-induced urinary stones","authors":"Takehiro Nakamura, Ryoji Takazawa, Yosuke Umino","doi":"10.1002/iju5.12779","DOIUrl":"10.1002/iju5.12779","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atazanavir, an anti-HIV drug, induces urinary stone formation. We herein report a case of atazanavir-induced bilateral ureteral stones treated with endourological procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 47-year-old male patient on atazanavir was admitted with right flank pain. The patient's serum creatinine level was 3.60 mg/dL. Plain computed tomography showed bilateral hydronephrosis. The left upper ureter was obstructed by a 13 × 12 × 9-mm mass, which had very low CT attenuation values. The lower part of the right ureter was obstructed, but no mass was observed. Given his medical history, we suspected bilateral ureteral obstruction caused by drug-induced stones. A ureteral stent was successfully inserted on the right side, but not on the left side. Thereafter, a bilateral ureteroscopic lithotripsy was performed. Infrared spectrophotometry revealed that the stone component was atazanavir.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Understanding the characteristics of these rare drug-induced stones will aid in the proper early diagnosis and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"463-466"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577320","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}
Human T-cell lymphotropic virus type 1 infection can cause HTLV-1-associated myelopathy/tropical spastic paraparesis, characterized by spastic paralysis of both lower limbs. More than 90% of HAM/TSP patients show lower urinary tract symptoms and dysfunction.
Case presentation
A 27-year-old woman diagnosed with HAM/TSP presented with overactive bladder. A urodynamic study revealed detrusor overactivity. OAB remained despite improvements in spastic paralysis of the lower limbs after starting prednisolone. The addition of solifenacin likewise failed to improve OAB or DO in this patient. Switching from solifenacin to vibegron improved OAB symptoms.
Conclusion
In patients for whom OAB and DO do not improve with steroid treatment and solifenacin, treatment with vibegron may improve OAB symptoms.
{"title":"Urodynamic findings and vibegron effects on neurogenic lower urinary tract dysfunction caused by human T-cell leukemia virus type I-associated myelopathy/tropical spastic paraparesis","authors":"Tomoyuki Kumekawa, Hidenori Akaihata, Hiroki Natsuya, Yuki Harigane, Hitomi Imai, Kanako Matsuoka, Ryo Tanji, Junya Hata, Soichiro Ogawa, Yoshiyuki Kojima","doi":"10.1002/iju5.12773","DOIUrl":"10.1002/iju5.12773","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Human T-cell lymphotropic virus type 1 infection can cause HTLV-1-associated myelopathy/tropical spastic paraparesis, characterized by spastic paralysis of both lower limbs. More than 90% of HAM/TSP patients show lower urinary tract symptoms and dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 27-year-old woman diagnosed with HAM/TSP presented with overactive bladder. A urodynamic study revealed detrusor overactivity. OAB remained despite improvements in spastic paralysis of the lower limbs after starting prednisolone. The addition of solifenacin likewise failed to improve OAB or DO in this patient. Switching from solifenacin to vibegron improved OAB symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients for whom OAB and DO do not improve with steroid treatment and solifenacin, treatment with vibegron may improve OAB symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"438-441"},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577380","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}
In Japan, transgender individuals have historically had limited therapeutic options, prompting many to seek gender-affirming surgeries in private or foreign clinics because of restricted access to public hospitals. This has led to challenges for patients undergoing surgery.
Case presentation
A transgender man underwent surgery at a private clinic and experienced recurrent complications. Subsequent examination at another clinic and our hospital revealed limited medical records, complicating our understanding of this case. After a detailed investigation, the urethrocutaneous and urethrovaginal fistulas were identified and addressed by joint urologists and plastic surgeons, resulting in no recurrence after 1 year.
Conclusion
This case underscores the importance of thorough preoperative assessment with a flexible mindset, emphasizing the need to avoid being misled by inadequate records or appearances in complication management of gender-affirming surgery. Collaborative efforts among healthcare professionals based on comprehensive evaluations lead to safer complication treatments.
{"title":"Reconstructive surgery of difficult urethrocutaneous fistula following gender-affirming surgery","authors":"Kazuna Matsuo, Miki Kanbe, Fumitoshi Sakamoto, Yuzuru Kamei, Shusuke Akamatsu","doi":"10.1002/iju5.12762","DOIUrl":"10.1002/iju5.12762","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In Japan, transgender individuals have historically had limited therapeutic options, prompting many to seek gender-affirming surgeries in private or foreign clinics because of restricted access to public hospitals. This has led to challenges for patients undergoing surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A transgender man underwent surgery at a private clinic and experienced recurrent complications. Subsequent examination at another clinic and our hospital revealed limited medical records, complicating our understanding of this case. After a detailed investigation, the urethrocutaneous and urethrovaginal fistulas were identified and addressed by joint urologists and plastic surgeons, resulting in no recurrence after 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case underscores the importance of thorough preoperative assessment with a flexible mindset, emphasizing the need to avoid being misled by inadequate records or appearances in complication management of gender-affirming surgery. Collaborative efforts among healthcare professionals based on comprehensive evaluations lead to safer complication treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"427-430"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577298","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 describe a case in which robot-assisted radical ureterectomy was performed for residual ureteral recurrence in a postoperative patient with renal pelvis cancer.
Case presentation
A 75-year-old woman underwent laparoscopic radical nephroureterectomy for left renal pelvic cancer at another hospital. During follow-up, a papillary tumor was found in the bladder on cystoscopy, and a continuous tumor was found in the residual ureter on computed tomography. Robot-assisted radical ureterectomy was performed in combination with transurethral resection of bladder tumors. To avoid urine spillage, bladder cuff excision was performed using a mechanical suture device while monitoring the interior of the bladder.
Conclusion
We developed a new technique for remnant ureteral resection using cystoscopy and a vascular stapler to prevent urine dissemination and cancer seeding.
{"title":"A new technique for ureteral resection to prevent urine dissemination and cancer seeding","authors":"Hayato Hoshina, Toru Sugihara, Masayuki Kurokawa, Kaori Endo, Ei-ichiro Takaoka, Satoshi Ando, Haruki Kume, Tetsuya Fujimura","doi":"10.1002/iju5.12777","DOIUrl":"10.1002/iju5.12777","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We describe a case in which robot-assisted radical ureterectomy was performed for residual ureteral recurrence in a postoperative patient with renal pelvis cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 75-year-old woman underwent laparoscopic radical nephroureterectomy for left renal pelvic cancer at another hospital. During follow-up, a papillary tumor was found in the bladder on cystoscopy, and a continuous tumor was found in the residual ureter on computed tomography. Robot-assisted radical ureterectomy was performed in combination with transurethral resection of bladder tumors. To avoid urine spillage, bladder cuff excision was performed using a mechanical suture device while monitoring the interior of the bladder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We developed a new technique for remnant ureteral resection using cystoscopy and a vascular stapler to prevent urine dissemination and cancer seeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"454-458"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577290","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}
Distant recurrence of non-muscle invasive bladder cancer is a rare condition that is poorly understood and difficult to detect in follow-up protocols.
Case presentation
A 73-year-old female with a history of T1N0M0 bladder cancer 8 years ago suffered from a left axillary tumor, a left lung tumor, left mediastinal lymph node swelling, and bilateral adrenal gland tumors. Initially, she was diagnosed with metastatic left breast cancer of the left accessory mamma by needle biopsy of an axillary tumor. Subsequent bronchoscopic biopsy of the mediastinal lymph node revealed metastatic urothelial carcinoma, although no recurrence was detected in the urinary tract. She underwent systemic therapy, and all regions shrank without reprogression.
Conclusion
Non-muscle invasive bladder cancer should be managed considering distant metastasis. If the origin of the metastatic lesions is unknown, this disease should be considered as a possible origin, even in the absence of urinary tract recurrence.
{"title":"Distant recurrence of non-muscle invasive bladder cancer 8 years after initial treatment","authors":"Mahoro Watanabe, Naoki Kawamorita, Tetsuro Shiraiwa, Tomonori Sato, Takuma Sato, Yoshihide Kawasaki, Shinichi Yamashita, Akiko Ebata, Satoko Sato, Akihiro Ito","doi":"10.1002/iju5.12775","DOIUrl":"10.1002/iju5.12775","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Distant recurrence of non-muscle invasive bladder cancer is a rare condition that is poorly understood and difficult to detect in follow-up protocols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 73-year-old female with a history of T1N0M0 bladder cancer 8 years ago suffered from a left axillary tumor, a left lung tumor, left mediastinal lymph node swelling, and bilateral adrenal gland tumors. Initially, she was diagnosed with metastatic left breast cancer of the left accessory mamma by needle biopsy of an axillary tumor. Subsequent bronchoscopic biopsy of the mediastinal lymph node revealed metastatic urothelial carcinoma, although no recurrence was detected in the urinary tract. She underwent systemic therapy, and all regions shrank without reprogression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Non-muscle invasive bladder cancer should be managed considering distant metastasis. If the origin of the metastatic lesions is unknown, this disease should be considered as a possible origin, even in the absence of urinary tract recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"448-453"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577294","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}
Hypoglycemia occasionally develops after the resection of pheochromocytoma due to decreased catecholamine secretion. The unique glucose metabolism in dialysis patients may potentially affect postoperative hypoglycemia, although few reports have focused on this issue.
Case presentation
A 47-year-old woman who had chronic renal failure under hemodialysis was diagnosed with right pheochromocytoma and underwent an adrenalectomy. Three hours after surgery, she experienced symptomatic hypoglycemia, which was repeated until postoperative day 3. Continuous glucose infusion was required until postoperative day 8 and asymptomatic hypoglycemia was repeated until postoperative day 11.
Conclusion
In hemodialysis patients, more careful management of hypoglycemia may be required after the resection of pheochromocytoma compared with non-hemodialysis patients.
{"title":"Prolonged hypoglycemia after the resection of pheochromocytoma in a hemodialysis patient","authors":"Yuya Maezawa, Masaki Kobayashi, Masanori Murakami, Ayumi Yamamura, Shotaro Naito, Hajime Tanaka, Soichiro Yoshida, Tetsuya Yamada, Yasuhisa Fujii","doi":"10.1002/iju5.12770","DOIUrl":"10.1002/iju5.12770","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypoglycemia occasionally develops after the resection of pheochromocytoma due to decreased catecholamine secretion. The unique glucose metabolism in dialysis patients may potentially affect postoperative hypoglycemia, although few reports have focused on this issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 47-year-old woman who had chronic renal failure under hemodialysis was diagnosed with right pheochromocytoma and underwent an adrenalectomy. Three hours after surgery, she experienced symptomatic hypoglycemia, which was repeated until postoperative day 3. Continuous glucose infusion was required until postoperative day 8 and asymptomatic hypoglycemia was repeated until postoperative day 11.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In hemodialysis patients, more careful management of hypoglycemia may be required after the resection of pheochromocytoma compared with non-hemodialysis patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"7 6","pages":"431-433"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577295","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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