Renal artery stenosis (RAS) reduces renal blood flow and activates the renin-angiotensin-aldosterone (RAA) system, resulting in renovascular hypertension (RVH).
Case Presentation
We report a case of a 49-year-old woman with RVH due to bilateral renal artery stenosis, predominantly on the right. Despite pharmacological treatment, blood pressure remained poorly controlled; leading to severe heart failure that required dialysis. Percutaneous renal angioplasty was considered but deemed technically difficult. The patient underwent a successful laparoscopic right nephrectomy, leading to improved blood pressure control and reduced need for antihypertensive medications.
{"title":"A Case of Drug-Resistant Renovascular Hypertension due to Renal Artery Stenosis Successfully Treated by Nephrectomy of the Affected Kidney","authors":"Moeto Shimoda, Shinji Otake, Masashi Imano, Tetsuya Aoki, Jurii Karibe, Yosuke Shibata, Masahiro Inoue, Akiko Nagatomo, Mayumi Yakeishi, Kazuki Kobayashi","doi":"10.1002/iju5.70084","DOIUrl":"https://doi.org/10.1002/iju5.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Renal artery stenosis (RAS) reduces renal blood flow and activates the renin-angiotensin-aldosterone (RAA) system, resulting in renovascular hypertension (RVH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We report a case of a 49-year-old woman with RVH due to bilateral renal artery stenosis, predominantly on the right. Despite pharmacological treatment, blood pressure remained poorly controlled; leading to severe heart failure that required dialysis. Percutaneous renal angioplasty was considered but deemed technically difficult. The patient underwent a successful laparoscopic right nephrectomy, leading to improved blood pressure control and reduced need for antihypertensive medications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"525-528"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935438","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 in which triplet therapy demonstrated efficacy for multiple metastatic recurrences following radical prostatectomy.
Case Presentation
A 70-year-old man with relapsed metastatic castration-sensitive prostate cancer (mCSPC) following radical prostatectomy (Gleason 9, pT3bN1M0) presented with rectal involvement and extensive lymph node and bone metastases, as evidenced by a markedly elevated PSA level of 59.57 ng/mL. He received triplet therapy consisting of androgen deprivation therapy (ADT) with degarelix, darolutamide (1200 mg/day), and docetaxel (70 mg/m2). This combination led to a complete PSA response, dropping below the detection limit (< 0.006 ng/mL). At 24 months post-treatment, the patient remained in a stable condition without any signs of PSA recurrence.
Conclusion
This case highlights the potential of triplet therapy as a highly effective treatment strategy for high-risk mCSPC patients who experience recurrence after initial local therapy.
{"title":"A Case of Triplet Therapy Showing Remarkable Efficacy for Multiorgan Metastatic Recurrence After Radical Prostatectomy in Prostate Cancer","authors":"Shuhei Kusano, Shohei Tobu, Minika Yukimoto, Yukako Yamaguchi, Yuka Kakinoki, Akihiro Maeda, Maki Kawasaki, Hiroaki Kakinoki, Mitsuru Noguchi","doi":"10.1002/iju5.70082","DOIUrl":"https://doi.org/10.1002/iju5.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We report a case in which triplet therapy demonstrated efficacy for multiple metastatic recurrences following radical prostatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 70-year-old man with relapsed metastatic castration-sensitive prostate cancer (mCSPC) following radical prostatectomy (Gleason 9, pT3bN1M0) presented with rectal involvement and extensive lymph node and bone metastases, as evidenced by a markedly elevated PSA level of 59.57 ng/mL. He received triplet therapy consisting of androgen deprivation therapy (ADT) with degarelix, darolutamide (1200 mg/day), and docetaxel (70 mg/m<sup>2</sup>). This combination led to a complete PSA response, dropping below the detection limit (< 0.006 ng/mL). At 24 months post-treatment, the patient remained in a stable condition without any signs of PSA recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the potential of triplet therapy as a highly effective treatment strategy for high-risk mCSPC patients who experience recurrence after initial local therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"517-520"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935468","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}
Apalutamide, an androgen receptor antagonist for prostate cancer, rarely causes drug-induced hypersensitivity syndrome (DIHS).
Case Presentation
A 75-year-old male with prostate cancer and multiple bone metastases developed grade 2 rash and grade 3 liver dysfunction according to the Common Terminology Criteria for Adverse Events (CTCAE) 3 weeks after starting apalutamide with a GnRH antagonist, followed by a 3-day fever. Ten days later, symptoms worsened to grade 3 rash and grade 4 liver dysfunction. He met five diagnostic criteria for DIHS. Hormonal therapy was discontinued, and prednisolone plus intravenous immunoglobulin (IVIG) was administered. Fatigue resolved within 2 days, rash by day 6, and liver function improved to grade 2 by day 10. The patient is currently on abiraterone and a GnRH antagonist without adverse events.
Conclusion
This report highlights the importance of caution and regular blood tests when using apalutamide owing to the risk of DIHS.
{"title":"A Case of Drug-Induced Hypersensitivity Syndrome Caused by Apalutamide","authors":"Yuki Tanaka, Yui Fujimura, Koya Morishita, Yuta Kashiwagi, Satoshi Katsuno, Tatsuya Nagai","doi":"10.1002/iju5.70085","DOIUrl":"https://doi.org/10.1002/iju5.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Apalutamide, an androgen receptor antagonist for prostate cancer, rarely causes drug-induced hypersensitivity syndrome (DIHS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 75-year-old male with prostate cancer and multiple bone metastases developed grade 2 rash and grade 3 liver dysfunction according to the Common Terminology Criteria for Adverse Events (CTCAE) 3 weeks after starting apalutamide with a GnRH antagonist, followed by a 3-day fever. Ten days later, symptoms worsened to grade 3 rash and grade 4 liver dysfunction. He met five diagnostic criteria for DIHS. Hormonal therapy was discontinued, and prednisolone plus intravenous immunoglobulin (IVIG) was administered. Fatigue resolved within 2 days, rash by day 6, and liver function improved to grade 2 by day 10. The patient is currently on abiraterone and a GnRH antagonist without adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This report highlights the importance of caution and regular blood tests when using apalutamide owing to the risk of DIHS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"529-532"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935489","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}
Lower urinary tract symptoms are common in patients with inflammatory bowel disease; however, the association between ulcerative colitis and chronic prostatitis remains underrecognized.
Case Presentation
A 38-year-old man presented with frequent and painful urination unresponsive to the standard treatment of chronic prostatitis. He was subsequently diagnosed with ulcerative colitis based on persistent hematochezia and colonoscopy findings. Treatment with mesalamine and corticosteroids for ulcerative colitis led to improvements in both gastrointestinal and urinary symptoms.
Conclusion
This case suggests a possible link between chronic prostatitis and ulcerative colitis, indicating that prostatitis might represent an extraintestinal manifestation. This association might be explained by shared inflammatory pathways and the prostate's anatomical proximity to the rectum. Clinicians should consider inflammatory bowel disease in male patients exhibiting refractory chronic prostatitis and concurrent gastrointestinal symptoms.
{"title":"Case Report: Chronic Prostatitis as an Extraintestinal Manifestation of Ulcerative Colitis","authors":"Naoya Sugihara, Ryuta Watanabe, Noriyoshi Miura, Takashi Saika, Katsuhisa Ohashi","doi":"10.1002/iju5.70083","DOIUrl":"https://doi.org/10.1002/iju5.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lower urinary tract symptoms are common in patients with inflammatory bowel disease; however, the association between ulcerative colitis and chronic prostatitis remains underrecognized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 38-year-old man presented with frequent and painful urination unresponsive to the standard treatment of chronic prostatitis. He was subsequently diagnosed with ulcerative colitis based on persistent hematochezia and colonoscopy findings. Treatment with mesalamine and corticosteroids for ulcerative colitis led to improvements in both gastrointestinal and urinary symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case suggests a possible link between chronic prostatitis and ulcerative colitis, indicating that prostatitis might represent an extraintestinal manifestation. This association might be explained by shared inflammatory pathways and the prostate's anatomical proximity to the rectum. Clinicians should consider inflammatory bowel disease in male patients exhibiting refractory chronic prostatitis and concurrent gastrointestinal symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"521-524"},"PeriodicalIF":0.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935488","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}
Pheochromocytoma is a rare catecholamine-producing tumor with metastatic potential. Recurrence after more than 40 years is exceptionally rare.
Case Presentation
During evaluation for ischemic colitis, a 71-year-old woman was found to have multiple bone metastases, possibly linked to catecholamine excess. She had undergone left adrenalectomy for pheochromocytoma at age 25. Bone biopsy confirmed metastatic pheochromocytoma, and immunohistochemical findings were similar to the original tumor. Urinary metanephrine and normetanephrine were markedly elevated. She declined systemic therapy and has remained clinically stable for 6 years, with her blood pressure well controlled on doxazosin.
Conclusion
This case illustrates a recurrence 46 years after adrenalectomy, potentially representing the longest reported interval to date. It highlights the silent and indolent nature of some metastatic pheochromocytomas and underscores the necessity of lifelong follow-up. The patient's stable course also emphasizes the clinical heterogeneity of metastatic pheochromocytoma and supports the need for individualized follow-up and treatment strategies.
{"title":"Late-Onset Bone Metastasis 46 Years After Initial Surgery for Pheochromocytoma: A Case Report","authors":"Fumio Ishizaki, Kaede Hiruma, Yusuke Tani, Hideaki Sugino, Tatsuro Sanami, Tsutomu Anraku, Masahiro Ikeda, Masayuki Tasaki, Kazuhide Saito, Yoshihiko Tomita","doi":"10.1002/iju5.70086","DOIUrl":"https://doi.org/10.1002/iju5.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pheochromocytoma is a rare catecholamine-producing tumor with metastatic potential. Recurrence after more than 40 years is exceptionally rare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>During evaluation for ischemic colitis, a 71-year-old woman was found to have multiple bone metastases, possibly linked to catecholamine excess. She had undergone left adrenalectomy for pheochromocytoma at age 25. Bone biopsy confirmed metastatic pheochromocytoma, and immunohistochemical findings were similar to the original tumor. Urinary metanephrine and normetanephrine were markedly elevated. She declined systemic therapy and has remained clinically stable for 6 years, with her blood pressure well controlled on doxazosin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case illustrates a recurrence 46 years after adrenalectomy, potentially representing the longest reported interval to date. It highlights the silent and indolent nature of some metastatic pheochromocytomas and underscores the necessity of lifelong follow-up. The patient's stable course also emphasizes the clinical heterogeneity of metastatic pheochromocytoma and supports the need for individualized follow-up and treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"533-538"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935484","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}
Kentaro Arinami, Gen Kawaguchi, Kozue Ito, Yurie Takizawa, Go Hasegawa, Yohei Ikeda, Noboru Hara, Tsutomu Nishiyama
Introduction
We report a case of nonseminoma germ cell tumor, in which solitary bone metastasis was detected by magnetic resonance imaging (MRI) after systemic chemotherapy, and resolution was achieved with stereotactic radiotherapy.
Case Presentation
A 42-year-old man was diagnosed with right-sided testicular cancer, T1N1M0, and right high orchiectomy was performed. Pathology revealed a mixed germ cell tumor. He received four 3-week courses of chemotherapy (BEP). Although computed tomography showed no new metastases, whole-body MRI revealed a solitary bone metastasis to the left sacrum, and stereotactic radiotherapy of 36.8 Gy/8f was administered to the same area. After radiotherapy, the accumulation in that area disappeared on MRI.
Conclusion
As evidence accumulates, it is likely that whole-body MRI will become a useful observational method for staging and monitoring patients with germ cell tumors. Stereotactic radiotherapy may be used as consolidation therapy for patients with residual masses after systemic therapy.
{"title":"A Case of Complete Remission Achieved Through Stereotactic Radiotherapy for Isolated Bone Metastasis Following Four Courses of Bleomycin, Etoposide, and Cisplatin Chemotherapy for Testicular Cancer","authors":"Kentaro Arinami, Gen Kawaguchi, Kozue Ito, Yurie Takizawa, Go Hasegawa, Yohei Ikeda, Noboru Hara, Tsutomu Nishiyama","doi":"10.1002/iju5.70080","DOIUrl":"https://doi.org/10.1002/iju5.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We report a case of nonseminoma germ cell tumor, in which solitary bone metastasis was detected by magnetic resonance imaging (MRI) after systemic chemotherapy, and resolution was achieved with stereotactic radiotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 42-year-old man was diagnosed with right-sided testicular cancer, T1N1M0, and right high orchiectomy was performed. Pathology revealed a mixed germ cell tumor. He received four 3-week courses of chemotherapy (BEP). Although computed tomography showed no new metastases, whole-body MRI revealed a solitary bone metastasis to the left sacrum, and stereotactic radiotherapy of 36.8 Gy/8f was administered to the same area. After radiotherapy, the accumulation in that area disappeared on MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As evidence accumulates, it is likely that whole-body MRI will become a useful observational method for staging and monitoring patients with germ cell tumors. Stereotactic radiotherapy may be used as consolidation therapy for patients with residual masses after systemic therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"508-512"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935483","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}
Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.
Case Presentation
A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra-abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high-positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0).
Conclusion
RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.
{"title":"Robot-Assisted Radical Nephrectomy for Renal Cell Carcinoma in a Right Intrathoracic Kidney Following Congenital Diaphragmatic Hernia Repair: A Case Report","authors":"Yutaro Sasaki, Saki Kobayashi, Fumiya Kadoriku, Kei Daizumoto, Ryotaro Tomida, Yoshito Kusuhara, Tomoya Fukawa, Kunihisa Yamaguchi, Yasuyo Yamamoto, Junya Furukawa","doi":"10.1002/iju5.70081","DOIUrl":"https://doi.org/10.1002/iju5.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Congenital diaphragmatic hernia (CDH) can result in intrathoracic displacement of the kidney, presenting anatomical challenges for robot-assisted radical nephrectomy (RARN). Reports of RARN in such cases are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 56-year-old man with a history of right-sided CDH repair was referred for evaluation of an incidentally discovered right renal mass. Computed tomography revealed two right renal tumors (cT1aN0M0) and cranial displacement of the kidney into the thoracic cavity. Given the possibility of intra-abdominal adhesions and the retrohepatic location of the kidney, retroperitoneal RARN was selected. An intercostal trocar was used to access the high-positioned kidney. The renal vessels were safely managed using a Vas Guide, and no complications occurred. Pathology confirmed clear cell renal cell carcinoma (pT1aN0M0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RARN can be safely performed in patients with prior CDH repair and intrathoracic renal displacement. Preoperative planning and alternative trocar strategies, such as intercostal placement, are essential for successful outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"513-516"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935086","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}
The diagnosis of systemic transthyretin amyloidosis based on prostate biopsy is very rare, and we report this case with a literature review.
Case Presentation
A 73-year-old male patient was referred to our department due to an increased serum prostate-specific antigen level at 10.4 ng/mL while receiving benign prostatic hypertrophy treatment. Prostate needle biopsy was performed, and the pathology revealed transthyretin amyloid deposits in the prostate tissue without adenocarcinoma. Subsequent 99mTc pyrophosphate scintigraphy confirmed the accumulation in the myocardium. The patient was diagnosed with cardiac transthyretin amyloidosis.
Conclusion
Amyloidosis is a systemic disease where amyloid is deposited in multiple organs, causing various dysfunctions. Considering both our case and previous reports, prostatic amyloidosis may frequently be associated with systemic involvement. The treatments including oligonucleotide therapeutic agents and transthyretin-stabilizing drugs will be more effective with early diagnosis and early treatment, and various symptoms suspicious of systemic amyloidosis should not be missed.
{"title":"Systemic Transthyretin Amyloidosis Incidentally Diagnosed With Prostate Biopsy: A Case Report","authors":"Michihide Nakamura, Shinnosuke Kuroda, Takashi Kawahara, Erika Muraoka, Genya Iwamoto, Kota Shimokihara, Takeaki Noguchi, Masanobu Yamazaki, Akihito Hashizume, Daiji Takamoto, Rie Horii, Satoshi Fujii, Miki Tanoshima, Junichi Teranishi, Hiroji Uemura","doi":"10.1002/iju5.70079","DOIUrl":"https://doi.org/10.1002/iju5.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The diagnosis of systemic transthyretin amyloidosis based on prostate biopsy is very rare, and we report this case with a literature review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 73-year-old male patient was referred to our department due to an increased serum prostate-specific antigen level at 10.4 ng/mL while receiving benign prostatic hypertrophy treatment. Prostate needle biopsy was performed, and the pathology revealed transthyretin amyloid deposits in the prostate tissue without adenocarcinoma. Subsequent 99mTc pyrophosphate scintigraphy confirmed the accumulation in the myocardium. The patient was diagnosed with cardiac transthyretin amyloidosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Amyloidosis is a systemic disease where amyloid is deposited in multiple organs, causing various dysfunctions. Considering both our case and previous reports, prostatic amyloidosis may frequently be associated with systemic involvement. The treatments including oligonucleotide therapeutic agents and transthyretin-stabilizing drugs will be more effective with early diagnosis and early treatment, and various symptoms suspicious of systemic amyloidosis should not be missed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"503-507"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935011","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 bladder eversion through a vesicovaginal fistula (VVF) in an elderly patient with severe pelvic organ prolapse (POP).
Case Presentation
A 90-year-old woman presented with a sensation of prolapse and urinary leakage. She was diagnosed with complete uterine prolapse and bladder mucosal ectropion through a VVF, with renal dysfunction due to bilateral hydronephrosis. A one-stage minimally invasive surgical repair was performed. The VVF was then closed in two layers and reinforced with a Martius flap. Colpocleisis was performed without the addition of transvaginal hysterectomy. At 18 months after surgery, the patient remained free of POP and urinary incontinence.
Conclusion
In elderly patients, VVF can develop in advanced POP. Minimally invasive treatment is desirable, and early intervention for POP may help prevent this complication.
{"title":"Bladder Eversion Through a Vesicovaginal Fistula in a Patient With Complete Uterine Prolapse","authors":"Ryoken Tsunekawa, Naoki Wada, Haruka Takagi, Tsubasa Hatakeyama, Masaya Nagabuchi, Shun Morishita, Hidetoshi Ichikawa","doi":"10.1002/iju5.70064","DOIUrl":"https://doi.org/10.1002/iju5.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We report a case of bladder eversion through a vesicovaginal fistula (VVF) in an elderly patient with severe pelvic organ prolapse (POP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 90-year-old woman presented with a sensation of prolapse and urinary leakage. She was diagnosed with complete uterine prolapse and bladder mucosal ectropion through a VVF, with renal dysfunction due to bilateral hydronephrosis. A one-stage minimally invasive surgical repair was performed. The VVF was then closed in two layers and reinforced with a Martius flap. Colpocleisis was performed without the addition of transvaginal hysterectomy. At 18 months after surgery, the patient remained free of POP and urinary incontinence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In elderly patients, VVF can develop in advanced POP. Minimally invasive treatment is desirable, and early intervention for POP may help prevent this complication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"458-461"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935425","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}
Leydig cell tumors (LCTs), constituting 1%–3% of testicular tumors, are mostly benign, but malignant cases present treatment challenges. We report a malignant LCT case with a notable response to mitotane.
Case Presentation
A 43-year-old male presented with a right testicular induration and was diagnosed with a Leydig cell tumor following orchiectomy. BEP chemotherapy was initiated for the liver metastases, but after four cycles, new lymph node and bone lesions appeared. Mitotane was started, which markedly reduced liver and nodal metastases. However, due to fatigue, anorexia, and nipple discomfort, mitotane was discontinued. The disease progressed, and the patient died 4 years post-diagnosis and 14 months after starting mitotane.
Conclusion
Mitotane shows promise in treating malignant LCTs, but careful management of adverse effects is necessary.
{"title":"Mitotane Treatment for Malignant Leydig Cell Tumor: A Case Report","authors":"Daiki Katsura, Mototsugu Muramaki, Takashi Okamoto, Masaya Yamamoto, Mizuki Yutaka, Shohei Morita, Takuya Fujimoto, Yuji Yamada","doi":"10.1002/iju5.70078","DOIUrl":"https://doi.org/10.1002/iju5.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Leydig cell tumors (LCTs), constituting 1%–3% of testicular tumors, are mostly benign, but malignant cases present treatment challenges. We report a malignant LCT case with a notable response to mitotane.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 43-year-old male presented with a right testicular induration and was diagnosed with a Leydig cell tumor following orchiectomy. BEP chemotherapy was initiated for the liver metastases, but after four cycles, new lymph node and bone lesions appeared. Mitotane was started, which markedly reduced liver and nodal metastases. However, due to fatigue, anorexia, and nipple discomfort, mitotane was discontinued. The disease progressed, and the patient died 4 years post-diagnosis and 14 months after starting mitotane.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mitotane shows promise in treating malignant LCTs, but careful management of adverse effects is necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 5","pages":"498-502"},"PeriodicalIF":0.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/iju5.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935399","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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