We treated 23 patients with metastatic transitional cell carcinoma with methotrexate, vinblastine, doxorubicin and cisplatinum(M-VAC) chemotherapy from March 1989 to June 1994. The mean age of the patients was 60.0 years old and ranged from 49 years old to 75 years old. They were 18 in male and 5 in female. Complete clinical remission was observed in 5 of 23 patients(21.7%) and 6 patients(26.1%) had a partial remission. An overall objective response rate was 47.8%. The median survival was 12.4 months in all 23 patients, and 20.6 months in 5 complete responder, 8.9 months in non-responder. The duration of survival of the patients with complete remission was prolonged significantly compared to the patients with progression. The progression of disease was in 3 of 4 patients with metastatic bone lesion in effect of M-VAC chemotherapy, but complete clinical remission was 1 of 4 patients. After treatment, complete clinical remission was observed in 5 of 18 patients with metastatic lymph node and 5 patients had a partial remission. The progression of disease was in 1 patient with lung and liver metastatic lesions. Toxicity included moderate to severe myelosuppression that resulted in sepsis in 3 patients and mild to moderately anorexia, vomiting, alopecia and renal dysfunction. It was suggested that M-VAC chemotherapy may be effective as treatment for patients with metastatic transitional cell carcinoma.
Aged ; Alopecia ; Anorexia ; Carcinoma, Transitional Cell* ; Doxorubicin* ; Drug Therapy* ; Female ; Humans ; Liver ; Lung ; Lymph Nodes ; Male ; Methotrexate ; Middle Aged ; Sepsis ; Urinary Bladder ; Vinblastine* ; Vomiting

Lymphangiomas are benign tumors of congenital origin, occurring mostly in children. They are found rarely in the scrotum. This rare clinical entity should be included in the differential diagnosis of cystic lesions of the external male genitalia, especially hydrocele in children. We present a case of 3 year old male with the scrotal lymphangioma arising from the perineum that have not any connection with the testis or spermatic cord.
Child ; Child, Preschool ; Diagnosis, Differential ; Genitalia, Male ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Male ; Perineum ; Scrotum ; Spermatic Cord ; Testis