Clear cell adenocarcinoma of the female urethra is extremely rare. Because the primary urethral carcinomas are rare, standard diagnostic algorism and management has not been established yet. We report a case of clear cell adenocarcinoma of the proximal urethra in a 76-year-old female. She was presented with voiding difficulty for several years after pubovaginal sling operation due to stress urinary incontinence twelve years ago. Before this period, she had managed with medication for detrusor hypocontractility. Recently she complained bloody vaginal discharge, and her vaginal examination revealed palpable mass on the anterior vaginal wall. Pelvic MRI showed a 5×4.5cm sized tumor surrounding the proximal urethra which was mimicking prostate with no lymphadenopathy. Biopsy of the mass confirmed it to be clear cell adenocarcinoma. She underwent anterior pelvic exenteration and ileal conduit with bilateral pelvic lymph node dissection. The patient received adjuvant radiotherapy and chemotherapy as treatment. We should carefully evaluate patients with voiding symptom after anti-incontinence surgery and multimodal treatment should be applied for locally advanced urethral carcinoma.
Adenocarcinoma, Clear Cell* ; Aged ; Biopsy ; Combined Modality Therapy ; Drug Therapy ; Female* ; Gynecological Examination ; Humans ; Lymph Node Excision ; Lymphatic Diseases ; Magnetic Resonance Imaging ; Pelvic Exenteration ; Prostate* ; Radiotherapy, Adjuvant ; Urethra* ; Urinary Diversion ; Urinary Incontinence ; Vaginal Discharge

Anastomosing hemangioma (AH), a rare benign vascular tumor, is a newly recognized variant of capillary hemangioma. In the microscopic examination, this tumor has characteristic feature of the unique anastomosing sinusoidal capillary sized vessels. It can be misdiagnosed as a malignancy such as renal cell carcinoma or angiosarcoma. Herein, we report a case of AH originating in the right kidney of a 43-year-old man, which was initially considered as cystic renal cell carcinoma on computed tomography (CT). The patient underwent laparoscopic radical nephrectomy, but pathologic result was AH of the kidney. There was no evidence of recurrence or metastasis 5 months after the surgery.
Adult ; Capillaries ; Carcinoma, Renal Cell* ; Hemangioma* ; Hemangioma, Capillary ; Hemangiosarcoma ; Humans ; Kidney ; Neoplasm Metastasis ; Nephrectomy ; Recurrence

As extra-mammary Paget's disease is rare and usually diagnosed at early stage when it is highly curable with surgical resection, it is much rarer to see patients with recurrent metastatic disease. Thrombotic thrombocytopenic purpura in patients with metastatic solid cancer is also a rare disease and may result from bone marrow metastasis or bone marrow necrosis. For the latter, the majority of cases are not eligible for systemic chemotherapy for rapid disease progression and poor performance status. Herein, authors report a patient with thrombotic thrombocytopenic purpura associated with bone marrow necrosis complicating extra-mammary Paget's disease who was successfully treated with docetaxel and carboplatin combination chemotherapy.
Bone Marrow* ; Carboplatin ; Disease Progression ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Necrosis* ; Neoplasm Metastasis ; Paget Disease, Extramammary* ; Purpura, Thrombotic Thrombocytopenic* ; Rare Diseases

PURPOSE: To assess outcomes from patients who underwent radical prostatectomy and had their indwelling urinary catheter removed on postoperative day (POD) 4 or 7. MATERIALS AND METHODS: The medical records of 107 consecutive patients receiving radical prostatectomy (RP), were retrospectively reviewed. Patients were categorized into two groups according to length of catheterization. Group 1 (n=40) had the urethral catheter removed on postoperative day (POD) 4, and group 2 (n=67) had the catheter removed on POD7. Group 1 had urethral catheter removal following no leakage on intraoperative leak testing and POD4 cystography, whilst group 2 exhibited leakage at POD4 and instead had routine POD7 urethral catheter removal if there was evidence of no leakage of POD7 cystography. Incontinence was checked according to the use of protective pad. RESULTS: The mean age of the study population was 67.0 years. acute urinary retension (AUR) following catheter removal occurred in 6 of the cohort (5.6%); 3 patients (7.5%) from group 1 and 3 (4.5%) from group 2 (p=0.669). The overall continence rate was 39.3%, 68.2%, 80.4%, and 91.6% at 1, 3, 6, and 12 months respectively. Importantly, the incontinence recovery pace of group 1 was notably higher than that of group 2 (p=0.001). Neither group exhibited bladder neck contracture. Intraoperative factors influencing the decision to remove catheter at POD4 following RP, are bladder neck reconstruction (OR=3.792, p=0.010) and nerve sparing (OR=6.646, p=0.008). CONCLUSIONS: Selective early urethral catheter removal may shorten the length of incontinence recovery, without increasing the risk of AUR and bladder neck contracture.
Catheterization ; Catheters ; Cohort Studies ; Contracture ; Humans ; Medical Records ; Neck ; Prostatectomy* ; Prostatic Neoplasms ; Retrospective Studies ; Urinary Bladder ; Urinary Catheters*

PURPOSE: The immunohistochemial markers can be used to predict prognosis more accurately for several cancers. In non-muscle invasive urothelial carcinoma, p53, c-erb-B2 and Ki-67 are applicable. We investigated a retrospective analysis of the relation between the markers and clinical prognostic factors of urothelial bladder cancer. MATERIALS AND METHODS: Data from 268 non-muscle invasive urothelial bladder cancer (Ta, T1) patients from one single center were collected. Immunohistochemical evaluation was carried out on 268 (p53, c-erb-B2, Ki-67) cases. Clinical prognostic factors are as follows; number of tumor, tumor invasiveness, tumor grade and recurrence. The sum of all positivity of 3 markers was made as a new factor and evaluation of correlation between this factor and prognostic factors was also done. Statistical analysis was done by chi-squares test and Pearson's correlation test. RESULTS: Through chi-square test, there were significant relations between all markers and tumor invasiveness (p<0.001), tumor grade (p<0.001). Number of tumor is significantly related with Ki-67 (p=0.043). Recurrence is related with c-erb-B2 (p=0.010) and Ki-67 (p=0.043). There was also significant correlations between the sum of the markers and prognostic factors-tumor invasiveness (p<0,001), tumor grade (p<0.001) and recurrence (p=0.007). CONCLUSIONS: In this study, evaluated markers were closely related with clinical prognostic factors and may contribute to decision making on risk-assessment and management strategy for non-muscle invasive urothelial bladder cancer.
Decision Making ; Humans ; Immunohistochemistry ; Prognosis* ; Recurrence ; Retrospective Studies ; Risk Assessment ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: A multi-subunit transcription factor NF-κB is associated with anti-apoptotic signals in several cancers including renal cell carcinoma (RCC). In this study, we investigated whether the expression levels of the NF-κB were related to the clinical properties of human renal cell carcinoma such as nuclear grade, TNM stage, and recurrence free survival. MATERIALS AND METHODS: Patients who were diagnosed with clear cell RCC between January 2006 and February 2013 were included. Clinicopathological data and survival were investigated. The expressions of NF-κB were investigated by performing immunohistochemical staining on 61 clear cell RCC. The expression levels of NF-κB were divided two groups by the expression levels. RESULTS: Results on the expression of NF-κB were not significant. Analysis of NF-κB expressions is not associated with any of the clinical properties including age, nuclear grade and TNM stage (p=0.613, p=0.059, p=0.107, p=0.570, and p=0.760, respectively). Also, a statistically correlation was not observed between recurrence free survival and NF-κB expression levels (p=0.573). CONCLUSIONS: The expressions of the NF-κB were not associated with the clinical properties of clear cell RCC such as age, nuclear grade, TNM stage, and recurrence free survival.
Carcinoma, Renal Cell* ; Humans ; Immunohistochemistry ; Prognosis ; Recurrence ; Transcription Factors

With the emergence of microbiome as a major player in many human diseases, bacteria as therapeutics are gaining significant interest. Whole bacteria or cytotoxic or immunogenic peptides carried by them exert potent anti-tumor effects in the experimental models of cancer. The use of attenuated microorganism (s) e.g., BCG to treat human urinary bladder cancer was found to be superior compared to standard chemotherapy. While bacteria alone may not offer full therapeutic benefits, modifying them with anti-tumor agents, anti-oncogenes or immunogenic antigens, either alone or in combination, will prove to be beneficial. Vectors for delivering shRNAs that target oncogenic products, express tumor suppressor genes and immunogenic proteins have been developed. These approaches have showed promising anti-tumor activity in mouse models against various tumors. These can be potential therapeutics for humans in the future and such therapeutics may become a future alternative or adjunct regimen along with conventional chemotherapy and radiotherapy. In this review, some conceptual and practical issues on how to improve these agents for human applications are discussed.
Animals ; Bacteria* ; Drug Therapy ; Genes, Tumor Suppressor ; Humans ; Mice ; Microbiota ; Models, Theoretical ; Mycobacterium bovis ; Peptides ; Radiotherapy ; RNA, Small Interfering ; Urinary Bladder Neoplasms

Despite recent advances in the management of a wide variety of solid tumors, the outcomes for patients with advanced urothelial carcinoma remain relatively poor. Cisplatin-based combination chemotherapy remains the standard of care for first-line systemic treatment of advanced urothelial carcinoma and for more than 10 years there have been no other Korean health insurance system-approved treatment options available for these patients. In this review article, we summarize the current state of chemotherapeutic agents, used either alone or in combination with other chemotherapy in advanced urothelial carcinoma. Our discussion focuses on the new agents for the cisplatin ineligible patients, including carboplatin, gemcitabine, paclitaxel, docetaxel and pemetrexed. Moreover, we addressed that neoadjuvant chemotherapy was supported in the patients planning radical cystectomy as an optimal treatment option by qualified studies.
Carboplatin ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Insurance, Health ; Paclitaxel ; Pemetrexed ; Standard of Care

A gastrointestinal stromal tumor is the most common mesenchymal tumor of the gastrointestinal tract, and is diagnosed on the basis of the combined expression of CD34 and CD117 (C-kit protein). An extragastrointestinal stromal tumor of the urinary bladder is a very rare neoplasm. In this report, we describe a case of an extragastrointestinal stromal tumor originating from the inner surface of the urinary bladder. A 46-year-old man presented with an incident bladder mass, and he was diagnosed with an extragastrointestinal stromal tumor after transurethral resection of the bladder tumor. A tumor on the inner urinary bladder wall is an unusual presentation of an extragastrointestinal stromal tumor. The patient is doing well with no recurrence at 18 months after surgery.
Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Middle Aged ; Recurrence ; Urinary Bladder Neoplasms ; Urinary Bladder*

To study the impact of single instillation of epirubicin (SIE) on the cancer recurrence of non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT) in Korean patients. The major inclusion criteria were NMIBC patients. The major exclusion criteria were muscle invasive bladder cancer, metastatic bladder cancer, combined urinary upper tract tumor, and carcinoma in situ. SIE group received 50 mg epirubicin within 6 hours after TURBT. Non-SIE group did not receive epirubicin. This study enrolled a total of 214 patients diagnosed as having NMIBC during the period from October 2003 through January 2010 at the single institutions. Follow-up of the patients was conducted through January 2012. The median age of patients was 63.4 years. Of 112 evaluable patients in the SIE group, cancer recurrence rate was 33.9% and in non-SIE group, cancer recurrence rate was 62.7% (p<0.001). The recurrence-free survival duration was longer in Group SIE compared with Group non-SIE (p<0.001). Multivariate analysis revealed that SIE was significantly associated with cancer recurrence (HR 0.213, p<0.001). We confirmed the impact of SIE on the cancer recurrence in the Korean patients who underwent TURBT for NMIBC. Single instillation of chemo-agent after TUR-B might be recommended in Korean patients for reduce bladder cancer recurrence and provide longer recurrence-free survival duration.
Carcinoma in Situ ; Epirubicin* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*