Bolesław Kuzaka

Expression of bone morphogenetic protein-2 and -7 in urinary bladder cancer predicts time to tumor recurrence

Introduction Urinary bladder cancer patients who have undergone transurethral resection of bladder tumor (TURBT) are at risk of recurrence. This study aims to correlate the level of bone morphogenetic protein (BMP) expression with urothelial carcinoma invasiveness, TNM stage and time to recurrence after TURBT. Material and methods In 33 specimens of healthy transitional epithelium and 42 of urothelial carcinoma, BMP2, BMP4 and BMP7 expression was determined by real-time polymerase chain reaction. Patients who underwent TURBT were followed up for 1 year. Results BMP2 and BMP7 were downregulated in infiltrating urothelial carcinoma, the relative expression being 0.76 (p = 0.04) and 0.28 (p = 0.025) respectively, while BMP4 was downregulated in non-invasive tumors. High expression of BMP2 and BMP7 correlated with prolonged time to recurrence (log-rank: p = 0.01 and p = 0.03 respectively). Conclusions Low expression of BMP2 and BMP7 is associated with shorter time to recurrence. The BMP expression levels are not indicative of tumor stage.

Nephrogenic adenoma of the urinary bladder: a report of three cases and a review of the literature.

BACKGROUND Nephrogenic adenoma (NA) is a rare, benign disease of the urinary tract, usually as a response to chronic irritation or trauma. Its diagnosis, staging, and treatment are not well established. CASE REPORT We report on 3 cases of nephrogenic adenoma of the urinary bladder treated in our hospital between February 2011 and December 2012 to assess our experience and clinical outcome updating and reviewing the literature concerning this issue. All patients had undergone previous open urosurgery. Two patients had kidney transplantation. Gross hematuria and microhematuria were found in 2 patients. One patient had recurrent urinary tract infection. One patient had NA associated with transitional cell carcinoma (TCC). Recurrent nephrogenic adenomas were diagnosed in 2 patients (time to disease relapse was 5 and 9 months). All nephrogenic adenomas and recurrent tumors were treated with transurethral resection. CONCLUSIONS Although NA is a benign metaplastic lesion of the urothelium, its recurrence rate is relatively high, thus careful and regular follow-up is necessary. Endoscopic characteristics of NA are not specific and a definite diagnosis must be made after histological analysis of resected specimens.

Lack of usefulness of ureteral reconstruction with free bladder mucosa flap in dogs confirmed by microangiography

Background There is a paucity of data addressing the blood supply in the surgically reconstructed ureter, and complete lack of microangiographic studies of the reconstructed ureter with the use of a free bladder mucosa flap. The present study evaluated the blood supply in the reconstructed dog ureter after a 5-centimeter segment resection, supplemented by a tube constructed from a free bladder mucosa flap. Material/Methods Female mongrel dogs (n=29) were used in this study. Under general anaesthesia, a 5-centimeter autologous free bladder mucosa flap was used to construct a tube, which was afterwards grafted to replace a 5-centimeter ureter resection. After a period of 3 months (n=2) and after 1 year (n=2), microangiography was performed to assess the revascularization of the grafted ureter. Results In our study, we observed the continuity of the ureter, but the grafted reconstruction was narrowed by the cicatrization in about 86% (n=25) of cases. This resulted in the development of hydronephrosis, as described in previous publications. The ureteral wall was covered by a normal urothelium, but consisted of fibrous connective tissue, which failed to restore a regular (normal) coat. The reconstructed segment showed no smooth muscle cells. A few smooth monocytes were found only at the border with intact portions of the ureter. The microangiography performed at the end of the experiments showed no vascularization of the restored segment of the ureter. Conclusions The experiments showed a whole regeneration of urothelium in the transected and reanastomosed ureters. However, there was no regeneration of the muscular coat and a complete lack of revascularization.

Intratesticular cellular angiofibroma — a rare benign tumour: case report and literature review

Cellular angiofibroma is a rare and benign tumour of mesenchymal origin. Within a microscopic image, two main cell populations are typically observed: spindle-shaped cells and blood vessels; both of which are sometimes accompanied by atypical liposarcoma-like cells. We present a case of a 31-year old male admitted to the Department of Urology because of a solid mass being present in the left testis. The patient underwent radical orchidectomy through the inguinal canal. Microscopic examination demonstrated an intratesticular cellular angiofibroma. During a two-year follow-up, there were no signs observed of any metastases nor disease recurrence. Intratesticular localisation of cellular angiofibroma has never been previously reported. Benign tumours of the testis are rare, but an awareness of this phenomenon may reduce the number of unnecessary orchidectomies, thereby increasing the rate of organ-sparing surgery.

Malignant peripheral nerve sheath tumor of the prostate

The diagnostic and therapeutic approach to prostatic neurosarcoma, currently known as a malignant peripheral nerve sheath tumor (MPNst) of the prostate, due to its rarity, is not well established. Our presenting case was a 73 year old patient, admitted to the Hospital with suspicion of a prostatic tumor. The patient underwent surgical resection of the described pathological mass. Gross appearance of the pathological examination revealed a yellow-gray colored tumor, 12 × 6 × 7 cm in size. On cross-section: tumor heterogeneity, fatty, yellow-gray, with no foci of necrosis, but with a few cysts of 1–3 cm in size, with a gelatinous substance. Microscopic examination — showed neurosarcoma of the prostate. The patient died at six months follow-up, due to cardiovascular insufficiency.

Fibroepithelial polyp of the urinary bladder. Case report

Polip wloknisto-naczyniowy drog moczowych jest lagodną zmianą, ktora rzadko wystepuje u osob mlodych i w średnim wieku. Zdarza sie, ze polipy zawierają komponent nablonkowy, ktory dominuje nad wloknistym zrebem, sprawiając wrazenie zmiany pseudonowotworowej. Przedstawiamy przypadek polipowatego guza z obfitą proliferacją nablonkową u mlodego mezczyzny leczonego na oddziale Kliniki Urologii Szpitala Dzieciątka Jezus w Warszawie. Guz wycieto i rozpoznano polipa wloknisto-nablonkowego.

Towards zero mortality in Fournier's gangrene.

The authors present a retrospective analysis of their 20 patients treated for Fourniers gangrene (FG) within three years in one urological department. This is the largest series known to us collected during 3 years in a single institution [1]. However, to give a reference scale, authors should have presented data on the total number of hospital admissions per year as well.