Keiichi Matsumoto

Transitional cell carcinoma of the bladder in patients with renal pelvic and ureteral cancer.

We reviewed 41 cases of transitional cell carcinoma of the renal pelvis and ureter with special reference to the coexistence or subsequent development of bladder cancer. Bladder cancer was associated with an upper urinary tract neoplasm in 20 of the 41 cases (48 per cent). Most of these patients (15 of 20) were treated by radical total cystectomy of 1-stage nephroureterocystectomy. The incidence of ureteral stump cancer after nephrectomy alone or incomplete nephroureterectomy was 64 per cent (7 of 11 patients). Twelve surgically removed specimens of the renal pelvis, ureter and/or bladder were examined extensively for the histological association of pre-neoplastic disease, such as atypical hyperplasia and carcinoma in situ. Every specimen had these changes of the urothelium adjacent to and remote from obvious tumors.

Adenocarcinoma of urachus report of 7 cases and review of literature

Seven cases of adenocarcinoma of the urachus treated at the National Cancer Center Hospital, Tokyo, over a nineteen-year period are reported. One hundred fifty-five cases reported in English literature and 140 cases in Japanese literature were analyzed with respect to the modalities of treatment, mean remission times, and sites of recurrence or metastases. From this review and experience on the 7 cases reported here, extended radical total cystectomy with well-designed radio- and chemotherapy was proposed for the treatment of this disease.

Clinical evaluation of intraoperative radiotherapy for carcinoma of the urinary bladder

Intraoperative radiotherapy using one shot high dose electron irradiation was performed for 116 bladder cancer patients as a radical means of treatment for superficial bladder cancer. Additional fractionated external supervoltage irradiation covering the whole bladder was given in most of the cases. The one‐, three‐, and five‐year survival rates were 100%, 100%, and 96.3% for T1 cases and 100%, 87.2%, and 61.6% for T2 cases, respectively. Heterotropic recurrences in the bladder were 5.3% within one year, 9.4% within two years, and 19.3% within five years, respectively. Normal vesical function was well preserved except in five patients who underwent total cystectomy subsequently because of multiple recurrences after radiotherapy and one patient who underwent urinary diversion because of contracted bladder and progressive bilateral hydronephrosis. Intraoperative radiotherapy was established as a reliable and superior method for the treatment of superficial bladder cancer because of the low recurrence rate and good preservation of vesical functions after treatment.

Carcinoma of the Bladder: A Clinical and Pathological Analysis of 87 Autopsy Cases

A clinical and pathological analysis was done on 87 autopsy cases of carcinoma of the bladder. Of the 87 cases 68 were men and 19 were women, with a mean age of 64 years. The average survival time was 39 months from the onset of symptoms to death. The patients with multiple tumors had a longer average survival time than the patients with single tumors (51 compared to 40 months), and the average survival times were definitely more favorable for men than for women (43 compared to 23 months). Histological examination revealed transitional cell carcinoma in 77 patients, squamous cell carcinoma in 4, vesical adenocarcinoma in 3 and urachal adenocarcinoma in 3. Squamous cell carcinoma and vesical adenocarcinoma seemed to be more malignant neoplasms. Metastasis was noted in 58 of 87 cases (66.7 per cent) and occurred most frequently in lymph nodes (37.9 per cent), liver (29.9 per cent), lungs (29.9 per cent) and bones (24.1 per cent). Of the 87 cases of bladder carcinoma 11 had primary carcinoma in organs other than the bladder.

Thymic enlargement following treatment for a metastatic germ cell tumor: a case report.

We describe a patient with metastatic testicular carcinoma in whom an anterior mediastinal mass developed 8 months after complete remission following chemotherapy and surgery. The mass was excised and pathological examination showed benign thymic hyperplasia. An anterior mediastinal mass encountered after successful chemotherapy does not always imply recurrence or relapse of malignant disease. The possibility of a benign etiology must be considered to prevent inappropriate treatment.

Treatment of carcinoma in situ by total cystectomy: Histopathological analysis

SummarySeventeen specimens of primary or secondary carcinoma in situ (CIS) obtained by cystectomy were examined by step-sectioning. The posterior and lateral walls were mainly affected and 53% of the specimens showed invasion. Cases with a past history of superficial bladder cancer showed a particularly high incidence of invasion. Varieties of biological behavior of CIS are discussed.

Two Cases of Bladder Carcinoma with Similar Initial Features That Exhibited Completely Different Clinical Courses

Two cases of bladder carcinoma are described. The patients were of similar age, were both smokers and were treated for the same period, but exhibited completely different later clinical courses. Initially, both had a single, papillary, pedunculate tumor, identified as a transitional cell carcinoma, grade 2, pTa. One patient, six years later, had multiple papillary tumors covering almost all the mucosal surface and underwent simple cystectomy. Histologically the tumors were identified as transitional cell carcinomas, grade 2, pT1. The other patient, nine years later, had a single nodular invasive tumor with a concomitant, very tiny papillary tumor and underwent radical cystectomy. Histologically the tumor was transitional cell carcinoma, grade 2 greater than 3, pT4. Many of the questions raised by these cases are unanswered, but comparison of such cases should provide some clues to the natural history of bladder carcinoma.