P. Mongiat-Artus

Nephron Sparing Surgery is a Feasible and Efficient Treatment of T1a Renal Cell Carcinoma in Kidney Transplant: A Prospective Series From a Single Center

PURPOSE Renal cell carcinoma in a renal graft is a rare condition whose incidence will increase in the future. To our knowledge no standardized treatment has been established for this disease. We performed a prospective study of nephron sparing surgery for small renal cell carcinoma in renal grafts. MATERIALS AND METHODS From January 2002 to December 2006, 2,050 renal graft recipients were followed at our transplantation center. Of these patients 7 were diagnosed with histologically confirmed renal cell carcinoma in the renal graft, 5 of whom presented with T1a renal cell carcinoma and prospectively underwent nephron sparing surgery. RESULTS Five patients with 15 to 30 mm (median 20) renal cell carcinoma were included in the study and were treated with nephron sparing surgery. Median operative time was 110 minutes (range 60 to 150). Blood loss was less than 200 ml in each case. All tumors were pT1aN0M0 with negative margins. No postoperative complications were observed (hemorrhage, urinary fistulas, renal failure). Preoperative immunosuppressive treatment was not modified postoperatively. At 3 months after nephron sparing surgery and at a mean of 17.4 months of followup (range 5 to 54) no significant impairment of renal function or recurrence was observed. CONCLUSIONS Nephron sparing surgery is a safe and efficient procedure for the treatment of renal cell carcinoma in renal grafts, resulting in the preservation of renal function and in short-term cancer control.

Primary Adenocarcinoma of the Seminal Vesicle

Primary adenocarcinoma of the seminal vesicle is a rare condition with only about 60 cases described in the literature. The unusual characteristics of this disease makes diagnosis difficult and treatment strategies differ as there are no specific guidelines available. This report presents a case of adenocarcinoma of the seminal vesicle with lung metastases in which surgical and chemotherapeutic treatments have been carried out. The MVAC dose dense regimen following local resection seems effective in this scenario and may be used in the treatment of this disease.

Placental Site Trophoblastic Tumor in Nonseminomatous Mixed Germ Cell Tumors of the Testis: a Case Report and Review of the Literature

Placental site trophoblastic tumor (PSTT) is a relatively uncommon trophoblastic neoplasm that mostly occurs in women. PSTT can be exceptionally found in men, essentially as component of testicular mixed germ cell tumors. Diagnosis is based on morphologic features (intermediate trophoblastic cells proliferation) and immunohistochemical profile (HPLþ, b-hCGþ, a-inhibinþ, GATA3þ, AE1/3þ, P63 ). PSTT is considered to be chemoresistant; thus, surgery is recommended as the mainstay of treatment according to tumor resectability. Tumor evolution is unpredictable and prognosis depends on tumor spread, a process that often remains undefined. Hence, regular follow-up is required.