Shigeo Sakashita

Congenital Anomalies in Children with Testicular Germ Cell Tumor

The incidence and type of congenital anomalies associated with childhood testicular germ cell tumors were studied retrospectively in 25 patients (20 cases of yolk sac tumor and 5 cases of teratoma). Congenital anomalies were observed in 3 patients with yolk sac tumors and in 1 patient who had a mature teratoma. The abnormalities observed included individual cases of retrocaval ureter, diverticulum of the bladder, Downs syndrome and an ipsilateral inguinal hernia. Children with a testicular tumor should be examined closely for congenital abnormalities.

Primary aldosteronism due to adrenal cortical carcinoma.

We report a rare case of primary aldosteronism due to adrenal cortical carcinoma. Endocrinological data showed an isolated excess of aldosterone production without any associated increase in other steroids. Adrenal scintigraphy, which has not been described in cases of primary aldosteronism due to adrenal cortical carcinoma, revealed an increased uptake of the radionuclide into the affected adrenal gland without suppression in the contralateral gland.

Paraganglioma of Urinary Bladder, Visualization with 131I-MIBG Scintigraphy

Three cases with paraganglioma of urinary bladder are described. All cases complained of palpitation, headache and paroxysmal hypertension after micturition. 131I metaiodobenzylguanidine scintigraphy successfully visualized the tumor of the bladder in all three cases.

Unusual extraperitoneal lesion of the pelvis: Cloacal cyst with transitional cell carcinoma

An unusual cystic tumor of retrovesical space was reported. After puzzling speculation on its histogenesis this extremely rate tumor was concluded to be a cloacal cyst with transitional cell carcinoma. Review of the literature revealed no similar case.

Papillary Adenoma of the Bladder in a Patient with Intermittent Self-Catheterization

We report a case of papillary adenoma of the bladder. The patient had had intermittent self-catheterization for the previous 3 years. The tumors developed multiply and were identified on the trigone and posterior wall of the bladder. Dysplasia of the urothelium was associated in nontumorous areas. Transurethral resection of the tumors was performed. The tumor recurred 3 times for 3 years, but no malignant changes were identified.

Ureteral ectopia in vestibule without urinary incontinence

Two cases of ureteral ectopia opening in the vestibule without urinary incontinence are reported. Urinary continence was probably due to the incorporation of the ectopic ureteral ends in the wall of the urethral sphincter.

Rat Yolk Sac Tumor: Biological Aspects and Microheterogeneity of AFP

α‐Fetoprotein (AFP)‐producing yolk sac tumors were established in rats as transplantable tumor lines growing in either solid or ascitic form. AFP levels in the ascites and in the serum of recipients were quite high, but higher in castrated female rats than male rats. The tumor cells were cultured also in vitro and showed synthesis of AFP and albumin. AFP produced by the yolk sac tumors was investigated comparatively with AFP produced by a hepatoma. There was no remarkable difference between two AFPs in behavior in gel filtration; however, AFP of yolk sac tumors migrated more slowly than that of hepatoma in immunoelectrophoresis. However, the mobilities of two AFP preparations became same after desialization by neuraminidase treatment. This fact suggests that AFP of yolk sac tumors contains sialic acids in smaller amount than that of hepatomas.

PATHOLOGIC CHARACTERISTICS AND CLINICAL COURSES OF BLADDER TUMORS AFTER NEPHROURETERECTOMY FOR UPPER URINARY TRACT CANCER

by genito-urinary pathologists who were blinded to the original slides and clinical outcomes. Uniand multivariate logistic regression analyses were performed. For comparison a base model was used that comprised lymph node status, pathologic stage, and tumor grade. RESULTS: LVI was found in 338 patients (24.8%). Proportion of LVI increased with advancing tumor stage (p<0.001), increasing tumor grade (p<0.001), sessile architecture (p<0.001), concomitant CIS (p<0.001), lymph node metastasis (28% vs. 72%, p<0.001), and symptoms at presentation (p=0.002). Five-years cancer recurrence and survival rates were 76.4±1.5% and 80.6±1.4% in the absence of LVI, compared to 44.4±3.1% and 49.5±3.3% in the presence of LVI, respectively (p<0.001). In multivariate analyses, LVI was an independent

Clinical significance of multiple biopsies of nontumorous bladder mucosa in patients with bladder cancer

Multiple biopsy specimens obtained from nontumorous bladder mucosa were investigated histologically. An average of 3.6 specimens was taken in 142 transurethral resection operations for 112 patients with bladder cancer. The histological categories used were normal epithelium, metaplasia, hyperplasia and G1-G3 dysplasia. Thirty-seven patients (27.7%) had G2 less than dysplasia within normal looking bladder mucosa. In patients with high grade bladder cancer, the incidence of the association with dysplasia was 51.7%, which was significantly higher than the rates in patients with low or moderate grade bladder cancer (p less than 0.05). The tumor recurrence was observed in 45 patients of 102 patients who were followed with bladder preservation. The recurrence was seen in 13 of 19 patients (68.4%) with mucosal dysplasia in the previous operation. The rate was significantly higher than 38.6% in patients without dysplasia (p less than 0.05). Thus, the epithelial dysplasia seen in nontumorous bladder mucosa were associated with higher grade bladder tumors more often, and the histology of multiple biopsy specimens might be one of predictors for tumor recurrence in near future.

Postoperative reduction of serum β-HCG in testicular seminoma

Serum β-HCG and urinary HCG were measured in 17 patients with histologically proved pure seminoma of the testis. The patients have been followed to date for 10 to 74 months after orchiectomy, and have no residual disease or recurrence of their disease. Preoperative urinary HCG levels were abnormal in 9 patients (53%). Serum β-HCG levels were slightly elevated in 6 out of 12 patients evaluated, and were reduced after orchiectomy even in patients with preoperative normal β-HCG levels (P<0.05). Preoperative levels of the tumour marker in seminoma were far lower than in patients with non-seminomatous germ cell tumours, but it would not be rare to see a small amount of HCG produced by the tumour cells in the seminoma.