Taku Mochizuki

Onco-testicular sperm extraction (onco-TESE) for bilateral testicular tumors: two case reports

BackgroundMost patients with testicular cancer are infertile; thus, the preservation of the sperm after surgery is an important factor to consider. We report two cases of bilateral testicular cancer in patients who underwent bilateral higher orchiectomy and simultaneous testicular sperm extraction.Case presentationTwo Asian-Japanese men were referred to our hospital with bilateral testicular tumors. Both of the patients were preoperatively diagnosed with azoospermia and requested testicular sperm extraction at the time of higher orchiectomy. In one patient, sperm was successfully harvested and then frozen. In the other patient, sperm could not be retrieved from the patient’s testis. In both patients, the pathological diagnosis was seminoma. Testicular tumors often occur in patients of reproductive age. The preservation of sperm before chemotherapy or bilateral orchiectomy is necessary for patients with testicular tumors who wish to be fathers.ConclusionsOnco-testicular sperm extraction might be an option for patients with testicular cancer and azoospermia or severe oligospermia.

Lack of an Association between Neutrophil-to-Lymphocyte Ratio and PSA Failure of Prostate Cancer Patients Who Underwent Radical Prostatectomy

Introduction. The neutrophil-to-lymphocyte ratio (NLR), which can be easily calculated from routine complete blood counts of the peripheral blood, has been suggested to serve as a prognostic factor for some solid malignancies. In the present study, we aimed to determine the relationship between NLR in prostate cancer patients undergoing radical prostatectomy (RP) and their prognosis. Materials and Methods. We assessed NLR in 73 men (patients) who received RP for their prostate cancer. We also performed immunohistochemistry for CD8 and CD66b in a separate set of RP specimens. Results. The median NLR in the 73 patients was 1.85. There were no significant correlations of NLR with tumor grade (p = 0.834), pathological T stage (p = 0.082), lymph node metastasis (p = 0.062), or resection margin status (p = 0.772). Based on the area under the receiver operator characteristic curve (AUROC) to predict biochemical recurrence after RP, potential NLR cut-off point was determined to be 2.88 or 3.88. However, both of these cut-off points did not precisely predict the prognosis. There were no statistically significant differences in the number of CD66b-positive neutrophils or CD8-positive lymphocytes between stromal tissues adjacent to cancer glands and stromal tissues away from cancer glands and between different grades or stages of tumors. Conclusions. There was no association between NLR and biochemical failure after prostatectomy.

Foreign body in the bladder: A case report

Highlights • We experienced the foreign body had become severely calcified.• The foreign bogy was successfully removed by bladder wall incision.• The foreign body was covered by labor.

RANK/RANKL expression in prostate cancer

Highlights • Expression of RANK and RANKL genes in prostate cancer is higher than non-neoplastic prostate.• RANK/RANKL expression is not related to pathological features.• There is no significant correlation of RANK/RANKL expression with biochemical recurrence after radical prostatectomy.

The half-loop transurethral incision technique for bilateral ureterocele in adult

Ureteroceles are divided into intravesical and extravesical ureteroceles. Only 20 cases of bilateral ureterocele in adult male patients have been reported in the literature. Intravesical ureteroceles can be cured by endoscopic surgery.1e3 An incision is made to reduce hydronephrosis, improve the renal function, reduce the risk of urinary tract infection, and prevent vesicoureteral reflux (VUR).4 The endoscopic treatments of ureteroceles vary; however, the standard procedure is incision using a transurethral resection device. We herein report an adult case of bilateral ureterocele that was successfully treated by a half-loop transurethral resection technique.

A case of long-term survival in a kidney transplantation patient with progressive multifocal leukoencephalopathy: Case Report

Post-kidney transplantation progressive multifocal leukoencephalopathy (PML) is a rare disease on which there are very few published reports on record. PML is a demyelinating disease caused by a destructive infection of the oligodendrocytes by the JC polyomavirus. No effective therapeutic protocol has been established other than measures to revive the immune function by reducing or discontinuing the administration of immunosuppressive agents. Most cases are progressive and show a poor prognosis. We herein report a case in which renal function has been maintained for 2 years following the onset of PML, which was initially diagnosed 3 years after kidney transplantation.

Editorial Comment to Ex vivo stone surgery in donor kidneys at renal transplantation

The expanded adaptation of renal transplantation donors to include donors with renal stones and the progression of ureteroscopy devices have led to increased reports on the performance of ex vivo stone surgery in donor kidneys at the time of renal transplantation. The article by Sarier et al. reports the outcomes of 13 donor kidneys with renal stones (stone size 5–15 mm) among 3748 living-donor kidney transplantation procedures. The outcomes of ex vivo stone surgery (ex vivo ureteroscopy, n = 6; ex vivo pyelolithotomy, n = 7) were good. This number is comparable with previous reports. The authors mentioned the usefulness of pediatric cystoscopy, which enabled faster and easier access to the pelvicalyceal system due to its short shaft. In contrast, in one case in which ex vivo pyelolithotomy was carried out, postoperative urinary leakage was observed from the pyelotomy incision and a repair operation was required. Further study is required to confirm the safety of pyelolithotomy in this setting. Furthermore, the longer-term outcomes, including ureteral stricture after ex vivo ureteroscopy and stone recurrence, should be investigated. Despite these limitations, ex vivo stone surgery in donor kidneys using a pediatric cystoscope might be a good approach. Ex vivo stone surgery in the donor kidney at renal transplantation is expected to be carried out in an increased number of cases. This article provides information that will be useful in this regard.

Lenalidomide decreased the PSA level for castration-resistant prostate cancer: a case report

Lenalidomide has been developed as the derivative of thalidomide that has fewer side effects. We herein report a rare case of castration‐resistant prostate cancer successfully maintained using lenalidomide for multiple myeloma.

Fluorescent Light-Guided Cystoscopy with 5-ALA Aids in Accurate Surgical Margin Detection for TURBO: A Case Report

Recent studies have revealed that transurethral resection in one piece (TURBO) has several benefits over standard transurethral resection of bladder tumor (TUR-Bt), including a higher rate of containing the bladder muscle tissue and single-block resection. Five-aminolevulinic acid (5-ALA) was approved for the detection of bladder tumor treated with TUR-Bt. A 71-year-old male patient who received right nephroureterectomy developed bladder tumor recurrence on routine cystoscopy follow-up. We planned TURBO using fluorescent light-guided cystoscopy with 5-ALA. We herein report a case of bladder tumor successfully treated with TURBO using fluorescent light-guided cystoscopy with 5-ALA to detect the tumor surgical margin.

Prostate Basal Cell Carcinoma: A Case Report

Prostate basal cell carcinoma (PBCC) accounts for 0.01% of all prostate cancers. A 68-year-old man complained of dysuria for 5 years on his initial visit. His PSA level was 3.87 ng/mL. Due to a diagnosis of benign prostate hyperplasia, he underwent transurethral resection of the prostate. A pathological examination revealed that basal cell-like atypical cells made alveolar with palisadal layout. Immunohistochemical analysis showed positive 34β12, P63, and Ki-67. Based on these findings, PBCC was diagnosed. Then, we performed radical prostatectomy. He was free from recurrence 22 months after the operation. We herein report an extremely rare case of PBCC.