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ABSTRACT: A 58-year-old man was referred to our hospital for investigation and treatment of a retrovesical cystic tumor that was detected during his annual health check-up. Computed tomography and magnetic resonance imaging (MRI) showed a 5 cm cystic mass including a 1.5 cm solid mass between the bladder and rectum. Transrectal biopsy was performed successfully, and did not show any evidence of malignancy. Six months later, the cystic mass enlarged, and video-assisted laparoscopic excision of the cystic mass was performed. The mass was pathologically diagnosed as a seminal vesicle cyst. Because of the rarity of this lesion, only 11 cases of laparoscopic excision have been reported and, to our knowledge, this is the first case in the Japanese literature. Under the laparoscopic prostatectomy approach, we could safely resect the lesion.
Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 09/2009; 100(6):650-4.
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ABSTRACT: A 76-year-old woman with right renal pelvic cancer underwent a laparoscopic nephroureterectomy via a retroperitoneal approach. During the 300 minutes of CO2 insufflation, arterial blood pressure, temperature, and oxygen saturation were stable, whereas the end-tidal CO2 (ETCO2) gradually increased and reached a peak of 55 mmHg. Her arterial blood gas analysis suggested acute respiratory acidosis. She developed hypercapnia in spite of controlled hyperventilation in response to the increasing ETCO2. Skin crepitus was extending into the neck and face from the operative site. A portable chest radiograph taken postoperatively showed pneumomediastinum and extensive subcutaneous emphysema of neck and chest wall. Laryngoscopy revealed grossly emphysematous pharyngeal tissues preventing direct vocal cord visualization. Her airway was appeared to be totally occluded by markedly edematous laryngeal tissues. As a leak sound around the tracheal tube was not heard after deflation of the tube cuff, her pharyngeal swelling was suspected to be severe and tracheal extubation during the operation was postponed. When cervicofacial emphysema occurs intraoperatively, we recommend that laryngoscopy should be performed before tracheal extubation to avoid potential airway obstruction from associated pharyngeal emphysema.
Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 06/2009; 100(4):540-4.
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ABSTRACT: A metastatic penile tumor of malignant melanoma is very rare. The patient had priapism caused by metastatic penile tumor and the primary cancer was in the end stage. However, in this case, we could relieve the dysuria and pain by percutaneous cystostomy and partial penectomy. The corpus spongiosumcorpus cavernosum shunt could not relieve the priapism and might have accelerated the metastasis.
Hinyokika kiyo. Acta urologica Japonica 04/2009; 55(3):149-52.
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ABSTRACT: We describe a patient whose complaints were related to pericardial effusion due to prostatic carcinoma. An 80-year-old man was admitted to our hospital because of chest discomfort and dyspnea. The chest radiograph revealed cardiomegaly and computed tomographic scan showed a large pericardial effusion. Pericardiocentesis revealed sanguinous exudates. Cytologic study suggested metastatic adenocarcinoma or malignant mesothelioma. He died suddenly because of ventricular tachycardia. At autopsy, the major finding was poorly differentiated adenocarcinoma of the prostate with metastases to the mediastinum.
Hinyokika kiyo. Acta urologica Japonica 06/2008; 54(5):369-72.
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ABSTRACT: A 30-year-old female received living donor kidney transplantation from her mother. The surgical procedure was uneventfully performed and urine output was observed a few minutes after reperfusion. However, 24 hours after the surgery, the urine volume rapidly decreased with worsened renal blood flow as determined by Doppler ultrasonography, diagnosed as accelerated acute rejection (AAR). Plasma exchange (PE) combined with therapies including administration of steroids and OKT3 dramatically improved the renal status, resulting in maintenance of good renal function (serum Cr; 1.5 mg/dl) even after 18 months PE was considered as a powerful tool for AAR, and the literature was reviewed.
Hinyokika kiyo. Acta urologica Japonica 06/2005; 51(5):325-9.
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ABSTRACT: A 58-year-old female presented with a well-encapsulated tumor in the left renal hilum on computed tomography (CT). On magnetic resonance imaging (MRI), the tumor showed low intensity on the T1-weighted image, high intensity on the T2-weighted image. Laparoscopic radical nephrectomy was performed because we could not exclude the possibility of malignancy such as renal cell carcinoma. Histopathological examination revealed that the tumor was a benign Schwannoma. Although renal hilum is a common site of renal schwannoma, it is difficult to differentiate benign tumors from malignant ones, and then nephrectomy is usually performed.
Hinyokika kiyo. Acta urologica Japonica 07/2004; 50(6):445-7.
