{"title":"[Superior Vena Cava Syndrome and Trousseau Syndrome in a Patient with Metastatic Urothelial Carcinoma Treated with Enfortumab Vedotin : A Case Report].","authors":"Takuya Hida, Naoko Fujita, Takaya Murashima, Masato Fujii, Takahiro Nagai, Chie Onizuka, Koshiro Nishimoto, Atsuro Sawada, Shoichiro Mukai, Toshiyuki Kamoto","doi":"10.14989/ActaUrolJap_71_6_191","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_6_191","url":null,"abstract":"<p><p>We report a case of superior vena cava syndrome and trousseau syndrome in a patient with metastatic urothelial carcinoma treated with enfortumab vedotin. The patient was a 59-year-old woman diagnosed with left renal pelvic cancer with multiple lymph node metastases and liver metastasis. Treatment with gemcitabine and cisplatin reduced the size of the local tumor but resulted in liver metastasis progression after three cycles. The patient was switched to pembrolizumab which resulted in rapid tumor growth causing superior vena cava syndrome and trousseau syndrome. Hyper-progression was suspected and the patient was immediately switched to enfortumab vedotin. After enfortumab vedotin therapy, the tumor and multiple metastases shrank significantly and tumor reduction was maintained.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 6","pages":"191-195"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Comprehensive Genomic Profiling Tests for Japanese Patients with Metastatic Castration-Resistant Prostate Cancer : A Single-Institution Experience].","authors":"Shiori Miyachi, Takeshi Sasaki, Momoko Kato, Shinichiro Higashi, Satoru Masui, Kouhei Nishikawa, Takumi Fujiwara, Takahito Kitajima, Yotaro Hashizume, Katsunori Uchida, Hiroshi Imai, Masatoshi Watanabe, Yoshinaga Okugawa, Takahiro Inoue","doi":"10.14989/ActaUrolJap_71_6_171","DOIUrl":"10.14989/ActaUrolJap_71_6_171","url":null,"abstract":"<p><p>Comprehensive genomic profiling for metastatic castration-resistant prostate cancer (mCRPC) is rapidly becoming widespread. This study sought to investigate the gene alteration profiles of Japanese patients with mCRPC. We retrospectively reviewed 80 consecutive mCRPC patients who underwent comprehensive genomic profiling tests at our institution between 2021 and 2022. All patients underwent next-generation sequencing (NGS) : FoundationOne® CDx (F1-CDx) or FoundationOne® Liquid CDx (F1L-CDx). F1LCDx was indicated for cases in which tissue specimens were older than 5 years or could not be analyzed using F1-CDx. The median patient age was 74 years. Thirty-five and 45 patients received F1-CDx and F1LCDx, respectively. At least one pathogenic variant was found in 35 (100%) who received F1-CDx and 43 (95%) who received F1L-CDx. In total, 11 and 1 patients had pathogenic variants of BRCA2 and BRCA1, respectively. Among them, 4 cases (33%) were found to be germline variants. TP53, CDK12, and PTEN were found in > 20% of cases who received F1-CDx. DNMT3A, TP53, AR, and TET2 were found in > 20% of cases who received F1L-CDx. The proportion of gene alteration subtypes of amplification and loss in F1L-CDx was less common than that in F1-CDx. Pathogenic variants were successfully detected in almost all F1-CDx and F1L-CDx cases in our mCRPC cohort. The total proportion of BRCA1/2 pathogenic variant patients was similar to those in previous reports.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 6","pages":"171-179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sena I, Teppei Yamamoto, Kazuyoshi Iijima, Akio Miyamoto, Yukiko Kusama, Tomomi Haba, Takashi Hagimoto, Masashi Koshiba, Haruaki Kato
{"title":"[A Case of Partial Nephrectomy for Juxtaglomerular Cell Tumor in the Renal Hilum].","authors":"Sena I, Teppei Yamamoto, Kazuyoshi Iijima, Akio Miyamoto, Yukiko Kusama, Tomomi Haba, Takashi Hagimoto, Masashi Koshiba, Haruaki Kato","doi":"10.14989/ActaUrolJap_71_6_181","DOIUrl":"10.14989/ActaUrolJap_71_6_181","url":null,"abstract":"<p><p>We report a case of a 27-year-old pregnant woman with juxtaglomerular cell tumor of the renal hilum treated by partial nephrectomy. Hypertension had been diagnosed prior to conception and she had been receiving antihypertensive treatment. Hyperreninemia was noted during pregnancy, and postpartum computed tomography revealed a nodule approximately 15 mm in size in the right renal portal region. The nodule was suspected to represent juxtaglomerular cell tumor, a benign tumor that presents with secondary hypertension. We performed open partial nephrectomy, which eliminated the need for antihypertensive treatment and preserved renal function.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 6","pages":"181-185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A Case of Urothelial Carcinoma of Renal Pelvis Intraoperatively Diagnosed during Robot-Assisted Ureterocalicostomy].","authors":"Yoshitaka Motoki, Toueki Yanagi, Shinpei Yoshioka, Masato Tomono, Motohiro Taguchi, Kimihiro Shimatani, Yusuke Yamada, Shuken Go, Akihiro Kanematsu, Shingo Yamamoto, Takashi Yamasaki, Seiichi Hirota","doi":"10.14989/ActaUrolJap_71_6_187","DOIUrl":"10.14989/ActaUrolJap_71_6_187","url":null,"abstract":"<p><p>A female in her sixties with a history of pyelolithotomy for right kidney stone at age 26 presented with right back pain. Computed tomography of the abdomen showed right hydronephrosis,and a retrograde pyelogram showed stenosis of the pelviureteric junction. Five years after initial presentation, robot-assisted renal ureterocalicostomy was planned for recurrent back pain, and decreased renal function. The lower renal calix was exposed and anastomosis with the ureter was performed for half of the caliceal hole. However, intraoperative flexible endoscopy, which was performed to confirm the position of the repositioned stent, revealed a papillary tumor in the upper renal calix. The patient underwent nephroureterectomy upon diagnosis of renal pelvic urothelial carcinoma.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 6","pages":"187-190"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Pyonephrosis Caused by Ureteral Stricture Due to Syphilitic Granuloma: A Case Report].","authors":"Seigo Machiya, Haruto Honda, Makoto Ishii, Hiromu Horitani, Sayaka Horii, Masao Kobayashi, Yutaka Ono, Shigeru Nakamori","doi":"10.14989/ActaUrolJap_71_5_145","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_5_145","url":null,"abstract":"<p><p>An 87-year-old woman was admitted to our hospital with anorexia, lightheadedness, and fever. She was referred to our department with a diagnosis of right pyonephrosis due to stenosis of the right ureter. The severe stenosis made it impossible to place a ureteral stent. Nephrostomy was performed and the infection improved. Antegrade pyelography and contrast CT did not reveal the cause of the stenosis. Considering the reduced quality of life due to the nephrostomy and the possibility of ureteral stricture due to malignancy, the patient underwent right nephrectomy at a later date. Pathological examination revealed an abscess and granuloma around the ureteral stenosis. Immunostaining showed a large number of fungi positive for Treponema pallidum within the granuloma. Therefore, the patient was diagnosed with ureteral stricture due to syphilis.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A Case of Ureteral Sciatic Hernia Treated by Laparoscopic Vesicoureterl Neoanastomosis].","authors":"Kanji Nagahama, Toru Kanno, Kazuto Imai, Norihiko Masuda, Takahiro Maruyama, Haruki Imura, Keita Hanada, Takakazu Matsushita, Toshiya Akao","doi":"10.14989/ActaUrolJap_71_5_159","DOIUrl":"10.14989/ActaUrolJap_71_5_159","url":null,"abstract":"<p><p>Pelvic herniation of the ureter through anatomical musculoskeletal foramina stands out as one of the rarest causes of ureteric obstruction. The herniation of the ureter through the sciatic foramen presents as a particularly uncommon variant of this condition. A 62-year-old woman was referred to our hospital from a family practioner with symptoms of fever and septic shock. Subsequent computed tomography imaging revealed left hydroureteronephrosis without clear evidence of ureteral stones or ureteral tumors and that the lower part of the ureter was shifted to the outside of the cavum pelvis minor from the greater sciatic foramen. She was diagnosed with ureterosciatic hernia, and a left retrograde ureteral stent was indwelled. Her hemodynamic status improved and the ureteral stent was removed after ureteral migration became normal. However, three months later, left ureterosciatic hernia recurred. Therefore, we performed laparoscopic vesicoureteral neoanastomosis and native tissue repair of hernia by uterine appendages. The postoperative course was uneventful. We believe this is a durable repair although longer follow-up is needed to establish the longevity of our treatment modality.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Pathophysiology of Semen Parameter Deterioration Associated with Varicocele --Evaluation of Total Antioxidant Capacity in Seminal Plasma and Serum-].","authors":"Masaki Kimura, Kazuki Takei, Kazuki Yanagida, Itsuki Yoshimura, Ichiro Takada, Tomoyuki Kaneko, Tohru Nakagawa","doi":"10.14989/ActaUrolJap_71_5_137","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_5_137","url":null,"abstract":"<p><p>Varicocele is a frequent cause of male infertility. On the contrary, the majority of men who have varicocele show normal semen parameters. This study aimed to clarify the pathophysiology of abnormal semen findings associated with varicocele by evaluating the total antioxidant capacity in seminal plasma and serum. Sixty patients with clinical varicocele were included in this study. Of the 60 patients, 22 men had scrotal pain caused by varicocele with normal semen parameters, and 38 men had abnormal semen parameters as defined by the 2010 World Health Organization criteria. Before the investigation, semen samples were collected. Total antioxidant capacity in serum and seminal plasma was analyzed by colorimetric assay and the relationship between semen parameters and total antioxidant capacity was evaluated. Positive associations were found between antioxidant capacity in seminal plasma and concentration (r=0.364, P=0.004), motility (r=0.254, P=0.050), and total motile sperm count (r=0.468, P<0.001). In multivariate analysis, higher total motile sperm count showed a significant positive relationship with higher total antioxidant capacity in seminal plasma (P=0.001). Our results indicated that the total antioxidant capacity of seminal plasma might affect varicocele-related male infertility.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"137-143"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A Case of Cut-to-the-light Incision for Ureteroileal Anastomotic Obstruction after Robot-Assisted Radical Cystectomy and Ileal Conduit].","authors":"Ryunosuke Murofushi, Daiki Ikarashi, Yasushi Nozaki, Moe Toyoshima, Ei Shiomi, Tomohiko Matsuura, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Jun Sugimura, Wataru Obara","doi":"10.14989/ActaUrolJap_71_5_155","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_5_155","url":null,"abstract":"<p><p>A 68-year-old man with muscle invasive bladder cancer underwent robot-assisted radical cystectomy and ileal conduit for urinary diversion using the Wallace procedure. Two months after surgery, the patient developed recurrent urinary tract infections, and computed tomography showed left hydronephrosis. Nephrostography revealed a left ureteroileal anastomotic obstruction. Ho-YAG laser-assisted incision and transureter dilatation were performed 6 months after surgery. Nephrostography performed 1 month after dilatation confirmed improvement of the obstructed area and no symptom recurrence.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"155-158"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A Case of Thrombocytopenia as an Adverse Effect of Mycophenolate Mofetil before Blood Type-Incompatible Living-Donor Renal Transplantation].","authors":"Suguru Ito, Kazutoshi Okubo, Yoshiyuki Okada, Kosuke Ogawa, Yukari Tanaka, Noriyuki Ito, Hitomi Miyata, Toru Matsugasumi, Masakatsu Hishizawa","doi":"10.14989/ActaUrolJap_71_5_149","DOIUrl":"https://doi.org/10.14989/ActaUrolJap_71_5_149","url":null,"abstract":"<p><p>We present a patient who developed thrombocytopenia before blood type-incompatible living-donor renal transplantation, which inhibited proper evaluation and treatment of thrombocytopenia. A 45-year-old woman with kidney failure of unknown etiology who was on peritoneal dialysis for 2 years was admitted after receiving immunosuppressive drugs at an outpatient clinic. The platelet count gradually decreased and eventually reached a level that could interfere with surgery. Mycophenolate mofetil was considered the cause of thrombocytopenia. Thus, it was discontinued, which increased the platelet count. The patient also received platelet transfusion, and renal transplantation was successfully performed as planned. The patient did not develop hemorrhage after the transplantation. The pretransplantation administration of mycophenolate mofetil was suspected to have caused thrombocytopenia in this patient. Hence, sudden decline in platelet count before surgery should be promptly investigated to identify potential causes in order of their likelihood. It is important to confirm that there is no evidence of platelet consumption or destruction.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 5","pages":"149-153"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A Case of Transverse Testicular Ectopia with Complete Descent to the Bottom of the Contralateral Scrotum].","authors":"Shinya Abe, Kazuma Hiramatsu, Toshihide Hosomi, Takashi Matsuoka, Yuki Kamiyama, Naofumi Tsutsumi, Takehiko Segawa","doi":"10.14989/ActaUrolJap_71_4_127","DOIUrl":"10.14989/ActaUrolJap_71_4_127","url":null,"abstract":"<p><p>We report a case of transverse testicular ectopia (TTE) with complete descent to the contralateral scrotum. A fifty-five-year-old man with malignant lymphoma in the left inguinal region was diagnosed with TTE and persistent Müllerian duct syndrome (PMDS) via CT scan. Ultrasound imaging and palpation revealed no malignant findings in the testes. Given the rarity of malignant transformation in müllerian duct remnant, we opted for follow-up through palpation and ultrasound. TTE is typically diagnosed in childhood, making adult cases comparatively rare. This case is particularly notable due to the complete descent of the testes. We also collected data on Japanese adult cases of TTE since 1980. Herein, we present this case of TTE along with a review of the literature.</p>","PeriodicalId":39291,"journal":{"name":"Acta Urologica Japonica","volume":"71 4","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}