1
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Yepes MM, Herrera Ortiz AF, Del Castillo V, Rojas J. Clear cell renal cell carcinoma with high PSMA uptake. BMJ Case Rep 2024; 17:e260372. [PMID: 38663894 PMCID: PMC11043719 DOI: 10.1136/bcr-2024-260372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Affiliation(s)
- Maria Monica Yepes
- Radiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
- Radiology, Universidad El Bosque, Bogotá, Bogotá, Colombia
| | - Andrés Felipe Herrera Ortiz
- Radiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
- Radiology, Universidad El Bosque, Bogotá, Bogotá, Colombia
| | - Valeria Del Castillo
- Radiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
- Radiology, Universidad El Bosque, Bogotá, Bogotá, Colombia
| | - Julian Rojas
- Nuclear Medicine, Hospital Universitario Fundación Santa Fe de Bogotá, Bogota, Colombia
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2
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Banerjee A, Babu R, Jayaraman D, Chilukuri S. Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour. BMJ Case Rep 2024; 17:e260600. [PMID: 38642931 PMCID: PMC11033631 DOI: 10.1136/bcr-2024-260600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
Bilateral Wilms tumour (BWT) is a surgically challenging condition. Virtual reality (VR) reconstruction aids surgeons to foresee the anatomy ahead of Nephron Sparing Surgery (NSS). Three-dimensional (3D) visualisation improves the anatomical orientation of surgeons performing NSS. We herewith report a case of BWT where VR planning and 3D printing were used to aid NSS. Conventional imaging is often found to be inadequate while assessing the tumour-organ-vascular anatomy. Advances like VR and 3D printing help surgeons plan better for complex surgeries like bilateral NSS. Next-generation extended reality tools will likely aid robotic-assisted precision NSS and improve patient outcomes.
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Affiliation(s)
- Avijit Banerjee
- Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Ramesh Babu
- Pediatric Urology, Sri Ramachandra University Medical College, Chennai, India
| | - Dhaarani Jayaraman
- Paediatric Hematology and Oncology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, India
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3
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Li T, Jiang Y, Bai Y, Jiang K, Du G, Chen P, Luo C, Li L, Qiao J, Shen J. A review for the impacts of circadian disturbance on urological cancers. Sleep Biol Rhythms 2024; 22:163-180. [PMID: 38524168 PMCID: PMC10959858 DOI: 10.1007/s41105-023-00500-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/18/2023] [Indexed: 03/26/2024]
Abstract
Circadian rhythm is an internal timing system and harmonizes a variety of cellular, behavioral, and physiological processes to daily environment. Circadian disturbance caused by altered life style or disrupted sleep patterns inevitably contributes to various disorders. As the rapidly increased cancer occurrences and subsequent tremendous financial burdens, more researches focus on reducing the morbidity rather than treating it. Recently, many epidemiologic studies demonstrated that circadian disturbance was tightly related to the occurrence and development of cancers. For urinary system, numerous clinical researches observed the incidence and progress of prostate cancer were influenced by nightshift work, sleep duration, chronotypes, light exposure, and meal timing, this was also proved by many genetic and fundamental findings. Although the epidemiological studies regarding the relationship between circadian disturbance and kidney/bladder cancers were relative limited, some basic researches still claimed circadian disruption was closely correlated to these two cancers. The role of circadian chemotherapy on cancers of prostate, kidney, and bladder were also explored, however, it has not been regularly recommended considering the limited evidence and poor standard protocols. Finally, the researches for the impacts of circadian disturbance on cancers of adrenal gland, penis, testis were not found at present. In general, a better understanding the relationship between circadian disturbance and urological cancers might help to provide more scientific work schedules and rational lifestyles which finally saving health resource by reducing urological tumorigenesis, however, the underlying mechanisms are complex which need further exploration.
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Affiliation(s)
- Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Yiting Jiang
- Department of Otorhinolaryngology, The Ninth People’s Hospital of Chongqing, Chongqing, China
| | - Yunjin Bai
- Department of Urology and Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Kehua Jiang
- Department of Urology, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Guangshi Du
- Translational Medicine Research Center of Guizhou Medical University, Guiyang, China
| | - Peng Chen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Chao Luo
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Lei Li
- Gastrointestinal Surgery Center, School of Medicine, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Qiao
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Jun Shen
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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4
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Bobbili PJ, Ivanova J, Solit DB, Mettu NB, McCall SJ, Dhawan M, DerSarkissian M, Arondekar B, Chang J, Niyazov A, Lee J, Huq R, Green M, Turski M, Lam P, Muthukumar A, Guo T, Mohan M, Zhang A, Duh MS, Oh WK. Treatment Patterns and Clinical Outcomes Among Patients With Metastatic Prostate Cancer Harboring Homologous Recombination Repair Mutations. Clin Genitourin Cancer 2024; 22:102080. [PMID: 38653037 DOI: 10.1016/j.clgc.2024.102080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND There is currently limited literature assessing the real-world treatment patterns and clinical outcomes of patients with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) mutations. METHODS Medical charts were abstracted for mCRPC patients with ≥ 1 of 12 HRR somatic gene alterations treated at US oncology centers participating in the American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange. Treatment patterns and clinical outcomes were assessed from the initiation of first-line or later (1L+) mCRPC therapy received on or after July 1, 2014. RESULTS Among 138 patients included in the study, the most common somatic HRR mutations were CDK12 (47.8%), BRCA2 (22.5%), and ATM (21.0%). Novel hormonal therapy and taxane chemotherapy were most commonly used in 1L; taxane use increased in later lines. Median overall survival (95% confidence interval [CI]) was 36.3 (30.7-47.8) months from initiation of 1L therapy and decreased for subsequent lines. Similarly, there was a trend of decreasing progression-free survival and prostate-specific antigen response from 1L to 4L+ therapy. CONCLUSIONS Treatment patterns identified in this study were similar to those among patients with mCRPC regardless of tumor HRR mutation status in the literature.
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Affiliation(s)
| | | | - David B Solit
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | | | | | | | - Jocelyn Lee
- American Association for Cancer Research, Philadelphia, PA
| | - Risha Huq
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michelle Green
- Department of Pathology, Duke University Medical Center, Durham, NC
| | | | - Phu Lam
- UCSF Hellen Diller Cancer Center, San Francisco, CA
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5
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Ghorai RP, Panaiyadiyan S, Singh P, Nayak B. Management conundrum in a case of renal cell cancer (RCC) on dual antiplatelet therapy (DAPT) for recently placed coronary drug-eluting stent (DES). BMJ Case Rep 2024; 17:e257750. [PMID: 38423578 PMCID: PMC10910470 DOI: 10.1136/bcr-2023-257750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
A man in his 50s presented in an emergency with breathlessness and chest discomfort. On evaluation, he was diagnosed with coronary artery disease, with more than 80% narrowing of the right coronary and left circumflex arteries. The patient underwent percutaneous coronary intervention and was started on dual antiplatelet (DAPT) therapy. After starting DAPT, the patient developed gross haematuria with a drop in haematocrit. Further evaluation revealed a left renal mass with urinary bladder clots. Because of the risk of stent thrombosis on stopping DAPT, radical nephrectomy was deferred, and the patient underwent left renal artery angioembolisation and bladder clot evacuation. On the follow-up, the patient was stable with a gradual decrease in renal mass size, and after a year, the patient underwent definitive surgery. The patient is doing well in 4 years of follow-up with no metastasis.
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Affiliation(s)
- Rudra Prasad Ghorai
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Sridhar Panaiyadiyan
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
- Department of Urology, National Cancer Institute - All India Institute of Medical Sciences, Jhajjar, Haryana, India
| | - Prabhjot Singh
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Brusabhanu Nayak
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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Saini V, Garg R, Kataria K, Nelson T. True mesothelial cyst of the adrenal gland: its clinical profile and management. BMJ Case Rep 2024; 17:e258485. [PMID: 38395468 PMCID: PMC10895221 DOI: 10.1136/bcr-2023-258485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
The incidence of adrenal cysts is 0.06% and only 9% of these are true mesothelial cysts. Here, we present a case of a true mesothelial cyst together with a review of the literature. A female in her 30s presented to the surgical outpatient department complaining of right flank pain. Her contrast-enhanced CT scan revealed a 7.5×6.5×4.5 cm right adrenal gland cyst. The patient underwent a laparoscopic right adrenalectomy. Immunohistopathology revealed the cyst to be mesothelial in nature. The majority of true mesothelial adrenal cysts are benign, unilateral and more common in women. Any adrenal cyst diagnosed as a functional lesion or one that may be malignant or with a diameter of 5 cm or greater requires surgical care whereas smaller lesions can be managed conservatively. Laparoscopic adrenalectomy for an adrenal cyst of diameter greater than 6 cm is a safe and feasible procedure in expert hands if there is no invasion of surrounding tissue.
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Affiliation(s)
- Vikram Saini
- Department of Surgical Discipline, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Richa Garg
- Department of Surgical Discipline, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Kamal Kataria
- Department of Surgical Discipline, All India Institute of Medical Sciences, New Delhi, Delhi, India
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7
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Sanchez Teran AI, Martínez Zamorano M, Trujillo Ortíz JA, Cerna Arriaga J. Renal cell carcinoma (RCC) spreading to the larynx: an unusual condition. BMJ Case Rep 2024; 17:e255459. [PMID: 38272511 PMCID: PMC10826486 DOI: 10.1136/bcr-2023-255459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
A man in his mid-70s, heavy smoker with chronic alcohol consumption and a chronic exposure to insecticides and burning of crop residues was referred to the surgical oncology department because of a 4-month onset of hoarseness, dyspnoea and laryngeal stridor. He had a history of left nephrectomy due to Fuhrman IV clear cell renal cancer 2 years ago. The patient underwent a bronchoscopy which identified a deforming tumour of the left vallecula, occlusion of 90% of the lumen and did not allow a safe biopsy. Following discussion between the oncological team, total laryngectomy and bilateral neck dissection of levels II, III, IV and V were performed, finding a transglottic tumour of approximately 4×3 cm with extension to the right anterolateral thyroid cartilage. The pathology report described metastatic RCC. The patient recovered well postoperatively and started systemic therapy with a vascular endothelial growth factor receptors inhibitor.
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8
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Kitamura K, Nonami T, Muto S, Horie S. Small cell bladder carcinoma treated with nivolumab as adjuvant maintenance therapy. BMJ Case Rep 2023; 16:e257402. [PMID: 38160025 PMCID: PMC10759028 DOI: 10.1136/bcr-2023-257402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
We report using the programmed death-1 immune checkpoint inhibitor (ICI) antibody, nivolumab, as part of a multimodal treatment strategy in small cell bladder carcinoma (SCBC). The patient presented with gross haematuria and was diagnosed with urothelial carcinoma with SCBC. He received neoadjuvant chemotherapy (NAC; carboplatin plus etoposide) according to the small cell lung cancer regimen. After three cycles of NAC, there was no progression of local disease, and a robot-assisted radical cystectomy with ileal conduit was conducted. Post surgery, the patient was treated with nivolumab (240 mg) every 2 weeks as a maintenance therapy after adjuvant cisplatin plus etoposide therapy. After more than 1.5 years post surgery, no tumour recurrence or metastases are present. The patient was treated with nivolumab, which was curative after radical cystectomy. Further research is required to elucidate the potential role of ICIs in SCBC.
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Affiliation(s)
- Kosuke Kitamura
- Department of Urology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Takahiro Nonami
- Department of Urology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Satoru Muto
- Department of Urology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Shigeo Horie
- Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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Navriya SC, Singh V, Choudhary GR, Tripathi S. Postradical cystectomy delayed urethral recurrence: a rare presentation posing diagnostic dilemma. BMJ Case Rep 2023; 16:e256700. [PMID: 38086572 PMCID: PMC10728915 DOI: 10.1136/bcr-2023-256700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
The incidence of urethral recurrence after radical cystectomy is 1% to 8%, with most cases occurring within the first 2 years of surgery. Prophylactic urethrectomy is rarely performed nowadays due to no known survival benefit and increased morbidity due to the procedure. However, we encountered a rare case of delayed urethral recurrence presenting as recurrent urethral collection 4 years after radical cystectomy with ileal conduit diversion, posing a diagnostic dilemma.
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Affiliation(s)
| | - Vikram Singh
- Urology, All india Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Shashank Tripathi
- Urology, All india Institute of Medical Sciences, Jodhpur, Rajasthan, India
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10
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Singh S, Kumar N, Anand M, Rizwi K. Renal neuroendocrine tumour with preoperative diagnostic dilemma. BMJ Case Rep 2023; 16:e257896. [PMID: 38087491 PMCID: PMC10728913 DOI: 10.1136/bcr-2023-257896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
| | | | - Madhur Anand
- King George Medical University, Lucknow, Uttar Pradesh, India
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11
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Korkes F, Gomez-Bueno MP, García-Perdomo HA. Incidence of urological tumors in Down's syndrome: a systematic review and meta-analysis. Int Urol Nephrol 2023; 55:2381-2387. [PMID: 37368086 PMCID: PMC10499742 DOI: 10.1007/s11255-023-03656-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/27/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Some authors have estimated that the incidence of testicular germ cell tumors in individuals with trisomy 21 is more than fivefold higher than that in the general population. OBJECTIVE This systematic review aimed to estimate the incidence of urological tumors in patients with Down's syndrome. STUDY DESIGN We conducted a search strategy in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to nowadays. We assessed the risk of bias and performed a meta-analysis. Also, the heterogeneity between trials was evaluated by the I2 test. We completed the subgroup analysis based on the type of urological tumor (testis, bladder, kidney, upper urological tract, penile, retroperitoneum). RESULTS We found 350 studies by the search strategy. After carefully reviewing, full-text studies were included. 16,248 individuals with Down's syndrome were included, and 42 patients presented with urological tumors. There was a total incidence of 0.1%, 95%CI (0.06-0.19), I2 61%. The most common urological tumor reported was testicular. We found six studies describing 31 events and an overall incidence of 0.19%, 95%CI (0.11-0.33), I2: 51%. Other studies reported kidney, penile, upper urinary tract, bladder, and retroperitoneum tumors with a very low incidence, 0.02%, 0.06%, 0.03%, 0.11%and 0.07%, respectively. DISCUSSION Regarding non-testicular urological tumors, we found incidences as low as 0.02% in kidney cancer or 0.03% in the upper-urothelial tract tumors. It is also lower than the general population. Compared to the age of onset of patients, it is also lower than the general population, perhaps related to a shorter life expectancy. As a limitation, we found a high heterogeneity and a lack of information regarding non-testicular tumors. CONCLUSION There was a very low incidence of urological tumors in people with Down's syndrome. Testis tumor was the most frequently described in all cohorts and within a normal distribution range.
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Affiliation(s)
| | - Maria Paula Gomez-Bueno
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cll 4b #36-00, Cali, Colombia
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia
| | - Herney Andrés García-Perdomo
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cll 4b #36-00, Cali, Colombia.
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia.
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12
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Coe C, Chirputkar K, Joseph L, Jude EB. Pedal acrometastasis secondary to urothelial carcinoma masquerading as Charcot arthropathy in a patient with diabetes. BMJ Case Rep 2023; 16:e254468. [PMID: 37730428 PMCID: PMC10514597 DOI: 10.1136/bcr-2022-254468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
A woman in her 80s with known diabetes mellitus and bladder cancer presented to her general practitioner (GP) with pain and swelling in her left foot following trauma. Initial radiographs were reported as normal, prompting a diagnosis of a simple sprain and conservative management. Three months later, the patient was referred to the orthopaedic team due to progressively increasing pain and swelling. Repeat X-rays revealed lytic lesions in both the talus and navicular bones; MRI confirmed the presence of a lytic and proliferative defect in the mid-foot, which was reported as acute Charcot arthropathy with superimposed infection. This was also considered the most likely diagnosis when imaging was reviewed in two separate multidisciplinary team) meetings. However, biopsy demonstrated that the cause of the presentation was in fact acrometastasis from urothelial carcinoma, an infrequently described entity.
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Affiliation(s)
- Calvin Coe
- Endocrinology and Diabetes, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Kedar Chirputkar
- Trauma and Orthopaedic Surgery, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Leena Joseph
- Histopathology, Manchester University NHS Foundation Trust, Manchester, UK
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Zeng Y, Lv C, Wan B, Gong B. The current landscape of m6A modification in urological cancers. PeerJ 2023; 11:e16023. [PMID: 37701836 PMCID: PMC10493088 DOI: 10.7717/peerj.16023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
N6-methyladenosine (m6A) methylation is a dynamic and reversible procession of epigenetic modifications. It is increasingly recognized that m6A modification has been involved in the tumorigenesis, development, and progression of urological tumors. Emerging research explored the role of m6A modification in urological cancer. In this review, we will summarize the relationship between m6A modification, renal cell carcinoma, bladder cancer, and prostate cancer, and discover the biological function of m6A regulators in tumor cells. We will also discuss the possible mechanism and future application value used as a potential biomarker or therapeutic target to benefit patients with urological cancers.
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Affiliation(s)
- Yaohui Zeng
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Cai Lv
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Bangbei Wan
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Binghao Gong
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
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14
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Arad U, Werren C, White D. Paraneoplastic sacroiliitis. BMJ Case Rep 2023; 16:e252572. [PMID: 37652573 PMCID: PMC10476127 DOI: 10.1136/bcr-2022-252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
A man in his early 70s presented with stiffness and aching in the shoulder and pelvic girdles. His C reactive protein level was elevated at 116 mg/L, leading to an initial diagnosis of polymyalgia rheumatica. Treatment with prednisone at 20 mg/day provided limited improvement and relapses recurred despite concomitant immunosuppressive agents. Extensive investigations failed to reveal an underlying aetiology.Five years later, gross painless haematuria led to the detection of an invasive papillary urothelial carcinoma. A review of the staging CT scan revealed findings compatible with bilateral erosive sacroiliitis, which had developed since his initial presentation. Radical cystoprostatectomy provided temporary relief but after a further 9 months, symptoms relapsed, and metastatic spread was discovered.Paraneoplastic sacroiliitis is a rare clinical entity; and to the best of our knowledge, this is the first reported case associated with a solid tumour.
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Affiliation(s)
- Uri Arad
- Rheumatology, Waikato Hospital, Hamilton, New Zealand
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand
| | | | - Douglas White
- Rheumatology, Waikato Hospital, Hamilton, New Zealand
- Waikato Clinical School, University of Auckland, Hamilton, New Zealand
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15
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Diederichsen MZ, Weile KS, Christiansen CB, Pietersen PI. Cryoablation following neoadjuvant tyrosine kinase inhibitor as treatment of a T1a renal clear cell carcinoma in a patient with a solitary kidney. BMJ Case Rep 2023; 16:e252800. [PMID: 37567735 PMCID: PMC10423794 DOI: 10.1136/bcr-2022-252800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
The case is presented of a woman in her 60s with renal cell carcinoma in a solitary kidney with normal renal function. Because of the solitary kidney status, the management strategy described in acknowledged guidelines was not possible. The patient was treated with standard first-line tyrosine kinase inhibitor followed by percutaneous CT-guided cryoablation. Before and after the procedure the patient had normal kidney function. The treatment resulted in local cancer control, but a bone metastasis developed in the thoracic part of the spine.
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Affiliation(s)
| | | | | | - Pia Iben Pietersen
- Department of Radiology, Odense University Hospital, Odense, Syddanmark, Denmark
- Research and Innovation Unit of Radiology - UNIFY, Department of Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
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16
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Yildirim H, Widdershoven CV, Aarts MJ, Bex A, Bloemendal HJ, Bochove-Overgaauw DM, Hamberg P, Herbschleb KH, van der Hulle T, Lagerveld BW, van Oijen MG, Oosting SF, van Thienen JV, van der Veldt AA, Westgeest HM, Zeijdner EE, Aben KK, van den Hurk C, Zondervan PJ, Bins AD. The PRO-RCC study: a long-term PROspective Renal Cell Carcinoma cohort in the Netherlands, providing an infrastructure for 'Trial within Cohorts' study designs. BMC Cancer 2023; 23:648. [PMID: 37434119 PMCID: PMC10337109 DOI: 10.1186/s12885-023-11094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/21/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Ongoing research in the field of both localized, locally advanced and metastatic renal cell carcinoma has resulted in the availability of multiple treatment options. Hence, many questions are still unanswered and await further research. A nationwide collaborative registry allows to collect corresponding data. For this purpose, the Dutch PROspective Renal Cell Carcinoma cohort (PRO-RCC) has been founded, for the prospective collection of long-term clinical data, patient reported outcome measures (PROMs) and patient reported experience measures (PREMs). METHODS PRO-RCC is designed as a multicenter cohort for all Dutch patients with renal cell carcinoma (RCC). Recruitment will start in the Netherlands in 2023. Importantly, participants may also consent to participation in a 'Trial within cohorts' studies (TwiCs). The TwiCs design provides a method to perform (randomized) interventional studies within the registry. The clinical data collection is embedded in the Netherlands Cancer Registry (NCR). Next to the standardly available data on RCC, additional clinical data will be collected. PROMS entail Health-Related Quality of Life (HRQoL), symptom monitoring with optional ecological momentary assessment (EMA) of pain and fatigue, and optional return to work- and/or nutrition questionnaires. PREMS entail satisfaction with care. Both PROMS and PREMS are collected through the PROFILES registry and are accessible for the patient and the treating physician. TRIAL REGISTRATION Ethical board approval has been obtained (2021_218) and the study has been registered at ClinicalTrials.gov (NCT05326620). DISCUSSION PRO-RCC is a nationwide long-term cohort for the collection of real-world clinical data, PROMS and PREMS. By facilitating an infrastructure for the collection of prospective data on RCC, PRO-RCC will contribute to observational research in a real-world study population and prove effectiveness in daily clinical practice. The infrastructure of this cohort also enables that interventional studies can be conducted with the TwiCs design, without the disadvantages of classic RCTs such as slow patient accrual and risk of dropping out after randomization.
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Affiliation(s)
- Hilin Yildirim
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC location University of Amsterdam, 4F De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
| | | | - Maureen Jb Aarts
- Department of Medical Oncology, GROW-School for Oncology and Development Biology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Axel Bex
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- The Royal Free London NHS Foundation Trust, London, UK
- UCL Division of Surgery and Interventional Science, London, UK
| | - Haiko J Bloemendal
- Department of Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Paul Hamberg
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, the Netherlands
| | - Karin H Herbschleb
- Department of Internal Medicine, St. Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | | | | | - Martijn Gh van Oijen
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC location University of Amsterdam, 4F De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - Sjoukje F Oosting
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Johannes V van Thienen
- Department of Medical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek hospital, Amsterdam, The Netherlands
| | - Astrid Am van der Veldt
- Department of Medical Oncology, Department of Radiology & Nuclear Medicine, Erasmus Medical Center-Cancer Institute, Rotterdam, the Netherlands
| | - Hans M Westgeest
- Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands
| | | | - Katja Kh Aben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Corina van den Hurk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Patricia J Zondervan
- Department of Urology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Adriaan D Bins
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC location University of Amsterdam, 4F De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
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17
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Pathak N, Kakkar A, Kaushal S, Batra A. Sclerosing epithelioid fibrosarcoma of the kidney. BMJ Case Rep 2023; 16:16/6/e253447. [PMID: 37295814 DOI: 10.1136/bcr-2022-253447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
A woman in her 20s presented with headache and back pain and was found to have a left renal mass with bony metastases. She underwent nephrectomy, and on histopathology was initially diagnosed with stage 4 clear cell sarcoma of the kidney. She underwent palliative radiation and chemotherapy; however, the disease progressed and she came to our centre. We started her on second-line chemotherapy and submitted her tissue blocks for review. Due to her age and lack of sclerotic stroma in the tissue, we had our doubts about the diagnosis and hence, tissue sample was submitted for next-generation sequencing (NGS). NGS detected an EWSR1::CREBL1 fusion, clinching the final diagnosis of sclerosing epithelioid fibrosarcoma of the kidney, a singular diagnosis rarely reported in the literature. Currently, the patient is post her third line of chemotherapy, is on maintenance, and is doing well and has resumed her daily activities.
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Affiliation(s)
- Neha Pathak
- Medical Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Aanchal Kakkar
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Seema Kaushal
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Atul Batra
- Medical Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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18
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Maclean E, Barns M, McDermott K. Pure primary renal yolk sac tumour in an adult: extremely rare clinical finding. BMJ Case Rep 2023; 16:16/5/e254024. [PMID: 37236676 DOI: 10.1136/bcr-2022-254024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
We present a rare case of an extragonadal retroperitoneal yolk sac tumour in an adult male, who presented with severe abdominal pain to his local hospital. Imaging revealed a large retroperitoneal soft tissue mass with no evidence of metastases. Initial biopsy demonstrated poorly differentiated carcinoma, favoured to be renal cell carcinoma. The patient underwent surgical resection following re-presentation with severe abdominal pain and significant interval enlargement of the mass. Laparotomy revealed a renal tumour that had ruptured through the left mesocolon into the peritoneal cavity. Postoperative histopathological examination revealed a yolk sac tumour involving the kidney, perinephric fat, renal sinus fat, renal hilar lymph node and colonic mesentery. Immunohistochemical staining for alpha-fetoprotein and glypican 3 was positive in the tumour cells without evidence of other germ cell elements, confirming the diagnosis of a pure yolk sac tumour. To our knowledge, this is an extremely rare case of a primary pure yolk sac tumour arising from the kidney in an adult.
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Affiliation(s)
- Ellen Maclean
- Department of Urology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mitchell Barns
- Department of Urology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Kara McDermott
- Department of Urology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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19
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Conroy S, Griffin J, Cumberbatch M, Pathak S. Acute haemorrhage from a large renal epithelioid angiomyolipoma: diagnostic and management considerations in a teenage patient with a rare cancer. BMJ Case Rep 2023; 16:16/5/e252351. [PMID: 37202109 DOI: 10.1136/bcr-2022-252351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Acute renal haemorrhage is a life-threatening condition that is complicated in the context of renal malignancy. Here, we present the case of a teenage male presenting acutely with a large, bleeding renal epithelioid angiomyolipoma (EAML) of the kidney-a rare cancer, which is part of the perivascular epithelioid cell tumour family. The patient was managed acutely with prompt resuscitation, transfer to a centre of expertise and haemorrhagic control using radiologically guided endovascular techniques; this subsequently permitted an oncologically sound procedure (radical nephrectomy, inferior vena cava thrombectomy and lymphadenectomy) to be performed within 24 hours. The description and discussion around this unique case summarises the patient's clinical journey, while exploring the current literature surrounding diagnosis and outcomes of patients with renal EAMLs.
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Affiliation(s)
- Samantha Conroy
- Academic Unit of Urology, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jon Griffin
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
- Department of Pathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Marcus Cumberbatch
- Academic Unit of Urology, Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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20
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Moreno-Fontela MP, Pinazo-Rubio I, Garrido-Abad P. Penoscrotal oedema as the first sign of metastatic urothelial bladder cancer. BMJ Case Rep 2023; 16:16/2/e254106. [PMID: 36731951 PMCID: PMC9896236 DOI: 10.1136/bcr-2022-254106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- María Pilar Moreno-Fontela
- Department of Urology, Francisco de Vitoria University, Pozuelo de Alarcón, Spain .,Department of Urology, Hospital Universitario del Henares, Coslada, Spain
| | - Ignacio Pinazo-Rubio
- Department of Urology, Francisco de Vitoria University, Pozuelo de Alarcón, Spain.,Department of Urology, Hospital Universitario del Henares, Coslada, Spain
| | - Pablo Garrido-Abad
- Department of Urology, Francisco de Vitoria University, Pozuelo de Alarcón, Spain.,Department of Urology, Hospital Universitario del Henares, Coslada, Spain
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21
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Klose P, Werner M, Saha F, Voiß P. [Mind-body medicine in integrative uro-oncology : Studies and areas of application]. Urologie 2023; 62:27-33. [PMID: 36471013 DOI: 10.1007/s00120-022-01978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mind-body medicine (MBM) complements somatically oriented medical practice with behavioral and lifestyle-oriented approaches: Thus, health-promoting attitudes and behaviors are strengthened in everyday life. In integrative oncology, it helps promote emotional and physical well-being. RESEARCH QUESTION Guideline recommendations and the current study situation in integrative uro-oncology are presented. RESULTS During and after completion of primary therapy, mindfulness-based stress reduction (MBSR) shows positive effects on anxiety, stress, and fatigue. However, it appears that the offer needs to be better tailored to the needs of prostate cancer patients. The effects of yoga are well documented, especially on fatigue, quality of life, and sexual function. Prostate cancer patients also showed a significantly increased immune response after completing a yoga intervention. Tai Ji Quan/Qigong improve quality of life, fatigue, and other symptoms. Hypnosis-especially in the palliative setting-mitigates anxiety, and relaxation techniques alleviate sleep problems and nausea/vomiting. Multimodal services improve quality of life on numerous levels. Higher resilience correlates with better quality of life and stronger male self-esteem. CONCLUSIONS MBSR alleviates many symptoms but needs to be adapted to the needs of prostate cancer patients; yoga and Tai Ji Chuan/Qigong alleviate fatigue and improve quality of life. Hypnosis and relaxation training reduce nausea/vomiting, and improve sleep and anxiety. Resilience promotion is important to support oncological patients.
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22
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Spazzapan M, Bullingham R, Nkwam NM, Ypsilantis E. Paraureteric space post-ureteric re-implantation: a rare cause of small bowel obstruction. BMJ Case Rep 2022; 15:15/12/e252356. [PMID: 36585052 PMCID: PMC9809218 DOI: 10.1136/bcr-2022-252356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A female patient in her 80s presented with a 2-day history of abdominal pain and absolute constipation, having previously undergone a robotic left distal ureterectomy with ureteric re-implantation. CT revealed a closed-loop small bowel obstruction with transition point adjacent to the left ureter and resultant upstream hydronephrosis. An emergency laparotomy revealed small bowel herniation into a paraureteric space created by her previous surgery and defined by the distal ureter medially, the common iliac vessels laterally and the mobilised bladder dome anteriorly. The viable small bowel was reduced, and the space was eliminated by omental flap transposition after omentoplasty. The patient made a full recovery. Preoperative diagnosis of such an unusual cause of internal herniation can be challenging. This very rarely reported case raises awareness of the condition and proposes a treatment strategy.
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Affiliation(s)
- Martina Spazzapan
- Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Roberta Bullingham
- Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Efthymios Ypsilantis
- Princess Royal University Hospital, Department of Surgery, King's College Hospital NHS Foundation Trust, London, UK
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23
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Andrif M, Elmarrachi H, Ismaili N. Paradigm change in urological, gynaecological and breast cancer management: A new practice-changing data from ASCO 2022 annual meeting. Cancer Treat Res Commun 2022; 35:100677. [PMID: 36696853 DOI: 10.1016/j.ctarc.2022.100677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
Changing medical practice has been a constant process based on many scientific findings for years. In the oncology community, the American Society of Clinical Oncology (ASCO), one of the major annual conferences, presented the latest updates on practice-changing in cancer. At the recent meeting of 2022, held this year on June 2-6, researchers presented essential findings in urological, gynecological, and breast cancer management. In urological cancer, olaparib + abiraterone was demonstrated thru the PROpel trial to benefit in first-line treatment mCRPC regardless of the HRR stratification factor, along with the adjuvant therapy everolimus, for fully resected RCC in the EVEREST trial. In gynecological cancer, tisotumab vedotin demonstrated a potential role in improving clinical outcomes in 1st line r/mCC thru InnovaTV-205. In breast cancer, trastuzumab deruxtecan showed significant benefit for redefined human epidermal growth factors receptor 2 status in HER2 low BC patients, where current targeted-HER2 therapies are ineffective in the DESTINY-BREAST 04 study. The use of Immuno-based combinations in the medical management of TNBC patients has been supported thru several recent studies, showing positive results and outcomes, as demonstrated by the expert's opinions in Rizzo et al. research papers. In this article, we resumed the different renowned and what we considered intriguing to review studies presented during these three long sessions at the ASCO 2022 meeting.
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Affiliation(s)
- Meriem Andrif
- Mohammed VI Center for Research & Innovation, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco; Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Hafsa Elmarrachi
- Mohammed VI Center for Research & Innovation, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco; Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Nabil Ismaili
- Mohammed VI Center for Research & Innovation, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco; Department of Medical Oncology, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco; Department of Medical Oncology, Mohamed VI International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Bouskoura, Morocco; Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
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24
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Yu CH, En M, Yu DS. Rare case of pancreatic adenocarcinoma with spermatic cord and testicular metastasis. BMJ Case Rep 2022; 15:15/12/e250289. [PMID: 36593606 PMCID: PMC9730350 DOI: 10.1136/bcr-2022-250289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Male gonadal metastases from pancreatic carcinomas are extremely rare, with fewer than 20 cases documented in the literature. Herein, we report a man in his 50s who presented at the genitourinary outpatient department with an enlarged scrotum (right side) that had developed progressively over several weeks. He also reported mild upper abdominal discomfort. Scrotal sonography revealed a hydrocele on the right side without testicular lesions. A mass pancreatic tail lesion with invasion of the spleen and left adrenal gland was identified through abdominal CT and MRI. Endoscopic ultrasound fine needle biopsy and right radical orchiectomy were performed. Moderately differentiated adenocarcinoma of the pancreatic tail with hematogenous metastasis to the right testis, epididymis and spermatic cord was verified on the basis of the pathology report. Disease progression occurred despite the patient receiving palliative chemoradiation therapy.
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Affiliation(s)
- Chung-Hao Yu
- Division of Urology, Department of Surgery, Tri-Service GeneralHospital, National Defense Medical Center, Taipei, Taiwan,Department of Surgery, Hua-lien Army General Hospital, Hua-lien, Taiwan
| | - Meng En
- Division of Urology, Department of Surgery, Tri-Service GeneralHospital, National Defense Medical Center, Taipei, Taiwan
| | - Dah-Shyong Yu
- Division of Urology, Department of Surgery, Tri-Service GeneralHospital, National Defense Medical Center, Taipei, Taiwan
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25
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Xu K, Han Y, Huang Y, Wei P, Yin J, Jiang J. The application of 3D bioprinting in urological diseases. Mater Today Bio 2022; 16:100388. [PMID: 35967737 DOI: 10.1016/j.mtbio.2022.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 12/02/2022] Open
Abstract
Urologic diseases are commonly diagnosed health problems affecting people around the world. More than 26 million people suffer from urologic diseases and the annual expenditure was more than 11 billion US dollars. The urologic cancers, like bladder cancer, prostate cancer and kidney cancer are always the leading causes of death worldwide, which account for approximately 22% and 10% of the new cancer cases and death, respectively. Organ transplantation is one of the major clinical treatments for urological diseases like end-stage renal disease and urethral stricture, albeit strongly limited by the availability of matching donor organs. Tissue engineering has been recognized as a highly promising strategy to solve the problems of organ donor shortage by the fabrication of artificial organs/tissue. This includes the prospective technology of three-dimensional (3D) bioprinting, which has been adapted to various cell types and biomaterials to replicate the heterogeneity of urological organs for the investigation of organ transplantation and disease progression. This review discusses various types of 3D bioprinting methodologies and commonly used biomaterials for urological diseases. The literature shows that advances in this field toward the development of functional urological organs or disease models have progressively increased. Although numerous challenges still need to be tackled, like the technical difficulties of replicating the heterogeneity of urologic organs and the limited biomaterial choices to recapitulate the complicated extracellular matrix components, it has been proved by numerous studies that 3D bioprinting has the potential to fabricate functional urological organs for clinical transplantation and in vitro disease models. Outline the advantages and characteristics of 3D printing compared with traditional methods for urological diseases. Guide the selection of 3D bioprinting technology and material in urological tissue engineering. Discuss the challenges and future perspectives of 3D bioprinting in urological diseases and clinical translation.
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26
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Ho NX, O'Meara S, Moran T, McGuire B. A curious case of metastatic parotid adenoid cystic carcinoma to kidney. BMJ Case Rep 2022; 15:15/10/e248833. [PMID: 36307140 PMCID: PMC9621166 DOI: 10.1136/bcr-2022-248833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A woman in her 60s presented with a 2-week history of non-specific left-sided abdominal pain. She previously underwent a total parotidectomy and adjuvant radiotherapy for left parotid adenoid cystic carcinoma 13 years prior, with a local recurrence 4 years after. Investigations revealed a large left-sided renal mass with appearances of renal carcinoma and no signs of metastatic disease. Pathology following nephrectomy revealed a metastatic adenoid cystic carcinoma.Metastatic disease recurred 11 months postradical nephrectomy to the contralateral kidney and lung, and she was referred to medical oncology for further management.This case history demonstrates the highly aggressive nature of an adenoid cystic carcinoma primary of salivary gland origin with rare metastasis to the kidney.
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Affiliation(s)
- Ning Xuan Ho
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.,Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Sorcha O'Meara
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
| | - Tom Moran
- Department of Otolaryngology/Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.,Department of Otolaryngology/Head and Neck Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Barry McGuire
- Department of Urology, St. Vincent's University Hospital, Dublin, Ireland
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27
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Seale KN, Labriola MK, Jiang X"S, Armstrong A. Remission of progressive metastatic castration-resistant prostate cancer during abiraterone therapy following unilateral adrenalectomy for a functioning adrenal adenoma. BMJ Case Rep 2022; 15:15/10/e251036. [PMID: 36198431 PMCID: PMC9535143 DOI: 10.1136/bcr-2022-251036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Despite advances and introduction of new therapies in the last decade, metastatic castration-resistant prostate cancer (mCRPC) has a poor prognosis. The development of androgen axis-targeted therapies such as abiraterone acetate, enzalutamide and darolutamide can prolong survival in mCPRC; however, resistance remains a barrier to prolonged response, necessitating exploration into resistance mechanisms and locoregional therapies. Here, we describe a patient with mCRPC that was progressing on abiraterone acetate. He was also found to have primary hyperaldosteronism from a functional adrenal adenoma, and thus he had a partial adrenalectomy to remove this tumour. Pathology confirmed an aldosterone-producing adrenal adenoma. After his adrenalectomy, he had a sharp decline in both his PSA (prostate specific antigen) and testosterone levels, and he enjoyed a year-long period of remission after his adrenalectomy. We propose several explanations for his response, the most likely being that his adenoma was producing both aldosterone and androgens. This is a unique case of mCRPC responding to partial adrenalectomy from a functional adrenal adenoma, and it raises insights that warrant further investigation into underlying mechanisms of resistance to androgen-targeted therapies.
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Affiliation(s)
| | - Matthew K Labriola
- Department of Medicine, Duke University, Durham, North Carolina, USA,Division of Medical Oncology, Duke Cancer Institute, Durham, North Carolina, USA
| | | | - Andrew Armstrong
- Department of Medicine, Duke University, Durham, North Carolina, USA,Division of Medical Oncology, Duke Cancer Institute, Durham, North Carolina, USA,Duke Cancer Institute, Center for Prostate and Urologic Cancer, Durham, North Carolina, USA
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28
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应 沂, 唐 琦, 杨 恺, 米 悦, 范 宇, 虞 巍, 宋 毅, 何 志, 周 利, 李 学. [Clinical features of immune checkpoint inhibitor-related myositis in patients with urological cancer]. Beijing Da Xue Xue Bao Yi Xue Ban 2022; 54:644-651. [PMID: 35950386 PMCID: PMC9385516 DOI: 10.19723/j.issn.1671-167x.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Immune checkpoint inhibitors (ICI) have significantly improved the treatment efficacy of a variety of malignant tumors. However, patients may experience a series of special side effects during treatments with ICI. Immune-related myositis after ICI treatment is characterized by autoimmune rheumatic and musculoskeletal damage, which is relatively rare. To analyze the clinical characteristics and outcomes of ICI-associated myositis in urological tumors, we summarized the clinical manifestations, electrophysiological and pathological characteristics, treatments and outcomes in 8 patients. METHODS The clinical data of the 8 patients with immune-related myositis after ICI treatment for urological tumors treated in the Department of Urology, Peking University First Hospital from March 2018 to March 2022 were retrospectively analyzed for demographic characteristics, drug regimen, clinical symptoms, laboratory indices, electromyography examination, pathological manifestations and outcomes. RESULTS The eight patients included 2 females and 6 males with a median age of 68 years, all treated with ICI for urological neoplasms, including 2 upper tract urothelial carcinoma (UTUC), 3 renal cell carcinoma (RCC), and 3 bladder cancer (BCa). The median time between the first ICI treatment and the detection of immune-related myositis was 39.5 days, and the median duration of treatment was 2 sessions. The main symptoms were muscle pain and weakness, 5 cases with ptosis, 3 cases with secondary rhabdomyolysis, 5 cases with myocarditis, 1 case with myasthenia gravis, and 1 case with enterocolitis. Among them, patients with immune-related myocarditis had a shorter interval from the first anti-programmed cell death protein-1 (PD-1) therapy to the onset of immune-related myositis (P=0.042) compared with patients without myocarditis. The 8 patients had significant elevation of transaminases and muscle enzyme profile indexes, and 5 patients showed positive auto-antibodies. 3 patients had perfected muscle biopsies and showed typical skeletal muscle inflammatory myopathy-like pathological changes with CD3+, CD4+, CD8+, CD20+ lymphocytes and CD68+ macrophage infiltration. After the diagnosis of immune-related myositis, all the 8 patients immediately discontinued ICI therapy and improved after intravenous administration of methylprednisolone alone or in combination with gamma-globulin. CONCLUSION Immune-related myositis after ICI treatment is an immune-related adverse reactions (irAEs) with unique clinical and pathological features, commonly combined with cardiovascular adverse reactions. Immediate discontinuation of ICI and initiation of glucocorticoid therapy may improve the patient's condition in a timely manner.
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Affiliation(s)
- 沂岑 应
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 琦 唐
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 恺惟 杨
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 悦 米
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 宇 范
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 巍 虞
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 毅 宋
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 志嵩 何
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 利群 周
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
| | - 学松 李
- />北京大学第一医院泌尿外科,北京大学泌尿外科研究所,国家泌尿、男性生殖系肿瘤研究中心,北京 100034Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
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Hopkins DT, Waters D, Manecksha RP, Lynch TH. Isolated soft tissue mass of the finger as the first presentation of oligometastatic renal cell carcinoma. BMJ Case Rep 2022; 15:15/5/e248718. [PMID: 35580945 DOI: 10.1136/bcr-2021-248718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A man in his 70s was referred to plastic surgery with a suspected foreign body in the pulp of his right index finger. An excisional biopsy was performed for a presumed foreign body granuloma. Histology revealed metastatic renal cell carcinoma (mRCC). CT imaging demonstrated a 7.4 cm heterogeneous mass arising from the upper pole of the left kidney consistent with primary renal malignancy, in addition to a 9 mm lung nodule. He underwent an uncomplicated left laparoscopic cytoreductive nephrectomy and made a satisfactory recovery. To our knowledge, this is the first reported case of primary mRCC presenting with digital soft tissue metastasis. Cytoreductive nephrectomy with metastasectomy is the preferred management for mRCC where feasible. For unfavourable mRCC cases, first-line systemic therapy is indicated. Adjuvant systemic therapy in mRCC is currently limited to clinical trials, though promising data emerging on the use of pembrolizumab may herald a future shift in practice.
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Affiliation(s)
- David T Hopkins
- Department of Urology, Saint James's Hospital, Dublin, Ireland .,Department of Surgery, Trinity College Dublin School of Medicine, Dublin, Ireland
| | - Darragh Waters
- Department of Urology, Saint James's Hospital, Dublin, Ireland
| | - Rustom P Manecksha
- Department of Urology, Saint James's Hospital, Dublin, Ireland.,Department of Surgery, Trinity College Dublin School of Medicine, Dublin, Ireland
| | - Thomas H Lynch
- Department of Urology, Saint James's Hospital, Dublin, Ireland.,Department of Surgery, Trinity College Dublin School of Medicine, Dublin, Ireland
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Hietala A, Joutsen J, Vaarala S, Säily M. A rare and complete response to combination therapy with radiation and nivolumab in a patient with metastatic urothelial cancer. BMJ Case Rep 2022; 15:e246653. [PMID: 35580957 PMCID: PMC9115022 DOI: 10.1136/bcr-2021-246653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 12/26/2022] Open
Abstract
According to the current understanding, radiotherapy can enhance the effectiveness of cancer immunotherapy due to radiation-induced release of tumour-associated antigens. Here, we present a case with a metastatic urothelial carcinoma who received nivolumab and palliative radiotherapy to a residual tumour in the vagina and to a large metastatic visceral lymph node. The treatment resulted in a rapid and virtually complete response for the time being in all metastases and in the large parailiac tumour mass. Follow up continues. The presented case demonstrates that the combinatory treatment with radiotherapy and immunotherapy can result in an exceptional response for the benefit of the patient with urothelial cancer. To our knowledge, this is one of the largest metastatic masses to disappear with a combination of immuno-oncologic (nivolumab) and radiation therapies.
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Affiliation(s)
- Aki Hietala
- Department of Surgery, Division of Urology, Lapland Central Hospital, Rovaniemi, Finland
- Department of Urology, Oulu University, Oulu, Finland
| | - Jenny Joutsen
- Department of Pathology, Lapland Central Hospital, Rovaniemi, Finland
| | - Svea Vaarala
- Department of Oncology, Lapland Central Hospital, Rovaniemi, Finland
| | - Matti Säily
- Department of Surgery, Division of Urology, Lapland Central Hospital, Rovaniemi, Finland
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31
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Galambos DM, Salei A, Rais-Bahrami S, Varma RK. Intrahepatic renal cell carcinoma implantation along a percutaneous biopsy and cryoablation probe tract. BMJ Case Rep 2022; 15:15/5/e248250. [PMID: 35568411 PMCID: PMC9109039 DOI: 10.1136/bcr-2021-248250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A man in his 60s underwent percutaneous biopsy and cryoablation of a right upper pole clear cell renal cell carcinoma followed by repeat cryoablation 8 months later for possible residual disease. The patient was followed with imaging with documented stability for 19 months after repeat ablation. However, imaging at 32 months demonstrated intrahepatic nodular enhancing lesions along the initial percutaneous biopsy and ablation tract, consistent with metastatic implantation. The patient underwent repeat percutaneous biopsy and two rounds of microwave ablation for treatment of the intrahepatic implants, with no residual disease at 10 months postablation. While needle tract seeding is a known complication of percutaneous manipulation of various abdominopelvic malignancies, there have been no prior reports of intrahepatic metastatic implants related to percutaneous renal cell carcinoma ablation. Awareness of this potential complication is important for treatment planning, informed consent and surveillance. This report shares our experience of the management of intrahepatic metastatic implants.
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Affiliation(s)
- David Maxwell Galambos
- Division of Interventional Radiology, Department of Radiology, The University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Aliaksei Salei
- Division of Interventional Radiology, Department of Radiology, The University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Soroush Rais-Bahrami
- Department of Urology, The University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
| | - Rakesh K Varma
- Division of Interventional Radiology, Department of Radiology, The University of Alabama Heersink School of Medicine, Birmingham, Alabama, USA
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32
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Tiwari RV, Di Jiang M, Jarvi K, Hamilton R. Elevated HCG and retroperitoneal adenopathy after clomiphene therapy for infertility. BMJ Case Rep 2022; 15:e249766. [PMID: 35473701 PMCID: PMC9045039 DOI: 10.1136/bcr-2022-249766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2022] [Indexed: 11/04/2022] Open
Abstract
In the context of an elevated human chorionic gonadotropin (HCG) with enlarged retroperitoneal nodes and absent testicular tumours, clinicians will consider a diagnosis of extragonadal germ cell tumours. We report the case of a man in his thirties who while on treatment for subfertility with clomiphene citrate was noted to have enlarged retroperitoneal nodes and elevated HCG levels of 75 IU/L. Chemotherapy with bleomycin, etoposide and cisplatin originally planned was deferred when two separate retroperitoneal nodal biopsies returned as benign fibroadipose tissue and HCG levels spontaneously down-trended to 4 IU/L within 4 months of clomiphene citrate discontinuation. Follow-up imaging revealed regression of the retroperitoneal nodes.
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Affiliation(s)
| | - Maria Di Jiang
- Medical Oncology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Keith Jarvi
- Division of Urology, Sinai Health System, Toronto, Ontario, Canada
| | - Robert Hamilton
- Division of Urology, University Health Network, Toronto, Ontario, Canada
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Zahoor A, Swamy R, Gogbashian A, Sharma A. Primary squamous cell carcinoma of the testis: a rare presentation. BMJ Case Rep 2022; 15:e246341. [PMID: 35459646 PMCID: PMC9036183 DOI: 10.1136/bcr-2021-246341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/04/2022] Open
Abstract
A man in his mid-70s presented with a lump in his left testicle. He had previously been treated for prostate cancer with radical radiotherapy. He was on treatment for hypertension and type 2 diabetes. An ultrasound of the testes demonstrated a solid intratesticular mass for which he underwent left orchidectomy. Histology from the orchidectomy was moderately differentiated squamous cell carcinoma (SCC), positive for cytokeratin (CK) 5/6 and p63. A positron emission tomogram (PET) scan was clear of any metastatic disease. His surveillance CT, done at 12 months, revealed mediastinal, abdominal and hilar adenopathy. Biopsy of hilar lymph nodes showed SCC and this was treated with platinum-based chemotherapy. Unfortunately, the patient died after 18 months. To our knowledge, this is the first reported case of metastatic SCC of testes with extensive spread and with platinum-refractory disease.
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Affiliation(s)
| | - Rajiv Swamy
- Histopathology, Lister Hospital, Stevenage, Hertfordshire, UK
| | - Andrew Gogbashian
- Consultant Radiologist, Paul Strickland Scanner Centre, Northwood, UK
| | - Anand Sharma
- Medical Oncology, Mount Vernon Cancer Centre, Northwood, UK
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Singh YP, Roy D, Jois B, Shetti M. Reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin for papillary carcinoma of bladder. BMJ Case Rep 2022; 15:e249208. [PMID: 35418381 PMCID: PMC9014044 DOI: 10.1136/bcr-2022-249208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/04/2022] Open
Abstract
A man in his 60s developed reactive arthritis following treatment with intravesical Bacillus Calmette-Guerin (iBCG) for papillary carcinoma of bladder. Evaluation revealed leucocytosis and raised inflammatory markers. HLA B27 was positive. Based on the temporal relationship, it was attributed to BCG-related reactive arthritis. iBCG was stopped. Treatment with non-steroidal anti-inflammatory drugs (NSAIDS) and glucocorticoids were ineffective. Prolonged course of disease-modifying antirheumatic drugs (DMARDS) was required which aided in alleviation of symptoms and sustained remission. Intravesical BCG therapy is a treatment for bladder cancer. It is rarely associated with reactive arthritis, which responds to discontinuation of iBCG and treatment with NSAIDS and/or short-term glucocorticoids. iBCG-related reactive arthritis commonly has an acute/subacute course. Chronic arthritis as observed in our case requiring prolonged treatment with DMARDS is rare.
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Affiliation(s)
- Yogesh Preet Singh
- Rheumatology, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
| | - Debaditya Roy
- Rheumatology, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
| | - Bhargavi Jois
- Nuclear Medicine, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
| | - Mohit Shetti
- Gastroenterology, Manipal Hospital HAL Airport road, Bangalore, Karnataka, India
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Wallace J, Abelardo E, Ramachandran K, Prabhu V. Renal cell carcinoma uvula metastasis leading to airway compromise: an unusual site. BMJ Case Rep 2022; 15:e248098. [PMID: 35396238 PMCID: PMC8995948 DOI: 10.1136/bcr-2021-248098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/03/2022] Open
Abstract
We present a case report of a gentleman presenting with a globular lesion arising from his uvula. Although elective admission was planned, he presented with airway compromise, and emergency excision was required. The patient had a background of metastatic clear cell renal carcinoma; histology confirmed the uvula lesion as a further secondary deposit. Renal cell carcinoma has a recognised metastatic propensity, but spread to the uvula is rare, with only two previously described cases in the literature. This case is notable for the unusual location of the metastasis, as well as the rapid progression of symptoms, which threatened the airway and necessitated urgent surgical intervention.
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Affiliation(s)
| | - Edgardo Abelardo
- Otolaryngology, Glangwili General Hospital, Carmarthen, UK
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | | | - Vinod Prabhu
- Otolaryngology, Glangwili General Hospital, Carmarthen, UK
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36
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Kitamura K, Isotani S, Muto S, Horie S. Efficacy of pembrolizumab in a rare type of bladder cancer arising 25 years after augmentation cystoplasty. BMJ Case Rep 2022; 15:e244719. [PMID: 35354571 PMCID: PMC8968561 DOI: 10.1136/bcr-2021-244719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/04/2022] Open
Abstract
We report using the checkpoint inhibitor, pembrolizumab, as part of a multimodal treatment plan in a 36-year-old man with a rare bladder cancer arising 25 years after augmentation cystoplasty (sigmoid colonic cystectomy for neuropathic bladder was performed at 9 years old). On a regular clinic visit for clean intermittent catheterisation, the patient presented with gross haematuria and was diagnosed with urothelial carcinoma with sarcomatoid change. Gemcitabine and cisplatin-based neoadjuvant chemotherapy was unsuccessful, and pembrolizumab infusions (200 mg every 3 weeks) were initiated. A partial response was confirmed after six courses of pembrolizumab, with significant tumour shrinkage. A radical cystoprostatectomy and ileal conduit construction was performed, and pathology revealed no evidence of malignancy (ypT0, N0). The patient was successfully treated with the anti-programmed death-1 inhibitor, pembrolizumab, which was curative after total cystectomy. Further research is required to elucidate the potential role of checkpoint inhibitors in bladder cancers arising after augmentation cystoplasty.
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Affiliation(s)
- Kosuke Kitamura
- Urology, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Urology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Shuji Isotani
- Urology, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Satoru Muto
- Urology, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shigeo Horie
- Urology, Juntendo University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
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37
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Tsikopoulos I, Papadopoulos DI, Floros T, Gkekas C. Portal venous gas (PVG) and postoperative necrotising enterocolitis in an adult (ECNA) following radical cystectomy. BMJ Case Rep 2022; 15:e247993. [PMID: 35354573 PMCID: PMC8968528 DOI: 10.1136/bcr-2021-247993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ioannis Tsikopoulos
- Urology, 424 General Military Training Hospital, Thessaloniki, Central Macedonia, Greece
| | | | - Theodoros Floros
- Radiology Department, General Hospital of Larissa, Larissa, Greece
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38
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Loria SJ, Siddiqui NN, Gary JM, Bhatnagar J, Bollweg BC, Ahmed B, Berenson CS. BK virus associated with small cell carcinoma of bladder in a patient with renal transplant. BMJ Case Rep 2022; 15:e244740. [PMID: 35351771 PMCID: PMC8966499 DOI: 10.1136/bcr-2021-244740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 01/21/2023] Open
Abstract
A man in his 70s with a complex medical history, including cadaveric renal transplant, presented with recurrent urinary tract infections. Investigation revealed recurrent urinary pathogens, including Enterobacter cloacae and persistent BK viruria. Cystoscopy revealed a pedunculated mass in the right posterior-lateral wall, inferior to the transplant urethral orifice, and biopsy of this mass showed invasive small cell carcinoma with a prominent adenocarcinoma component. The tumour was treated with complete transurethral resection followed by carboplatin, etoposide and radiation. Laboratory analysis of biopsied samples showed immunostaining and molecular evidence of BK virus DNA in the cancer cells. Follow-up cystoscopies have shown no recurrence of the cancer.
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Affiliation(s)
- Samantha J Loria
- Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Nabiya N Siddiqui
- Division of Infectious Diseases, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Joy M Gary
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julu Bhatnagar
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brigid C Bollweg
- Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Basem Ahmed
- Department of Pathology, VA Western New York Healthcare System, Buffalo, New York, USA
| | - Charles S Berenson
- Division of Infectious Diseases, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- Division of Infectious Diseases, VA Western New York Healthcare System, Buffalo, New York, USA
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Notghi AAA, Hosseini F, Tsogas N. Severe diffuse proliferative bronchiolitis complicating culture-proven disseminated BCG infection after intravesical instillation for bladder cancer. BMJ Case Rep 2022; 15:e248681. [PMID: 35321917 PMCID: PMC8943779 DOI: 10.1136/bcr-2021-248681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/04/2022] Open
Abstract
A man in his 70s was admitted to hospital following several months of dyspnoea, night sweats, weight loss and, latterly, fevers. His symptoms correlated with a second maintenance cycle of intravesical BCG instillation for superficial bladder cancer. Blood tests showed raised C-reactive protein, alkaline phosphatase and gamma-GT, although extensive further investigations did not reveal any specific cause. Treatment for a presumed diagnosis of disseminated BCG infection was started, following which his fevers ceased. Later available results of liver biopsy taken prior to treatment supported this diagnosis, and mycobacterial blood and urine cultures grew Mycobacterium bovis Recovery was complicated by a severe diffuse proliferative bronchiolitis which responded to corticosteroids. This case highlights an important dichotomy in the pathophysiology of disseminated BCG infection. It demonstrates how morbidity can be caused by both a direct dissemination of the organism and an immune hypersensitivity response in the same patient.
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40
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Neris RR, Nascimento LC, Zago MMF. Searching for a harmonious survival: the experience of quality of life of urological cancer survivors. Support Care Cancer 2022. [PMID: 35015135 DOI: 10.1007/s00520-021-06786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to analyze the experience of quality of life for urological cancer survivors. METHODS This is a qualitative narrative research based on the experience-centered approach. Twenty-one semi-structured face-to-face interviews were conducted with 12 survivors of urological cancer at different survival seasons. Participants were recruited from the convenience sampling. The thematic analysis approach was used to analyze the data. The findings are presented as narrative syntheses. The standards for reporting qualitative research (SPQR) were used in this study. RESULTS Two narrative syntheses were constructed: (1) Rupture in the different dimensions of QoL; and (2) QoL: Searching for a harmonious survival, each presenting their respective sub-themes. After the rupture in the different dimensions of QoL, the survivors resigned themselves and searched for a harmonious survival despite the physical, social, and psychological changes imposed by cancer treatments. Survivors achieved a new meaning of QoL with the support of family, hope, and spirituality. CONCLUSIONS The results highlight the changes experienced by survivors in different dimensions of QoL and the search for harmonious survival. Based on QoL experience reported in this study, health professionals can plan survival care and interventions that mitigate the consequences of treatment on QoL.
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Hernández-Gaytán CA, Rodríguez-Covarrubias F, Castillejos-Molina RA, Hernández-Porras A, Tobia I, Dubin JM, Autrán-Gómez AM. Urological Cancers and Kidney Transplantation: a Literature Review. Curr Urol Rep 2021; 22:62. [PMID: 34913107 DOI: 10.1007/s11934-021-01078-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to provide an overview of epidemiology, risk factors, and treatment of urological malignancies in renal transplant recipients (RTR). RECENT FINDINGS Although optimal immunosuppressive therapy and cancer management in these patients remain controversial, adherence to general guidelines is recommended. Kidney transplantation is recognized as the standard of care for the treatment of end-stage renal disease (ESRD) as it offers prolonged survival and better quality of life. In the last decades, survival of RTRs has increased as a result of improved immunosuppressive therapy; nonetheless, the risk of developing cancer is higher among RTRs compared to the general population. Urological malignancies are the second most common after hematological cancer and often have more aggressive behavior and poor prognosis.
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Dinesh AA, Helena Pagani Soares Pinto S, Brunckhorst O, Dasgupta P, Ahmed K. Anxiety, depression and urological cancer outcomes: A systematic review. Urol Oncol 2021; 39:816-828. [PMID: 34503900 DOI: 10.1016/j.urolonc.2021.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/25/2021] [Accepted: 08/05/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The interplay between physical and mental aspects of a cancer diagnosis are well recognised. However, little consensus exists on the impact of depression and anxiety on urological cancer outcomes. Therefore, this systematic review aimed to investigate the relationship between these conditions and functional or oncological outcomes in urological malignancy. MATERIALS AND METHODS A systematic search was conducted using PubMed, Embase, PsycINFO and Global Health databases up to June 2020. Studies evaluating the relationship of anxiety and depression disorders or symptoms on functional and mortality outcomes were included. Outcome measures included validated urinary, sexual, body image questionnaire scores and all-cause or disease-specific mortality. RESULTS Of 3,966 studies screened, 25 studies with a total of 175,047 urological cancer patients were included. Significant anxiety and depressive symptoms and disorders were found to impact functional outcomes in several cancer types. A consistent negative association existed for sexual function in prostate, testicular and penile cancer patients. Additionally, poorer urinary function scores were seen in prostate cancer, with increased body image issues in testicular and prostate cancer. Importantly, both overall and disease-specific mortality outcomes were poorer in bladder and prostate cancer patients. CONCLUSIONS Co-existing depression and anxiety appears to be negatively associated with functional and mortality outcomes in urological cancers. This appears especially evident in male cancers, including prostate and testicular cancer. Although not proving causation, these findings highlight the importance of considering mental wellbeing during follow-up for early recognition and treatment. However, current evidence remains heterogenous, with further studies required exploring patients at risk.
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Affiliation(s)
- Ayushi Anna Dinesh
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | | | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, King's College Hospital, London, United Kingdom.
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Grüne B, Kriegmair MC, Lenhart M, Michel MS, Huber J, Köther AK, Büdenbender B, Alpers GW. Decision Aids for Shared Decision-making in Uro-oncology: A Systematic Review. Eur Urol Focus 2021; 8:851-869. [PMID: 33980474 DOI: 10.1016/j.euf.2021.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/17/2021] [Accepted: 04/15/2021] [Indexed: 12/15/2022]
Abstract
CONTEXT Decision aids (DAs) aim to support patients in the process of shared decision-making for complex treatment decisions. To improve patient-centered care in uro-oncology, it is essential to evaluate the availability and quality of existing DAs. OBJECTIVE To assess the quality of existing DAs for patients across the most prevalent uro-oncological entities. EVIDENCE ACQUISITION This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. A systematic literature search (MedLine, Cochrane Library, Web of Science Core Collection, and CCMed) was conducted to identify DAs for treatment decisions for patients with prostate, renal, or bladder cancer. All studies reporting on the development or evaluation of DAs were included. The DAs were examined based on the International Patient Decision Aid Standards (IPDAS) and the evaluation studies were compared in accordance with Standards for Universal reporting of a patient Decision Aid Evaluations (SUNDAE). EVIDENCE SYNTHESIS The literature search identified 1995 potentially relevant publications. Thirty-two studies reporting on 25 DAs met the inclusion criteria. Twenty-two DAs address prostate cancer, two renal tumor, and one bladder cancer. In the majority of DAs (n = 20), patients can enter individual data. A few (n = 6) DAs allow for personalization using a risk-adapted presentation of treatment options. The percentage of IPDAS criteria met in DAs ranged between 50% and 100% (median 87.5%), and the studies' adherence to the SUNDAE checklist was between 62% and 96% (median 86.6%). Evaluation studies suggest that interventions are likely efficacious. However, a preliminary meta-analysis revealed no significant difference between "DA" and "usual care" for decisional conflict or decisional regret. CONCLUSIONS This review highlights that a number of well-developed DAs exist in urology. However, there is a need for specific instruments targeting kidney and bladder cancer. Personalization of tools and adherence to international standards of DAs should be further improved. PATIENT SUMMARY The majority of uro-oncological decision aids target prostate cancer, whereas fewer address kidney or bladder cancer. The quality of the existing instruments is high, but can be increased further to better address specific needs of individual patients.
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Affiliation(s)
- Britta Grüne
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maximilian C Kriegmair
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Maximilian Lenhart
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maurice S Michel
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Johannes Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Anja K Köther
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Björn Büdenbender
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
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Lucocq J, Ali A, Harrison W, Khalil T, Powar G, Raza K, Nandwani G. Does non-visible haematuria require urgent assessment? A retrospective cohort study from a university teaching hospital. World J Urol 2021; 39:3393-3397. [PMID: 33760946 PMCID: PMC8510922 DOI: 10.1007/s00345-021-03670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/13/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES It is not certain from current evidence which patient groups with non-visible haematuria (NVH) require urgent investigation and which investigations are sufficient. We report referral outcomes data from Scotland to identify patient groups who will benefit from urgent assessment to rule out urological cancer (UC) and whether full set of investigations are necessary in all referred patients. MATERIALS AND METHODS Data were collected from electronic patient records for patients referred with NVH to secondary care urology services between July 2017 and May 2020. The correlations between risk factors and final diagnosis were assessed using categorical variables in a multivariate logistic regression analysis and using chi-squared models. Statistical analysis was performed using IBM SPSS data editor version 25. RESULTS Our study cohort comprised 525 patients (43.4% males; median age 66 years), in which UC was diagnosed in 25 patients (4.8%). Age > 60 years had sensitivity and NPV for UC of 92% and 99%, respectively. Univariate and multivariate analysis showed male sex, age ≥ 60 years and smoking were significant predictors of UC in patients with NVH (p < 0.05). There was no significant difference in UC in patients with history of LUTS, anticoagulation and previous UC. CONCLUSION The risk of urologic cancer in NVH patients is significant and male gender, age ≥ 60 years and smoking are significant predictors of UC. Patients with risk factors of UC require complete assessment of both the upper and lower urinary tract; however, in the absence of risk factors, patients do not require urgent or complete assessment.
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Affiliation(s)
- James Lucocq
- Department of Urology, Ninewells Hospital, Dundee, Scotland.
| | - Adnan Ali
- Department of Urology, Ninewells Hospital, Dundee, Scotland
| | | | - Tarek Khalil
- Department of Urology, Ninewells Hospital, Dundee, Scotland
| | - Gursunil Powar
- Department of Urology, Ninewells Hospital, Dundee, Scotland
| | - Kamran Raza
- Department of Urology, Ninewells Hospital, Dundee, Scotland
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Rammant E, Bultijnck R, Caperchione CM, Trinh L. The Use of Theory to Develop Physical Activity Interventions in Urological Cancer Survivors: A Narrative Review. Semin Oncol Nurs 2021; 37:151109. [PMID: 33516584 DOI: 10.1016/j.soncn.2020.151109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To summarize the current available evidence on the use of behavior change theories to explain and change physical activity behavior in urological cancer survivors. DATA SOURCES Five electronic databases including Medline, Web of Science, Embase, Cochrane, and Psych INFO and reference lists of key studies were searched between database inception and November 2020. Peer-reviewed articles on the use of behavior change theories to understand or change physical activity in urological cancer survivors were included. CONCLUSION The theory of planned behavior and the social cognitive theory were the most used theories to explain and change physical activity behavior in urological cancers, respectively. However, the use of behavior change theories in physical activity interventions for urological cancers is still low across all urological tumor groups. Planning frameworks such as the intervention mapping approach should be used to enhance the systematic use of behavior change theories during every phase of intervention development. In addition, more research is needed to identity which behavior change techniques are most effective to change physical activity behavior in urological cancer survivors. IMPLICATIONS FOR NURSING PRACTICE Nurses play a key role in the urological cancer patients' clinical pathway and should be able to motivate patients to engage in sufficient physical activity levels. Therefore, it is important that nurses understand the underlying reasons why patients (do not) engage in physical activity and which behavior change techniques are most effective in changing a patients' behavior.
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Affiliation(s)
- Elke Rammant
- Ghent University, Human Structure and Repair, Ghent, Belgium.
| | - Renée Bultijnck
- Ghent University, Human Structure and Repair, Ghent, Belgium; Research Foundation, Flanders (FWO), Brussels, Belgium
| | - Cristina M Caperchione
- Faculty of Health, Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Liu Q, Gu J, Zhang E, He L, Yuan ZX. Targeted Delivery of Therapeutics to Urological Cancer Stem Cells. Curr Pharm Des 2020; 26:2038-2056. [PMID: 32250210 DOI: 10.2174/1381612826666200403131514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
Urological cancer refers to cancer in organs of the urinary system and the male reproductive system. It mainly includes prostate cancer, bladder cancer, renal cancer, etc., seriously threatening patients' survival. Although there are many advances in the treatment of urological cancer, approved targeted therapies often result in tumor recurrence and therapy failure. An increasing amount of evidence indicated that cancer stem cells (CSCs) with tumor-initiating ability were the source of treatment failure in urological cancer. The development of CSCstargeted strategy can provide a possibility for the complete elimination of urological cancer. This review is based on a search of PubMed, Google scholar and NIH database (http://ClinicalTrials.gov/) for English language articles containing the terms: "biomarkers", "cancer stem cells", "targeting/targeted therapy", "prostate cancer", bladder cancer" and "kidney cancer". We summarized the biomarkers and stem cell features of the prostate, bladder and renal CSCs, outlined the targeted strategies for urological CSCs from signaling pathways, cytokines, angiogenesis, surface markers, elimination therapy, differentiation therapy, immunotherapy, microRNA, nanomedicine, etc., and highlighted the prospects and future challenges in this research field.
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Affiliation(s)
- Qiang Liu
- Yaopharma Co., Ltd. Chongqing, China
| | - Jian Gu
- College of Pharmacy, Southwest Minzu University, Chengdu, Sichuan, China
| | - E Zhang
- Officers college of PAP, Chengdu, Sichuan, China
| | - Lili He
- College of Pharmacy, Southwest Minzu University, Chengdu, Sichuan, China
| | - Zhi-Xiang Yuan
- College of Pharmacy, Southwest Minzu University, Chengdu, Sichuan, China
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Yamamoto S, Ikeda M, Kanno Y, Okamoto K, Okugawa S, Moriya K. Microbiological analysis of infectious lymphocele: Case series and literature review. J Infect Chemother 2020; 27:172-178. [PMID: 32900660 DOI: 10.1016/j.jiac.2020.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/09/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Infectious lymphocele is a rare post-operative complication of abdominal surgery, and few studies have focused on its causative organisms. The aim in this research is to clarify microbiology and appropriate empiric treatment of infective lymphocele. METHODS We performed a single center, retrospective observational study between April 2000 and March 2018 with a case review and literature search. Data were collected in a chart review. RESULTS Twenty-four cases were founded in our institution. 153 cases, including 16 cases from our institution, that detected causative organisms was also analyzed. Infectious lymphocele was found to occur post gynecological/urological surgery in cancer patients. We also reported that bacteremia incidence and the mortality rate of infectious lymphocele cases were very low. The major sites of infectious lymphocele were pelvis or inguinal area. Our case series and literature review showed Gram positive cocci were the major causative organisms, with Staphylococcus aureus constituting one third of them (53/153 cases). Streptococcus species (26/153cases) and coagulase negative Staphylococci (17/153 cases) were the second and third most detected organisms. CONCLUSION In gynecologic and urologic cancer patients, Gram positive cocci were the most common organisms causing lymphocele infection. Gram-positive coverage might be reasonable for empiric therapy in infectious lymphocele.
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Affiliation(s)
- Shinya Yamamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Mahoko Ikeda
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan; Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Yoshiaki Kanno
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan; Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan
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Hevia V, Lorca J, Hevia M, Domínguez A, López-Plaza J, Artiles A, Álvarez S, Sánchez Á, Fraile A, López-Fando L, Sanz E, Ruiz M, Alcaraz E, Burgos FJ. [COVID-19 Pandemic: Impact and rapid reaction of Urology]. Actas Urol Esp 2020; 44:450-457. [PMID: 38620218 PMCID: PMC7181986 DOI: 10.1016/j.acuro.2020.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic caused by the SARS-CoV-2 virus has caused tens of thousands of deaths in Spain and has managed to breakdown the healthcare system hospitals in the Community of Madrid, largely due to its tendency to cause severe pneumonia, requiring ventilatory support. This fact has caused our center to collapse, with 130% of its beds occupied by COVID-19 patients, thus causing the absolute cessation of activity of the urology service, the practical disappearance of resident training programs, and the incorporation of a good part of the urology staff into the group of medical personnel attending these patients. In order to recover from this extraordinary level of suspended activity, we will be obliged to prioritize pathologies based on purely clinical criteria, for which tables including the relevance of each pathology within each area of urology are being proposed. Technology tools such as online training courses or surgical simulators may be convenient for the necessary reestablishment of resident education.
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Affiliation(s)
- V Hevia
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - J Lorca
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - M Hevia
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Domínguez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - J López-Plaza
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Artiles
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - S Álvarez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - Á Sánchez
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - A Fraile
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - L López-Fando
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - E Sanz
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - M Ruiz
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - E Alcaraz
- Área de Diagnóstico Urológico y Pruebas Instrumentales de Urología, Servicio de Urología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - F J Burgos
- Servicio de Urología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
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Rodler S, Apfelbeck M, Stief C, Heinemann V, Casuscelli J. Lessons from the coronavirus disease 2019 pandemic: Will virtual patient management reshape uro-oncology in Germany? Eur J Cancer 2020; 132:136-40. [PMID: 32361628 DOI: 10.1016/j.ejca.2020.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/23/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is challenging for physicians treating patients with genitourinary cancers as they are considered at high risk of severe events. The uro-oncology outpatient clinic at our academic institution was affected early by the outbreak owing to the widespread infection of healthcare personnel. Subsequently, we developed a strategy to ensure the patient's safety by efforts focused on strict quarantine observation, reduction of clinic visits and implementation of virtual patient management into the workflow. Furthermore, we analysed susceptibility to COVID-19 and its effects on patients with uro-oncological cancer treated with antitumoural agents. The goal is to warrant high-quality cancer care, despite being an academic centre on the front line of Germany's response to COVID-19.
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Su S, Liu L, Li C, Zhang J, Li S. Prognostic role of pretreatment derived neutrophil to lymphocyte ratio in urological cancers: A systematic review and meta-analysis. Int J Surg 2019; 72:146-153. [PMID: 31707011 DOI: 10.1016/j.ijsu.2019.10.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/05/2019] [Accepted: 10/27/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND To investigate the possible prognostic role of pretreatment derived neutrophil-lymphocyte ratio (dNLR) in urological cancers, including renal cell carcinoma (RCC), prostate cancer (PCa), and urothelial cancer (UCa). MATERIALS AND METHODS Eligible studies were comprehensively searched from PubMed, Embase, Cochrane Library and Web of Science, up to April 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the relationships. RESULTS A total of 12 studies embracing 6585 patients were included in the meta-analysis. Our results indicated that a higher pretreatment dNLR was associated with a decreased cancer-specific survival (CSS, HR 2.67, 95% CI 1.06-6.71, P = 0.037) and disease-free survival (DFS, HR 2.02, 95% CI 1.03-3.94, P = 0.040) in RCC, but not for overall survival (OS, HR 1.05, 95% CI 0.71-1.53, P = 0.818). A higher dNLR was associated with an inferior biochemical recurrence-free survival (BRFS, HR 1.70, 95% CI 1.00-2.87, P = 0.049) and OS (HR 1.35, 95% CI 1.20-1.51, P < 0.001) in PCa. A higher dNLR was associated with a worse OS (HR 1.29, 95% CI 1.03-1.61, P = 0.029) and CSS (HR 1.51, 95% CI 1.06-2.15, P = 0.024) in UCa, but not for DFS (HR 1.44, 95% CI 0.89-2.34, P = 0.139). CONCLUSION A higher dNLR level was negatively associated with OS, CSS, DFS and BRFS, forecasting that it could be an independent prognosis predictor in urological cancers.
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Affiliation(s)
- Shiqiang Su
- Department of Urology, The NO.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Lizhe Liu
- Institute of Medical and Health, Hebei Medical University, Shijiazhuang, China
| | - Chao Li
- Department of Urology, The NO.1 Hospital of Shijiazhuang, Shijiazhuang, China.
| | - Jin Zhang
- Department of Urology, The NO.1 Hospital of Shijiazhuang, Shijiazhuang, China
| | - Shen Li
- Department of Urology, The NO.1 Hospital of Shijiazhuang, Shijiazhuang, China
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