Table of Contents
1
UI - 21336424
AU - Kong C; Zhang X; Takenaka I
TI -
Apoptotic cell death and Smad4 expression in transitional cell carcinoma
of the renal pelvis and ureter.
SO - Int J Urol 2001 Jul;8(7):386-90
AD - Department of Urology, Kagawa Medical University, Kagawa, Japan.
PURPOSE: To investigate the frequency of apoptosis and the expression of
Smad4 protein as well as their roles in transitional cell carcinoma
(TCC) of the renal pelvis and ureter. METHODS: Apoptosis was detected by
using terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin
nick end labeling (TUNEL) technique in 34 formalin-fixed and
paraffin-embedded specimens of renal pelvic and ureteral TCC. The
expression of Smad4 was immunohistochemically studied. RESULTS: The
incidence of apoptosis ranged from 1.10 to 3.75% with a median of 2.50%
in TCC of the renal pelvis and ureter. The incidence of apoptosis was
noted to be closely related to histologic grade but not to pathologic
stage of the cancer. The expression of Smad4 was detected in six of 34
cases (17.6%). Regarding subcellular distribution, Smad4 protein was
localized both in cytoplasm and nucleus of the cancer cells. In
comparing the incidence of apoptosis with the expression of Smad4, no
significant associations were seen between them. The expression of Smad4
was not related to the tumor grade nor stage of the cancer. CONCLUSIONS:
The present study demonstrated close association of the incidence of
apoptosis with the tumor grade of TCC of the renal pelvis and ureter.
Significance of Smad4 expression was not noted in the study. It suggests
that apoptotic cell death may play an important role in the tumor
progression of renal pelvic and ureteral TCC.
2
UI - 21388458
AU - Tsuchiya T; Yoh M; Ito Y; Ban Y
TI -
[Primary adenocarcinoma of the renal pelvis with a pyeloduodenal
fistula: a case report]
SO - Hinyokika Kiyo 2001 Jun;47(6):421-3
AD - Department of Urology, Gifu Municipal Hospital.
A 62-year-old woman visited our hospital complaining of fever and right
flank pain. On excretory pyelography the right kidney containing three
renal stones was not visualized. Retrograde pyelography revealed an
irregular filling defect in the right renal pelvis. Computed tomography
revealed renal stones and a tumor mass in the right renal pelvis. From
these findings, the pelvic tumor of the right kidney complicated by
renal stones was diagnosed. Right nephrectomy was performed. Because a
fistula between the renal pelvis and the second portion of the duodenum
was found in the operation, partial resection of the duodenum was also
performed. Pathological diagnosis was adenocarcinoma of the renal pelvis
and pyeloduodenal fistula due to chronic pyelonephritis. Postoperative
chemotherapy was not given. This is the first case report of
adinocarcinoma of the renal pelvis coexisting with a pyeloduodenal
fistula.
3
UI - 21372584
AU - Rimondini A; Morra A; Bertolotto M; Locatelli M; Pozzi Mucelli R
TI -
[Spiral-CT with multiplanar reconstructions (MPRS) in the evaluation of
ureteral neoplasms: preliminary results]
SO - Radiol Med (Torino) 2001 Jun;101(6):459-65
AD - Unita Clinica Operativa di Radiologia, Universita degli Studi, Ospedale
di Cattinara, Trieste, Italy.
PURPOSE: Urothelial tumors of the upper urinary tract (renal pelvis and
ureters) are rare: the most common of these are Transitional Cell
Carcinomas (TCC), usually localized in the bladder (75% of cases),
whereas only 7-10% arise in the renal pelvis and 2,5-5% in the ureter.
Multicentricity is not infrequent and synchronous or metachronous tumors
have been reported to develop in 11-13% of patients with upper urinary
tract cancer and 2-4% of those with bladder cancer. The presence of
additional lesions can change patient management. Clinically these
tumors may present with hematuria or flank pain, but sometimes there are
no specific clinical findings. Radiological studies play an important
role in tumor detection and staging and in follow up. The diagnosis is
usually performed by IVU and US, while CT is generally employed in the
staging. Our purpose was to verify the role of Spiral CT with
Multiplanar Reconstructions (MPRs) in the evaluation of ureteral tumors.
MATERIAL AND METHODS: Nine patients with ureteral neoplasms were
examined with a single detector spiral-CT, using the following
parameters: 120 kV, 200 mA; 5 mm collimation, pitch 1.4, slice
reconstruction every 5 mm; image acquisition 2-5 minutes after injection
of 120 cc of contrast medium (300 mgI/ml). All the exams were
transferred to a separate workstation to obtain curvilinear MPRs.
RESULTS: Spiral CT on the axial plane visualized 4 urothelial tumors as
concentric ureteral wall thickening; 3 as intraluminal soft tissue
masses, with involvement of almost the entire urinary tract, as far as
the bladder in 1 case. In other 2 patients there were synchronous
lesions which presented both patterns (wall thickening and intraluminal
mass). In all cases the lesions exhibited moderate enhancement after
c.m. injection. Medium- to high-grade hydronephrosis above the tumors
was always present. On MPRs both ureteral involvement and dilated,
urine-filled upper urinary tract were clearly represented on coronal and
sagittal oblique planes; these images allowed to visualize the
craniocaudal extension of short or long lesions, and to detect
multicentricity. DISCUSSION: The radiological diagnosis of ureteral
tumors is usually performed by IVU, US and CT. IVU allows to visualize
the tumors as filling defects or irregular narrowing of the ureteral
lumen. IVU however is unable to show the real extent of the tumor in
obstructive disease or in nonfunctioning kidney. US visualizes the
lesion as an echoic mass in the lumen, although it is sometimes
difficult to differentiate neoplastic lesions from other filling defects
and to visualize the entire ureteral tract. CT is generally employed in
the staging of ureteral tumors. CT findings are usually very useful for
distinguishing ureteral neoplasms from other filling defects based on
their attenuation and enhancement characteristics. Spiral CT with MPRs
allows to obtain panoramic views of the urinary tract; these images are
more effective than those of IVU, because of their capability to show
the longitudinal extension of the lesion and the presence of
multicentric tumors. Furthermore with MPRs it is possible to visualize
the ureteral tract distal to the lesion, overcoming the limitations of
IVU in nonfunctioning kidney or obstructive disease. CONCLUSIONS: Spiral
CT with MPRs is useful in the evaluation of ureteral tumors as it is
capable of visualizing the whole extension of the lesion and the
presence or absence of multicentric lesions, which can change patient
management.
4
UI - 21382651
AU - Uchida K; Fukuta F; Ando M; Miyake M
TI -
Female urethral hemangioma.
SO - J Urol 2001 Sep;166(3):1008
AD - Department of Urology, Asahikawa Red Cross Hospital, Asahikawa, Japan.
5
UI - 21414862
AU - Seki H; Ukimura S; Mizutani Y; Kawauchi A; Nakao M; Miki T
TI -
[A case of primary adenocarcinoma of the female urethra]
SO - Hinyokika Kiyo 2001 Jul;47(7):509-12
AD - Department of Urology, Kyoto Prefectural University of Medicine.
A 53-year-old female visited our hospital with a complaint of acute
urinary retention. Transvaginal ultrasonography, computed tomography and
magnetic resonance imaging showed extreme thickening of the urethral
wall. Histopathological examination of the transvaginal needle biopsy
suggested well-differentiated adenocarcinoma. She underwent total
cysto-urethrectomy with partial vaginal wall resection and ileal conduit
urinary diversion. Pathological diagnosis of the tumor was columnar
adenocarcinoma invading into the vaginal wall and periurethral
connective tissue. Fifty-eight cases of primary adenocarcinoma of the
female urethra in the Japanease literature are briefly reviewed.
6
UI - 21439132
AU - Dalbagni G; Ren ZP; Herr H; Cordon-Cardo C; Reuter V
TI -
Genetic alterations in tp53 in recurrent urothelial cancer: a
longitudinal study.
SO - Clin Cancer Res 2001 Sep;7(9):2797-801
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA. dalbagng@mskcc.org
PURPOSE: Because bladder cancer has a recurrence rate that can be as
high as 90% at 2 years, we sought to clarify whether these metachronous
tumors are polyclonal or monoclonal in origin. We have examined the
genetic alterations of the TP53 gene in a cohort of patients with
urothelial cancer who underwent multiple biopsies at different times and
sites because of tumor recurrence and/or progression. We postulated that
if tumor cells at different points in the natural history of the disease
contain an identical mutation in the TP53 gene, this pattern could
provide evidence for the monoclonality of the recurrent bladder tumors.
EXPERIMENTAL DESIGN: Fifty-three biopsy specimens from 13 patients at
different times and sites were selected for this study. Microdissection
was used to ensure the purity of tumor cells. DNA extraction, PCR, and
direct sequencing of exons 5 through 8 of the TP53 gene were conducted
following protocols optimized in our laboratory. RESULTS: We found that
specimens from seven patients carried tumor-specific TP53 mutations. The
number of lesions in these patients ranged from two to seven, extending
from 2 to 4 years. All of the seven patients displayed identical
mutations in the different microdissected tumors. CONCLUSIONS: On the
basis of these data, it appears that the recurrent bladder tumors
originate from the same clone.
7
UI - 21287661
AU - Liatsikos EN; Dinlenc CZ; Kapoor R; Smith AD
TI -
Transitional-cell carcinoma of the renal pelvis: ureteroscopic and
percutaneous approach.
SO - J Endourol 2001 May;15(4):377-83; discussion 397
AD - Department of Urology, Albert Einstein College of Medicine, Long Island
Jewish Medical Center, New Hyde Park, New York 11042, USA.
There are a variety of publications advocating the ureteroscopic or the
percutaneous approach for the treatment of transitional cell carcinoma
of the renal pelvis. The diagnostic tool of choice for the upper urinary
tract and collecting system is the flexible ureteroscope. One of the
major concerns about ureteroscopic management of renal disease initially
was the lack of flexibility of the instruments and therefore the
inability to deal with demanding sites. The advent of new ureteroscopic
techniques, as well as the continuous evolution of the technology, have
paved the way for safe and effective access to the upper urinary tract.
In the hands of an experienced urologist, such procedures can provide
reliable treatment options for small upper urinary tract lesions.
Coupling minimal morbidity with ever-improving optics and flexibility,
the ureteroscope of today leaves no area of the urinary tract unseen. In
patients with bulky tumors or in whom easy access and resection is not
possible ureteroscopically, the percutaneous approach to the renal
pelvis, although more invasive, provides a better working environment.
Clearly, the most difficult aspect of ureteroscopic access to the lower
pole is not just visibility but the loss of deflection caused by passage
of various instruments through the working channel. Direct access via
percutaneous approach with a large resectoscope avoids these problems.
8
UI - 21287665
AU - Pohar KS; Sheinfeld J
TI -
When is partial ureterectomy acceptable for transitional-cell carcinoma
of the ureter?
SO - J Endourol 2001 May;15(4):405-8; discussion 409
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA.
Because the disease is so often multifocal and has a high likelihood of
recurrence, transitional-cell carcinoma of the ureter traditionally has
been treated by nephroureterectomy. As reviewed in this article, partial
ureterectomy may be a feasible option for some patients, particularly
those with a solitary kidney, bilateral tumors, or renal insufficiency.
This conservative procedure also may be appropriate for patients with
grade 1 and possibly grade 2 tumors in stage Ta/T1.
9
UI - 21438052
AU - Ryu J; Kim B
TI -
MR imaging of the male and female urethra.
SO - Radiographics 2001 Sep-Oct;21(5):1169-85
AD - Department of Radiology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea.
Conventional radiographic contrast material-enhanced studies (eg,
retrograde urethrography [RUG], voiding cystourethrography [VCUG],
double-balloon catheter urethrography) and ultrasonography are useful in
evaluating the anatomy of the urethra but are limited in demonstrating
anatomic derangement of adjacent structures. Since the anatomic details
of both the urethra and periurethral tissues can be evaluated
noninvasively with magnetic resonance (MR) imaging, this modality can be
used as an adjunctive tool for evaluation of urethral abnormalities. In
patients with congenital anomalies, MR imaging is reserved for cases of
intersex anomalies or complex genitourinary anomalies, in which
evaluation of internal organs is essential. MR imaging may demonstrate
diverticula that are not seen on radiographic contrast-enhanced studies,
including VCUG, RUG, or double-balloon catheter study. In cases of
inflammation, MR imaging can demonstrate not only inflammatory
infiltration around the urethra but also the presence of a periurethral
abscess or sinus tract. In cases of trauma, MR imaging is helpful in
assessing the presence and extent of anterior or posterior urethral
injury and predicting the occurrence of complications. At MR imaging, a
fistula can be seen as a direct communicating channel with an adjacent
organ. In patients with urethral tumors, the major role of MR imaging is
in local staging.
10
UI - 21150754
AU - Bhatt RI
TI -
A urethral duplication cyst complicated by a squamous cell carcinoma.
SO - BJU Int 2001 Mar;87(4):417
11
UI - 21227050
AU - Sakamoto N; Naito S; Kumazawa J; Ariyoshi A; Osada Y; Omoto T; Fujisawa
TI -
Y; Morita I; Yamashita H; The Kyushu University Urological Oncology
Group
Prophylactic intravesical instillation of mitomycin C and cytosine
arabinoside for prevention of recurrent bladder tumors following surgery
for upper urinary tract tumors: a prospective randomized study.
SO - Int J Urol 2001 May;8(5):212-6
AD - Department of Urology, Graduate School of Medical Sciences, Kyushu
University, Japan.
BACKGROUND: A recurrence of bladder tumors following surgery for
transitional cell carcinoma of the upper urinary tract is not rarely
observed. A prospective randomized study was conducted to examine the
significance of prophylactic intravesical instillation of mitomycin C
(MMC) and cytosine arabinoside (Ara-C) to prevent recurrent bladder
tumors after surgery for superficial transitional cell carcinoma of the
upper urinary tract. METHODS: The patients were randomized into an
instillation group, who received postoperative intravesical instillation
of MMC (20 mg) and Ara-C (200 mg) 28 times over a period of 2 years, and
a non-instillation group. The non-recurrence rate was then compared
between the groups. RESULTS: Of the 27 patients registered, 25 patients
(13 with instillation and 12 without instillation) were able to be
evaluated, with a median follow-up period of 45 months. The
non-recurrence rate of bladder tumors in the instillation group was
higher than that in the non-instillation group. Although the difference
was not statistically significant, the P-value (P = 0.079) demonstrated
a strong trend. When any possible bias was allowed for a multivariate
analysis, the difference was almost significant (P = 0.0567). No
patients withdrew from this study due to any side-effects. CONCLUSION:
The postoperative instillation of MMC and Ara-C may be a useful approach
for reducing the recurrence of bladder tumors after surgery for upper
urinary tract tumors.
12
UI - 21384078
AU - Chepurov AK; Krivoborodov GG; Raksha AP; Malenko VP; Shvarts PG
TI -
[Acute urinary retention caused by urethral polyp]
SO - Urol Nefrol (Mosk) 2001 Mar-Apr;(2):45-7
A polyp of the prostatic part of the urethra is a rare pathological
finding. A 20-year-old male visited our clinic with acute urinary
retention. Ultrasound investigation, x-ray and endoscopic examinations
revealed a polyp of the prostatic urethra. The polyp was resected by
Ho-YAG laser. The resection resolved the urinary retention. The
histopathological diagnosis was fibroepithelial polyp.
13
UI - 21464047
AU - Matsushita Y; Ohuchi A; Owari Y; Kudoh S; Nozawa T; Ogata M; Suzuki Y;
TI -
Fujioka T
[Prognostic factors of renal pelvic and ureteral cancer: a multivariate
analysis]
SO - Hinyokika Kiyo 2001 Aug;47(8):543-6
AD - Department of Urology, Iwate Medical University School of Medicine.
We clinicopathologically reviewed 54 cases (40 males and 14 females) of
renal pelvic and ureteral cancer examined between 1983 and 1998, in
order to determine the impact of prognostic factors. Follow-up ranged
from 2 to 173 months (mean, 45.6 months). The age of the patients ranged
from 39 to 88 years (mean, 68.9 years). The 1, 3 and 5-year
cause-specific survival rates (Kaplan-Meier's method) for all of the
patients were 74.6%, 58.4% and 54.5%, respectively. According to
univariate analysis, a high grade and high stage of tumor, the presence
of lymphatic invasion and positive regional lymph nodes indicated a
significantly poor prognosis. On the other hand, multivariate analysis
using Cox proportional hazards regression revealed the presence of
lymphatic invasion as the most significant predictor of survival.
Therefore, patients with lymphatic invasion have a poor prognosis, and
the development of effective adjuvant therapy is needed to improve the
outcome in these patients.
14
UI - 21464053
AU - Tawada M; Tanase K; Muranaka K; Sawada S
TI -
[A case of renal pelvic tumor with heterotopic bone formation]
SO - Hinyokika Kiyo 2001 Aug;47(8):569-71
AD - Department of Urology, Nagahama City Hospital.
The patient was a 74-year-old man who was referred to our hospital with
a complaint of left flank pain. Laboratory data were almost within
normal limits and urine cytology was positive. X-ray examination
revealed a calcification in the left kidney and abdominal CT scan
confirmed the presence of a heterogenous renal pelvic mass which
contained a calcification. Based on these examinations, a diagnosis of a
renal pelvic cancer with heterotopic bone formation was made.
Subsequently, left nephroureterectomy was performed. Grossly, the renal
pelvis of the resected kidney was filled with a mass which had a white
cut surface and bone-like tendency. Histopathologically, a poorly
differentiated transitional cell carcinoma with massive bone formation
was found. Fifty five cases of heterotopic bone formation in the kidney
have been reported in Japan. Among the cases, 4 cases were complicated
with renal pelvic tumor and our case was the second case of heterotopic
bone formation complicated with a transitional cell carcinoma of the
renal pelvis in Japan.
15
UI - 21464054
AU - Tanuma Y
TI -
Ureteral endometriosis: a case report and a review of the Japanese
literature.
SO - Hinyokika Kiyo 2001 Aug;47(8):573-7
AD - Department of Urology, NTT East Sapporo Hospital.
A 42-year-old woman was referred to our hospital because of abdominal
fullness and a large abdominal mass. Computed tomography (CT)
demonstrated bilateral ovarian tumors, uterine myoma and left
hydronephrosis. On excretory urography the left kidney was not
visualized and retrograde pyelography (RP) revealed left hydronephrosis
and a filling defect in the left lower ureter. Based on the diagnoses of
endometriosis of bilateral ovaries, uterine myoma and a left ureteral
tumor, abdominal total hysterectomy, right salpingo-oophorectomy and
partial ureterectomy were performed. Pathologically, in the uterus, both
leiomyoma and adenomyosis, and endometriosis of the right ovary and
ureter were diagnosed. Medication with buserelin acetate was started.
16
UI - 21464055
AU - Taki T; Matuura O; Isobe Y; Kamihira O; Yamada S; Kondo A; Yamada Y;
TI -
Honda N
Ureteral fibroepithelial polyp associated with urolithiasis induced by
steroid therapy in a child: a case report.
SO - Hinyokika Kiyo 2001 Aug;47(8):579-82
AD - Department of Urology, Komaki Shimin Hospital.
A 14-year-old boy complained of left flank pain. He had been given
high-dose corticosteroid therapy for chronic inflammatory demyelinating
polyneuropathy (CIDP). Retrograde pyelography revealed irregular defects
at the left ureteropelvic junction (UPJ), and ureteroscopy demonstrated
ureteral polyp. The polyp was removed and histologically diagnosed as
fibroepithelial polyp. Hypercalciuria due to the corticosteroids and
bedridden was assumed to have been a causative factor in the stone
formation. To our knowledge, this is the first report of a ureteral
fibroepithelial polyp in children associated with urolithiasis, and
associated with CIDP.
17
UI - 21470125
AU - Dalbagni G; Donat SM; Eschwege P; Herr HW; Zelefsky MJ
TI -
Results of high dose rate brachytherapy, anterior pelvic exenteration
and external beam radiotherapy for carcinoma of the female urethra.
SO - J Urol 2001 Nov;166(5):1759-61
AD - Department of Urology, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA.
PURPOSE: We evaluated a multimodality approach to locally advanced
the urethra with anterior pelvic exenteration followed by high dose
192iridium intraoperative radiation therapy. Four of the 6 patients were
also treated with neoadjuvant or concomitant platinum based
chemotherapy. RESULTS: Two patients had no evidence of disease, 3 had
distant metastasis and 2 had local recurrence at a mean followup of 21
months (range 12 to 47). Radiation was relatively well tolerated with no
major adverse events. CONCLUSIONS: High dose intraoperative
brachytherapy followed by external beam radiation is relatively well
tolerated. Local control seems to have improved. We must evaluate a
larger cohort of patients to determine this impact of the combined
modality on local control and patient survival.
18
UI - 21470144
AU - Hvarness H; Krarup T; Eldrup J
TI -
Long-term remission of transitional cell carcinoma after Bacillus
Calmette-Guerin instillation in the renal pelvis.
SO - J Urol 2001 Nov;166(5):1829
AD - Department of Urology, Frederisksberg Hospital, Fredericksberg Hospital,
Aalborg, Denmark.
19
UI - 21470145
AU - Sakata Y; Onishi T; Yamada Y; Arima K; Yanagawa M; Kawamura J
TI -
alpha-Fetoprotein producing renal pelvic and ureter tumor.
SO - J Urol 2001 Nov;166(5):1830
AD - Department of Urology, Mie University School of Medicine, Tsu, Mie,
Japan.
20
UI - 21470146
AU - Chen KT
TI -
Primary carcinoid tumor of the urethra.
SO - J Urol 2001 Nov;166(5):1831-2
AD - Department of Pathology, Saint Agnes Medical Center, Fresno, California,
USA.
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