Cooperholt1900

Hem-o-Lok

clips are widely used in robot-assisted radical prostatectomy because of their ease of application and secure clamping. Although there have been some reports of their migration into the urinary tract, this usually occurs a few months after robot-assisted radical prostatectomy. Late-onset cases of Hem-o-Lok

clip migration, that is, after more than 1 year, are rare.

We report three cases of delayed endourethral Hem-o-Lok

clip migration more than 2 years after robot-assisted radical prostatectomy. The Hem-o-Lok

clips were almost completely endoluminal, and were attached at one end to the vesicourethral anastomosis. We successfully removed them via transurethral surgery using a holmium laser.

This case series describes late-onset Hem-o-Lok

clip migration into the bladder more than 1 year after robot-assisted radical prostatectomy. Transurethral holmium laser surgery was very effective for Hem-o-Lok

clip removal. To avoid involvement of Hem-o-Lok

clips in the vesicourethral anastomosis, appropriate resection at the time of bladder neck transection is important.

This case series describes late-onset Hem-o-Lok® clip migration into the bladder more than 1 year after robot-assisted radical prostatectomy. Transurethral holmium laser surgery was very effective for Hem-o-Lok® clip removal. To avoid involvement of Hem-o-Lok® clips in the vesicourethral anastomosis, appropriate resection at the time of bladder neck transection is important.

Intravesical Bacillus Calmette-Guerin immunotherapy is known to prevent recurrence of bladder cancer, but it can cause tuberculosis infections as an adverse event.

A 75-year-old man visited our hospital due to hematuria. The patient was diagnosed with bladder cancer and underwent transurethral resection of the bladder tumor. Postoperatively, the patient received Bacillus Calmette-Guerin immunotherapy. One year later, we performed transurethral surgery and prostate biopsy because of cystoscopic findings showing nodulous lesions in the bladder and an elevated serum prostate-specific antigen level. The patient presented with high fever and malaise since the surgery. After careful examination, the patient was diagnosed with miliary tuberculosis caused by

. The pathology of the bladder and prostate revealed acid-fast bacilli collection by Ziehl-Neelsen staining.

The surgery exacerbated the local infection into a systemic infection. The risk of developing miliary tuberculosis should be considered at transurethral surgery or prostate biopsy in patients after intravesical Bacillus Calmette-Guerin immunotherapy.

The surgery exacerbated the local infection into a systemic infection. The risk of developing miliary tuberculosis should be considered at transurethral surgery or prostate biopsy in patients after intravesical Bacillus Calmette-Guerin immunotherapy.

Deoxyribonucleic acid repair gene mutations are now being studied in a variety of solid tumors, with the hope of predicting prognosis, pathogenesis, and treatment outcomes.

We report the case of a Japanese patient with advanced castration-resistant prostate cancer who exhibited a prominent response to platinum therapy and had coexisting

and

mutations according to retrospective multigene panel analysis.

Through a review of clinical outcomes and genetic/pathologic profiling, the presented case provides insights into future management strategies based on the tumor genetic status.

Through a review of clinical outcomes and genetic/pathologic profiling, the presented case provides insights into future management strategies based on the tumor genetic status.

Retropubic parasymphyseal cysta are rare, and few cases have been reported in men.

A 65-year-old male patient presented with a 6-month history of pelvic and perineal pain. Magnetic resonance imaging revealed a high-intensity, irregular-shaped mass extending from the pubic symphysis to the bladder. Contrast enhancement revealed no uptake in the central part of the mass, indicating a cystic component. Computed tomography showed erosion of the pubic symphysis and pubic osteophytes. Pathological findings of biopsy specimens revealed inflammatory fibrous tissue but no malignancy. The definitive diagnosis was retropubic parasymphyseal cyst associated with inflammation. The patient was treated with cefazolin from 1 day before surgery until postsurgical day 7. Oral antibiotic therapy was then prescribed for 1 month to maximize treatment. After 2 months, the patient's symptoms resolved.

Retropubic parasymphyseal cysts with inflammation and smaller asymptomatic cysts can be managed effectively with conservative or minimally invasive treatment.

Retropubic parasymphyseal cysts with inflammation and smaller asymptomatic cysts can be managed effectively with conservative or minimally invasive treatment.

Mucin-producing adenocarcinoma of the prostate is a rare disease that includes prostate adenocarcinoma with mucus production, secondary adenocarcinoma from the bladder or colorectum, and adenocarcinoma from the urothelium of the prostatic urethra. We describe prostate-specific antigen-negative mucin-producing urothelial-type adenocarcinoma of the prostate.

The patient had urinary retention and a serum prostate-specific antigen level of 0.74 ng/mL. Computed tomography and magnetic resonance imaging revealed a prostate tumor with a mucous component. We diagnosed adenocarcinoma by prostate biopsy and subsequently performed robot-assisted radical prostatectomy. Mucin-producing urothelial-type adenocarcinoma of the prostate was diagnosed by pathological examinations. Lung metastasis, developing within 3 months after surgery, was treated using chemotherapy.

Endocrine therapy is ineffective for mucin-producing urothelial-type adenocarcinoma of the prostate. Mucin-producing urothelial-type adenocarcinoma of the prostate diagnosis requires pathological and immunohistochemical analyses. It is important to surgically remove the primary lesion, and robot-assisted radical prostatectomy may provide an effective approach. Multimodal therapy is essential to treat for mucin-producing urothelial-type adenocarcinoma of the prostate.

Endocrine therapy is ineffective for mucin-producing urothelial-type adenocarcinoma of the prostate. Mucin-producing urothelial-type adenocarcinoma of the prostate diagnosis requires pathological and immunohistochemical analyses. It is important to surgically remove the primary lesion, and robot-assisted radical prostatectomy may provide an effective approach. Multimodal therapy is essential to treat for mucin-producing urothelial-type adenocarcinoma of the prostate.

Granulocyte colony-stimulating factor-associated arteritis is a rare adverse event of granulocyte colony-stimulating factor, with an incidence of 0.47% among all patients who receive granulocyte colony-stimulating factor. We herein present a case of granulocyte colony-stimulating factor-associated arteritis.

A 72-year-old man with castration-resistant prostate cancer and multiple bone metastases was treated with docetaxel and pegfilgrastim. He developed a high fever on day 12 without other symptoms. His white blood cell count and C-reactive protein levels were high. Antibiotic therapy was ineffective, and contrast-enhanced computed tomography showed thickened subclavian and brachiocephalic artery walls. He was diagnosed with granulocyte colony-stimulating factor-associated arteritis.

When patients receiving chemotherapy with granulocyte colony-stimulating factor develop an unexplained fever, granulocyte colony-stimulating factor associated arteritis should be considered.

When patients receiving chemotherapy with granulocyte colony-stimulating factor develop an unexplained fever, granulocyte colony-stimulating factor associated arteritis should be considered.

Left renal vein thrombus complicating nutcracker syndrome is relatively rare. To the best of our knowledge, there have been only four previous case reports. Furthermore, there have been no reports of pulmonary thromboembolism caused by nutcracker syndrome. Herein, we report a rare case of pulmonary thromboembolism caused by nutcracker syndrome and its clinical management.

A 40-year-old man was admitted to our hospital with acute left flank pain. Computed tomography angiography revealed compression of the left renal vein between the aorta and the superior mesenteric artery with a left renal vein thrombus. Furthermore, computed tomography revealed bilateral pulmonary thromboembolism. Rivaroxaban was administered as an anticoagulant. Twenty days after initiation, computed tomography revealed complete resolution of pulmonary thromboembolism and left renal vein thrombus, and repeated computed tomography showed no recurrence.

This case report highlights nutcracker syndrome as a likely cause of pulmonary thromboembolism.

This case report highlights nutcracker syndrome as a likely cause of pulmonary thromboembolism.

We report a rare case of an extramedullary plasmacytoma of the ureter.

A 77-year-old man was referred to our hospital because of left hydronephrosis. Computed tomography showed a tumor in the left ureter, and tumor invasion into the periureteric fat was suspected. Urine cytology showed Eatypical cells whose nuclei were hyperchromatic (class IIIb). The left ureteral tumor was diagnosed as urothelial carcinoma (cT3N0M0) preoperatively. Subsequently, we performed laparoscopic radical nephroureterectomy with bladder cuff excision. The tumor was pathologically diagnosed as a plasmacytoma. Postoperative positron emission tomography did not reveal abnormal uptake, and bone marrow aspiration findings were normal. Consequently, the left ureter tumor was diagnosed as an extramedullary plasmacytoma of the ureter.

Extramedullary plasmacytoma commonly occurs in the upper respiratory tract or upper gastrointestinal tract. Extramedullary plasmacytoma of the ureter is rare. This is only the fourth reported case of extramedullary plasmacytoma of the ureter.

Extramedullary plasmacytoma commonly occurs in the upper respiratory tract or upper gastrointestinal tract. Extramedullary plasmacytoma of the ureter is rare. This is only the fourth reported case of extramedullary plasmacytoma of the ureter.

Immune checkpoint inhibitors are one of the standard treatments for metastatic renal cell carcinoma. Among immune-related adverse events, the sarcoidosis-like reaction is frequently difficult to differentiate from cancer progression.

A 58-year-old man with renal cell carcinoma with multiple lung metastases was treated with ipilimumab and nivolumab after nephrectomy. Computed tomography after three courses of treatment revealed hilar/mediastinal lymphadenopathies, pleural nodules, and pulmonary interstitial lesions, whereas lung metastases were markedly regressed. Considering positive findings of Gallium scintigraphy and serological tests together, we clinically judged the new lesions as a sarcoidosis-like reaction and continued the treatment until cessation by liver dysfunction. After discontinuation of the immunotherapy, the sarcoidosis-like reaction was regressed without cancer relapse.

We report here the first case of a clinically diagnosed sarcoidosis-like reaction in metastatic renal cell carcinoma following treatment with immune checkpoint inhibitors.