Reecelam4622

The safety and efficacy of combination therapy comprising immune checkpoint inhibitors and cancer-specific peptide vaccines have not yet been established.

A 71-year-old female metastatic renal cell carcinoma patient with multiple lung and pleural metastases. She had been treated with interferon alpha, sunitinib, axitinib, and pazopanib sequentially, but no clinical efficacy was observed. She participated in a clinical trial using cancer-specific peptide vaccine therapy. Initially no antitumor effect was observed, and vaccine therapy was ceased after two courses. But 3months after the start of nivolumab, remarkable tumor shrinkage was observed at all metastatic sites, which resulted in almost complete response at 6months. At 10months, nivolumab was stopped due to cellulitis at the peptide vaccine inoculation site. Intriguingly, even after nivolumab discontinuation, complete response was maintained for more than 1year.

We experienced a remarkable antitumor effect by nivolumab in a patient who was previously treated with vaccine therapy.

We experienced a remarkable antitumor effect by nivolumab in a patient who was previously treated with vaccine therapy.

There are no established treatments for asymptomatic ectopic ureteroceles, with completely duplicated ureters, during the neonatal period and infancy. However, conservative treatment is sometimes successful.

Two patients were prenatally diagnosed, via ultrasonography, with left hydronephrosis. In each case, magnetic resonance imaging confirmed an ectopic ureterocele accompanying the left, completely duplicated ureter. Prophylactic antibiotics were administered and conservative treatment was started. Currently, one patient is 44months old and the other is 49months old; in neither patient has the ureterocele or hydronephrosis been exacerbated.

Patients with (i) a nonfunctional kidney, (ii) mild hydronephrosis or moderate vesicoureteral reflux, (iii) no bladder neck obstruction on urination, and (iv) a Churchill classification≤Grade II (Churchill classification) may be able to select conservative treatment.

Patients with (i) a nonfunctional kidney, (ii) mild hydronephrosis or moderate vesicoureteral reflux, (iii) no bladder neck obstruction on urination, and (iv) a Churchill classification ≤Grade II (Churchill classification) may be able to select conservative treatment.

Chromophobe renal cell carcinoma presents in early pathological stages with a lower risk of metastasis. However, aggressive features and metastasis can occur. A rare case of rapidly progressive disease with histological changes is presented.

A 56-year-old woman had a right renal tumor with multiple lymph node metastases, and the pathological diagnosis of the biopsy specimens from the primary tumor was chromophobe renal cell carcinoma. After sunitinib treatment, the metastatic lymph node had decreased in size and the numbers of circulating tumor cells were decreased, consequently, cytoreductive nephrectomy was performed. However, rapid progression of lymph node metastases was observed. Histopathological examination showed that the renal tumor was diagnosed as spindle cell renal carcinoma.

It appears that the primary tumor underwent epithelial-mesenchymal transition; further tissue specimen collection and analysis might be needed.

It appears that the primary tumor underwent epithelial-mesenchymal transition; further tissue specimen collection and analysis might be needed.

When ileal conduit construction is performed for urinary tract drainage during radical cystectomy, the conduit is usually constructed in the right lower abdomen. However, no reports have described ileal conduit construction in the left lower abdomen when it cannot be performed on the right side. In addition, some ingenuity is necessary for construction on the left.

A 75-year-old woman visited our hospital with chief complaint of gross hematuria. Computed tomography and cystoscopy showed a huge bladder tumor, and blood analysis showed anemia. The patient was treated by radical cystectomy with ileal conduit construction. An ileal conduit was constructed in the left lower abdomen; it was impossible to construct in the right lower abdomen because of the abdominal wall scar hernia due to the past open surgery.

We herein reported a patient who underwent ileal conduit for urinary diversion on the left side of low abdominal wall.

We herein reported a patient who underwent ileal conduit for urinary diversion on the left side of low abdominal wall.

Regression of non-irradiated metastatic lesions after radiation therapy is known as the abscopal effect. We report a case of urothelial carcinoma in which the abscopal effect was possibly observed after immune checkpoint inhibitor administration.

A 68-year-old woman diagnosed with left renal pelvic cancer underwent total nephroureterectomy and regional lymph node dissection. Eight months later, imaging studies detected local recurrence and paraaortic lymph node metastasis. The tumor progressed despite cisplatin+gemcitabine, pembrolizumab, and gemcitabine+docetaxel therapy. Radiation therapy was administered to a painful back lesion, which resulted in dramatic symptom relief. Computed tomography 2months after radiation therapy indicated reduced size of the irradiated lesion and some non-irradiated lymph nodes.

Combined radiation therapy and immune checkpoint inhibitors can provide additional benefits for certain cancers, possibly due to negative immunomodulatory response blockade. Thus, this combined therapy may be a new metastatic urothelial carcinoma treatment strategy.

Combined radiation therapy and immune checkpoint inhibitors can provide additional benefits for certain cancers, possibly due to negative immunomodulatory response blockade. Thus, this combined therapy may be a new metastatic urothelial carcinoma treatment strategy.

Refractory fistulas of the bladder are not rare, but they can rarely be closed naturally. Bladder fistulas can be treated in various ways. We report the case of an old woman who had a refractory fistula of the bladder that was able to be repaired with transurethral cystoscopic injection of

-butyl-2-cyanoacrylate.

For decades after being treated for cervical cancer in 1970s, the woman frequently suffered from fevers. A computed tomography scan showed pelvic abscess at the left side of her bladder, and cystography showed urine leakage at the wall. Thus, we diagnosed her with a pelvic abscess due to a bladder fistula after radiation. Then, we treated her with drainage, antibiotic agents, and

-butyl-2-cyanoacrylate. After that, she no longer had fevers, and cystography showed no leakage of urine.

This result indicates transurethral cystoscopic injection of

-butyl-2-cyanoacrylate may treat bladder fistulas safely, minimally invasively, and quickly.

This result indicates transurethral cystoscopic injection of N-butyl-2-cyanoacrylate may treat bladder fistulas safely, minimally invasively, and quickly.

Pembrolizumab cause immune-related adverse events. We herein report a case of advanced bladder cancer, who treated with pembrolizumab and exhibited intriguing clinical course.

A 63-year-old man with bladder carcinoma was treated by radical cystectomy, however, the bladder carcinoma recurred and invaded to the rectum. He was treated by combination therapy using gemcitabine and cisplatin, which were not effective for the tumor. He subsequently underwent treatment with pembrolizumab. In several 30days, he suffered from the symptoms of myasthenia gravis. Serum levels of creatine kinase, its isozyme creatine kinase-myocardial band, and troponin I were elevated. Electrocardiography showed a right bundle branch block. These findings suggested that he was myasthenia gravis with general myositis and presumable myocarditis. Oral prednisolone administration significantly attenuated these findings. The tumor drastically shrunk only by the single injection of pembrolizumab.

Early intervention with corticosteroid was effective for neuromuscular complications due to pembrolizumab.

Early intervention with corticosteroid was effective for neuromuscular complications due to pembrolizumab.

Sarcoidosis is a disease in which noncaseating granulomas form in several organs, particularly in the lungs and skin. Male genitourinary involvement in sarcoidosis is uncommon.

A 32-year-old male with painless bilateral scrotal swelling who was diagnosed with lung sarcoidosis presented to our hospital. Selleck Nintedanib Serum tumor marker levels were normal. Scattered hypoechoic mass lesions in both testes were noted on ultrasound examination. Biopsy of both testes revealed pathologically noncaseating epithelioid cell granuloma, and perihilar lymphadenopathy and a granulomatous lung nodule were found on chest computed tomography. Semen examination was performed after the biopsy, demonstrating oligospermia. A corticosteroid regimen was administered. After treatment, no abnormal accumulation in both testes was observed on gallium-67 scintigraphy, and semen examination demonstrated the mild improvement of the sperm count.

Treatments for testicular sarcoidosis vary, and malignancy and fertility must be considered.

Treatments for testicular sarcoidosis vary, and malignancy and fertility must be considered.

Laparoscopic ureterocalicostomy is a useful alternative to laparoscopic pyeloplasty for treating ureteropelvic junction obstruction under certain conditions. One concern regarding this technique is the inevitability of amputation of the renal lower pole to expose the lower renal calyx.

A 43-year-old man who presented ureteropelvic junction obstruction and multiple renal cysts underwent laparoscopic pyeloplasty, which could not be performed because of the intrarenal ureteropelvic junction. We switched the surgical technique to modified laparoscopic ureterocalicostomy, wherein amputation of the lower renal pole was substituted with fenestration of a renal cyst under the guidance of ureteroscopic light. Computed tomography performed 2months postoperatively showed good patency of the anastomosis.

Light-guided laparoscopic renal cyst fenestration followed by ureterocalicostomy is feasible in patients with ureteropelvic junction obstruction and lower pole renal cysts adjacent to the lower renal calyx.

Light-guided laparoscopic renal cyst fenestration followed by ureterocalicostomy is feasible in patients with ureteropelvic junction obstruction and lower pole renal cysts adjacent to the lower renal calyx.

Fistula formation between an ileac artery and an ileal conduit after radical cystectomy is a rare complication.

A 72-year-old woman underwent laparoscopic radical cystectomy with ileal conduit. After surgery, leakage of ileal-ureteral anastomosis with infection was observed. Five months after surgery, sudden bleeding from the ileal conduit occurred that stopped spontaneously. Contrast-enhanced computed tomography suggested a pseudo aneurysm of the right external iliac artery in contact with the ileal conduit. A fistula between the artery and ileal conduit was suspected. She underwent embolization of the common iliac artery and femorofemoral bypass. She had a good clinical course and no sign of hematuria over 6months of follow-up.

An episode of warning hemorrhage from the urostomy is an important sign of fistula, and endovascular treatment is a feasible approach to treat this condition.

An episode of warning hemorrhage from the urostomy is an important sign of fistula, and endovascular treatment is a feasible approach to treat this condition.