[Terminal care of final stage for digestive system diseases].
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Anemia↗
Biomedical subjects
M Hosomi
Publications and source records attributed to M Hosomi.
Alpha-fetoprotein-producing adenocarcinoma of the ureter.
We report a case of primary ureteral tumor producing alpha-fetoprotein (AFP). Computerized tomography, ultrasonography and endoscopy of the bile duct revealed no obvious tumor in the liver, gallbladder, bile duct, pancreas or ovary. Total nephroureterectomy was performed, and histopathological examination revealed adenocarcinoma of the ureter lined with transitional cell carcinoma in its base. The tumor was stained with immunohistological AFP stain, and the high serum AFP level normalized after resection of the tumor.
Adenocarcinoma↗
[Renal arteriovenous fistula detected 25 years after nephrolithotomy: a case report].
We report a case of intrarenal arteriovenous fistula (AVF) with macroscopic hematuria detected after nephrolithotomy performed 25 years previously. The present case, successfully treated by transcatheter embolization with steel coils, is the eighth case of postnephrolithotomy AVF reported in English and Japanese literatures. The necessity of renal arteriography in patients with postoperative massive hematuria is stressed.
Arteriovenous Fistula↗
[Retroperitoneal cavernous hemangioma: a case report].
A 55-year-old man was shot at the age of 50. At that time CT revealed a mass near the spleen. Thereafter, CT did not reveal any growth of the mass, but to examine the mass in detail he was hospitalized to our department. The mass was diagnosed as left adrenal cavernous hemangioma, since, on aortography, it was typical cavernous hemangioma and fed mainly from the left inferior phrenic artery. The mass was resected with the spleen, thoracic wall, and part of diaphragma. At the operation the left adrenal gland was identified to be intact. Histopathological diagnosis was retroperitoneal cavernous hemangioma. This is the 19th case of retroperitoneal cavernous hemangioma in the Japanese literature.
Hemangioma, Cavernous↗
[Leiomyosarcoma of the spermatic cord: a case report].
A 63-year-old man presented with painless hard swelling of left scrotal contents. Left orchiectomy with high ligation of the spermatic cord was done with clinical diagnosis of testicular tumor. Histopathologically, this tumor was diagnosed as leiomyosarcoma, primarily, arising from the spermatic cord. After operation, prophylactic radiotherapy (60Co, 5,890 rad) was given locally. There has been neither local recurrence nor metastasis for 10 months after operation. This is the 18th case of leiomyosarcoma of the spermatic cord in Japan.
Combined Modality Therapy↗
[A case of retroperitoneal Hodgkin's disease with dysuria].
A case of retroperitoneal Hodgkin's disease with dysuria is reported. A 56-year-old man visited our hospital with the complaints of dysuria and lower abdominal mass. On physical examination, an unmovable hard smooth mass of fist size was palpable in the lower abdomen and prostate was slightly swelling by rectal digital examination. Excretory urography demonstrated medial deviation of left lower ureter and bladder deformity. Retrograde urethrocystography showed deviation and compression of prostatic urethra. On CT, tumors were composed of several round masses, which surrounded the left common iliac artery on angiography. Surgical extirpation was carried out and histological examination revealed Hodgkin's disease. As postoperative treatment, chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisolone was performed, and 30 months after the operation the patient was asymptomatic.
Antineoplastic Combined Chemotherapy Protocols↗
Spontaneous rupture of pyelocaliceal diverticulum.
One rare case of spontaneous rupture of pyelocaliceal diverticulum is reported in a 31-year-old Japanese man presented with a severe left flank pain. Intravenous pyelography and computerized tomography demonstrated extravasation of contrast medium from his diverticulum which contained numerous calculi. As a possible cause of spontaneous rupture of pyelocaliceal diverticulum in this case, we suggest that the paper-thin parenchyma covering the diverticulum was not strong enough to tolerate the minimum elevation of intrapelvic pressure due to the obstruction of delivered stones.
Adult↗
[Extramammary Paget's disease with a large mass in male genitalia: a case report].
A 57-year-old Japanese man presented with a mass 3 cm in diameter at the root of the penis. The patient had noticed the mass growing for 5 years, but had no pain or itching. Histological examination revealed it to be invasive Paget's disease, and the mass was resected along with skin of normal appearance within 3 cm around it. Regional lymph node metastasis was also revealed in the operation, and irradiation at the pelvic and inguinal region was done. Extramammary Paget's disease with a large mass is relatively rare, and invasive extramammary Paget's disease has a poor prognosis.
Adenocarcinoma↗
[A case of papillary cystadenoma of epididymis].
We present a case of papillary cystadenoma of the right epididymis in a 52-year-old man. He visited our hospital complaining of painless mass in his right scrotum. This painless hard mass was palpable at the head of his right epididymis and was 1 cm in diameter. Right epididymectomy was performed. A histological examination revealed epithelial proliferation of ectatic efferent ducts and microcysts filled with papillary processes, and a diagnosis of papillary cystadenoma of the right epididymis was made. In Japan, our present case is the 12th of papillary cystadenoma of epididymis. We chiefly reviewed the clinical aspects of this disease, especially the relationship between this disease and von Hippel-Lindau's disease.
Cystadenoma↗
[Congenital unilateral multicystic kidney in an adult].
Congenital unilateral multicystic kidney is relatively rare in adult (16% in adult, and 84% in children). Most of the adult cases are asymptomatic, and should be followed up conservatively, but nephrectomy was performed in many cases reported in Japan, because it was difficult to distinguish those cases from renal tuberculosis. Here we present one adult case, and discuss its clinical findings, diagnosis, treatment, etiology and embryology.
Female↗
[Localized amyloidosis of urinary bladder: a case report].
A case of localized amyloidosis of the urinary bladder is reported. A 82-year-old woman visited our hospital with the chief complaint of miction pain and residual urine sensation. Cystoscopic examination revealed a broad-based and nonpapillary tumor without bleeding on the right lateral wall. A transurethral biopsy of this tumor was performed. A histopathological examination with H.E. and Congo red stains demonstrated amyloid deposition in the submucosal layers of the vesical wall. Rectal biopsy and other findings suggested no deposition of amyloid in other organs. On the basis of these findings, we made a diagnosis of localized amyloidosis of the urinary bladder. To the best of our knowledge, the present case is the 23rd of localized amyloidosis of urinary bladder in Japan. The patient was asymptomatic after biopsy. We discuss the clinical features and management of this disease.
Aged↗
[Hydronephrosis caused by Crohn's disease: a case report--review of 41 cases with urinary tract complication reported in Japan].
A 34 year-old man, who had been under care with diagnosis of Crohn's disease in the department of gastroenterology of our hospital since 1983, was referred to our urological clinic on May 21, 1987, because of right hydronephrosis found on ultrasonography. He did not complain of any urological symptoms. He underwent further roentgenographic examinations and a diagnosis of hydronephrosis complicated with Crohn's disease was made. On surgery of July 30, resection of ileocecal lesion, end-to-end ileocolostomy, right ureterolysis were performed. He is now visiting our clinic without recurrence of hydronephrosis up to present (7 months). In addition, we reviewed the 41 cases of urological disorders complicated with Crohn's disease in the literature reported in Japan. The cases were of vesicoenteric fistula including pericystitis (33 cases), hydronephrosis (10 cases), urolithiasis (2 cases) and ureterocolonic fistula (1 case). The patients were from 10 to 57 years (27.2 years in average) old. Sex distribution was uneven, 39 of patients were men and 2 were women. Urologic surgery was performed in almost all of the cases except for the patient with urolithiasis. All the patients having vesicoenteric fistula had urological complaints but the patients with hydronephrosis were relatively free from urological complaints. Thus, Crohn's disease has been recognized as an important gastrointestinal disease for urologists, and we will emphasize that periodical abdominal ultrasonography and urography for the patients with this disease should be necessary for checking up other complications such as hydronephrosis.
Adult↗
[A case of adrenal myelolipoma].
A case of adrenal myelolipoma is presented. The patient was a 61-year-old woman who complained of lumbago this time. A tumor of the left adrenal gland, however, had been found by computed tomography 4 years earlier. Judging from the CT, the size of this tumor had not changed at all, although the density of the mass on admission had reduced, compared with that of 4 years earlier. Laboratory examinations of adrenal function was normal. Left adrenalectomy was performed. Histologically, this tumor consisted of adipose and some hematopoietic tissue. We reviewed 43 cases of adrenal myelolipoma resected surgically in Japan.
Adrenal Gland Neoplasms↗
[Mixed gonadal dysgenesis with plasty in males].
A 13-year-old Korean boy is reported here as a case of mixed gonadal dysgenesis. The patient presented with perineal hypospadia. He had scrotal testis, epididymis, vas deferens on right side, and abdominal streak gonad, Fallopian tube on left side. He had also uterus and vagina. His chromosome was 46XY type. Among 59 reported cases in Japan, 12 had undergone plasty into male. All of them had hypospadia. In 51 cases, 17 had testes in scrotum. None of them had a testicular tumor. So we decided to do plasty in male, and to follow up his testis quite carefully.
Adolescent↗
[A study on bacteria within stones in urolithiasis].
The bacteria in 37 stones obtained from 37 patients with urinary stone diseases, that is, 11 renal stones (containing 2 staghorn calculi), 21 ureteral stones, 4 bladder stones and 1 urethral stone, were studied, according to the Nemoy & Stamey's method. The stones were collected by partial nephrectomy (1 case), nephrolithotomy (1 case), pyelolithotomy (1 case), percutaneous nephrolithotripsy (PNL) (6 cases), 12 ureterolithotomies, transurethral ureterolithotripsy (2 cases), cystolithotripsies (4 cases) and spontaneous deliveries (10 cases). According to a stone analysis by infrared spectrophotometer revealed 30 were noninfection stones (81.1%) and 7 infection stones (18.9%). Of these 37 stones, 5 stones (13.5% of 11 stones) had bacteria within them. These stones consisted of 4 infection stones (57.1% of all infection stones) and 1 noninfection stone (3.3% of all noninfection stones). Out of 4 patients having bacteria within their stones, urine culture of whom were carried out before stones were collected, only one patient (25%) had the same species of bacterium (E. coli) both within the stone and in urine. The E. coli within the stone and that in urine, however, showed quite different reactions to some antibiotics. The fact that all organisms within stones cannot be detected by urine culture before collecting stones of the patients in our present study, suggests that patients undergoing endourological surgery, such as extracorporeal shock wave lithotripsy and PNL, may have a risk of complications, such as severe urinary tract infection and urosepsis, if the possibility of the presence of organisms within stones is not taken into consideration.
Adult↗
Complete duplication of male urethra. Two case reports.
Complete urethral duplication is a rare anomaly in boys. About 60 cases have been reported in the literature, of which approximately one-third were managed with a surgical procedure of total excision of the accessory urethra. Another third were managed by partial excision, and the rest were managed conservatively. Here 2 cases are presented, and the surgical treatment is discussed.
Child↗
[Lipogranuloma with marked eosinophile infiltration in male genitalia].
A characteristic lipogranuloma in the male genitalia is presented. Histopathological examination revealed a granuloma resembling sclerosing lipogranuloma with marked eosinophile infiltration. Only 11 cases with such a histopathological feature have been reported. Including this case all cases have similar localization, shape and clinical course. The genesis of these granulomas is discussed.
Adult↗
[Giant vesical diverticulum: a case report].
A case of giant vesical diverticulum is reported. A 31-year-old man was admitted with intermittent self-catheterization for 6 months duration due to urinary retention. A cystogram demonstrated a giant solitary diverticulum extended left-posteriorly, which compressed the bladder outlet and caused obstruction. On cystoscopy, the neck of the diverticulum was seen postero-lateral to left ureteral orifice. There was no vesical trabeculation, but slight obstruction of the bladder neck was suspected secondary to intermittent self-catheterization. A diverticulectomy was carried out by combined approach without ureterocystoneostomy. The patient had no difficulty in voiding after the operation.
Adult↗