The possibility of ''de novo'' cancer in the prostate

BACKGROUND: To investigate the possibility of 'de novo' prostate cancer by analyzing the relationship between high grade prostatic intraepithelial neoplasia (HGPIN) and latent prostate cancer. MATERIALS AND METHODS: Latent prostate cancers found at autopsy were examined and 55 cancer foci with a poorly (Gleason grade 4 and 5) or moderately (Gleason grade 3) differentiated component were selected. The 55 foci were separated into two groups: (i) foci with either a poorly or moderately differentiated component only (single differentiation group, SDG); and (ii) mixed foci with two or more types of differentiation components (mixed differentiation group, MDG). High grade intraepithelial neoplasia was defined as positive if it was observed within 2 mm from the edge of the cancer focus and the relationship between HGPIN and the two groups was investigated. RESULTS: The MDG had 39 cancer foci (71.0%) and there were 16 in the SDG (29.0%). There were 31 foci that were small-volume cancers (<0.2 mL). In the MDG, 13 small-volume cancer foci were HGPIN positive, but in the SDG, none of the small-volume cancers were HGPIN positive. CONCLUSIONS: Small-volume cancer foci without HGPIN in the SDG may be candidates for de novo prostate cancers.     

Flexible video cystoscope with built-in high-frequency cauterizing element for transurethral resection of bladder tumor

The major advantage of the flexible video cystoscope is that a digital signal can be obtained while high frequency cauterization is carried out. Cauterization while observing a digital signal picture was not possible before this new model was developed. We decided to use this new cystoscope to resect a bladder tumor and coagulate the bleeding because the patient could tolerate only local anesthesia due to severe heart disease complications. We successfully treated the patient with this technique and no complications were noted. This new flexible video cystoscope was found to be safe for resecting bladder tumor under local anesthesia.     

Experience with flexible video cystoscope equipped with built-in high-frequency cauterizing element for transurethral resection of the bladder

We successfully treated three patients using the flexible video cystoscope (CYF-240A, Olympus, Japan) for superficial bladder cancer under local anesthesia and/or spinal anesthesia. The major advantage of this new technique is that surgeons can use digital pictures and high frequency cauterization. This new system provides good quality of life for bladder cancer patients experiencing frequent recurrences.     

In Vitro Biological Activity of an Insulin-like Active Substance Extracted from the Tumor Tissue of a Patient with Primary Liver Cell Carcinoma Associated with Severe Spontaneous Hypoglycemia

Biological activity of an insulin-like active substance, extractedfrom the tissue of a tumor tissue of a patient with primaryliver cell carcinoma associated with severe spontaneous hypoglycemia,was studied in vitro. The substance was acid insoluble. It stimulatedglucose uptake and glucose oxidation by rat muscle and adiposetissue, and these effects were not suppressed by anti-insulinantibody. It stimulated glycogen synthesis in rat muscle tissuebut not in adipose tissue. Oxidation of glucose C-1 by adiposetissue was enhanced strongly by the substance, but it had noeffect on glucose C-6 oxidation. The biological activity ofthe substance resembled that of non-suppressible insulin-likeactivity-precipitated (NSILA-P) rather than that of pancreaticinsulin or nonsuppressible insulin-like activity-soluble (NSILA-S).     

Alveolar soft-part sarcoma of the retroperitoneum

A 33-year-old woman was referred to Iida Municipal Hospital because of left back pain. Computed tomography showed a tumor (17 x 11 x 10 cm) in the left retroperitoneal space. T1- and T2-weighted magnetic resonance imaging showed an inhomogeneous mass with marginal blood vessels. The tumor was resected via lumbar oblique incision with the thoraco-abdominal approach. The tumor weighed 1800 g and consisted of nests of 5-100 large, loosely arranged, polygonal cells, surrounded by capillaries, resembling alveoli. The tumor cells were rich in cytoplasm, containing periodic acid-Schiff- and diastase-positive granules and typical crystals. The pathological diagnosis was alveolar soft-part sarcoma (ASPS). Alveolar soft-part sarcoma is a rare soft-tissue tumor that accounts for approximately 0.5-1% of soft-tissue sarcomas. Such tumors originating in the retroperitoneal space are extremely rare. Herein is reported a case of ASPS of the retroperitoneum with radiological and pathological findings.