Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,...Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,incontinence,urinary retention,recurrent urinary tract infections,and metabolic disorders,significantly impacting patients'quality of life[2].Partial cystectomy(PC)is a bladdersparing alternative for patients who cannot accept RC and has been utilized in managing muscle-invasive bladder cancer since the last century.However,the application of PC has always been a subject of controversy in clinical practice due to the high recurrence rate.In a matched case-control analysis conducted by Knoedler et al.[3],38%of the patients experienced intravesical tumor recurrence,and 19%of the patients ultimately underwent RC.Another study in the Memorial Sloan-Kettering Cancer Center showed that 22 of 58 patients who received PC experienced superficial or advanced recurrence[4].展开更多
Introduction:Radical cystectomy with pelvic node dissection remains the standard of care for muscle-invasive bladder carcinoma(MIBC);however,there is a growing interest in bladder preservation alternatives among the e...Introduction:Radical cystectomy with pelvic node dissection remains the standard of care for muscle-invasive bladder carcinoma(MIBC);however,there is a growing interest in bladder preservation alternatives among the elderly population.Guidelines indicate that partial cystectomy(PC)combined with pelvic node dissection(LND)can be considered as an alternative in carefully selected individuals.Using the National Cancer Database,we analyzed the overall survival(OS)between PC with and without LND among octogenarians.Methods:We identified octogenarians with localized muscle-invasive bladder carcinoma(cT2-3N0M0)and urothelial histology who underwent PC with or without LND between 2004 and 2018.Based on the number of lymph nodes removed(LNR),the LND group was further subdivided into<10 and>=10 lymph node groups.A propensity-matched Kaplan-Meier survival analysis was performed to compare OS between these groups.Results:Among 2573 patients who underwent PC,492 octogenarians met our selection criteria.208(42.2%)had LND,while 284(57.8%)had no LND.Within the LND group,53(25.5%)had<10 LNR,and 155(74.5%)had>=10 LNR.The median OS for the matched LND and non-LND groups was 36.9 and 33.4 months(p=0.96),respectively.Similarly,<10 LNR and>=10 LNR had 36.9 and 43.5 months(p=0.42),respectively.Multivariate Cox regression analysis revealed no difference in the risk of mortality.Conclusion:Among octogenarians who underwent PC,there was no significant difference in OS between those with or without LND,and between<10 or>=10 LNR groups.Therefore,the role and extent of LND after PC need further exploration in this subset of the population.展开更多
Duodenal duplication cysts are rare congenital anomalies.Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the d...Duodenal duplication cysts are rare congenital anomalies.Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the duodenum.Here,we present an 8-year-old girl with a duodenal duplication cyst treated with partial cystectomy with mucosal stripping performed laparoscopically.Laparoscopic surgery can be considered as a treatment option for duodenal duplication cysts,especially in extraluminal locations.展开更多
Pheochromocytoma （PCC） is a catecholamine producing tumor of neuroectodermal origin that is made up of chromaftin cells, anti it mostly arises from me adrenal medulla. Extra-adrenal pheochromocytomas occur in about ...Pheochromocytoma （PCC） is a catecholamine producing tumor of neuroectodermal origin that is made up of chromaftin cells, anti it mostly arises from me adrenal medulla. Extra-adrenal pheochromocytomas occur in about 10% of all cases in adults.展开更多
BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the bladder is a rare nonurothelial tumor of the bladder.The treatment of LCNEC of the bladder is different from that of urothelial carcinoma(UC);therefore,early...BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the bladder is a rare nonurothelial tumor of the bladder.The treatment of LCNEC of the bladder is different from that of urothelial carcinoma(UC);therefore,early and accurate diagnosis is particularly important.As LCNEC of the bladder is rare and its clinical symptoms and radiographic features are similar to those of urothelial tumors,the clinical diagnosis of the disease remains challenging.CASE SUMMARY We report a 72-year-old female patient who presented with gross hematuria for 3 mo.A solitary tumor located in the anterior wall of the bladder was found by cystoscopy.Pathological examination after biopsy suggested UC of the bladder in the absence of immunohistochemical assessment.The patient underwent partial cystectomy and was finally diagnosed with LCNEC(pT2bN0M0)based on the results of postoperative immunohistochemical examination.During the 10-mo follow-up,no signs of tumor recurrence or metastasis were found.CONCLUSION Immunohistochemical examination is essential for diagnosing LCNEC of the bladder.Accurate diagnosis and multidisciplinary treatment in the early stage of the disease are crucial for improving the prognosis.展开更多
BACKGROUND Granular cell tumor(GCT)is a neurogenic tumor mainly occurring in the head and neck.GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported.Most u...BACKGROUND Granular cell tumor(GCT)is a neurogenic tumor mainly occurring in the head and neck.GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported.Most urinary bladder GCT cases are benign and only two malignant cases have been reported.Due to its rarity,no consensus criteria for the treatment of urinary bladder GCT are available at present.CASE SUMMARY A 62-year-old Chinese woman was found to have a urinary bladder tumor without any clinical manifestations on physical examination.Cystoscopy revealed a semispherical shaped lesion measuring approximately 4.0 cm in diameter at the junction of the left wall and roof of the bladder,which was covered with normal bladder mucosa.Computed tomography scan demonstrated a high-density lesion on the left wall of the bladder,measuring approximately 2.9 cm×2.4 cm with clear boundaries.Contrast-enhanced pelvic magnetic resonance imaging revealed a space-occupying lesion on the left wall of the bladder(non-mucosal origin/external pressure),which was preliminarily suspected to be a desmoplastic fibroma or leiomyoma.In the context of the above findings,a pre-operative diagnosis of bladder leiomyoma was made.The patient consequently underwent a laparoscopic partial cystectomy.The resected bladder mass looked yellowish and well-demarcated,measuring 4.0 cm×3.5 cm and infiltrated the muscular layer.The diagnosis of urinary bladder GCT was finally made by postoperative pathology,with positive immunohistochemical S-100 staining and negative pancytokeratin.The patient has been followed for 6 mo so far,with no tumor recurrence detected.CONCLUSION This case highlights the biological feature and differential diagnosis of urinary bladder GCT at the pathological and molecular levels.Transurethral resection of the bladder tumor and partial cystectomy are recommended in most urinary bladder GCT cases,while radical cystectomy is recommended in malignant cases.展开更多
基金supported by Natural Science Foundation of Hubei Province(ZRMS2020002466 to Liu Z).
文摘Dear Editor,Radical cystectomy(RC)remains the standard treatment for muscle-invasive bladder cancer[1].However,urinary diversion after RC can lead to a range of postoperative complications,including parastomal hernia,incontinence,urinary retention,recurrent urinary tract infections,and metabolic disorders,significantly impacting patients'quality of life[2].Partial cystectomy(PC)is a bladdersparing alternative for patients who cannot accept RC and has been utilized in managing muscle-invasive bladder cancer since the last century.However,the application of PC has always been a subject of controversy in clinical practice due to the high recurrence rate.In a matched case-control analysis conducted by Knoedler et al.[3],38%of the patients experienced intravesical tumor recurrence,and 19%of the patients ultimately underwent RC.Another study in the Memorial Sloan-Kettering Cancer Center showed that 22 of 58 patients who received PC experienced superficial or advanced recurrence[4].
文摘Introduction:Radical cystectomy with pelvic node dissection remains the standard of care for muscle-invasive bladder carcinoma(MIBC);however,there is a growing interest in bladder preservation alternatives among the elderly population.Guidelines indicate that partial cystectomy(PC)combined with pelvic node dissection(LND)can be considered as an alternative in carefully selected individuals.Using the National Cancer Database,we analyzed the overall survival(OS)between PC with and without LND among octogenarians.Methods:We identified octogenarians with localized muscle-invasive bladder carcinoma(cT2-3N0M0)and urothelial histology who underwent PC with or without LND between 2004 and 2018.Based on the number of lymph nodes removed(LNR),the LND group was further subdivided into<10 and>=10 lymph node groups.A propensity-matched Kaplan-Meier survival analysis was performed to compare OS between these groups.Results:Among 2573 patients who underwent PC,492 octogenarians met our selection criteria.208(42.2%)had LND,while 284(57.8%)had no LND.Within the LND group,53(25.5%)had<10 LNR,and 155(74.5%)had>=10 LNR.The median OS for the matched LND and non-LND groups was 36.9 and 33.4 months(p=0.96),respectively.Similarly,<10 LNR and>=10 LNR had 36.9 and 43.5 months(p=0.42),respectively.Multivariate Cox regression analysis revealed no difference in the risk of mortality.Conclusion:Among octogenarians who underwent PC,there was no significant difference in OS between those with or without LND,and between<10 or>=10 LNR groups.Therefore,the role and extent of LND after PC need further exploration in this subset of the population.
文摘Duodenal duplication cysts are rare congenital anomalies.Duodenal duplication should be considered in the differential diagnosis of patients who present with abdominal symptoms with cystic structures neighboring the duodenum.Here,we present an 8-year-old girl with a duodenal duplication cyst treated with partial cystectomy with mucosal stripping performed laparoscopically.Laparoscopic surgery can be considered as a treatment option for duodenal duplication cysts,especially in extraluminal locations.
文摘Pheochromocytoma （PCC） is a catecholamine producing tumor of neuroectodermal origin that is made up of chromaftin cells, anti it mostly arises from me adrenal medulla. Extra-adrenal pheochromocytomas occur in about 10% of all cases in adults.
文摘BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the bladder is a rare nonurothelial tumor of the bladder.The treatment of LCNEC of the bladder is different from that of urothelial carcinoma(UC);therefore,early and accurate diagnosis is particularly important.As LCNEC of the bladder is rare and its clinical symptoms and radiographic features are similar to those of urothelial tumors,the clinical diagnosis of the disease remains challenging.CASE SUMMARY We report a 72-year-old female patient who presented with gross hematuria for 3 mo.A solitary tumor located in the anterior wall of the bladder was found by cystoscopy.Pathological examination after biopsy suggested UC of the bladder in the absence of immunohistochemical assessment.The patient underwent partial cystectomy and was finally diagnosed with LCNEC(pT2bN0M0)based on the results of postoperative immunohistochemical examination.During the 10-mo follow-up,no signs of tumor recurrence or metastasis were found.CONCLUSION Immunohistochemical examination is essential for diagnosing LCNEC of the bladder.Accurate diagnosis and multidisciplinary treatment in the early stage of the disease are crucial for improving the prognosis.
文摘BACKGROUND Granular cell tumor(GCT)is a neurogenic tumor mainly occurring in the head and neck.GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported.Most urinary bladder GCT cases are benign and only two malignant cases have been reported.Due to its rarity,no consensus criteria for the treatment of urinary bladder GCT are available at present.CASE SUMMARY A 62-year-old Chinese woman was found to have a urinary bladder tumor without any clinical manifestations on physical examination.Cystoscopy revealed a semispherical shaped lesion measuring approximately 4.0 cm in diameter at the junction of the left wall and roof of the bladder,which was covered with normal bladder mucosa.Computed tomography scan demonstrated a high-density lesion on the left wall of the bladder,measuring approximately 2.9 cm×2.4 cm with clear boundaries.Contrast-enhanced pelvic magnetic resonance imaging revealed a space-occupying lesion on the left wall of the bladder(non-mucosal origin/external pressure),which was preliminarily suspected to be a desmoplastic fibroma or leiomyoma.In the context of the above findings,a pre-operative diagnosis of bladder leiomyoma was made.The patient consequently underwent a laparoscopic partial cystectomy.The resected bladder mass looked yellowish and well-demarcated,measuring 4.0 cm×3.5 cm and infiltrated the muscular layer.The diagnosis of urinary bladder GCT was finally made by postoperative pathology,with positive immunohistochemical S-100 staining and negative pancytokeratin.The patient has been followed for 6 mo so far,with no tumor recurrence detected.CONCLUSION This case highlights the biological feature and differential diagnosis of urinary bladder GCT at the pathological and molecular levels.Transurethral resection of the bladder tumor and partial cystectomy are recommended in most urinary bladder GCT cases,while radical cystectomy is recommended in malignant cases.
