1/11. A sensitive bladder: an atypical presentation of cancer in a U.S. Army pilot.Bladder cancer is the most common cancer in the urinary tract, the vast majority (90%) of which are transitional cell carcinomas. A papilloma (grade I) lesion offers an excellent prognosis after excision, though recurrence is possible. The classic sign of bladder cancer is gross, painless hematuria. We report a case of transitional cell papillary carcinoma in an aircrew member with atypical presentation: irritative voiding symptoms without hematuria. With a careful history and physical, and aggressive clinical suspicion, an early diagnosis was made offering an excellent prognosis. The patient, an Army helicopter pilot, returned to flight status with a waiver.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. nicotine dependence and withdrawal in an oncology setting: a risk factor for psychiatric comorbidity and treatment non-adherence.Highly nicotine dependent oncology patients are at high risk for psychiatric morbidity when they enter the medical care setting where smoking restrictions apply. nicotine withdrawal symptoms exacerbate cancer-related distress as well as common physical side effects of cancer treatment. This case report illustrates the management of a patient whose ongoing treatment for bladder cancer was jeopardized as a result of nicotine dependence and withdrawal. Several associated complications are described, the most serious of which were his acute anxiety and non-adherence to medical recommendations. A short-term management approach that included anxiolytics and nicotine replacement was effectively used to reduce this patient's excessive anxiety and thus facilitate compliance with stressful treatments. The severity of complications that can result from untreated nicotine dependence and withdrawal underscores the importance of assessing and monitoring smoking status in every patient. Greater staff awareness of the clinical practice guidelines regarding the diagnosis and treatment of nicotine dependence will likely result in improved patient care and compliance.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Human papillomavirus type 16 found in primary transitional cell carcinoma of the Bartholin's gland and in a lymph node metastasis.We report a case of primary transitional cell carcinoma of the Bartholin's gland and its lymph node metastasis that contained HPV 16 sequences by polymerase chain reaction. The physical state of HPV 16 dna in the primary cancer was investigated by Southern blot analysis which showed the presence of the episomal form of viral dna. Our findings of HPV 16 dna in the transitional cell carcinoma of the Bartholin's gland and its metastasis would indicate that both tumors arose from a single clonal event, thus providing evidence that the HPV 16 may have an oncogenic potential in this rare malignancy even in the episomal state.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/11. A possible case of werner syndrome presenting with multiple cancers.The treatment of a man with six metachronous primary cancers is described. The primary lesions were in the soft palate, both edges of the tongue, the hard palate, the esophagus, and the right ureter. Pathologically, all of the first five tumors in the head and neck and esophagus were proven to be squamous cell carcinoma with various grades of differentiation, and the last one was transitional cell carcinoma. The cancers were found in the early clinical stage, and were completely controlled one by one except for the ureteral tumor under treatment. His characteristic medical history and physical findings, i.e. bilateral cataracts, short stature, baldness, diabetes mellitus, high-pitched voice, and multiple malignancies, met the clinical criteria for possible werner syndrome, a genetic premature aging disorder, though the possibility of phenocopy of this syndrome has not been ruled out. We have followed him carefully because he might be vulnerable to malignant tumor formation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/11. Penile metastasis from primary transitional cell carcinoma of the renal pelvis: first manifestation of systemic spread.BACKGROUND: Almost one-third of all penile metastases are detected at the same time as a primary tumor, whereas the remaining two-thirds are detected a mean of 18 months after the discovery of the primary tumor. Cutaneous metastasis of transitional cell carcinoma (TCC) is extremely rare and generally accepted as the late manifestation of a systemic spread. CASE PRESENTATION: We report the first case of simultaneous penile and lung metastases from a primary TCC of the renal pelvis in a 76-year-old man, that occurred 8 years after a left nephroureterectomy. CONCLUSIONS: This case report underscores the importance of physical examinations of the skin of patients who undergo surgical procedures for TCC from bladder as well as from the upper urinary tract, including those seemingly without metastatic disease, because of the possibility of skin and penile metastatic spread.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/11. recurrence of vaginal implantation of transitional cell carcinoma of the urinary tract.BACKGROUND: Vaginal recurrence of bladder carcinoma is extremely rare, with only two cases already reported. We have experienced a third case with the same characteristics of the first one, which was a vaginal recurrence with a prior resected urothelial vaginal tumor. CASE: An 82-year-old woman first presented in 1994 with frequency and gross hematuria. Cystoscopic evaluation revealed a single superficial tumor of the bladder which was treated by endoscopic resection. During the following 7 years, she underwent endoscopic procedures to remove recurrent Ta G2 tumor. In 2002, a cystoscopy revealed a papillary lesion, and a physical examination demonstrated multiple papillary lesion on the vaginal wall. histology of excised genital lesions showed a Grade 2 transitional cell carcinoma. Two years later, the patient presented with a 1-cm solitary lesion on the right vaginal wall, which was then excised. Histological examination showed high-grade transitional cell carcinoma, infiltrating the chorion of the vagina. CONCLUSION: Implantation of shed tumor cells in tissues during micturition or resection seems the only plausible cause of the first implantation. For the second recurrence in the vagina, the possibility is of an incomplete locally excision or a relapse, tied to lymphatic micro metastasis, due to involvement of its own lamina propia.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. Humoral hypercalcemia of malignancy. Release of a prostaglandin-stimulating bone-resorbing factor in vitro by human transitional-cell carcinoma cells.Secretion by tumor cells of circulating bone-resorbing factors may frequently underlie the hypercalcemia that occurs in patients with malignancy. Efforts to identify the responsible mediators have been hampered by a lack of available human tumor cell systems suitable for study of the pathogenesis of the humoral hypercalcemia syndrome. We have established a transitional-cell carcinoma (TCC) line in vitro from a patient with humoral hypercalcemia. These cells are tumorigenic and cause hypercalcemia in athymic nude mice. culture medium conditioned by TCC cells contains potent bone-resorbing activity in vitro, the physical and biological properties of which are similar to those of bone-resorbing activity present in the original patient's urine. The bone-resorbing activity of the TCC factor is accompanied by increased prostaglandin release from bone and is blocked by indomethacin and calcitonin. The TCC-derived bone-resorbing activity coelutes with prostaglandin-stimulating activity during gel filtration with an approximate molecular weight of 15,000. This activity is nondialyzable, stable to concentrated urea and reducing agents, and destroyed by boiling. The TCC factor does not increase cyclic amp production in bone or kidney bioassays and does not exhibit transforming growth factor activity. We conclude that a unique macromolecular factor released by TCC cells causes bone resorption by a mechanism dependent upon stimulation of bone cell cyclooxygenase, and that this factor is the probable cause of the hypercalcemia in vivo. The TCC cell line provides a new model for study of the human humoral hypercalcemia syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. Bladder carcinoma presenting as exercise-induced hematuria.exercise-induced hematuria is becoming a common diagnosis for postexercise hematuria. However, a number of genitourinary tract diseases also may cause gross or microscopic hematuria in some physically active patients. Four cases of postexercise hematuria in patients with transitional cell carcinoma of the bladder are presented. The authors recommend urologic evaluation with excretory urography and cystoscopy for all patients with postexercise hematuria.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/11. Transitional cell carcinoma in ureteral stump after radical nephrectomy for renal cell carcinoma.In a seventy-five-year-old white man gross total painless hematuria developed one year after right radical nephrectomy for renal cell carcinoma. Results of physical examination, laboratory studies, intravenous pyelography, and cystoscopy were normal at that time. One year later, the patient had another episode of gross hematuria. Once again, physical examination, laboratory values, intravenous pyelogram, and cystogram were normal. A right retrograde ureterogram revealed a midureteral filling defect. Total ureterectomy and bladder cuff excision ensued. Pathologic examination revealed well-differentiated transitional cell carcinoma without muscle invasion.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
10/11. Optimum fractionation for irradiation of carcinoma of the bladder. Experiments based on one case.A patient with multiple metastases of transitional cell carcinoma of the bladder to the skin and subcutaneous tissues proved a model where most of the biologic and host-related factors were constant. The effects of varying the physical factors of radiation dose and time were observed. The results indicate that fractionated irradiation at intervals of 48 h was more effective than at intervals of 24 h and that superfractionation (intervals of 5 h) was not an effective method for the treatment of this tumor. The possible reasons for this effect and the implication for the treatment of bladder carcinoma are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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