Primary arterial neoplasms are rare lesions which have been most frequently associated with local or constitutional symptomatology, and with distal embolization. Perirenal aortic disruption with pseudoaneurysm formation due to an intimal sarcoma adjacent to a previously placed prosthetic graft is reported in a 66-year-old man. This case supports the premise that the presence of a vascular prosthesis might result in the induction of an arterial wall malignancy. This should be considered when an intraluminal mass is identified in the absence of other arterial pathology. Although the prognosis of these tumors is poor, their preoperative recognition may enhance treatment outcomes.

METHODS: Female C57BL/6 mice received intravesical PAR4 (100mM; 1 hr) 3 times every other day and abdominal mechanical hypersensitivity (50% mechanical threshold) was tested before first PAR4 injection (baseline) and at days 1, 2, 3, 4, 7 and 9. At the end of the experiment, micturition changes were measured and bladders were examined for histological changes. MIF antagonist (MIF098; 40 mg/kg; i.p.; bid) or HMGB1 inhibitor (glycyrrhizin; 50 mg/kg; i.p.; daily) were administered daily starting from day 2 until day 8 after first instillation.RESULTS: Repeated control peptide instillation did change abdominal mechanical hypersensitivity. There was a significant and persistent abdominal mechanical hypersensitivity starting from day 3 after first intravesical instillation in the PAR4-treated group that persisted until day 9 (5 days post-last instillation). Glycyrrhizin fully reversed while MIF098 partially reversed abdominal mechanical hypersensitivity in PAR4 treated mice (Fig. 1). The changes started on day 3 after first PAR4 instillation and analgesic effects lasted throughout rest of testing period. There were no significant micturition changes or histological changes.CONCLUSIONS: Repeated intravesical PAR4 instillation produced persistent bladder pain without overt bladder inflammation that mimics debilitating bladder pain in PBS/IC patients. MIF and its signaling downstream (HMGB1) are effective targets for bladder pain alleviation.

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