We report a case of spontaneous hemorrhage secondary to renal angiomyolipoma treated with percutaneous transcatheter arterial embolization. Fourteen and 18 months after the procedure, the patient showed repeated spontaneous hemorrhage during pregnancy. However, a healthy female infant was delivered at the 39th week of the pregnancy. We discuss the management of renal angiomyolipoma in young married women before pregnancy.

The simplified CHOKAI score is a useful tool to screen for ureteral stones in patients with renal colic.

To compare detection rates of adrenal tumors by ultrasonography, computed tomography and magnetic resonance image, we studied 61 patients with adrenal tumor, who underwent adrenalectomy. In 45 (73.8%) of the 61 patients. adrenal tumor was detected by ultrasonography. However, computed tomography and magnetic resonance imaging could detect all adrenal tumors. All adrenal tumors measuring more than 3.0 cm in diameter were detected by ultrasonography, computed tomography and magnetic resonance image. When adrenal tumors were smaller than 3.0 cm. however, ultrasonography, computed tomography and magnetic resonance imaging correctly found adrenal tumors in 30 (65.2%) and 46 (100.0%) of 46 patients and 30 (100.0%) of 30 patients, respectively. These facts suggest that ultrasonography seems to be an effective diagnostic procedure for the prevention of overlooking adrenal tumors larger than 3.0 cm.

A case is presented of a 40 y.o. female with Cushing's syndrome. Her plasma glucocorticoid values were elevated (11-deoxy-cortisol: 3.46 ng/ml, cortisol: 25.6 micrograms/dl and cortisone: 35.7 ng/ml) with loss of diurnal variation. Urine 17-OHCS value failed to b suppressed by high dose dexamethasone and was unchanged after metyrapone administration. Her plasma mineral corticoids and androgens were within normal limits. There were 3 separate tumors in the right adrenal on CT and the left adrenal had no uptake on 131I-adosterol scintigram. We, therefore, diagnosed her illness as Cushing's syndrome due to unilateral multiple adenomas. Gross and histological examination of the right adrenal revealed one compact cell dominant adenoma and two clear cell dominant adenomas. This is the 4th case of Cushing syndrome due to unilateral multiple adrenal adenomas in Japan.

Introduction The safety and efficacy of pembrolizumab administration in patients with urothelial carcinoma and underlying autoimmune disease (including overlap syndrome) is unknown. Case presentation We present the case of a 67‐year‐old woman with cT3N2M0 metastatic renal pelvic cancer who had been treated with prednisolone for overlap syndrome involving systemic sclerosis and systemic lupus erythematosus for 20 years. She had a remarkable response to pembrolizumab as a third‐line systemic therapy, wherein the tumor reduced in size and all regional lymph node and pulmonary metastases disappeared. She did not develop any immune‐related adverse events or autoimmune disease flare‐ups during the treatment. Conclusion This case report suggests that pembrolizumab could be beneficial to patients with urothelial carcinoma and underlying well‐controlled overlap syndrome.