We here present a patient with an extragonadal germ cell tumor followed by a metachronous testicular tumor 7 years later. The histological findings of the extragonadal tumor and the subsequent testicular tumor were quite different; the former was of a mixed type with teratoma, embryonal carcinoma and yolk sac tumor, and the latter a pure seminoma. Such a long clinical time lag as 7 years and the histological differences between the two tumors suggest that they occurred independently. To our knowledge, this may be the first case report in the literature, in which a testicular tumor occurred metachronously after extragonadal tumor extirpation.

We report a case of small cell carcinoma of the kidney in a 61-year-old female. Chief complaints were left lumbago, gross hematuria and high fever. The computed tomography revealed a large invasive tumor in the left renal pelvis with renal pedicle lymph nodes swelling. Systemic chemotherapy with methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) showed a considerable effect and left nephrectomy was performed. But she died within 3 months postoperatively. Histologically, the tumor was composed of hyperchromatic small cells with increased N/C ratio. Immunohistochemical studies revealed positive staining for chromogranin A, synaptophysin, NSE, EMA, cytokeratin, and argyrophilic (Grimelius) silver impregnation stain. Electron microscopy revealed neurosecretory granules also. In conclusion, the present case was diagnosed as small cell carcinoma of the kidney with only 12 similar cases reported in the world literature.

Using electron microscope, distribution of lanthanum tracer in the seminiferous epithelium was evaluated in adult male rats 2, 7, 25 and 53 days after single intraperitoneal injection of 3 mg/kg of CDDP. Lanthanum penetrated beyond the tight junction between Sertoli cells and the maximum penetration around the spermatid was found on the 7th day, when any degenerative changes of seminiferous epithelium were not recognized light microscopically. And 4 weeks pretreatment with Cephalantin and Kallikulein had no effects on this lanthanum tracer penetration around the spermatid. On decreasing this lanthanum tracer penetration after 7 days, some lanthanum was also found around the spermatocytes on the 53rd day but not around the spermatid. It is proposed that lanthanum tracer penetration beyond the Sertoli cell tight junction may be a morphological marker of early Sertoli cell dysfunction after CDDP administration.

Benign polyp with prostatic-type epithelium in the anterior urethra is rare. We present a case of the same lesion accompanied with urethral stricture. A literature review and discussion of this rare entity are also presented.

Congenital neurogenic bladder dysfunction with spina bifida and sacral dysgenesis manifested itself at middle age is reported. A 48-year-old male who had urinary retention and suprapubic cystostomy one year and a half before in another hospital was seen, asking for removal of the cystostomy. He had never had any neurologic or bladder dysfunction in his childhood and adulthood. X-ray examination revealed a bifid spine and sacral dysgenesis, bilateral hydronephrosis, bilateral VUR and urethral stricture. Uroflowmetry showed a severe dysuric pattern (voided volume 5 ml, residual urine 230 ml) and the cystometrogram revealed a hyperactive bladder. Optical urethrotomy for stricture yielded some improvement i.e. recovery of voluntary voiding with large amount of residual urine. TUR of the bladder neck resulted in almost complete voiding. Cohen's antireflux operation yielded favorable improvement of hydronephrosis. The bladder and renal function remained favorable in the follow-up period of about two years. The clinical course of this patient suggested that his bladder dysfunction was due to late manifestation of congenital neurogenic bladder.