Key Clinical MessageThe association between thrombosis and cancer has been recognized since Trousseau's report in 1865. We present a case of bladder squamous cell carcinoma associated with multiple cerebral infarctions. This patient was diagnosed as having Trousseau's syndrome and received radiotherapy for bladder cancer treatment, along with anticoagulation therapy.

Introduction Since the diagnosis of small renal masses is often a challenge despite improvements in imaging modalities, renal tumor biopsy provides useful information regarding treatment decisions. However, there is no established treatment strategy when renal biopsy shows lymphoid tissue. Case presentation A 63‐year‐old woman was referred to our department for the investigation of a small renal mass. Contrast‐enhanced computed tomography showed a weakly enhancing mass 39 × 17 mm in diameter in the left kidney. A renal tumor biopsy was performed, and histopathological examination showed lymphoid tissue, but the diagnosis was not confirmed. The tumor was bluntly dissected from the renal capsule via robotic‐assisted laparoscopic surgery without renal artery clamping. The pathological diagnosis was non‐specific lymphadenitis. Conclusion We report a rare case of perirenal non‐specific lymphadenitis mimicking a solitary renal mass. Non‐specific lymphadenitis is a possible differential diagnosis of renal masses.

Abstract:A 73-year-old male patient with hypertension and hyperglycemia was referred to our hospital because of a diagnosis regarding his left adrenal tumor. Because the levels of urinary metanephrine and normetanephrine were elevated , and 131 I-MIBG scintigraphy showed intense uptake in the adrenal tumor, the tumor was diagnosed as a pheochromocytoma. An adrenalectomy was carried out. Severe polyuria, which was accompanied by a rapid decrease in central venous pressure, started 1 hour after the operation. Urine output of more than 8000 mL/day continued until the 16th postoperative day. Plasma antidiuretic hormone (ADH) levels were within the normal range. Plasma human atrial natriuretic peptide (hANP) and brain natriuretic peptide (BNP) were elevated postoperatively, and the elevation of these peptides was one possible cause for the severe polyuria. Because ADH levels in the tumor fluid were not elevated , the tumor was not an ADH-secreting tumor. Urinary b2-microglobulin was significantly elevated after the operation, thus suggesting that renal tubule dysfunction might also have been involved in the polyuria. However, the mechanism of polyuria after the resection of adrenal pheochromocytoma is not fully understood. Polyuria after the resection of adrenal pheochromocytoma is extremely rare, and the present subject is the second case to date.

A 66-year-old man visited his nearby clinic with a complaint of left lower abdominal pain. Abdominal CT scan showed left hydronephrosis due to lower ureteral involvement by infiltrative retroperitoneal mass located outside of the left posterior wall of the bladder and left seminal vesicle. He was referred to our hospital for further examination. Pathological diagnosis of the percutaneous CT-guided biopsy of retroperitoneal mass was fibrosis without any malignant tumor. Because we could not rule out the possibility of the secondary fibrosis accompanied by malignant tumor, we performed surgical resection of the retroperitoneal mass involving left ureter and confirmed that the mass contains no malignant tumor by frozen section analysis. We augmented the defected ureter by Boari flap method. We should be noticed that retroperitoneal fibrosis could be a differential diagnosis of retroperitoneal pelvic mass.