Collecting duct carcinoma (CDC) of the kidney is a rare and aggressive malignant tumor arising from the distal collecting tubules which has been shown to have a poor response to several kinds of systemic therapy. We present a case of metastatic CDC that responded favorably to a multiple tyrosine kinase inhibitor, sunitinib, achieving a partial response in both lung and skeletal metastases. To our knowledge, this is the first report showing therapeutic activity of sunitinib against CDC. Considering these findings, it would be worthwhile prospectively investigating the role of multiple tyrosine kinase inhibitors, particularly sunitinib, in the management of metastatic CDC.

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The purpose of this study was to analyze the relationship between the reproducibility of holmium laser enucleation of the prostate (HoLEP) and prostate size over the learning curve. We compared the outcome among three institutions in three subgroups on the basis of the weight of tissue retrieved. There were no significant differences in operating time, efficiency of the procedure, decrease in hemoglobin level and postoperative urinary incontinence among three institutions, only in patients with prostates X20 g-o40 g retrieved. Our data indicate that HoLEP is more reproducible in patients with a moderate-sized prostate over the learning curve.

Abbreviations & Acronyms AR = adrenoceptor BPH = benign prostatic hyperplasia IPSS = International Prostate Symptom Score LUTS = lower urinary tract symptoms Qmax = maximum urinary flow rate QOL = quality of life SAS = statistical analysis system Correspondence: Toshiro