Introduction We report a rare case of renal cell carcinoma with vaginal metastasis that recurred with rapid progression and was resistant to sunitinib and nivolumab. Case presentation A 68‐year‐old woman presented with renal cell carcinoma and vaginal metastasis. Multiple lung metastasis appeared 3 months after simultaneous radical nephrectomy and hysterectomy with vaginal resection. Despite the treatment with sunitinib and nivolumab, the patient died 7 months after surgery. Immunohistochemical staining of primary and metastatic tumor specimens was CD8 and programmed death ligand‐1 negative. Conclusion Although vaginal metastasis of renal cell carcinoma is rare, lack of CD8 and programmed death ligand‐1 expression may cause nivolumab resistance and may be useful markers in patients with metastatic renal cell carcinoma.
A 73-year-old-male patient with hypertension and grade 3B chronic kidney disease underwent radical nephrectomy in the year 2000. As the renal function gradually worsened, the patient was started on hemodialysis in 2003. Eleven years after nephrectomy, the metastases were pointed out. The patient received sunitinib as first-line therapy. Thereafter, as the metastatic lesions became larger, we initiated nivolumab therapy (3 mg/m2 every 2 weeks). After 52 weeks, the metastatic lesions continued showing complete response (CR). No adverse effects were observed during nivolumab treatment.
Introduction Aggressive angiomyxoma is a rare mesenchymal tumor in females of reproductive age that occurs in the pelvis and perineal zone with a high risk of local infiltration and recurrence. Male aggressive angiomyxoma in perineal zone is very rare. Case presentation A 63‐year old male presented to our hospital with chief complaint of perineal mass. He was diagnosed with perineal lipoma by needle biopsy 3 years before. Computed tomography revealed a 16 cm perineal tumor without lymph node or distal metastasis. As the tumor had gradually increased, we performed tumor resection. The histological diagnosis of tumor using immunohistochemistry was aggressive angiomyxoma with complete resection. Moreover, expressions of both estrogen and progesterone receptors were recognized. No recurrence was seen 9 months after surgery. Conclusion Male aggressive angiomyxoma is a very rare tumor, which has expressions of female hormone receptors. Hormonal therapy might be effective for perioperative therapy or recurrence.
Keywords: evocalcet, cinacalcet, secondary hyperparathyroidism (SHPT), gastrointestinal symptoms, Izumo scale questionnaire 〈Abstract〉 Cinacalcet, a representative calcimimetic compound, can reduce parathyroid hormone levels, but it causes a high incidence of gastrointestinal (GI) tract related adverse events. Evocalcet is a new calcimimetic that is expected to reduce GI symptoms. Using the Izumo scale questionnaire, we analyzed the changes in GI symptoms seen after switching from cinacalcet to evocalcet. Nineteen hemodialysis patients with secondary hyperparathyroidism were included. We prospectively analyzed their GI symptoms at three points: before they switched to evocalcet and at three and six months after they switched to evocalcet. Switching to evocalcet decreased the number of patients suffering from GI symptoms from 14 to 9 after three months and to 12 after six months. In particular, the score for the feeling of fullness significantly decreased from 0.8±1.3 points (mean ±standard deviation) before the switch to 0.7±1.5 points after three months and 0.1±1.9 points after six months (p <0.05, respectively), and that for diarrhea also significantly decreased from 1.1±2.3 points to 0.6±1.6
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