[Endoscopic lithotripsy with pneumatic shockwave (Swiss Lithoclast) using a mini-ureteroscope].

We performed endoscopic lithotripsy for 23 urinary stones (21 ureteral and 2 bladder stones) with a pneumatic shockwave unit (Swiss Lithoclast; EMS, Angiomed), for the first time applying the probe through the tangential working channel of a semirigid 6.9-Fr ureteroscope (Circon, ACMI). Disintegration was successful in all stones (5-24 mm).

Metachronous germ cell and Leydig cell tumors of the testis. Do testicular germ cell tumors and Leydig cell tumors share common etiologic factors?

Background: Testicular germ cell neoplasms occur bilaterally in approximately 2-5% of patients. Bilateral testicular tumors of different histogenesis are extremely rare, and the study of such cases may offer clues to the pathogenesis of both tumor entities.

Methods: A report of a case and review of the literature are presented.

Single-agent carboplatinum for advanced seminoma. A phase II study.

Background: To reduce the side effects of cisplatin-based combination chemotherapy, the activity of carboplatinum was evaluated in patients with advanced seminoma.

Methods: Forty-two evaluable patients with advanced seminoma (defined as abdominal lymph nodes > 5 cm or supradiaphragmatic or visceral disease) received single-agent carboplatinum at a dose of 400 mg/m2 intravenously every 4 weeks for a maximum of six cycles. The median follow-up was 31 months (18-67 months).

HLA antigens, Lewis antigens, and blood groups in patients with testicular germ-cell tumors.

Clinical observations, epidemiologic data, and results of animal experiments support the theory of genetic anticipation of testicular germ-cell tumors. Attempts to find genetic markers of testicular cancer have yielded conflicting results. We studied blood groups of 577 patients treated for testicular germ-cell tumor (GCT) and controls.

[Metachronous or contralateral adrenal metastases in renal cell cancer].

There are few reports on contralateral or metachronous adrenal gland metastases in renal cell carcinoma (RCC) in the literature. Since sonography has been more frequently used in follow-up examinations these metastases have been found more often. We report on five patients with solitary metastases from RCC to the ipsi- or contralateral adrenal gland.

[Degree of familiarity with carcinoma in situ of the testis. A study of a representative selection of established urologists].

Method: By a telephone poll conducted among 143 selected representative urologists in private practice throughout the west German Länder.

Basic Remarks: Via a search for carcinoma in situ of the testicles (CIS, or testicular intra-epithelial neoplasia, TIN), active early detection of testicular germ cell tumors is now possible.

Results: Among 143 urologists questioned, 62 claimed to be familiar with testicular CIS.

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia.

A 32-year-old patient with unilateral beta hCG-positive seminoma and contralateral testicular intraepithelial neoplasia (TIN; so-called carcinoma-in-situ) with no metastases (clinical stage I) received one course of adjuvant carboplatin therapy. He refused further treatment of TIN in his remaining testis. His wife became pregnant by him 4 months later and delivered a healthy child at term.

Prevalence of bilateral testicular germ cell tumours and early detection based on contralateral testicular intra-epithelial neoplasia.

The prevalence of bilateral tumours was found to be 4% in a retrospective analysis of 531 consecutive patients with testicular germ cell tumours. Patients with bilateral tumours were younger when their first tumour was diagnosed than those who had only 1 testicular tumour. Bilateral undescended testis was more frequent in 21 patients with bilateral tumours than in the total population of patients examined (2 of 21 versus 10 of 452, i.

Neuron-specific enolase: a serum tumor marker in malignant germ-cell tumors?

Neuron-specific enolase was determined in 100 patients with germ-cell tumors. An elevation was found in 5/18 patients with advanced seminoma and in 7/25 patients with advanced nonseminoma. Including all tumor stages of both seminoma and nonseminoma, we found less than 20% NSE-positive patients.

Virus-related serology and in situ hybridization for the detection of virus DNA among patients with testicular cancer.

Viral infections have been implicated in the pathogenesis of several malignancies. A high incidence of the Epstein-Barr virus (EBV) genome and increased EBV-specific antibody titers were frequently observed in Hodgkin's disease. Some epidemiologic and clinical similarities have been demonstrated between Hodgkin's disease and human testicular germ-cell carcinoma.

Prevalence of contralateral testicular intraepithelial neoplasia (carcinoma in situ) in patients with testicular germ cell tumour. Results of the German multicentre study.

Contralateral biopsies taken from 1,188 patients with testicular germ-cell tumour were examined immunohistologically by staining for placental alkaline phosphatase. Testicular intraepithelial neoplasia (TIN; carcinoma in situ) was detected in 53 patients (4.5%; 95% confidence interval 3.

Low-dose radiation therapy for testicular intraepithelial neoplasia.

Four patients with unilateral testicular germ-cell tumor and biopsy-proven contralateral testicular intraepithelial neoplasia (TIN; so-called carcinoma in situ) received localized low-dose radiation therapy (18-20 Gy) of the testis with TIN. Repeated biopsies disclosed the disappearance of TIN and germ cells. No recurrence of TIN or germ cells was observed after a follow-up of 18-42 months.

Mixed gonadal dysgenesis associated with unilateral cavernosal fibrosis and presenting as a cystic lower abdominal mass.

We report the first case of a patient suffering from mixed gonadal dysgenesis and fibrosis of the left cavernous body. The patient who complained about erectile dysfunction had received a penile prosthesis and was diagnosed 3 years after surgery when internal rudimentary gonads presented as a lower abdominal mass.

Neuron-specific enolase: a serum tumor marker in renal cell carcinoma?

In previous reports, neuron-specific enolase (NSE) has been considered to be a useful tumor marker in renal cell carcinoma (RCC). This led us to perform a prospective clinical trial in this field. NSE was checked as a tumor marker for diagnosis and monitoring of patients with RCC.

Renal cell cancer and concomitant transitional cell cancer of the renal pelvis and ureter in the same kidney--report of 4 cases and review of the literature.

Three patients (1 man, 81 years old; 2 women, 56 and 61 years old) had renal cell cancer and transitional cell cancer in the same kidney, and another patient (female, 77 years old) had renal cell cancer and transitional cell cancer in the ipsilateral ureter. Simultaneous occurrence of renal cell cancer and transitional cell cancer is an extremely rare entity with only 15 cases having been reported.

Fibroepithelial polyp of the renal pelvis: report of a case treated with nephron-sparing surgery and review of the literature.

This is the first report of a benign fibroepithelial polyp situated in a renal calyx where nephron-sparing surgery was performed successfully.

A test for the identification of relevant sympathetic nerve fibers during nerve sparing retroperitoneal lymphadenectomy.

We present a new intraoperative test for the identification of sympathetic nerve fibers relevant to ejaculation during nerve sparing retroperitoneal lymphadenectomy in patients with nonseminomatous testicular tumors. Electrostimulation of specific isolated postganglionic nerve fibers resulted in intraoperative ejaculation in 9 of 11 patients. Ejaculation was without tumescence in a noneruptive manner and was reproducible in most cases upon repeated stimulation.

[Incidental detection of renal cell cancer].

In the present study, a comparative analysis of clinical-prognostic factors in symptomatic and incidentally found renal cell carcinomas is evaluated. A total of 141 patients with renal cell carcinoma were analyzed according to the TNMG system and involvement of the adrenals. More than 50% of surgically treated renal cell carcinomas are found incidentally.

Unusual differential diagnosis of testis tumor: intrascrotal sarcoidosis.

We report 2 cases of sarcoidosis with extrapulmonary manifestations in the testis, epididymis and spermatic cord. Each patient presented with an intrascrotal mass of unknown origin that suggested a testicular tumor. Sarcoidosis was confirmed in case 1 by radical orchiectomy and further small sarcoid foci were detected in 1 of the lacrimal glands.

False-negative biopsy for testicular intraepithelial neoplasia.

A routine biopsy of the contralateral testis obtained during orchiectomy for embryonal carcinoma in a 26-year-old patient was negative for testicular intraepithelial neoplasia (TIN; carcinoma in situ of the testis). However, a rebiopsy that was taken because of unexplained elevation of alpha-fetoprotein 15 months later proved to be positive for TIN. Six previously reported cases of false-negative testicular biopsies obtained during a search for TIN are reviewed.