Introduction: Adenocarcinoma of the rete testis is a rare malignancy with a poor prognosis. We report a case of adenocarcinoma of the rete testis with a durable response to cisplatin‐based chemotherapy.Case presentation: A 48‐year‐old man with Down syndrome (trisomy 21) presented with a 1‐month history of painless swelling of the left scrotum. The physical examination revealed a left testis with a hydrocele associated with a tumor and enlarged pelvic and para‐aortic lymph nodes. He underwent a radical orchiectomy. The specimen was diagnosed as adenocarcinoma of the rete testis. The patient received 7 cycles of chemotherapy (1 cycle of BEP and 6 cycles of EP) postoperatively. The metastatic lymph nodes were reduced in size for at least 12 months. Our patient with adenocarcinoma of the rete testis obtained an acceptable response to cisplatin‐based chemotherapy.Conclusion: We treated a patient with an adenocarcinoma of the rete testis who had an acceptable response to platinum‐based chemotherapy.

Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachytherapy has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision making regarding radiological parameters by radiation oncologists. The combined use of LDR brachytherapy with other therapeutic modalities, such as external beam radiation and androgen deprivation therapy, for the clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology departments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.

Objectives: To assess the clinical and functional significance of steroid sulfatase (STS) in bladder cancer. STS is steroid sulfates activation enzyme and is considered one of the key enzymes in androgen signaling pathway. Androgen signal is recently suggested to be involved in the growth of bladder cancer. However, the role of STS in bladder cancer has not been elucidated. Methods: STS expression was measured in 170 bladder cancer tissues by immunohistochemistry. The effect of STS knockdown on cell proliferation, migration and invasion capacity was evaluated using bladder cancer cell line (T24). Results: The incidences of STS positive cancers were 21.3% and 41.2% in non-muscle invasive and muscle invasive bladder cancers, respectively (p = 0.0262). STS positive cancers showed shorter recurrence-free survival and cancer specific survival (CSS) (p = 0.0083, 0.0014, respectively). By multivariate analysis, STS expression level was identified as an independent prognostic factor for CSS (p = 0.043). Furthermore, in vitro knockdown of STS significantly reduced cell migration and invasion capacities of bladder cancer cells accompanied by up-regulation of E-cadherin and down-regulation of vimentin. However, the expression of androgen receptor (AR) was not correlated with that of STS, pathological stage or survival of patients with bladder cancer, suggesting that AR is not likely to play an important role in the progression of bladder cancer. Conclusions: The present study demonstrates that STS promotes the invasion capability of bladder cancer and is a useful marker for predicting the progression of bladder cancers. Disclosure: All authors have declared no conflicts of interest.

Introduction: Granulocyte colony‐stimulating factor‐associated aortitis remains poorly understood among clinicians.Case presentation: We present a case of G‐CSF‐associated aortitis in a 70‐year‐old male with stage IVb castration‐resistant prostate cancer (cT3bN0M1b) receiving docetaxel chemotherapy. Neutropenia (280/μL) developed on day 8 of the first chemotherapy cycle, prompting subcutaneous administration of filgrastim, a short‐acting G‐CSF, on days 8–10. On day 14, the patient presented to the outpatient clinic with fever but no other significant symptoms. Computed tomography revealed filgrastim‐induced thoracic aortitis. Daily prednisone treatment (equivalent to 25 mg prednisolone) was initiated on the following day. Although the initial episode of aortitis resolved within 5 weeks, subsequent pegfilgrastim resulted in recurrence around the left subclavian artery, necessitating further steroid therapy.Conclusion: Persistent high fever following G‐CSF administration may indicate drug‐induced aortitis, highlighting the potential for aortitis recurrence with repeated G‐CSF use.

Fluoroquinolones (FQs) have been traditionally used for prophylaxis against bacterial infection. However, the rapid emergence of FQ-resistant Escherichia coli due to overuse and misuse have resulted in an increase in post-biopsy infections. We requested 723 patients undergoing transrectal or transrectal plus transperineal targeted prostate biopsy to provide preprocedure rectal swabs. The rectal swabs were plated onto deoxycholate hydrogen sulfate lactose agar culture and FQ resistance tests were conducted using the disc diffusion method following the guidelines of the Clinical and Laboratory Standards Institute. All patients undergoing biopsy were given a 1.0 g intravenous injection of cefmetazole (CMZ) 30 min before and 12 h after biopsy. Patients with FQ-resistant organisms received an additional 1.0 g intravenous injection of CMZ every 12 h for an additional 1.5 days, while those without FQ-resistant organisms received levofloxacin 500 mg for 4 days. We evaluated infectious symptoms during the 30 days after the biopsy. We also evaluated the incidence of acute prostatitis within 7 days after the biopsy and isolation rates of FQ-resistant strains. A total of 289 patients (40%) had FQ-resistant isolates on rectal swabs. The overall infectious complication rate was 0.69%. Two patients with FQ-resistant isolates and three patients without them experienced infectious episodes. One patient with FQ-resistant isolates and two patients without them suffered acute prostatitis. The difference in the rates of infectious complication and acute prostatitis rates between FQ-resistant and FQ-susceptible carriers were not significant (p = 1.0 and 1.0, respectively). Post-biopsy sepsis was identified in one patient (0.14%) who had FQ-resistant Escherichia coli. Targeted antimicrobial prophylaxis with cefmetazole based on presence of FQ-resistant isolates on rectal swabs may prevent post-prostate biopsy infectious complications, especially in geographic lesions with a high incidence of FQ-resistant strains in rectal flora.