Tsuyoshi Matsuda

Introduction: Primary prostatic lymphoma is rare and may mimic prostate cancer clinically and radiologically. Case Presentation: A 66‐year‐old man was referred for evaluation of suspected advanced prostate cancer. Despite a normal prostate‐specific antigen level of 0.573 ng/mL, imaging revealed a prostatic mass with suspected bladder invasion and bilateral hydronephrosis. Prostate needle biopsy showed atypical lymphocytic infiltration but could not distinguish lymphoma from inflammatory changes. Additional transurethral biopsy provided sufficient tissue for histopathological and immunohistochemical evaluation, establishing a diagnosis of primary prostatic diffuse large B‐cell lymphoma. Conclusion: Primary prostatic lymphoma should be considered when clinical and imaging findings suggest prostate cancer despite a normal prostate‐specific antigen level. Additional tissue sampling should be considered when needle biopsy is inconclusive despite persistent clinical suspicion of lymphoma.

Objectives: To compare differences in clinical outcomes between dual immune checkpoint blockade and immunotherapy plus tyrosine kinase inhibitors (TKIs) as first‐line treatment for metastatic renal cell carcinoma in routine clinical practice. Patients and Methods: Retrospective multicenter cohort study including 311 patients with International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) intermediate or poor‐risk metastatic RCC who received first‐line immune checkpoint inhibitor (ICI)‐based combination therapy between 2018 and 2023. Patients were treated with either ICI + ICI or ICI + TKI. Inverse probability of treatment weighting (IPTW) was applied to reduce baseline imbalances. Progression‐free survival (PFS), second progression‐free survival (PFS2), overall survival (OS), objective response rate (ORR), and duration of response (DOR) were analyzed using weighted survival models. Results: After adjustment, ICI + TKI was associated with a trend toward longer PFS compared with ICI + ICI (median 28.7 vs. 16.6 months, HR 0.69, p = 0.050). No significant differences were observed in PFS2 (median 46.6 vs. 35.5 months, HR 0.84, p = 0.436) or OS (median 57.4 vs. 57.0 months, HR 1.01, p = 0.965). ORR (56.5% vs. 52.2%, p = 0.473) and DOR (median 54.6 vs. 44.9 months, HR 0.83, p = 0.502) were comparable. Subgroup analysis suggested more noticeable PFS benefit with ICI + TKI in intermediate‐risk patients and those without central nervous system or bone metastases, whereas OS was similar across all subgroups. The incidence of grade ≥ 3 adverse events was comparable between groups. Conclusion: In this real‐world cohort, TKI‐containing combinations were associated with improved initial disease control, whereas no statistically significant difference in long‐term survival was observed between treatment strategies. Given the retrospective design and potential for residual confounding despite IPTW adjustment, these findings should be interpreted with caution. Treatment selection should therefore be individualized according to therapeutic priorities, such as the need for initial tumor control versus the expectation of sustained immune‐mediated benefit.

Introduction: Intravesical Bacillus Calmette‐Guérin (BCG) therapy is an established treatment for non‐muscle‐invasive bladder cancer. Although systemic BCG infection is rare, infectious aortic aneurysm is a potentially fatal complication. Case Presentation: A man in his 70s underwent transurethral resection of a bladder tumor followed by intravesical BCG therapy. One year later, computed tomography revealed a saccular abdominal aortic aneurysm with extensive periaortic inflammation and an iliopsoas abscess. Polymerase chain reaction analysis confirmed Mycobacterium bovis BCG infection. Despite antituberculosis therapy, aneurysmal rupture with abscess progression occurred, necessitating prosthetic graft replacement with omental flap coverage. The patient recovered without recurrence after prolonged therapy. Conclusion: BCG‐related infectious aortic aneurysm may develop even in the absence of fever or marked inflammatory response. Clinicians should suspect and consider early CT evaluation in patients with a history of intravesical BCG therapy when unexplained retroperitoneal or vascular abnormalities are identified, regardless of inflammatory status.

Introduction: Desmoid tumors are rare, locally invasive, non‐metastasizing intermediate grade neoplasms. According to the organ procurement and transplantation network report, approximately one million solid organ transplants have been performed globally, from which only three desmoid tumors have been reported.Case presentation: We present the case of a 61‐year‐old male who developed an asymptomatic abdominal mass 3 years after kidney transplantation. Computed tomography revealed a 50‐mm mass attached to the Hem‐o‐lok clip beneath the right rectus abdominis muscle. A needle biopsy revealed β‐catenin positivity, which raised suspicion for a desmoid tumor. Due to progressive tumor enlargement, surgical excision was performed. The patient was discharged on postoperative day 5 without any surgical complications.Conclusion: This is the first documented case of an extra‐abdominal desmoid tumor after kidney transplantation. Although no recurrence has been observed over a 5‐year follow‐up period, careful long‐term monitoring is required because of the high recurrence rate of desmoid tumors.

Sustainable vascular or peritoneal access for dialysis is very important for patients undergoing dialysis therapy, and access trouble is occasionally involved with unexpected occurrence of complications. Once access trouble occurs, dialysis therapy might be discontinued and be followed by a life-threatening state of patients with end-stage kidney disease. Bacterial infection, massive bleeding, and thrombosis in patients undergoing hemodialysis and acute infectious peritonitis and chronic encapsulating peritoneal sclerosis in patients undergoing peritoneal dialysis are important clinical issues. Preemptive kidney transplantation prior to dialysis has several advantages over transplantation after exposure to dialysis therapy. One of the notable advantages is the lack of necessity of dialysis access, which avoids access operations before transplantation. However, some transplant recipients may need short-term dialysis therapy due to the unexpected progression of chronic renal dysfunction. Dialysis access is required in a short preoperative period for preconditioning. The selection of renal replacement therapy without complications in a short-term dialysis before transplant surgery is important for the success of kidney transplantation. Appropriate preparation of short-term dialysis therapy and access is a key to success of preemptive kidney transplantation.

Benign prostatic hyperplasia (BPH) is arguably the most common benign disease among men. This disease is often associated with lower urinary tract symptoms (LUTS) in men and significantly decreases the quality of life. Polyphenol consumption reportedly plays an important role in the prevention of many diseases, including BPH. In recent years, in addition to disease prevention, many studies have reported the efficacy and safety of polyphenol treatment against various pathological conditions in vivo and in vitro. Furthermore, numerous studies have also revealed the molecular mechanisms of the antioxidant and anti-inflammatory effects of polyphenols. We believe that an improved understanding of the detailed pharmacological roles of polyphenol-induced activities at a molecular level is important for the prevention and treatment of BPH. Polyphenols are composed of many members, and their biological roles differ. In this review, we first provide information regarding the pathological roles of oxidative stress and inflammation in BPH. Next, the antioxidant and anti-inflammatory effects of polyphenols, including those of flavonoids and non-flavonoids, are discussed. Finally, we talk about the results and limitations of previous clinical trials that have used polyphenols in BPH, with particular focus on their molecular mechanisms of action.

Bladder cancer (BC) is a common urological cancer, with poor prognosis for advanced/metastatic stages. Various intensive treatments, including radical cystectomy, chemotherapy, immune therapy, and radiotherapy are commonly used for these patients. However, these treatments often cause complications and adverse events. Therefore, researchers are exploring the efficacy of natural product-based treatment strategies in BC patients. Fucoidan, derived from marine brown algae, is recognized as a multi-functional and safe substrate, and has been reported to have anti-cancer effects in various types of malignancies. Additionally, in vivo and in vitro studies have reported the protective effects of fucoidan against cancer-related cachexia and chemotherapeutic agent-induced adverse events. In this review, we have introduced the anti-cancer effects of fucoidan extracts in BC and highlighted its molecular mechanisms. We have also shown the anti-cancer effects of fucoidan therapy with conventional chemotherapeutic agents and new treatment strategies using fucoidan-based nanoparticles in various malignancies. Moreover, apart from the improvement of anti-cancer effects by fucoidan, its protective effects against cancer-related disorders and cisplatin-induced toxicities have been introduced. However, the available information is insufficient to conclude the clinical usefulness of fucoidan-based treatments in BC patients. Therefore, we have indicated the aspects that need to be considered regarding fucoidan-based treatments and future directions for the treatment of BC.

Oxidative stress plays an important role in cellular processes. Consequently, oxidative stress also affects etiology, progression, and response to therapeutics in various pathological conditions including malignant tumors. Oxidative stress and associated outcomes are often brought about by excessive generation of reactive oxygen species (ROS). Accumulation of ROS occurs due to dysregulation of homeostasis in an otherwise strictly controlled physiological condition. In fact, intracellular ROS levels are closely associated with the pathological status and outcome of numerous diseases. Notably, mitochondria are recognized as the critical regulator and primary source of ROS. Damage to mitochondria increases mitochondrial ROS (mROS) production, which leads to an increased level of total intracellular ROS. However, intracellular ROS level may not always reflect mROS levels, as ROS is not only produced by mitochondria but also by other organelles such as endoplasmic reticulum and peroxisomes. Thus, an evaluation of mROS would help us to recognize the biological and pathological characteristics and predictive markers of malignant tumors and develop efficient treatment strategies. In this review, we describe the pathological significance of mROS in malignant neoplasms. In particular, we show the association of mROS-related signaling in the molecular mechanisms of chemically synthesized and natural chemotherapeutic agents and photodynamic therapy.