Urothelial tumors characteristically occur in elderly persons, more commonly in males with typical complaints of hematuria. Although few studies attempted to describe clinic-pathological features of urothelial malignancies in young patients, due to heterogeneity in the inclusion of age groups under \"young patients\" no reliable conclusions can be derived. Herein, we are describing an interesting case of papillary urothelial neoplasm of low malignant potential with osseous metaplasia in a 19-year-old chronic smoker young patient presented with chief complaints of abdominal pain with a review of the literature.

暂无摘要。

Metastatic urothelial carcinoma (mUC) is associated with poor prognosis. Cisplatin-based combination chemotherapy is the preferred initial regimen for patients with mUC. However, a substantial proportion of patients cannot receive cisplatin-based chemotherapy due to renal impairment or other comorbidities. Currently, immune checkpoint inhibitors (ICI) showed to be effective in cisplatin-ineligible mUC patients on first-line treatment. Tislelizumab is an anti-human programmed death receptor-1 monoclonal IgG4 antibody, which was specifically engineered to minimize binding to FcɣR on macrophages to abrogate antibody-dependent phagocytosis. But there is no report of tislelizumab as a first-line treatment for cisplatin-ineligible patients with mUC currently. Here, we report a cisplatin-ineligible mUC patient with PD-L1-negative, microsatellite stable (MSS), high tumor mutational burden (TMB-H) obtained complete response receiving tislelizumab therapy after laparoscopic debulking surgery. Progression-free survival has exceeded 16 months since treatment with tislelizumab. To our knowledge, this is the first reported case of cisplatin-ineligible mUC patient with PD-L1-negative, MSS and TMB-H who responded well to tislelizumab as a first-line treatment. However, we still need more studies to assess the efficacy of tislelizumab as a first-line treatment in cisplatin-ineligible mUC patients and to confirm predictive values of TMB for efficacy of tislelizumab.

COVID-19 has had a major effect on health care activities, especially surgery. At first, comparisons were proposed using 2019 activities as the highest standard. However, while such an approach might have been suitable during the first months of the pandemic, this might no longer be the case for a longer period.
To examine approaches that may better assess the use of cancer surgeries.
In a cross-sectional design, the nationwide French hospital facility data (Medicalised Information System Program) were used to assess cancer surgery for 6 cancer site categories in adults from January 1, 2010, to December 31, 2021.
Estimated cancer surgery activity during the COVID-19 pandemic.
Three models were proposed to assess the expected number of surgical procedures between 2020 and 2021 and make a comparison with those observed in earlier years.
In France, cancer removal surgeries account for approximately 7000 hospitalizations per year for liver cancer; 4000 for pancreatic cancer; 7700 for ovarian cancer; 1300 for esophagus cancer; 23 000 for ear, nose, and throat (ENT) cancer; 78 000 for breast cancer; and 16 600 for thoracic cancers. For most cancer sites, the number of surgical procedures increased from 2010 to 2019: liver, 14%; pancreas, 38%; ovary, 14%; esophagus, 18%; breast, 8%; and thoracic, 29%. Assuming stability, these values underestimate the gap in activity observed in 2020-2021. For other procedures, a decrease was observed: stomach, -10%, and ENT, -6%. Assuming stability, these values overestimate the gap in activity observed in 2020-2021. At the end of 2021, according to the model, the gap in activity observed in 2020-2021 was estimated at between -1.4% and 1.7% for breast, -6.6% and -7.3% for thoracic, -3.1% and -2.5% for ovarian, -4.2% and -1.7% for pancreas, -6.7% and 5.9% for stomach, and -13.0% and -13.9% for esophageal cancers. For ENT, liver, and urologic cancers, because the trend was different before and after 2015, it was necessary to opt for modeling using only the most recent period. The cumulative gap in activity observed in 2020-2021 was estimated at -1.0% for ENT cancers, -5.3% for liver cancers, and -2.9% for urologic cancers.
The findings of this study suggest that short- and medium-term trends must be considered to estimate COVID-19 cancer surgery activities. Breast cancer is the site for which the activity showed the smallest decrease during the pandemic, with almost full recovery in 2021.

UNASSIGNED: \"Other oncocytic renal tumors of the kidney\" is a new category constituted by 2022 WHO classification and different in the point of morphology and immunohistochemistory from typical oncocytic/eosinophilic renal tumors including chromophobe renal cell carcinoma and oncocytoma.
UNASSIGNED: The patient was an 84-year-old woman in whom a left renal tumor was incidentally discovered. She underwent left nephrectomy, and the pathological specimens showed a borderline eosinophilic renal tumor between chromophobe renal cell carcinoma and renal oncocytoma. After all recognized oncocytic tumors were excluded, we diagnosed the tumor as other oncocytic renal tumor of the kidney.
UNASSIGNED: Other oncocytic renal tumor of the kidney is a provisional category. Therefore, further research and accumulation of similar cases are necessary.

UNASSIGNED: Signet-ring cell carcinoma is an extremely rare histological variant of upper urinary tract carcinoma, associated with poor prognosis.
UNASSIGNED: We report a case of a 75-year-old female diagnosed with left primary upper urinary tract signet-ring cell carcinoma, initially treated with surgery. Post-surgical development of multifocal metastases was followed by a devastating clinical course. An autopsy confirmed the tumor\'s primary origin in the upper urinary tract.
UNASSIGNED: We experienced a case of upper urinary tract signet-ring cell carcinoma, with a rare opportunity to thoroughly confirm its primary site with an autopsy.

BACKGROUND: Bladder cancer is the tenth most common cancer worldwide, with Europe having the highest incidence rates. Regarding the treatment of metastatic disease, first-line treatment for fit patients is cisplatin-containing combination chemotherapy. However, a significant percentage of patients are ineligible for platinum-based chemotherapy, or progress under these regimens. Recently, immune checkpoint blockade has become a treatment option for this group of patients. In this report, we present the case of a male patient diagnosed with metastatic bladder cancer who did not tolerate cisplatin-containing chemotherapy and achieved complete response after treatment with pembrolizumab.
METHODS: A 58 years-old Caucasian man with a medical history of high-grade urothelial carcinoma pT3bN0R0 under a watchful waiting strategy for 6 months presented to the Medical Oncology appointment with two axillary and cervical adenopathies.
METHODS: Cervicothoracoabdominal computed tomography confirmed the presence of two large necrotic lymphadenopathies in the cervical and axillary lymphatic chains, and bone scintigraphy revealed dorsal (D11) and lumbar (L5) metastatic lesions. Ultrasonography-guided biopsy of the axillary nodule revealed the presence of metastatic tissue of primary urothelial origin.
METHODS: The patient was initiated on a palliative chemotherapy regimen of carboplatin area under the curve 5 plus gemcitabine (1000 mg/m2). During the first cycle of chemotherapy, acute kidney failure akin 2 developed due to nonobstructive toxic acute tubular necrosis with progressive deterioration of kidney function. Therefore, palliative chemotherapy with carboplatin plus gemcitabine was changed to 200 mg of pembrolizumab every 21 days.
RESULTS: Overal survival of 57 months with an immune complete response according to the immune Response Evaluation Criteria in Solid Tumours criteria and an excellent quality of life.
CONCLUSIONS: This case illustrates that second-line therapy with ICIs (pembrolizumab or atezolizumab) has favourable results in achieving an immune complete response after intolerance to cisplatin-based regimens. ICIs provide durable responses that improve overall survival and quality of life.

BACKGROUND: Urothelial neoplasms with a varus growth pattern are rare, and few urologists have encountered inverted urothelial carcinoma of the ureter.
METHODS: An 82-year-old man was referred to our hospital for investigation of gross hematuria. Magnetic resonance imaging revealed nodules measuring 1-2 mm in diameter in the left upper ureter with slight reduction in signal intensity on diffusion-weighted imaging. Ureteroscopy showed a pedunculated smooth tumor that had the appearance of an inverted papilloma rather than the papillary shape typical of urothelial carcinoma. The tumor was biopsied and histopathological examination revealed a noninvasive, low-grade urothelial carcinoma with inverted multiple layers. Laparoscopic radical nephroureterectomy was subsequently performed, and a pedunculated tumor measuring 20 mm in diameter was found in the left upper ureter. The histopathological diagnosis was inverted papillary urothelial carcinoma, low-grade, pTa, pN0.
CONCLUSIONS: This report provides the first clinical description of inverted papillary urothelial carcinoma of the ureter.

UNASSIGNED: Osteoclast-like giant cell bladder carcinomas are an extremely unusual and aggressive histological subtype of urothelial carcinomas. Only 30 cases are reported in the international literature.
UNASSIGNED: A 79-year-old male patient attended our Urology department for a six-month history of macroscopic hematuria. As part of its diagnostic protocol, a CT scan of the abdomen and pelvis with elimination phase was performed, finding a 12-mm filling defect at the level of the posterior wall of the bladder; subsequently, a cystoscopy was performed confirming the presence of a 1.5 cm bladder tumor, which was completely resected. Pathology analysis with hematoxylin and eosin staining revealed a composition of mononuclear cells and osteoclast-like giant cells; immunohistochemistry was positive for epithelial markers CK AE-1 / AE-3, EMA, P53 and CD68.
UNASSIGNED: These tumors are extremely unusual and aggressive. The only diagnostic method is through immunohistochemistry where the presence of epithelial markers for urothelium in neoplastic cells is confirmed. Radical surgical treatment is recommended and to date there is no proven effective adjuvant treatment. Its median overall survival is 15 months.
UNASSIGNED: los carcinomas de vejiga de células gigantes parecidas a osteoclasto son un subtipo histológico extremadamente inusual y agresivo de los carcinomas uroteliales. Solamente se encuentran reportados 30 casos en la literatura internacional.
UNASSIGNED: un paciente masculino de 79 años acudió a valoración a nuestro departamento de Urología por un cuadro de hematuria macroscópica de seis meses de evolución. Como parte de su protocolo diagnóstico se realizó una TC de abdomen y pelvis con fase de eliminación, encontrando un defecto de llenado de 12 mm a nivel de la pared posterior de la vejiga; posteriormente se realizó una cistoscopia confirmando la presencia de un tumor vesical de 1.5 cm, el cuál fue resecado en su totalidad. El análisis por Patología con tinción de hematoxilina y eosina reveló una composición por células mononucleares y células gigantes parecidas a osteoclasto; la inmunohistoquímica fue positiva para marcadores epiteliales CK AE-1/AE-3, EMA, P53 y CD68.
UNASSIGNED: estos tumores son extremadamente inusuales y agresivos. El único método diagnóstico es a través de inmunohistoquímica en donde se confirme la presencia de marcadores epiteliales para urotelio en las células neoplásicas. Se recomienda un tratamiento quirúrgico radical y a la fecha no existe un tratamiento adyuvante efectivo demostrado. Su supervivencia media global es de 15 meses.

Bladder cancer is the most common urinary tract malignancy. Platinum-based chemotherapy is the first line of treatment in locally advanced or metastatic bladder cancer. Immunotherapy has become a novel therapy option in a broad variety of malignancies including bladder cancer. Immunotherapy is approved as first line of treatment in patients who are ineligible for platinum-based chemotherapy and second-line treatment for metastatic urothelial cancer who progressed after platinum-based treatments. We present the case of an 83-year-old female with metastatic bladder cancer who was chemotherapy ineligible and had complete response with immune checkpoint inhibitor pembrolizumab.