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Urology Case Reports

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https://www.readbyqxmd.com/read/28607879/intravesical-alt-803-for-bcg-unresponsive-bladder-cancer-a-case-report
#1
Jeffrey Huang, John Schisler, Hing C Wong, Charles J Rosser, Joseph Sterbis
The administration of intravesical chemotherapy or BCG often can prolong the progression-free interval after initial transurethral resection in select bladder cancer (BCa) patients. However, 60% of these patients will recur and up to 30% of patients with recurrent BCa will progress and succumb to their disease over a 15 year period, while another 50% will cystectomy in an attempt to control their disease. Thus better therapeutic strategies are needed for patients who have failed intravesical therapy. In this article, we report the treatment of a 91-year-old man with NMIBC with high-risk features that had failed multiple intravesical therapies...
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28607878/targeted-prostate-biopsy-using-68-gallium-psma-pet-ct-for-image-guidance
#2
Demetrios N Simopoulos, Shyam Natarajan, Tonye A Jones, Wolfgang P Fendler, Anthony E Sisk, Leonard S Marks
Prostate specific membrane antigen (PSMA) scanning is a sensitive method of prostate cancer detection. In a 71 y.o. man with a PSA of 49 (6%F), 4 negative MRI studies and 6 negative biopsies over an 8 year interval, a (68)Ga-PSMA PET/CT scan showed a PSMA-avid spot in the prostate. Using image fusion technology, the lesion was target-biopsied and Gleason 3 + 4 = 7 (cancer core length of 12 mm) was identified. This case may herald a new application for PSMA scanning and prostate cancer imaging.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28607877/recurrent-kidney-stone-episodes-leading-to-a-diagnosis-of-occult-acromegaly
#3
Julie N Thai, Timothy Y Tran, Oksana Davydov, Mantu Gupta
The association between nephrolithiasis and acromegaly has been previously described. Although the mechanism has been established, the urological literature sparsely discusses clinically suspecting that patients with recurrent nephrolithiasis could have acromegaly and subsequently referring them for accurate diagnosis and treatment. We present a case of occult acromegaly secondary to a pituitary tumor discovered 20 years after the patient's first stone episode.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28607876/chromophobe-renal-cell-carcinoma-and-the-synchronous-presence-of-primary-colon-malignancies-is-there-a-relation
#4
Georgios Sahsamanis, Ilias Katikaridis, Georgios Mikros, Vasileios Tzelepis, Dionysios Pinialidis, Titos Deverakis, Georgios Dimitrakopoulos
While the presence of multiple primary malignancies in the same patient is a well described phenomenon, there is no clear association between various histological subtypes of renal cell carcinoma (RCC) and the synchronous presence of colon malignancies. We present the rare case of an 81-year-old female patient suffering from chromophobe renal cell carcinoma (chRCC) and an angiomyolipoma of her left kidney, synchronous with an adenocarcinoma of the caecum. While there is an established connection between RCC and colon cancer, a literature review is performed to specify this association in regard to chRCC and the synchronous presence of colon malignancies...
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28607875/congenital-scaphoid-megalourethra-a-case-report
#5
Kenji Obara, Hiroyuki Yamazaki, Kazutoshi Yamana, Hiroo Kuroki, Yoshihiko Tomita
A congenital megalourethra is an enlargement of the pendulous urethra without evidence of distal obstruction. A 1-month-old boy presented to us with complaint of weak stream, ballooning of the penis before and during voiding and post voiding dribbling, since birth. Physical examination and cystourethroscope confirmed the diagnosis of congenital scaphoid megalourethra. He underwent reduction urethroplasty. During postoperative follow up, he had normal looking penis with good urinary stream.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28607874/robotic-assisted-abdomino-perineal-vesicourethral-anastomotic-reconstruction-for-4-5-centimeter-post-prostatectomy-stricture
#6
Brian F Dinerman, Nicholas J Hauser, Jim C Hu, Rajveer S Purohit
We report surgical management of a disrupted radical prostatectomy vesicourethral anastomosis after bleeding from undiagnosed hemophilia that required re-exploration, pudendal artery embolization, and urinary diversion with nephrostomy and surgical drains. After referral, the 4.5 cm vesicourethral anastomotic defect was reconstructed with a robotic-assisted abdomino-perineal approach. Intra-abdominal robotic-assisted mobilization of the bladder and perineal mobilization of the urethra permitted a tension-free vesicourethral anastomosis while avoiding a pubectomy...
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28593147/single-large-bladder-stone-in-a-young-male-adult-with-primary-hyperparathyroidism
#7
Omar Halalsheh, Firas Sahawneh, Khaled Altopajee, Abdelrahman Almanasra
Bladder stones are caused when minerals are built up in the bladder, especially if the bladder is incompletely emptied. These stones will pass while they are small. Otherwise, they get stuck to the bladder wall or ureter. If this happens, they gradually gather more mineral crystals, becoming larger over time. Primary hyperparathyroidism is usually caused by a tumor within the parathyroid gland, and elevated calcium levels can cause digestive symptoms, psychiatric abnormalities, bone disease and multiple kidney stones...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28593146/cholesterol-granuloma-of-the-abdominal-wall-an-unusual-finding-in-the-setting-of-renal-cell-carcinoma
#8
Robert Abraham Obeid, Daniel James Hoppe, Tamer Jacob Dafashy, Rebecca Elaine Waters, Susan Elizabeth Tarry
Cholesterol granulomas are composed of a distinct type of granulation tissue that contains lipids and cholesterol crystals. They are not believed to be a pathological entity, but rather an inflammatory tissue reaction to the presence of trapped blood secondary to localized hemorrhage.(1) Cholesterol granulomas can be identified histologically by the presence of multi-nucleated giant cells, hemosiderin, and red blood cells along with their associated break-down products.(1) Recognizing cholesterol granulomas can provide clinical utility as they demonstrate a tendency to mimic carcinoma both clinically and radiologically...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567336/management-of-hepatic-granulomatous-tuberculosis-after-bcg-therapy-for-bladder-cancer
#9
Mohsen Ayati, Mohammad Reza Nowroozi, Afshin Mortazavi, Solmaz Ohadian Moghadam, Hossein Ghorani
BCG therapy is used as a treatment in bladder cancer. Intravesical administration of Bacillus Calmette-Guérin is used as a treatment method in superficial bladder cancer. While it is commonly effective, some serious side effects may occur. We hereby report a 65-year-old man who developed granulomatous hepatitis as a complication following BCG therapy. He was treated successfully with antitubercular therapy and prednisolone.
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567335/rare-presentation-of-metastatic-cystic-trophoblastic-tumor-in-a%C3%A2-patient-without-prior-chemotherapy
#10
Michael L Wang, Jonathan B McHugh, Alon Z Weizer, Todd M Morgan, Arul M Chinnaiyan, Andrew P Sciallis, Amir Lagstein, Daniel E Spratt, Rohit Mehra
Cystic trophoblastic tumor (CTT) is a rare testicular germ cell tumor (GCT) predominantly seen in post-chemotherapy patients. It is prognostically similar to teratoma and requires no additional chemotherapy in the absence of a nonteratomatous GCT component. We report a case of metastatic CTT in a patient with primary testicular teratoma without prior chemotherapy. Retroperitoneal lymph node metastases contained teratoma, embryonal carcinoma, and CTT. The CTT was β-hCG positive and SALL4 negative by immunohistochemistry (IHC)...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567334/case-presentation-lung-consolidation-as-sequelae-of-bcg-sepsis-after-combined-intravesical-and-intraurethral-bcg
#11
Jeffrey Strich, Sam Brancato, Rebecca Dolan, Mahir Maruf, Mohammad R Siddiqui, Thomas Sanford, Christa Zerbe, Piyush K Agarwal
BCG sepsis is rarely seen with modern intravesical therapy and therefore its presentation may not be apparent to recently trained urologists. We describe BCG sepsis occurring in a patient treated with combined intravesical and intraurethral BCG which resulted in lung consolidation with acid-fast bacilli requiring cessation of BCG and initiation of systemic antibiotic therapy.
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567333/post-incisional-hernia-meshplasty-vesicocutaneous-fistula-a-rare-complication
#12
M Raghavendran, Kiran G Kumar, Shiva Prasad, H A Venkatesh
Laparoscopic meshplasty is gold standard in hernia surgery. Mesh migration into bowel/bladder has been documented after laparoscopic repair, though migration into bowel is more common than bladder. Only 12 cases of migration into bladder have been described post inguinal meshplasty. We report the 1st case of mesh migration into bladder post Incisional hernia meshplasty, presenting as vesicocutaneous fistula. The objectives of this report are highlighting important points enabling earlier diagnosis, treatment...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567332/successful-radiotherapy-for-advanced-small-cell-carcinoma-of-the-prostate-with-syndrome-of-inappropriate-secretion-of-antidiuretic-hormone
#13
Masanari Fukasawa, Norifumi Sawada, Hiroshi Shimura, Tatsuya Ihara, Satoru Kira, Hidenori Zakoji, Takahiko Mitsui, Masayuki Takeda
Small cell carcinoma of the prostate (SCCP) is rare in clinical practice. It is often accompanied with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present a case of SCCP with SIADH that was successfully treated with radiotherapy in the metastatic lymphnodes and prostate. The patient was an 81-year-old male with a castrate-resistant prostate cancer (CRPC) with invaded rectum and multiple metastases of pelvic lymphnodes. Hyponatremia was present. After radiotherapy, serum sodium increased and neuron-specific enolase (NSE) decreased...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567331/laparoscopic-management-of-pelvic-organ-prolapse-in-a-kidney-transplant-recipient
#14
Jean Rouffilange, Maxime Deslandes, Laurent Lopez
This is a report of a laparoscopic double mesh sacrocolpopexy performed in the setting of a 73-year-old woman carrying a grafted kidney. The patient had a vaginal prolapse of the anterior and posterior floor without urinary incontinence. Despite immunosuppression due to anti-rejection treatments and the presence of kidney transplant in left iliac fossa, laparoscopic intervention with the introduction of prosthetic material was conducted. The intervention showed no major difficulty in its implementation and the postoperative course was uneventful...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567330/cystic-dysplasia-of-the-testis-in-an-intraabdominal-undescended-testicle
#15
Molly E Fuchs, Timothy H Atkinson, Daniel G DaJusta
Cystic dysplasia of the testis is a rare, benign pathologic finding. We present two recent cases of cystic dysplasia of the testis to our practice. The first case involves an 11 month old male presenting with a non-palpable, intra-abdominal left testis. The second case involves a 7 year old male with left scrotal swelling and a history of left renal agenesis. After review of the literature, the first case represents the first report of cystic dysplasia of the testis in an undescended, intra-abdominal testicle...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567329/carcinosarcoma-of-the-tunica-vaginalis-following-radiation-therapy-for-localized-prostate-cancer
#16
Charles D Viers, Subodh M Lele, Tara Kirkpatrick, Chad A LaGrange
Spermatic cord tumors (SCTs) are rare neoplasms with 80% exhibiting benign pathology. Of the malignant SCTs, 90% are sarcomas. To date there has only been one documented case of primary CS of the spermatic cord which occurred in a 40 year old with no reported medical history. A 76-year-old male with a history of biopsy proven Gleason score 7 (3 + 4) prostatic adenocarcinoma underwent external beam radiation therapy (7920 cGy) in 44 fractions in 2004. He presented with a 3 year history of an asymptomatic right hydrocele...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567328/squamous-cell-carcinoma-of-the-renal-pelvis-atypical-presentation-of-a-rare-malignancy
#17
Kyrollis Attalla, Kenneth Haines, Daniel Labow, Reza Mehrazin
Primary squamous cell carcinoma (SCC) of the renal pelvis is exceedingly rare and is associated with advanced stage at diagnosis and a poor prognosis. Diagnosis is often difficult due to vague presenting symptoms and nonspecific radiologic findings. The mainstay of treatment is nephrectomy, with cisplatin based chemotherapy and palliative radiation reserved for metastatic disease. We report a SCC of the renal pelvis in a 72 year-old female who presented with abdominal pain. To date, this is the largest SCC originating from the renal pelvis reported in the literature, made even more exceptional by the lack of antecedent risk factors...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567327/robot-assisted-laparoscopic-management-of-caliceal-diverticular%C3%A2-calculi
#18
Anneleen Verbrugghe, Loïc Gaillandre, Damien Mouton, Franck Deschildre, Philippe Koenig, Charles Ballereau, Pierre Colin
Standard treatment modalities of caliceal diverticular calculi range from extracorporal shockwave lithotripsy (SWL) over retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PNL) and laparoscopic stone removal. A 55-year-old woman presented with a history of pyelonephritis based on a caliceal diverticular calculus. Due to the narrow infundibulum and anterior location, a robot-assisted laparoscopic calicotomy with extraction of the calculi and fulguration of the diverticulum was performed, with no specific perioperative problems and good stone-free results...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567326/renal-myxoma-an-incidental-finding
#19
Parth Thakker, Tam Ramsey, Fernando Navarro
Myxomas are mesenchymal tumors commonly found in the heart and skin. Renal myxomas are rare, having only been documented 14 times. Our case is a 55-year-old woman who presented to our clinic after a right renal mass was incidentally found on CT. Evaluation with MRI showed a mass that appeared to arise from the supero-medial cortex of the right kidney. As the imaging was concerning for renal cell carcinoma, the patient underwent a partial nephrectomy. Microscopic examination showed a well-circumscribed mass with polygonal to spindle-shaped cells in a granular eosinophilic cytoplasm...
July 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28567325/metastatic-adenocarcinoma-of-the-prostate-presenting-as-supraclavicular-and-bulky-generalized-lymphadenopathy-with-a-benign-digital-rectal-exam
#20
Edward J Park, Florian A Stroie, Brian J McArdle, Sarah P Psutka
A 63-year-old male presented with complaints of an enlarging left supraclavicular mass and weight loss. Computed tomography demonstrated a large retroperitoneal mass causing displacement of the adjacent organs, and moderate left hydroureteronephrosis. Multiple pulmonary nodules, lytic spinal lesions, and generalized lymphadenopathy including the left supraclavicular region were seen. Serum prostate-specific antigen level was 2064.0 ng/mL. Digital rectal exam revealed an enlarged prostate without nodularity...
July 2017: Urology Case Reports
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