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Urology Case Reports

Hiroshi Shimura, Takahiko Mitsui, Tadashi Aoki, Manabu Kamiyama, Takashi Yamagishi, Masayuki Takeda
Inverted-Y ureteral duplication is one of the rarest anomalies of ureteral branching. We encountered a 20-year-old female patient with persistent incontinence even after nephrectomy for ectopic ureteral insertion into the vagina. She had inverted-Y ureteral duplication between the bladder and vagina, and urine was being transported from the bladder to the vagina. To the best of our knowledge, this is a rare case of inverted-Y ureteral duplication with ectopic ureteral insertion into the vagina as well as the ureter into the bladder, which became apparent due to persistent urinary incontinence even after nephrectomy...
November 2016: Urology Case Reports
Nobuo Tsuru, Soichi Mugiya, Yutaka Kurita, Shigenori Sato, Yasuhiro Hirano
We present a case of UPJO associated with an incompletely duplicated collecting system in a horseshoe kidney that was successfully treated by laparoscopic pyeloplasty with concomitant pyelolithotomy. A 53-year-old man had three urological anomalies and urolithiasis. We performed a pyeloplasty and pyelolithotomy using a fully intracorporeal technique. Clinical and radiographic evaluation confirmed complete resolution of the patient's condition. To our knowledge, there have been no reported cases of UPJO in an incompletely duplicated collecting system with a horseshoe kidney in the same patient...
November 2016: Urology Case Reports
Hyun Kim, Mohammed Alshalalfa, Jean Hoffman-Censits, Costas D Lallas, Elai Davicioni, Jianqing Lin, Ruth Birbe, Nicholas Erho, Jonathan Lehrer, Hussam Al-Deen Ashab, Mandeep Takhar, Anders Olson, Lucia L C Lam, W Kevin Kelly, Karen E Knudsen, Chellappagounder Thangavel, Roland Seiler, Felix Y Feng, Edward M Schaeffer, Edouard J Trabulsi, Leonard G Gomella, Mark D Hurwitz, Adam P Dicker, Robert B Den
Management of men with prostate cancer is fraught with uncertainty as physicians and patients balance efficacy with potential toxicity and diminished quality of life. Utilization of genomics as a prognostic biomarker has improved the informed decision-making process by enabling more rationale treatment choices. Recently investigations have begun to determine whether genomic information from tumor transcriptome data can be used to impact clinical decision-making beyond prognosis. Here we discuss the potential of genomics to alter management of a patient who presented with high-risk prostate adenocarcinoma...
November 2016: Urology Case Reports
Hiromichi Katayama, Hiroshi Aoki, Katsuyuki Taguchi, Yuu Sakurada, Tomonori Sato, Masahiro Takahashi, Rie Shibuya, Hiroshi Naganuma, Shigeto Ishidoya
We report a histologically pure stage 1 seminoma with an elevated human chorionic gonadotropin (hCG). A 38 year-old man was referred for the evaluation of the left testicular swelling. He showed an elevated serum hCG level of 25,265 mIU/ml with normal a fetoprotein and lactate dehydrogenase. Imaging showed heterogeneous tumor without any metastatic lesions. We conducted 4 courses of chemotherapy before detecting hCG nadir. The final pathological report showed pure seminoma with syncytiotrophoblastic cells but no choriocarcinoma components...
November 2016: Urology Case Reports
Annelies Ringoir, Bernard Rappe, Karl Dhaene, Denis Schallier
A pure leiomyoma of the prostate is a rare tumor. Less than 30 cases about prostatic leiomyoma have been reported. Pathologic anatomy examination is the only medium for definitive diagnosis and is important to rule out malignancies such as leiomyosarcoma. We describe an accidental finding of a tumor in the right prostate lobe of a 54 year old man, who was diagnosed with prostatic leiomyoma and treated with open radical prostatectomy.
November 2016: Urology Case Reports
M F B Andersen, T P Norus
Tumor seeding following biopsy of renal cell carcinoma is extremely rare with an incidence of 1:10.000. In this paper two cases with multiple recurrent RRC metastasis in the biopsy tract following biopsy of renal tumor is presented and the current literature is shortly discussed.
November 2016: Urology Case Reports
Andrew M Harris
Splenogonadal fusion (SGF) is a rare cause of testicular mass with the vast majority of cases presenting in men under the age of 30 and represents a diagnostic challenge. Discontinuous splenogonadal fusion presenting as a new testicular mass in a 55-year-old man is discussed to aid other surgeons in diagnosing this condition.
November 2016: Urology Case Reports
Stephanie L Skala, Scott R Owens, Hong Xiao, Kristy A Bauman, Scott A Tomlins, Arul M Chinnaiyan, Lina Shao, Jeffrey M Jentzen, David Gordon, Rohit Mehra
Hepatic cirrhosis is commonly associated with hyperestrogenism. Previous studies have reported morphologic changes in benign and malignant prostate tissue exposed to estrogen or anti-androgens. To our knowledge, histopathologic features of prostatic adenocarcinoma in patients with cirrhosis have not been well-reported. We present a case of incidental, but pathologically significant, prostatic adenocarcinoma detected on autopsy in a 67-year-old male patient with cirrhosis and spider angiomata. The morphologic and immunohistochemical features (including variable ERG expression) of the prostatic adenocarcinoma were consistent with hormone exposure related changes, suggesting that cirrhosis-induced elevated estrogen-to-testosterone ratio and exogenous hormone therapy might induce similar phenotypes...
November 2016: Urology Case Reports
Katherine Brewer, Kyrollis Attalla, Fatima Husain, Che-Kai Tsao, Ketan K Badani, John P Sfakianos
Primary leiomyosarcomas of the inferior vena cava (IVC) are rare tumors associated with poor prognosis, and surgical resection with the goal of obtaining negative margins is the gold standard for initial treatment. Tumor characteristics of both extraluminal extension into renal parenchyma and intraluminal extension of the subdiaphragmatic IVC are even less common. The prognosis of vascular leiomyosarcomas is determined by the location and the size of the tumor, as these factors determine the risk of local recurrence and metastasis...
November 2016: Urology Case Reports
Koichi Kodama, Yasukazu Takase, Katsuhiko Saito
Nontraumatic rupture of the bladder is less widely recognized than traumatic rupture, with a challenging early diagnosis due to high variability in clinical presentations. We report a case of extraperitoneal rupture of a bladder diverticulum in a patient with diabetes mellitus who presented with paralytic ileus. Despite conservative management, the patient developed sepsis requiring surgical treatment. Urinary tract infection and bladder outlet obstruction were considered to be potential mechanisms of the rupture...
November 2016: Urology Case Reports
Bunya Kawamoto, Masashi Honda, Hideto Iwamoto, Shuichi Morizane, Katsuya Hikita, Atsushi Takenaka
The recurrence of urothelial carcinoma in an orthotopic neobladder is rare. We report the case of a 61-year-old man with a muscle-invasive bladder tumor that was treated using radical cystectomy and the creation of a Studer's orthotopic neobladder. However, nine years after the cystectomy, we detected a mass at the left ureteroileal anastomosis. We successfully performed Studer's neobladder resection, urethrectomy, and left nephroureterectomy to remove the entire mass. Pathological examination revealed urothelial carcinoma with adenocarcinoma in the neobladder and adenocarcinomatous metastasis in the mesenteric lymph node...
November 2016: Urology Case Reports
Tatsuhiko Hoshii, Go Hasegawa, Yohei Ikeda, Shigeko Takaki, Kenji Obara, Tsutomu Nishiyama
A 20 years old woman had an external urethral orifice mass and received an excision operation. Seven years later, she complained a tumor with pain that was similar to the previous tumor. She underwent the tumor removal. Pathological diagnosis was a urethral angiomyomatous leiomyoma in the new concept of estrogen receptor-positive smooth muscle tumors.
November 2016: Urology Case Reports
Jagan K Kansal, Mahmoud Mohamed, Ayman Mahdy
Leiomyomas are benign tumors of smooth muscle origin occurring throughout the genitourinary system. While leiomyomas in the uterus are frequently seen, urethral and paraurethral leiomyomas are extremely rare with a hand full of cases in the literature. Typically, periurethral leiomyomas can present with a mass protruding from the urethra originating from the proximal and posterior portion of the urethra. Herein, we present a new case of a paraurethral leiomyoma causing mass effect on the bladder leading to lower urinary tract symptoms (LUTS) with no gross involvement of the urethra...
November 2016: Urology Case Reports
Kailash Kapadia, Felix Cheung, Wai Lee, Richard Thalappillil, F Barry Florence, Jason Kim
Methylene blue is an intravenously administered agent that may potentiate serotonin syndrome. The usage of methylene blue to evaluate ureters for injuries and patency during urological surgeries is recognized as common practice. However, there is no mention of serotonin syndrome caused by methylene blue in urological literature or for urological surgery. We report the first urological case in order to raise awareness of the risk for serotonin toxicity with utilizing methylene blue.
November 2016: Urology Case Reports
Pedram Ansari Pirsaraei, Kareem Tabsh, Jacob Lentz
We present a case of disseminated coccidioidomycosis with formation of a prostatic abscess in a 28-year-old diabetic male. Though rare, Coccidiodes prostatitis should be included in the differential for patients who have spent time in endemic areas and present with prostatitis or other genitourinary tract symptoms, especially in the setting of immunocompromise. The small number of Coccidiodes prostatitis cases described in the literature previously are reviewed, along with a wider discussion of coccidioidomycosis...
November 2016: Urology Case Reports
Benjamin Miron, Benjamin T Ristau, Jeffrey J Tomaszewski, Josh Jones, Bart Milestone, Yu-Ning Wong, Robert G Uzzo, Donna Edmondson, Walter Scott, Alexander Kutikov
Adrenocortical carcinoma (ACC) is a rare malignancy that is generally associated with a poor prognosis whose existence dictates the management of incidental renal masses. We report a case of ACC diagnosed and treated at its apparent inception in a patient undergoing close surveillance imaging of a prior malignancy. Despite timely detection and resection of a localized ACC this patient rapidly progressed to systemic disease. This case highlights the rapid growth kinetics of ACC and puts into perspective the challenges associated with the established treatment paradigm for patients diagnosed with an adrenal mass...
November 2016: Urology Case Reports
Matthew Truong, Wenqing Cao, Erdal Erturk
A 69 year-old male with a past medical history of hypertension, diabetes, and atrial fibrillation presented to the Urology clinic with asymptomatic microscopic hematuria. His work up for hematuria included a negative cystoscopy and a computed tomography (CT) scan, which revealed what appeared to be a fluid collection around the left kidney with a perinephric infiltrative mass and two para-aortic enlarged lymph nodes.
November 2016: Urology Case Reports
M Raghavendran, Mrityunjoy Sarkar, Kiran G Kumar
Many patients present with severe abdominal pain. Renal Artery Thrombosis (RAT) is rare, serious and misdiagnosed. RAT has been well described in association with various disorders, but isolated spontaneously occurring RAT is rare and only 2 cases have been described as of date. We present a case of flank pain presenting to emergency for evaluation and discuss the clinical aspects and management. We would like to stress on the important role of serum LDH levels and CT scan in RAT. Early diagnosis may result in salvage of organ by minimally invasive techniques...
November 2016: Urology Case Reports
Daniele G Soares, Françoise Millot, Isabelle Lacroix, Jean-Pierre Lotz
Human heterophile antibodies may develop after infection or contact with animal tissues or animal serum products. These antibodies have the capacity to bind to the animal immunoglobulins used in immunoassays leading to erroneous results. We here report a case of a testicular germ cell tumor patient who developed heterophile antibodies during the surveillance period of his disease. Following false-positive results of human chorionic gonadotropin (hCG) he received unneeded chemotherapy. This article also stresses the problem of using serum tumor markers without no major imaging abnormalities to diagnose a patients' relapse...
November 2016: Urology Case Reports
Diego Martin Barreiro, Johanna Belén Losada, Francisco Castro Montiel, Norberto Lafos
Case report of a patient who, while being under study due to total urinary incontinence and multiple urinary tract infections, interoccurs with urosepsis due to a forgotten and encrusted double-J stent. An open surgery is performed with two surgical approaches, suprapubic and minimal lumbotomy, in which a nephrectomy of the atrophic kidney, a resection of the urether with a calcified double-J in its interior and a cystolithotomy were conducted with the resulting favorable resolution of the pathology.
September 2016: Urology Case Reports
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