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Urology Case Reports

Andrew Higgins, Waleed Eisa, John Walton, Jacob Baber, Shaobo Zhu, Heinric Williams
Concurrent primary carcinoid tumor and primary mucinous adenocarcinoma arising within a mature cystic teratoma of a horseshoe kidney is a rare event and has been reported once in the literature. We present the first case where this tumor subtype has metastasized to lymph nodes. Treatment included open partial nephrectomy, lymph node dissection, and adjuvant chemotherapy with temozolomide and capecitabine. Due to the rare combination of tumor histologies, it is unlikely that this cohort will ever be able to be adequately studied to determine a standard of care...
February 2017: Urology Case Reports
M R Siddiqui, T Sanford, A Nair, C S Zerbe, M S Hughes, L Folio, Piyush K Agarwal, S J Brancato
A 46-year old man with X-linked chronic granulomatous disease (CGD) being followed at the National Institute of Health with uncontrolled CGD colitis who developed chronic colovesical fistula, and end-stage renal disease (ESRD). Despite aggressive medical management of symptoms with immunomodulators and antibiotic prophylaxis, the chronic colovesical fistula led to chronic pyelonephritis, recurrent urinary tract infections, persistent air in the collecting system and bladder, and post-renal obstruction resulting in renal failure...
February 2017: Urology Case Reports
Rohit V Patil, Solomon L Woldu, Elena Lucas, Andrew M Quinn, Franto Francis, Vitaly Margulis
A 49-year-old Caucasian woman presented to the dermatology clinic for follow-up of malignant melanoma with a complaint of painless gross hematuria. Two years prior she was diagnosed with malignant melanoma from a skin lesion on her left flank treated with wide excision, negative axillary sentinel lymph node biopsy, and adjuvant radiotherapy. Subsequently, she had no evidence of disease until urologic evaluation of her hematuria revealed two lesions in her bladder and cytopathology demonstrated findings consistent with malignant melanoma...
February 2017: Urology Case Reports
Joana Alfarelos, Gustavo Gomes, Francisco Campos, Mário Matias, Amaral Canelas, Matilde Gonçalves
Paratesticular sarcomas are rare. Most cases reported in the literature are depending on retrospective analysis of case reports, small series, literature reviews, and expert opinion and they show different outcomes depending on several variables. The majority indicate that this may be an indolent tumor with a potential for cure if treated early. We present a case of a 58 year old man with a history of painless enlargement of the right testis. The ultrasound showed an extratesticular lesion and a right excisional of the mass was performed...
February 2017: Urology Case Reports
Charles J Paul, Conrad M Tobert, Chad R Tracy
Vesicourethral anastomosis leaks are not uncommon following radical prostatectomy. We present a case of a 59-year-old male who presented to our ED with hematuria, abdominal pain, and clot retention 17 days after a robotic-assisted laparoscopic prostatectomy. A 50% vesicourethral disruption was ultimately managed endoscopically and with hemostatic agents. At 9-month follow-up he is fully continent with normal erectile function. Vesicourethral leaks can typically be managed conservatively with gentle traction and prolonged catheterization...
February 2017: Urology Case Reports
Charles Rotenberry, Katherine Dowd, Douglas Russell, Werner DeRiese, Sloan Teeple, Thomas Cammack
Inflammatory myofibroblastic tumors rarely occur in the urinary bladder. These masses follow an indolent course, but due to their histologic similarities to more malignant types of bladder masses, they must be differentiated with immunohistochemical staining. Once diagnosed, the mainstay of treatment for these masses is surgical resection. Due to advancements in robotic surgery, new surgical techniques can be employed to treat these masses with fewer perioperative complications. We report a case of inflammatory myofibroblastic tumor of the urinary bladder in a 29-year-old male treated with robot-assisted partial cystectomy...
February 2017: Urology Case Reports
Zachary E Stewart, Mohammed Shaker, J David Baxter
Urological problems are common in spina bifida and are often treated with urinary diversions. Spina bifida and ileal conduits put patients at increased risk for ascending urinary tract infections. Here we present a novel case of a Citrobacter koseri urinary tract infection complicated by a perinephric abscess with pleural extension. To our knowledge, no case of an ascending C. koseri UTI progressing to peri-nephric abscess and empyema by direct extension exists in the literature.
February 2017: Urology Case Reports
Manabu Kato, Satoru Masui, Hideki Kanda, Kiminobu Arima, Taizo Shiraishi, Yoshiki Sugimura
Inflammatory myofibroblastic tumor is a rare benign entity of unclear etiology. It can present with histological features that include a mixture of spindle cells, myofibroblasts and inflammatory cells. Positive immunohistochemical staining for ALK/p80 is often observed, and this marker has been considered diagnostically effective. Despite having these histological features, a previous case was incorrectly diagnosed as malignant disease and was treated with extensive surgical resection. Here we present a case of inflammatory myofibroblastic tumor in the bladder, diagnosed in part based on immunohistochemical and fluorescence in situ hybridization analysis of ALK/p80...
February 2017: Urology Case Reports
W Kerkeni, Y Ayari, L Charfi, A Bouzouita, H Ayed, M Cherif, M R Ben Slama, K Mrad, A Derouiche, M Chebil
Cutaneous metastases from bladder malignancies are rare. We report the case of a 74 year old man who underwent cysto-prostatectomy and adjuvant chemotherapy for a pT3b N+ bladder transitional cell carcinoma. Four months later, he presented with skin disseminated pigmented lesions. Skin biopsy confirmed cutaneous metastasis from urothelial carcinoma.
February 2017: Urology Case Reports
Maria Fernanda W Facio, Luis Cesar F Spessoto, Marcio Gatti, Pedro F Ferraz Arruda, Jose G Ferraz Arruda, Thiago S Antoniassi, Ana Paula Bogdan, Maria de Fatima G Godoy, José Maria P Godoy, Fernando Nestor Facio
Genital lymphedema in men can affect the penis and/or scrotum, causing deformity and causing sexual limitations, social isolation, poor quality of life and recurrent subcutaneous infections due to difficulties in hygiene. There are few studies in the literature emphasizing the treatment of penile fibrosis after penoscrotal lymphedema. The purpose of this report is to describe a case of penile fibrosis treated using a new compression method.
February 2017: Urology Case Reports
Daiki Ikarashi, Yoshiharu Mue, Ei Shiomi, Misato Takayama, Renpei Kato, Yoichiro Kato, Kazuyuki Ishida, Takaya Abe, Tamotsu Sugai, Wataru Obara
Here we report a case of 57-year-old woman with renal angiomyolipoma associated with tuberous sclerosis complex involving inferior vena cava thrombus. We could perform less invasive nephrectomy with thrombectomy because everolimus administration reduced the inferior vena cava thrombus. To the best of our knowledge, this is the first report the use of everolimus before performing surgery to treat renal angiomyolipoma with inferior vena cava thrombus.
February 2017: Urology Case Reports
Charalampos Konstantinidis, Spiridon Vlachos
A 68 year old lady presented to urology department suffering from acute urinary retention. The U/S revealed hydronephrosis in left kidney and a mass at the left side of the small pelvis which pushed forward the uterus and the bladder. The CT scan confirmed a mixed (solid and cystic) mass, with diameter of 12 cm with interpretation of the left ovary. The patient underwent laparotomy and the mass was excised after a difficult dissection due to severe adhesion with the bowel. The well-capsulated mass was a retained surgical sponge...
February 2017: Urology Case Reports
Ridwan Alam, Jeffrey J Tosoian, Ofobuike Okani, Ashley E Ross, Milena Vuica-Ross
Prostate cancer screening by PSA testing remains controversial, particularly in the elderly. Practice guidelines from most clinical societies suggest discontinuing PSA screening at age 70 while the USPSTF recommends against screening at any age. Recent reports have demonstrated an increased incidence of metastatic prostate cancer, with men aged 75 or older accounting for roughly half of those newly diagnosed at an incurable stage. We herein describe the case of an elderly gentleman with no history of prostate cancer screening who presented with anorexia and back pain of unclear etiology...
February 2017: Urology Case Reports
Hiroshi Shimura, Tatsuya Ihara, Takahiko Mitsui, Masayuki Takeda
Rare cases of tuberculous urinary tract or genital infection caused by intravesical Intravesical Bacillus Calmette-Guerin (BCG) instillation therapy have been reported. We encountered a patient with tuberculous granuloma in the scrotal skin after intravesical BCG therapy for bladder cancer. There was evidence of infection in the scrotal skin, but not in the epididymis. To the best of our knowledge, this is the first report of tuberculous granuloma in the scrotal skin without epididymitis after intravesical BCG therapy...
February 2017: Urology Case Reports
Scott P Campbell, Steven P Rowe, Michael A Gorin, Mohamad E Allaf
The development of an iatrogenic vascular lesion, such a renal pseudoaneurysm or arteriovenous fistula, is a rare complication of partial nephrectomy. These lesions should be considered in patients presenting with an enhancing mass in the resection bed shortly following partial nephrectomy. Early timing following surgery, large relative size, and the presence of recurrent hematuria suggest the diagnosis of an iatrogenic vascular lesion. Duplex ultrasound is a useful non-invasive imaging modality for differentiating these lesions from a local tumor recurrence...
February 2017: Urology Case Reports
Bambang Soeprijanto, Wahjoe Djatisoesanto, Willy Sandhika
Colocutaneous fistula with nephrocutaneous fistula is a rare condition. Renal replacement lipomatosis is the result of the atrophy and destruction of renal parenchyma. We report a 60-year-old male with intermittent drainage mucus and fluid from ulcer of his right lumbar region. Renal ultrasound and plain abdominal X-ray revealed a chronic parenchymal disease with stone of the right kidney. Fistulography showed a fistula tract connecting the skin and the right pelvicalyceal system and the colon. Computerized tomography demonstrated a renal calculus with a massive fatty proliferation...
January 2017: Urology Case Reports
Paula M Domino, Jong Taek Kim, Lawrence L Yeung
Urethroplasty may involve the use of tissue substitution including buccal mucosa graft (BMG), penile fasciocutaneous flaps, or skin grafts. Stricture recurrence and fistula formation are some uncommon complications that can result from surgery. The development of squamous cell carcinoma (SCC) after BMG substitution urethroplasty is a new complication that we encountered that has not been described in the literature. We present the first reported case of a patient who developed SCC of the buccal mucosa graft used to reconstruct the urethra...
January 2017: Urology Case Reports
Paul O'Neill, Robin Brown
Nicorandil is a medication used for treatment and prevention of angina pectoris. Its mode of action involves both arterial and venous vasodilation. Although there are numerous known side effects, one of the more unusual, adverse reactions is ulceration of the external genitalia. This case reports the finding of penile preputial ulceration secondary to the use of Nicorandil. The authors make some recommendations for management.
January 2017: Urology Case Reports
Pooya Banapour, Christopher Tenggardjaja, Polina Reyblat
A 61-year-old male with prior history of endoscopic urethral calculus removal presented to the emergency room with urinary retention and a palpable perineal mass. A CT showed a large calcification within the bulbar urethra. After multiple unsuccessful attempts at foley catheter insertion, the urology service was consulted. The patient was taken to the operating room where an obstructing urethral calculus with associated urethral stricture was visualized on cystoscopy. We present an exceedingly rare case of recurrent urethrolithiasis with associated urethral stricture managed with initial suprapubic tube and delayed primary end-to-end urethroplasty, excision of urethral stricture and urethral diverticulectomy...
January 2017: Urology Case Reports
Stephani C Wang, Lezah P McCarthy, Syed Mehdi
Worldwide, prostate cancer is considered the second most common cancer in men. Most common sites for metastatic disease are lymph nodes and bones. However, isolated liver metastasis from prostate cancer is rare. We present a 75 year-old male with prostate adenocarcinoma diagnosed 7 years ago. With rising PSA, he underwent imaging and found to have isolated hepatic metastasis. After left hepatic lobectomy, his PSA dramatically decreased to < 0.01. Physicians should be aware of isolated hepatic metastasis in patients with prostate cancer...
January 2017: Urology Case Reports
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