Urology Case Reports最新文献

Primary adrenal tuberculosis is an extremely rare benign lesion that typically presents with no clinical symptoms in its early stages, making it prone to clinical misdiagnosis. We report a case of a middle-aged man initially thought to have adrenal nodules, which further examination revealed to be adrenal tuberculosis accompanied by Addison's disease. This report discusses the diagnostic approach, progressive features, and treatment options for this rare disease.

Molecular tumor profiling has become an important diagnostic for prostate cancer, allowing for personalized treatment regimens based on somatic and germline genetic information. We report a 67-year-old patient with metastatic castrate-resistant prostate cancer which was intermittently responsive to androgen-deprivation therapy, docetaxel, abiraterone, radium-223, Sipuleucel-T, and radiotherapy who ultimately demonstrated a remarkable and durable response to pembrolizumab. Our case report underlines the significance of early tumor molecular profiling in aggressive or atypical prostate cancer patients and exhibits the potential for a remarkable clinical response with immunotherapy in candidates with the appropriate tumor profiles.

A case of synchronous bilateral native kidneys papillary RCC is presented in a 48 year old patient who underwent a living donor kidney transplant 10 years prior. He was on regular immunosuppressant therapy. Despite the long term follow-up, bilateral cystic and exophytic masses were incidentally found on CT scan. Subsequent bilateral open radical nephrectomy revealed papillary RCC in both kidneys.

Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has been reported to be present in approximately 5% of all reported xanthogranulomatous cases. The clinical relevance of this disease is that it often mimics malignancy, and preoperative imaging is unable to differentiate between the two. Our case report demonstrated a renal lesion that mimicked malignancy and ultimately required histopathological examination for the diagnosis of XGP. Current consensus remains that surgery is the mainstay form of treatment. However, this case report showed that use of antibiotics alone can be successful as the patient showed significant improvement and resolution on interval imaging.

Blue-light cystoscopy with intravesical hexyl-aminolevulinate has been shown to improve identification of bladder carcinoma. The application of photodynamic techniques in the upper tract has not been well studied. We present a patient with a patulous ureteral orifice allowing for dwelling of photodynamic reagent and cystoscopic evaluation of the distal ureter. This case was significant for blue light fluorescent, biopsy proven upper tract carcinoma in situ that otherwise would have been a benign examination using traditional white light technique. Future work should be done to study the use of photodynamic techniques in the evaluation of upper tract malignancies.

The kidney is frequently injured in blunt abdominal trauma, accounting for 10 % of such cases and being the most commonly affected genitourinary organ in all traumas. Pelviureteric junction obstruction (PUJO) is typically a congenital and asymptomatic anatomical dilatation to the renal pelvis. This article reports on a 21-year-old male who ruptured a congenital PUJO following blunt abdominal trauma. He was managed with a retrograde ureteric stent and a staged pyeloplasty. This case highlights a rare case of urogenital injury due to blunt trauma and explores the impact of congenital anomalies can contribute to injury and lead to significant complications.

Midline retroperitoneal masses in young males often present a diagnostic challenge, with metastases from testicular origins being a primary consideration. Beyond the initial pathology of testicular cancer, these masses can undergo transformation, including the development of teratomas. This report describes an unusual case of a calcified retroperitoneal mass originating from a testicular pure teratoma that underwent a rare transformation into a Primitive Neuroectodermal Tumor (PNET), comprising approximately 85 % of the tumor volume. The patient's successful treatment involved a comprehensive approach combining surgical resection and chemotherapy.

Fibroepithelial polyps (FEP) are rare benign tumors urinary collecting system. Diagnosis is suspected on Computed Tomography (CT) and confirmed via histopathology. Treatment options vary from historic nephroureterectomy to more contemporary methods of ablation. Authors present a case of a symptomatic FEP causing left-sided hydronephrosis and episodic flank pain treated by a urologic surgeon. The patient underwent robotic pyeloplasty and excision of the tumors, yielding preserved renal function and resolution of the hydronephrosis.

We describe the first case of a recto-urethral fistula following an MRI-guided transurethral prostate ablation procedure (TULSA). The patient experienced urine per rectum six weeks after the procedure. A voiding cystourethrogram confirmed the presence of a recto-urethral fistula, which was managed with a urethral catheter and a suprapubic tube. Patient was then asymptomatic, with spontaneous healing of the fistula and catheters removed after six weeks. Not previously reported following TULSA, rectourethral fistula is a rare but known complication with other focal therapy modalities. Awareness of this potential complication will help improve patient counseling, early detection and adequate management of this rare complication.

This article discusses a case study of a 68-year-old male patient with lung squamous cell carcinoma (LUSC) who developed solitary renal metastasis. The importance of routine imaging for detecting asymptomatic renal metastasis is highlighted. The efficacy of various treatment options, including nephrectomy, stereotactic body radiation therapy, and cryoablation, is explored. The study underscores the need for a multidisciplinary team approach in managing LUSC with renal metastasis, due to the lack of clear treatment guidelines.