Urology Case Reports最新文献

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.

Background

Valveless trocars like AirSeal system are maintain a stable pneumoperitoneum and reduce instrument friction.

Case presentation

A 65-year-old man's robotic radical cystectomy was complicated by a missing needle while using AirSeal system. The needle was detected via backward inspection using the endo camera inserted through the trocar, tip at its most distal end let the visualization of the needle within the air channels and confirmed with a trocar X-ray.

Conclusion

Our findings suggest that retrograde inspection and targeted radiography of the trocar, prior to patient imaging, can be helpful in locating the lost needle and prevent prolongation of surgeries.

Renal infarction is a rare pathology, which can be life-threatening for the kidney. Its low incidence and non-specific clinical manifestations make it difficult to diagnose, often resulting in delayed or misdiagnosis. Contrast-enhanced CT has a role to play in early positive diagnosis, enabling rapid and effective management. We report the case of a right renal infarction simulating renal colic, with a review of the literature.

We present the case of a 64-year-old patient with metastatic renal cell carcinoma, who experienced disease progression despite undergoing multiple lines of systemic therapy, including immune checkpoint inhibitors (ICI). Two months after stereotactic radiosurgery to his brain lesions and while the patient was not on any systemic therapy, restaging scans demonstrated a dramatic near complete regression of the primary renal lesion and metastatic sites, which was attributed to the abscopal effect, mediated by the exposure to ICI and radiotherapy. While its mechanisms are not fully understood, it is believed to stem from the tumor immunosuppression and immunogenicity induced by radiation.