Urology Case Reports最新文献

Mixed epithelial and stromal tumor (MEST) is very rare neoplasm of the kidney, commonly affecting women at menopausal age. MEST is usually considered a benign tumor with low risk of local recurrence or distance metastases. Our case presents a case of a 66 years old male patient with a complex cystic lesion of the left kidney incidentally diagnosed on urinary tract computerized scan (CT) performed for other reasons. The patient underwent a radical nephrectomy. The pathology report came back as MEST of the kidney. The present case report highlights the asymptomatic presentation of MEST as a benign renal masses.

Extrahepatic metastasis of hepatocellular carcinoma (HCC) is a sign of advanced disease with poor prognosis. Haematogenous metastasis to the urinary bladder is extremely rare. We describe a case of a 66-year-old male with advanced HCC that developed HCC metastasis to the bladder. There have only been six case reports previously documenting this. Uniquely this is the first case to develop metastatic disease to the bladder after receiving both locoregional and systemic therapy.

Primary urethral melanoma is an exceptionally rare malignancy, comprising a small fraction of melanomas and malignant tumors affecting the female urethra. We report the case of a 74-year-old woman presenting with symptoms initially suggestive of a benign urethral caruncle, which was later diagnosed as nodular melanoma upon histopathological examination. Despite complete surgical excision, subsequent imaging revealed widespread metastases to lymph nodes, liver, lungs, and brain. The patient was promptly referred for systemic therapy. This case highlights the diagnostic challenges and emphasizes the importance of thorough staging and emerging treatment modalities, such as immunotherapy, in managing this aggressive malignancy.

The optimal treatment of adult-onset Wilms tumors (WTs) in elderly patients is a debated area, as pediatric protocols are thought to carry unacceptable toxicity. We treated a 62-year-old female with good performance status and Stage IV (T1b N1 M1) favorable histology WT using pediatric adjuvant and salvage chemoradiation protocols. Though she experienced nodal relapse and both adjuvant and salvage treatment were discontinued early due to toxicity, she obtained excellent oncologic outcomes, having remained disease-free for 32 months. We recommend considering pediatric protocols for elderly WT patients with good performance status, anticipating dose reductions and possible early chemotherapy termination.

Adenocarcinoma of the prostate affects up to 70 % of men over 80 and is the second leading cause of cancer related death in men. We reported an unusual case of a giant prostatic adenocarcinoma compressing bilaterally the 2 external and internal iliac veins that was revealed by a bilateral edema of the lower limbs after histological confirmation the patient was treated by radiotherapy and hormone therapy with a clinical amelioration.

Renal Artery Embolization (RAE) is a first-line treatment for arteriovenous fistula complications, which may occur following percutaneous nephrolithotomy (PCNL). A rare complication of RAE is metal coil migration, which may present with nephrolithiasis symptoms, including hematuria and flank pain. Imaging like Computed Tomography (CT) Angiography can help assess the risk of hemorrhage due to coil location relative to vasculature. Subsequently, ureteroscopy can be done with thulium laser excision of the coils and lithotripsy of adherent stone. This case is one of the first to demonstrate that endourological thulium laser excision is a safe and effective management for migrated angioembolization coils.

We present a case of acute urinary retention (AUR) with hyper-angulation of the urinary bladder neck secondary to uterine leiomyoma. Our patient is a 45-year-old female who presented with AUR and suprapubic pain requiring catheterization. CT images highlight the level of obstruction secondary to suspension of the urinary bladder rather than direct urethral compression. This case highlights this unique manifestation of AUR demonstrating the necessity for understanding its different mechanisms. Clinicians should maintain a high index of suspicion for AUR in patients with leiomyoma and lower urinary tract symptoms. Heightened awareness and timely intervention are crucial in preventing potential complications.

Obstructive lower urinary tract symptoms in young men can occasionally be attributed to rare intra-prostatic cystic lesions. This case reports a 27-year-old man presenting with sudden onset voiding difficulty, diagnosed with a midline prostatic cyst at the anterior bladder neck, a rare location. The cyst was successfully treated with bipolar transurethral endoscopic resection, resulting in the resolution of urinary symptoms without retrograde ejaculation which is a common complication that is a central concern in the literature regarding the choice of surgical modality.

Vesicostomy is a temporary solution for patients with bladder outlet challenger who are not eligible for catheterization.

A 73 year-old man who has successfully managed his bladder using a vesicostomy for 59 years. Complications of prolapse and dermatitis led to vesicostomy closure and cystostomy placement at age 73.

Vesicostomy can be safely used to preserve bladder and upper urinary tract health for a lifetime.

This case report describes the surgical management of a giant left adrenal mass (27 x 26 × 27 cm, 9.370 kg) in a 69-year-old female. We review the multidisciplinary decision-making process for pre-operative preparation, embolization, resection feasibility, and strategies to mitigate intra-operative complications. This is the largest adrenal adenoma removal reported to date. The case highlights the importance of meticulous surgical planning and execution in managing rare and challenging cases, with significant implications for patient outcomes.