Miguel Toledo Jiménez, David Carracedo Calvo, Pietro Moscatiello, Alessandro Fiorillo, Rebeca Quintana Álvarez, Nathalie Pereira Rodríguez, Irene Hernández Bermejo, Iñigo Miñana Toscano, Miguel Sánchez Encinas
Introduction
Recurrent priapism is a rare variant of ischemic priapism that involves recurrent erections typically lasting less than 4 h. The primary goal of treatment is to prevent future episodes, with options ranging from pharmacological treatments to various surgeries.
Case presentation
A 38-year-old man experienced multiple episodes of priapism that were refractory to angioembolization of an arteriocavernous fistula and oral treatment with Cetirizine and Bicalutamide. After the patient refused intracavernous self-injections, various surgical options were considered. Ultimately, a proximal penile shunt surgery with a cavernosal–spongiosal shunt using the Quackles technique was chosen, which proved effective in preventing episodes and did not affect the patient's erectile function.
Conclusion
Penile shunt surgery using the Quackles proximal technique is a safe and effective option for the treatment of recurrent priapism.
{"title":"Treatment of recurrent priapism using proximal shunt: Quackles technique","authors":"Miguel Toledo Jiménez, David Carracedo Calvo, Pietro Moscatiello, Alessandro Fiorillo, Rebeca Quintana Álvarez, Nathalie Pereira Rodríguez, Irene Hernández Bermejo, Iñigo Miñana Toscano, Miguel Sánchez Encinas","doi":"10.1002/iju5.12818","DOIUrl":"10.1002/iju5.12818","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recurrent priapism is a rare variant of ischemic priapism that involves recurrent erections typically lasting less than 4 h. The primary goal of treatment is to prevent future episodes, with options ranging from pharmacological treatments to various surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 38-year-old man experienced multiple episodes of priapism that were refractory to angioembolization of an arteriocavernous fistula and oral treatment with Cetirizine and Bicalutamide. After the patient refused intracavernous self-injections, various surgical options were considered. Ultimately, a proximal penile shunt surgery with a cavernosal–spongiosal shunt using the Quackles technique was chosen, which proved effective in preventing episodes and did not affect the patient's erectile function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Penile shunt surgery using the Quackles proximal technique is a safe and effective option for the treatment of recurrent priapism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"73-76"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Choroidal metastasis from renal cell carcinoma is relatively rare and unresponsive to systemic treatment.
Case presentation
A man in his eighties with left renal cell carcinoma and pulmonary metastasis developed visual impairment in the left eye during primary treatment with ipilimumab and nivolumab followed by secondary treatment with cabozantinib. Consultation with an ophthalmologist revealed choroidal metastasis, which was subsequently treated with local radiotherapy (3 Gy × 10 Fr), resulting in a significant reduction in the metastatic lesions.
Conclusion
If visual impairment arises while treating renal cell carcinoma, it is essential to consider the possibility of intraocular metastasis. In terms of treatment, local therapies such as radiotherapy should be taken into consideration.
{"title":"A case of choroidal metastasis from renal cell carcinoma significantly reduced by radiotherapy","authors":"Koichiro Kanazawa, Shinnosuke Oishi, Akihiko Sakamoto, Kuniaki Tanabe, Kazutaka Sugiyama, Akihiko Matsumoto, Akari Arakawa, Hiromi Matsunaga, Takafumi Harada, Haruki Kume","doi":"10.1002/iju5.12819","DOIUrl":"10.1002/iju5.12819","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Choroidal metastasis from renal cell carcinoma is relatively rare and unresponsive to systemic treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A man in his eighties with left renal cell carcinoma and pulmonary metastasis developed visual impairment in the left eye during primary treatment with ipilimumab and nivolumab followed by secondary treatment with cabozantinib. Consultation with an ophthalmologist revealed choroidal metastasis, which was subsequently treated with local radiotherapy (3 Gy × 10 Fr), resulting in a significant reduction in the metastatic lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>If visual impairment arises while treating renal cell carcinoma, it is essential to consider the possibility of intraocular metastasis. In terms of treatment, local therapies such as radiotherapy should be taken into consideration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"77-80"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cytokine release syndrome is a rare but potentially life-threatening complication of immune checkpoint inhibitor therapy. Its occurrence in renal cell carcinoma treated with combination therapy is less recognized and poses significant management challenges.
Case presentation
A 50-year-old male with metastatic renal cell carcinoma developed severe cytokine release syndrome after receiving ipilimumab–nivolumab combination therapy. The patient presented with high fever, fatigue, and elevated inflammatory markers. Early recognition and prompt intervention with tocilizumab led to rapid clinical improvement.
Conclusion
This case highlights the importance of increased awareness, prompt recognition, and targeted management of cytokine release syndrome in renal cell carcinoma patients receiving immune checkpoint inhibitor combination therapy. The rapid response to tocilizumab suggests its potential efficacy in managing immune checkpoint inhibitor-induced cytokine release syndrome.
{"title":"Cytokine release syndrome treated with tocilizumab following ipilimumab–nivolumab combination therapy in advanced renal cell carcinoma","authors":"Toru Inoue, Akiko Todaka, Masahiro Fuse, Shuntaro Suzuki, Shinya Sejiyama, Tadasuke Ando, Toshitaka Shin","doi":"10.1002/iju5.12812","DOIUrl":"10.1002/iju5.12812","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cytokine release syndrome is a rare but potentially life-threatening complication of immune checkpoint inhibitor therapy. Its occurrence in renal cell carcinoma treated with combination therapy is less recognized and poses significant management challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 50-year-old male with metastatic renal cell carcinoma developed severe cytokine release syndrome after receiving ipilimumab–nivolumab combination therapy. The patient presented with high fever, fatigue, and elevated inflammatory markers. Early recognition and prompt intervention with tocilizumab led to rapid clinical improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case highlights the importance of increased awareness, prompt recognition, and targeted management of cytokine release syndrome in renal cell carcinoma patients receiving immune checkpoint inhibitor combination therapy. The rapid response to tocilizumab suggests its potential efficacy in managing immune checkpoint inhibitor-induced cytokine release syndrome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"64-68"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intravesical Bacillus Calmette-Guérin immunotherapy is generally a safe treatment for non-muscle-invasive bladder cancer but sometimes causes complications.
Case presentation
The patient was an 80-year-old man who had undergone Bacillus Calmette-Guérin immunotherapy for non-muscle-invasive bladder cancer. Two months later, he developed an irregular pelvic mass surrounding the prostate and rectum with no fever. A colonoscopy showed purulent mucus discharge in the lower rectum, and a CT-guided needle biopsy revealed epithelioid granuloma containing Langhans giant cells. Although acid-fast bacteria culture and PCR of biopsy samples were negative, he was clinically diagnosed with Bacillus Calmette-Guérin-related tuberculous prostatic abscess spreading to the rectum. After receiving combined antitubercular drugs for 6 months, his discomfort disappeared with almost complete shrinkage of the prostatic abscess.
Conclusion
Tuberculous prostatic abscess is a rare complication associated with Bacillus Calmette-Guérin immunotherapy and sometimes induces rectal fistula. Conservative treatment with antitubercular drugs is efficient and safe for treatment of tuberculous prostatic abscess.
{"title":"Afebrile tuberculous prostatic abscess with rectal fistula after intravesical Bacillus Calmette-Guérin immunotherapy","authors":"Tatsuhiro Sawada, Ayaka Igarashi, Seiji Arai, Akira Ohtsu, Yuji Fujizuka, Shun Nakazawa, Yoshitaka Sekine, Hidekazu Koike, Yosuke Furuya, Kazuhiro Suzuki","doi":"10.1002/iju5.12814","DOIUrl":"10.1002/iju5.12814","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intravesical Bacillus Calmette-Guérin immunotherapy is generally a safe treatment for non-muscle-invasive bladder cancer but sometimes causes complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>The patient was an 80-year-old man who had undergone Bacillus Calmette-Guérin immunotherapy for non-muscle-invasive bladder cancer. Two months later, he developed an irregular pelvic mass surrounding the prostate and rectum with no fever. A colonoscopy showed purulent mucus discharge in the lower rectum, and a CT-guided needle biopsy revealed epithelioid granuloma containing Langhans giant cells. Although acid-fast bacteria culture and PCR of biopsy samples were negative, he was clinically diagnosed with Bacillus Calmette-Guérin-related tuberculous prostatic abscess spreading to the rectum. After receiving combined antitubercular drugs for 6 months, his discomfort disappeared with almost complete shrinkage of the prostatic abscess.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tuberculous prostatic abscess is a rare complication associated with Bacillus Calmette-Guérin immunotherapy and sometimes induces rectal fistula. Conservative treatment with antitubercular drugs is efficient and safe for treatment of tuberculous prostatic abscess.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"69-72"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a rare case of long-term survival following metastasectomy for lumbar metastasis with growing teratoma syndrome.
Case presentation
An 18-year-old man presented with left scrotal mass and lumbago. Alpha-fetoprotein was elevated to 648.8 ng/mL, while human chorionic gonadotropin and lactate hydrogenase were normal. Pathology of left inguinal orchiectomy revealed immature teratoma, and computed tomography confirmed a single metastasis in the second lumbar vertebra. After two courses of bleomycin, etoposide, cisplatin chemotherapy, alpha-fetoprotein decreased, but computed tomography confirmed an enlarged lumbar metastasis. A vertebral biopsy demonstrated teratoma with a dominant mature component, and growing teratoma syndrome was suspected. Following additional etoposide, cisplatin chemotherapy, and normalization of alfa-fetoprotein, total spondylectomy was performed. Vertebral pathology proved mature teratoma. After adjuvant chemotherapy, he has been recurrence-free for 17 years.
Conclusion
Spondylectomy of a single metastatic vertebra contributed to long-term survival in a testicular teratoma case.
{"title":"Total en bloc spondylectomy in testicular immature teratoma: Long-term survival amidst vertebral metastasis escalated by growing teratoma syndrome","authors":"Masahiro Tamaki, Kouhei Maruno, Tatsuya Hazama, Toshifumi Takahashi, Yuya Yamada, Masakazu Nakashima, Kazuro Kikkawa, Noriyuki Ito","doi":"10.1002/iju5.12810","DOIUrl":"10.1002/iju5.12810","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We present a rare case of long-term survival following metastasectomy for lumbar metastasis with growing teratoma syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>An 18-year-old man presented with left scrotal mass and lumbago. Alpha-fetoprotein was elevated to 648.8 ng/mL, while human chorionic gonadotropin and lactate hydrogenase were normal. Pathology of left inguinal orchiectomy revealed immature teratoma, and computed tomography confirmed a single metastasis in the second lumbar vertebra. After two courses of bleomycin, etoposide, cisplatin chemotherapy, alpha-fetoprotein decreased, but computed tomography confirmed an enlarged lumbar metastasis. A vertebral biopsy demonstrated teratoma with a dominant mature component, and growing teratoma syndrome was suspected. Following additional etoposide, cisplatin chemotherapy, and normalization of alfa-fetoprotein, total spondylectomy was performed. Vertebral pathology proved mature teratoma. After adjuvant chemotherapy, he has been recurrence-free for 17 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Spondylectomy of a single metastatic vertebra contributed to long-term survival in a testicular teratoma case.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"60-63"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Návan van Jaarsveld, Alessandro Pietro Aldera, Jeff John
Introduction
Solitary fibrous bladder tumors are extremely uncommon, with only a few cases reported. These fibroblastic mesenchymal neoplasms are typically benign, indolent, and slow growing.
Case presentation
A 44-year-old male patient with obstructive uropathy was referred to our unit for workup. Ultrasonography and MRI of the pelvis showed a large, well-circumscribed bladder mass, also visualized cystoscopically. This mass was excised en bloc using the Pfannenstiel approach. Histopathological and immunohistochemical analyses revealed a solitary fibrous tumor.
Conclusion
The management of SFTs can be challenging due to the lack of established guidelines. Hence, we offered our patient long-term follow-up. Twelve months postoperatively, no recurrence or metastases were found on the follow-up imaging.
{"title":"Solitary fibrous tumor of the bladder: A rare cause of bladder outlet obstruction in an adult male","authors":"Návan van Jaarsveld, Alessandro Pietro Aldera, Jeff John","doi":"10.1002/iju5.12789","DOIUrl":"10.1002/iju5.12789","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Solitary fibrous bladder tumors are extremely uncommon, with only a few cases reported. These fibroblastic mesenchymal neoplasms are typically benign, indolent, and slow growing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 44-year-old male patient with obstructive uropathy was referred to our unit for workup. Ultrasonography and MRI of the pelvis showed a large, well-circumscribed bladder mass, also visualized cystoscopically. This mass was excised en bloc using the Pfannenstiel approach. Histopathological and immunohistochemical analyses revealed a solitary fibrous tumor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The management of SFTs can be challenging due to the lack of established guidelines. Hence, we offered our patient long-term follow-up. Twelve months postoperatively, no recurrence or metastases were found on the follow-up imaging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"11-14"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matsumoto et al. reported a case of renal cell carcinoma (RCC) with multiple brain metastases (BMs) treated with stereotactic brain radiation followed by pembrolizumab plus lenvatinib.1 As demonstrated in the Discussion section of this case report, monotherapies with tyrosine kinase inhibitors (TKI), such as cabozantinib, or immune checkpoint inhibitors have exhibited efficacy in improving survival outcomes in the management of BMs from RCC. Therefore, proactive drug treatment for BMs from RCC is warranted. In this regard, Takemura et al. recently reported the outcomes of 389 patients with BMs from RCC utilizing data from the International Metastatic Renal Cell Carcinoma Database Consortium.2 In this study, a significant difference in overall survival (OS) was observed between patients with BMs from RCC receiving IO-based combination as first-line drug therapy (32.7 months) compared with those receiving TKI monotherapy (20.6 months). Meanwhile, the group treated with stereotactic radiation or neurosurgery for multiple BMs from RCC showed a longer OS of 31.4 months compared with the group treated with whole brain radiation or no radiation (16.5 months). Yomoet al. reported a longer survival without increase in adverse event after stereotactic brain radiation with IO combination therapy for BMs from RCC.3
Thus far, stereotactic radiation, monotherapy with TKI, or IO have shown effectiveness in controlling BMs in patients with RCC. With more evidence from the aforementioned articles, multimodality treatments composed of stereotactic radiation and IO plus TKI could improve the OS of patients with RCC with multiple BMs.
Manabu Kato: Writing – review and editing.
The authors declare no conflict of interest.
{"title":"Editorial Comment on “Efficacy of pembrolizumab plus lenvatinib as first-line treatment for metastatic renal cell carcinoma with multiple brain metastases”","authors":"Manabu Kato M.D., Ph.D","doi":"10.1002/iju5.12805","DOIUrl":"10.1002/iju5.12805","url":null,"abstract":"<p>Matsumoto <i>et al</i>. reported a case of renal cell carcinoma (RCC) with multiple brain metastases (BMs) treated with stereotactic brain radiation followed by pembrolizumab plus lenvatinib.<span><sup>1</sup></span> As demonstrated in the Discussion section of this case report, monotherapies with tyrosine kinase inhibitors (TKI), such as cabozantinib, or immune checkpoint inhibitors have exhibited efficacy in improving survival outcomes in the management of BMs from RCC. Therefore, proactive drug treatment for BMs from RCC is warranted. In this regard, Takemura et al. recently reported the outcomes of 389 patients with BMs from RCC utilizing data from the International Metastatic Renal Cell Carcinoma Database Consortium.<span><sup>2</sup></span> In this study, a significant difference in overall survival (OS) was observed between patients with BMs from RCC receiving IO-based combination as first-line drug therapy (32.7 months) compared with those receiving TKI monotherapy (20.6 months). Meanwhile, the group treated with stereotactic radiation or neurosurgery for multiple BMs from RCC showed a longer OS of 31.4 months compared with the group treated with whole brain radiation or no radiation (16.5 months). Yomoet al. reported a longer survival without increase in adverse event after stereotactic brain radiation with IO combination therapy for BMs from RCC.<span><sup>3</sup></span></p><p>Thus far, stereotactic radiation, monotherapy with TKI, or IO have shown effectiveness in controlling BMs in patients with RCC. With more evidence from the aforementioned articles, multimodality treatments composed of stereotactic radiation and IO plus TKI could improve the OS of patients with RCC with multiple BMs.</p><p>Manabu Kato: Writing – review and editing.</p><p>The authors declare no conflict of interest.</p>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"9-10"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Local recurrence for upper tract urothelial carcinoma typically occurs within 2 years post-surgery. We report a rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy.
Case presentation
A 67-year-old female was referred to our urology department for a left ureteral tumor. The surgical specimen of the laparoscopic left nephroureterectomy revealed urothelial carcinoma at the pT3 stage. Ten years post-nephroureterectomy, magnetic resonance cholangiopancreatography revealed a mass lesion in the left retroperitoneum, a computed tomography-guided biopsy revealed squamous cell carcinoma. Despite suspected distant metastases of other organ tumors, examinations such as digestive endoscopy and bronchoscopy did not reveal any tumor lesions. The patient was diagnosed with recurrent invasive urothelial carcinoma as a pathological feature of squamous cell carcinoma.
Conclusion
The decision-making process for treating malignant tumors, such as in cases with recurrence as squamous cell carcinoma, can be challenging.
{"title":"A rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy","authors":"Koichiro Uehara, Tatsuaki Onuki, Yukari Ishibashi, Sayuki Matsunuma, Hiroaki Ishida, Jiro Kumagai, Takayuki Murakami","doi":"10.1002/iju5.12809","DOIUrl":"10.1002/iju5.12809","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Local recurrence for upper tract urothelial carcinoma typically occurs within 2 years post-surgery. We report a rare case of retroperitoneal recurrence as squamous cell carcinoma 10 years after nephroureterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>A 67-year-old female was referred to our urology department for a left ureteral tumor. The surgical specimen of the laparoscopic left nephroureterectomy revealed urothelial carcinoma at the pT3 stage. Ten years post-nephroureterectomy, magnetic resonance cholangiopancreatography revealed a mass lesion in the left retroperitoneum, a computed tomography-guided biopsy revealed squamous cell carcinoma. Despite suspected distant metastases of other organ tumors, examinations such as digestive endoscopy and bronchoscopy did not reveal any tumor lesions. The patient was diagnosed with recurrent invasive urothelial carcinoma as a pathological feature of squamous cell carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The decision-making process for treating malignant tumors, such as in cases with recurrence as squamous cell carcinoma, can be challenging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"56-59"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bassem Skaff, Rayane Diab, Mohamad Moussa, Christopher Massaad, Kariman Ghazal
Objectives
This case report highlights the clinical presentation, diagnostic challenges, and effective management of bladder endometriosis, while emphasizing the importance of considering this diagnosis in patients with chronic pelvic pain and urinary symptoms.
Methods
A 32-year-old woman presented with severe pelvic pain, dysuria, and dyspareunia. Diagnosis of bladder endometriosis was achieved through clinical suspicion supported by vaginal ultrasound, 3D imaging, and magnetic resonance imaging.
Results
Conservative medical treatment provided temporary relief, which necessitated resection of endometriotic nodule.
Conclusions
Due to its rarity and non-specific presentation, bladder endometriosis is often underdiagnosed or misdiagnosed. In this case, the patient's pain can be correlated with the deeply infiltrating nature of the endometriotic lesions, causing irritation, and involvement of the bladder.
{"title":"Diagnosis of infiltrating bladder endometriosis after fourth cesarean section","authors":"Bassem Skaff, Rayane Diab, Mohamad Moussa, Christopher Massaad, Kariman Ghazal","doi":"10.1002/iju5.12807","DOIUrl":"10.1002/iju5.12807","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This case report highlights the clinical presentation, diagnostic challenges, and effective management of bladder endometriosis, while emphasizing the importance of considering this diagnosis in patients with chronic pelvic pain and urinary symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 32-year-old woman presented with severe pelvic pain, dysuria, and dyspareunia. Diagnosis of bladder endometriosis was achieved through clinical suspicion supported by vaginal ultrasound, 3D imaging, and magnetic resonance imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Conservative medical treatment provided temporary relief, which necessitated resection of endometriotic nodule.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Due to its rarity and non-specific presentation, bladder endometriosis is often underdiagnosed or misdiagnosed. In this case, the patient's pain can be correlated with the deeply infiltrating nature of the endometriotic lesions, causing irritation, and involvement of the bladder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"52-55"},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica A Paynter, Kirby R Qin, Justin Chee, Todd Manning, Janelle Brennan
Introduction
This report describes late erosion of an Adjustable Transobturator Male System device which was inserted for post-prostatectomy incontinence. The Adjustable Transobturator Male System device eroded the bulbar urethra 5 years post insertion, despite initial improvement of symptoms.
Case presentation
Following an open radical retropubic prostatectomy, a 64 year-old male patient developed post-prostatectomy incontinence. He had a known urethral stricture and had also undergone salvage radiotherapy for biochemical recurrence of prostate cancer. His incontinence was initially successfully treated with an Adjustable Transobturator Male System device, yet this eroded his bulbar urethra 5 years post insertion, which was deemed to be a late erosion.
Conclusion
Urologists should be aware that late erosion of the Adjustable Transobturator Male System device can occur, and risk stratification of patients undergoing Adjustable Transobturator Male System device insertion may help to minimize erosion rates.
{"title":"Late erosion of an Adjustable Transobturator Male System (ATOMS®) device","authors":"Jessica A Paynter, Kirby R Qin, Justin Chee, Todd Manning, Janelle Brennan","doi":"10.1002/iju5.12804","DOIUrl":"10.1002/iju5.12804","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This report describes late erosion of an Adjustable Transobturator Male System device which was inserted for post-prostatectomy incontinence. The Adjustable Transobturator Male System device eroded the bulbar urethra 5 years post insertion, despite initial improvement of symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case presentation</h3>\u0000 \u0000 <p>Following an open radical retropubic prostatectomy, a 64 year-old male patient developed post-prostatectomy incontinence. He had a known urethral stricture and had also undergone salvage radiotherapy for biochemical recurrence of prostate cancer. His incontinence was initially successfully treated with an Adjustable Transobturator Male System device, yet this eroded his bulbar urethra 5 years post insertion, which was deemed to be a late erosion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Urologists should be aware that late erosion of the Adjustable Transobturator Male System device can occur, and risk stratification of patients undergoing Adjustable Transobturator Male System device insertion may help to minimize erosion rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":52909,"journal":{"name":"IJU Case Reports","volume":"8 1","pages":"44-46"},"PeriodicalIF":0.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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