Kalyani Regeti, W. Jehangir, Sherry Kumar, C. Chua, A. Yousif, Shuvendu Sen
Dialysis disequilibrium syndrome (DDS) is a critical and ultimately fatal condition that presents in hemodialysis patients. Serious manifestations of DDS involve impaired concentration, disorientation, and coma. Risk factors for the condition include dialysis treatment, elevated BUN, renal disease, metabolic acidosis, and pre-existing neurologic disease. There are three main theories proposed to account for the development of DDS, including a reverse urea effect, idiogenic osmoles, and paradoxical brain acidosis. Each of these theories potentiates cerebral edema, and eventually brain herniation, that leads to death. This case examines a 33-year-old Hispanic male brought to the emergency room. He was admitted to the ICU based on hospital findings and had a metabolic acidosis that persisted despite appropriate initial treatment. He was eventually placed on hemodialysis over the course of 2 weeks, and ultimately expired from DDS. This paper aims to demonstrate that hemofiltration is a superior alternative in patients where hemodialysis is indicated, so that DDS, and subsequent fatality, can be avoided. World J Nephrol Urol. 2015;4(3):247-250 doi: http://dx.doi.org/10.14740/wjnu228e
{"title":"Intermittent Dialysis Leading to Dialysis Disequilibrium Syndrome","authors":"Kalyani Regeti, W. Jehangir, Sherry Kumar, C. Chua, A. Yousif, Shuvendu Sen","doi":"10.14740/WJNU228E","DOIUrl":"https://doi.org/10.14740/WJNU228E","url":null,"abstract":"Dialysis disequilibrium syndrome (DDS) is a critical and ultimately fatal condition that presents in hemodialysis patients. Serious manifestations of DDS involve impaired concentration, disorientation, and coma. Risk factors for the condition include dialysis treatment, elevated BUN, renal disease, metabolic acidosis, and pre-existing neurologic disease. There are three main theories proposed to account for the development of DDS, including a reverse urea effect, idiogenic osmoles, and paradoxical brain acidosis. Each of these theories potentiates cerebral edema, and eventually brain herniation, that leads to death. This case examines a 33-year-old Hispanic male brought to the emergency room. He was admitted to the ICU based on hospital findings and had a metabolic acidosis that persisted despite appropriate initial treatment. He was eventually placed on hemodialysis over the course of 2 weeks, and ultimately expired from DDS. This paper aims to demonstrate that hemofiltration is a superior alternative in patients where hemodialysis is indicated, so that DDS, and subsequent fatality, can be avoided. World J Nephrol Urol. 2015;4(3):247-250 doi: http://dx.doi.org/10.14740/wjnu228e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2015-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Bouassida, W. Hmida, S. Mestiri, G. Tlili, M. Mokni, A. Mosbah
Primary tumors of the seminal vesicle are extremely rare lesions, and adenocarcinoma is the most common histology found. We report the case of a 54-year-old patient who has consulted with a bladder outlet obstruction and two episodes of initial hematuria for 3 months. Digital rectal examination revealed a hard, palpable mass in the prostate wall. The prostate-specific antigen (PSA), the serum carcinoembryonic antigen and the cancer antigen 125 (CA125) were normal. On imaging, a prostatic abscess, granulomatous prostatitis or a prostatic cancer were highly suspected at first. But the patient was afebrile and PSA was normal. Transrectal ultrasound-guided biopsies of the mass were performed. The pathological examination showed a poorly differentiated adenocarcinoma. Immunohistological analysis was strongly suggestive of adenocarcinoma of the seminal vesicle. At surgical exploration, it was impossible to make cystoprostato-vesiculectomy because the tumor was locally advanced. We decided to make hormonal blockage by antiandrogen and five sessions of radiotherapy. Unfortunately, the patient died 5 months later. Adenocarcinoma of the seminal vesicles is a rare diagnosis. We must think in this diagnosis when relatively young patient is presented with dysuria, hematuria or hemospermia and when we found hard palpable mass on digital rectal examination associated to normal PSA level. On histology, specific immunohistochemical markers would be helpful in this differential diagnosis. Actually, surgical excision is the mainstay of the treatment. Radiotherapy and androgen deprivation therapy can be an alternative in locally advanced and metastatic carcinomas. World J Nephrol Urol. 2015;4(3):242-246 doi: http://dx.doi.org/10.14740/wjnu204e
{"title":"Primary Seminal Vesicle Adenocarcinoma Presenting as Acute Urinary Retention and Hematuria: A Case Report","authors":"K. Bouassida, W. Hmida, S. Mestiri, G. Tlili, M. Mokni, A. Mosbah","doi":"10.14740/WJNU204E","DOIUrl":"https://doi.org/10.14740/WJNU204E","url":null,"abstract":"Primary tumors of the seminal vesicle are extremely rare lesions, and adenocarcinoma is the most common histology found. We report the case of a 54-year-old patient who has consulted with a bladder outlet obstruction and two episodes of initial hematuria for 3 months. Digital rectal examination revealed a hard, palpable mass in the prostate wall. The prostate-specific antigen (PSA), the serum carcinoembryonic antigen and the cancer antigen 125 (CA125) were normal. On imaging, a prostatic abscess, granulomatous prostatitis or a prostatic cancer were highly suspected at first. But the patient was afebrile and PSA was normal. Transrectal ultrasound-guided biopsies of the mass were performed. The pathological examination showed a poorly differentiated adenocarcinoma. Immunohistological analysis was strongly suggestive of adenocarcinoma of the seminal vesicle. At surgical exploration, it was impossible to make cystoprostato-vesiculectomy because the tumor was locally advanced. We decided to make hormonal blockage by antiandrogen and five sessions of radiotherapy. Unfortunately, the patient died 5 months later. Adenocarcinoma of the seminal vesicles is a rare diagnosis. We must think in this diagnosis when relatively young patient is presented with dysuria, hematuria or hemospermia and when we found hard palpable mass on digital rectal examination associated to normal PSA level. On histology, specific immunohistochemical markers would be helpful in this differential diagnosis. Actually, surgical excision is the mainstay of the treatment. Radiotherapy and androgen deprivation therapy can be an alternative in locally advanced and metastatic carcinomas. World J Nephrol Urol. 2015;4(3):242-246 doi: http://dx.doi.org/10.14740/wjnu204e","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"242-246"},"PeriodicalIF":0.0,"publicationDate":"2015-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Disseminated intravascular coagulation (DIC) is an acquired syndrome that develops as a result of an underlying disorder, and is characterized by a consumptive coagulopathy that induces hemorrhage and microclot formation. Most frequently, it develops as a result of sepsis and trauma, but can infrequently be induced secondary to malignancy. Herein, we outline the management of a patient with an occult diagnosis of metastatic prostate cancer who presented with DIC. World J Nephrol Urol. 2015;4(3):240-241 doi: http://dx.doi.org/10.14740/wjnu223w
{"title":"Disseminated Intravascular Coagulation as a Result of Metastatic Prostate Cancer: A Case Report","authors":"A. Looney, Niamh Harnedy, M. O'Brien","doi":"10.14740/WJNU223W","DOIUrl":"https://doi.org/10.14740/WJNU223W","url":null,"abstract":"Disseminated intravascular coagulation (DIC) is an acquired syndrome that develops as a result of an underlying disorder, and is characterized by a consumptive coagulopathy that induces hemorrhage and microclot formation. Most frequently, it develops as a result of sepsis and trauma, but can infrequently be induced secondary to malignancy. Herein, we outline the management of a patient with an occult diagnosis of metastatic prostate cancer who presented with DIC. World J Nephrol Urol. 2015;4(3):240-241 doi: http://dx.doi.org/10.14740/wjnu223w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"240-241"},"PeriodicalIF":0.0,"publicationDate":"2015-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. O. Suh, J. Song, Hee Gyeong Kim, K. Park, Y. Cho, Hyungjong Kim
Background: Leptin is known as an adipose-derived peptide hormone that has various physiological effects on energy intake and expenditure, glucose homeostasis, the reproductive and circulatory systems, and weight balance. The first goal of this study was to reveal the difference in the blood leptin depending on obesity. The second goal was to uncover the relationship between leptin and inflammatory markers such as homocysteine and C-reactive protein (CRP). The third goal was to demonstrate the relationship of leptin with a non-diabetic hemodialysis (HD) patient’s nutritional status and insulin resistance. Methods: This cross-sectional study included 44 patients with end-stage renal failure on HD for more than 6 months who had not been diagnosed with diabetes mellitus. Insulin resistance was assessed using the homeostasis model assessment method of insulin resistance (HOMA-IR). The serum leptin levels were measured using radioimmunometric assay. The serum pre-albumin, albumin insulin, glucose, and CRP were checked by various methods. Results: Serum leptin has a correlation with factors related to the nutritional status, insulin resistance and inflammation. The bivariate analysis showed that the body mass index (BMI), nPCR, total cholesterol, total protein, albumin, pre-albumin and HOMA-IR were positively correlated with the serum leptin levels, and high-sensitivity C-reactive protein (hsCRP) and tCO 2 were negatively correlated with the serum leptin concentrations. The linear regression analysis also showed that the BMI, nPCR, total protein, pre-albumin and HOMA-IR were positively correlated, and tCO 2 was negatively correlated with the serum leptin level. Conclusions: This study showed that obese non-diabetic HD patients have higher serum leptin. It also revealed that patients with a high serum leptin level have increased insulin resistance. Therefore, it could be expected that patients who have an elevated serum lepin level have an elevated cardiovascular risk. In addition, further study is needed for the relationship between inflammation markers and serum leptin level. World J Nephrol Urol. 2015;4(2):201-206 doi: http://dx.doi.org/10.14740/wjnu217w
{"title":"Relationships of Serum Leptin With Nutrition Status and Insulin Resistance in Non-Diabetic Hemodialysis Patients","authors":"S. O. Suh, J. Song, Hee Gyeong Kim, K. Park, Y. Cho, Hyungjong Kim","doi":"10.14740/WJNU217W","DOIUrl":"https://doi.org/10.14740/WJNU217W","url":null,"abstract":"Background: Leptin is known as an adipose-derived peptide hormone that has various physiological effects on energy intake and expenditure, glucose homeostasis, the reproductive and circulatory systems, and weight balance. The first goal of this study was to reveal the difference in the blood leptin depending on obesity. The second goal was to uncover the relationship between leptin and inflammatory markers such as homocysteine and C-reactive protein (CRP). The third goal was to demonstrate the relationship of leptin with a non-diabetic hemodialysis (HD) patient’s nutritional status and insulin resistance. Methods: This cross-sectional study included 44 patients with end-stage renal failure on HD for more than 6 months who had not been diagnosed with diabetes mellitus. Insulin resistance was assessed using the homeostasis model assessment method of insulin resistance (HOMA-IR). The serum leptin levels were measured using radioimmunometric assay. The serum pre-albumin, albumin insulin, glucose, and CRP were checked by various methods. Results: Serum leptin has a correlation with factors related to the nutritional status, insulin resistance and inflammation. The bivariate analysis showed that the body mass index (BMI), nPCR, total cholesterol, total protein, albumin, pre-albumin and HOMA-IR were positively correlated with the serum leptin levels, and high-sensitivity C-reactive protein (hsCRP) and tCO 2 were negatively correlated with the serum leptin concentrations. The linear regression analysis also showed that the BMI, nPCR, total protein, pre-albumin and HOMA-IR were positively correlated, and tCO 2 was negatively correlated with the serum leptin level. Conclusions: This study showed that obese non-diabetic HD patients have higher serum leptin. It also revealed that patients with a high serum leptin level have increased insulin resistance. Therefore, it could be expected that patients who have an elevated serum lepin level have an elevated cardiovascular risk. In addition, further study is needed for the relationship between inflammation markers and serum leptin level. World J Nephrol Urol. 2015;4(2):201-206 doi: http://dx.doi.org/10.14740/wjnu217w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"201-206"},"PeriodicalIF":0.0,"publicationDate":"2015-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Montazerifar, M. Karajibani, M. Hashemi, F. Ardali, Parisa Akrami, A. Dashipour
Background: There is evidence that hemodialysis (HD) leads to oxidative stress. However, reports about balance between oxidant and antioxidant are contradictory. Thus, the aim of this study was to evaluate the prooxidant-antioxidant balance (PAB) in HD patients and its correlation with clinical parameters and food intakes. Methods: This case-control study was performed in 35 HD patients and 35 healthy controls. Food intake was assessed by a 24-hour dietary recall questionnaire for at least 2 days. Routine biochemical parameters and C-reactive protein (CRP) were measured using the standard techniques. PAB was simultaneously measured by a new modified PAB assay using 3,3?,5,5?-tetramethylbenzidine benzidine (TMB). Results: PAB in HD patients was significantly higher compared with control group (88.2 ± 33 vs. 68.4 ± 23.3, P < 0.01). A significant positive correlation was established between PAB values and serum levels of creatinine (r = 0.38, P < 0.001), blood urea nitrogen (BUN) (r = 0.42, P < 0.0001) and CRP (r = 0.34, P < 0.001). An inverse correlation was found between PAB values and intake of vitamins A (r = -0.28, P < 0.05) and C (r = -0.31, P < 0.01) in HD patients. Conclusion: Since little data exits on the PAB assay in the HD patients, the high values of PAB indicated in our study need to be confirmed by further studies. World J Nephrol Urol. 2015;4(2):207-212 doi: http://dx.doi.org/10.14740/wjnu194w
背景:有证据表明血液透析(HD)会导致氧化应激。然而，关于氧化剂和抗氧化剂之间平衡的报道是相互矛盾的。因此，本研究的目的是评估HD患者的促氧化-抗氧化平衡(PAB)及其与临床参数和食物摄入量的关系。方法:选取35例HD患者和35例健康对照者进行病例-对照研究。通过24小时饮食回忆问卷评估至少2天的食物摄入量。采用标准技术测定常规生化指标及c反应蛋白(CRP)。采用一种新的改进的PAB检测方法，使用3,3?，5,5?-四甲基联苯胺(TMB)。结果:HD患者PAB明显高于对照组(88.2±33比68.4±23.3,P < 0.01)。PAB值与血清肌酐(r = 0.38, P < 0.001)、尿素氮(r = 0.42, P < 0.0001)、CRP (r = 0.34, P < 0.001)呈显著正相关。HD患者PAB值与维生素A (r = -0.28, P < 0.05)、维生素C (r = -0.31, P < 0.01)的摄入量呈负相关。结论:由于HD患者PAB检测数据较少，本研究显示的PAB高值有待进一步研究证实。世界植物学报，2015;4(2):207-212 doi: http://dx.doi.org/10.14740/wjnu194w
{"title":"Determination of Prooxidant and Antioxidant Balance, Clinical Parameters and Nutrient Intakes in Hemodialysis Patients","authors":"F. Montazerifar, M. Karajibani, M. Hashemi, F. Ardali, Parisa Akrami, A. Dashipour","doi":"10.14740/WJNU194W","DOIUrl":"https://doi.org/10.14740/WJNU194W","url":null,"abstract":"Background: There is evidence that hemodialysis (HD) leads to oxidative stress. However, reports about balance between oxidant and antioxidant are contradictory. Thus, the aim of this study was to evaluate the prooxidant-antioxidant balance (PAB) in HD patients and its correlation with clinical parameters and food intakes. Methods: This case-control study was performed in 35 HD patients and 35 healthy controls. Food intake was assessed by a 24-hour dietary recall questionnaire for at least 2 days. Routine biochemical parameters and C-reactive protein (CRP) were measured using the standard techniques. PAB was simultaneously measured by a new modified PAB assay using 3,3?,5,5?-tetramethylbenzidine benzidine (TMB). Results: PAB in HD patients was significantly higher compared with control group (88.2 ± 33 vs. 68.4 ± 23.3, P < 0.01). A significant positive correlation was established between PAB values and serum levels of creatinine (r = 0.38, P < 0.001), blood urea nitrogen (BUN) (r = 0.42, P < 0.0001) and CRP (r = 0.34, P < 0.001). An inverse correlation was found between PAB values and intake of vitamins A (r = -0.28, P < 0.05) and C (r = -0.31, P < 0.01) in HD patients. Conclusion: Since little data exits on the PAB assay in the HD patients, the high values of PAB indicated in our study need to be confirmed by further studies. World J Nephrol Urol. 2015;4(2):207-212 doi: http://dx.doi.org/10.14740/wjnu194w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"207-212"},"PeriodicalIF":0.0,"publicationDate":"2015-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report the clinical presentation, imaging findings, intra-operative appearance and pathological results of an exophytic renal cell carcinoma (RCC) of the upper pole of kidney which was presumed to arise from the ipsilateral adrenal gland. The origin of the mass was virtually indistinguishable on imaging and intraoperatively. It was determined only at histopathology examination of the resected tumor specimen. The authors are presenting few observations based on retrospective analysis of imaging and intra-operative finding of this diagnostic dilemna. This case highlights the prudent use of imaging and management approach in this group of tumors, so that adequate treatment strategies can be made preoperatively. World J Nephrol Urol. 2015;4(2):222-225 doi: http://dx.doi.org/10.14740/wjnu220w
{"title":"Beyond the Boundaries: Enigma of Distinguishing Exophytic Upper Pole Renal Cell Carcinoma From an Adrenal Mass","authors":"S. Laroia, V. Jain, A. Rastogi","doi":"10.14740/WJNU220W","DOIUrl":"https://doi.org/10.14740/WJNU220W","url":null,"abstract":"We report the clinical presentation, imaging findings, intra-operative appearance and pathological results of an exophytic renal cell carcinoma (RCC) of the upper pole of kidney which was presumed to arise from the ipsilateral adrenal gland. The origin of the mass was virtually indistinguishable on imaging and intraoperatively. It was determined only at histopathology examination of the resected tumor specimen. The authors are presenting few observations based on retrospective analysis of imaging and intra-operative finding of this diagnostic dilemna. This case highlights the prudent use of imaging and management approach in this group of tumors, so that adequate treatment strategies can be made preoperatively. World J Nephrol Urol. 2015;4(2):222-225 doi: http://dx.doi.org/10.14740/wjnu220w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"222-225"},"PeriodicalIF":0.0,"publicationDate":"2015-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Abbott, Arman Cicic, A. Dimatteo, E. Fazio, J. Davalos
Upper tract urothelial carcinoma (UTUC) represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75%, with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment of the upper urinary tract urothelial cancers. However, endoscopic and laparoscopic approaches are rapidly evolving as reasonable alternatives of care depending on grade and stage of disease. A critical review of the current literature and various guidelines regarding tumor management in UTUC was undertaken, with a focus on surgical options. Topics reviewed include percutaneous and endoscopic approaches, laparoscopic nephroureterectomy (LNU), options regarding the management of the distal ureter, the role of lymphadenectomy, and the emerging role of chemotherapy in the treatment of UTUC. Both National Comprehensive Cancer Network (NCCN) and European Association of Urology (EAU) current guidelines are reviewed. Limited recommendations are provided by the American Urological Association (AUA). Scant level 1 or grade A evidence was noted in the establishment of the various guidelines. There is debate regarding how to best manage UTUC. With the current trend towards minimally invasive, localized, and precise surgical treatments for all solid malignancies, we must evaluate this movement as it applies to UTUC. Nephron sparing surgery is the preferred option, when feasible, in the management of other renal malignancies. This, too, must be considered when managing UTUC. Higher quality research is needed to better establish evidence-based guidelines. However, this is a challenging prospect given the low incidence of UTUC and the difficulties encountered in creating appropriate protocols. World J Nephrol Urol. 2015;4(2):189-200 doi: http://dx.doi.org/10.14740/wjnu200w
{"title":"Contemporary Management and Trends in the Treatment of Upper Tract Urothelial Carcinoma","authors":"J. Abbott, Arman Cicic, A. Dimatteo, E. Fazio, J. Davalos","doi":"10.14740/WJNU200W","DOIUrl":"https://doi.org/10.14740/WJNU200W","url":null,"abstract":"Upper tract urothelial carcinoma (UTUC) represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75%, with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment of the upper urinary tract urothelial cancers. However, endoscopic and laparoscopic approaches are rapidly evolving as reasonable alternatives of care depending on grade and stage of disease. A critical review of the current literature and various guidelines regarding tumor management in UTUC was undertaken, with a focus on surgical options. Topics reviewed include percutaneous and endoscopic approaches, laparoscopic nephroureterectomy (LNU), options regarding the management of the distal ureter, the role of lymphadenectomy, and the emerging role of chemotherapy in the treatment of UTUC. Both National Comprehensive Cancer Network (NCCN) and European Association of Urology (EAU) current guidelines are reviewed. Limited recommendations are provided by the American Urological Association (AUA). Scant level 1 or grade A evidence was noted in the establishment of the various guidelines. There is debate regarding how to best manage UTUC. With the current trend towards minimally invasive, localized, and precise surgical treatments for all solid malignancies, we must evaluate this movement as it applies to UTUC. Nephron sparing surgery is the preferred option, when feasible, in the management of other renal malignancies. This, too, must be considered when managing UTUC. Higher quality research is needed to better establish evidence-based guidelines. However, this is a challenging prospect given the low incidence of UTUC and the difficulties encountered in creating appropriate protocols. World J Nephrol Urol. 2015;4(2):189-200 doi: http://dx.doi.org/10.14740/wjnu200w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"189-200"},"PeriodicalIF":0.0,"publicationDate":"2015-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67237714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tasuku Hiroshige, Yoshiro Eguchi, Kazuhisa Ejima, O. Yoshizumi, T. Igawa
Spontaneous rupture of renal cell carcinoma (RCC) in a horseshoe kidney has not been described previously. We report a case of this condition in a 52-year-old man with a chief complaint of back pain. Spontaneous rupture of renal tumor in a horseshoe kidney was diagnosed by enhanced computed tomography, and treated with transarterial embolization (TAE). Radical heminephrectomy was performed after TAE. This case indicates that enhanced computed tomography and renal angiography are desirable prior to surgery for evaluation of the anatomical variations of a horseshoe kidney, and that preoperative TAE may be beneficial for achieving reliable vascular control. World J Nephrol Urol. 2015;4(2):218-221 doi: http://dx.doi.org/10.14740/wjnu215w
{"title":"Spontaneous Rupture of Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report","authors":"Tasuku Hiroshige, Yoshiro Eguchi, Kazuhisa Ejima, O. Yoshizumi, T. Igawa","doi":"10.14740/WJNU215W","DOIUrl":"https://doi.org/10.14740/WJNU215W","url":null,"abstract":"Spontaneous rupture of renal cell carcinoma (RCC) in a horseshoe kidney has not been described previously. We report a case of this condition in a 52-year-old man with a chief complaint of back pain. Spontaneous rupture of renal tumor in a horseshoe kidney was diagnosed by enhanced computed tomography, and treated with transarterial embolization (TAE). Radical heminephrectomy was performed after TAE. This case indicates that enhanced computed tomography and renal angiography are desirable prior to surgery for evaluation of the anatomical variations of a horseshoe kidney, and that preoperative TAE may be beneficial for achieving reliable vascular control. World J Nephrol Urol. 2015;4(2):218-221 doi: http://dx.doi.org/10.14740/wjnu215w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"218-221"},"PeriodicalIF":0.0,"publicationDate":"2015-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Young Suk Kwon, Amirali Salmasi, Christopher Sejong Han, Jane Date C Hon, Eric A Singer
Leiomyosarcoma of the kidney is a rare entity, and our understanding of this type of renal sarcomas is limited. A 46-year-old Caucasian male presented with a chief complaint of right flank pain for one month. He came to our facility for an additional opinion regarding the management of his renal mass. Computed tomography (CT) of the abdomen showed an enhancing, heterogeneous right renal mass, consistent with the features of renal cell carcinoma (RCC). Robotic-assisted total nephrectomy of the right kidney revealed a tan mass with central necrosis that involved the upper pole of the kidney. Based on gross specimen observation and immunochemical analysis, the patient was diagnosed with high-grade leiomyosarcoma. While the prognosis is poor, radical nephrectomy remains the treatment of choice. The potential benefits of adjuvant therapy should be discussed with selected patients.
{"title":"Renal Leiomyosarcoma: Case Report and Review of the Literature.","authors":"Young Suk Kwon, Amirali Salmasi, Christopher Sejong Han, Jane Date C Hon, Eric A Singer","doi":"10.14740/wjnu214w","DOIUrl":"https://doi.org/10.14740/wjnu214w","url":null,"abstract":"<p><p>Leiomyosarcoma of the kidney is a rare entity, and our understanding of this type of renal sarcomas is limited. A 46-year-old Caucasian male presented with a chief complaint of right flank pain for one month. He came to our facility for an additional opinion regarding the management of his renal mass. Computed tomography (CT) of the abdomen showed an enhancing, heterogeneous right renal mass, consistent with the features of renal cell carcinoma (RCC). Robotic-assisted total nephrectomy of the right kidney revealed a tan mass with central necrosis that involved the upper pole of the kidney. Based on gross specimen observation and immunochemical analysis, the patient was diagnosed with high-grade leiomyosarcoma. While the prognosis is poor, radical nephrectomy remains the treatment of choice. The potential benefits of adjuvant therapy should be discussed with selected patients.</p>","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 2","pages":"213-217"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831729/pdf/nihms740908.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34409825","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}
Rafay Khan, W. Jehangir, Shilpi Singh, Shuvendu Sen, A. Yousif
Prostatic calculi can be common but are usually found incidentaly. In most cases, they are asymptomatic; however, they have been associated with various symptoms, some of which are well documented. We report a case of an 85-year-old male who initially presented with dyspnea but also a complaint of urinary retention, and was found to have prostalithiasis after transurethral resection of the prostate (TURP). The association of prostatic calculi, benign prostatic hypertrophy, and urinary tract infection has been reported but not well documented in the literature. Although they are discovered in patients with benign prostatic hypertrophy (BPH) or those being evaluated with prostate cancer, no well etiology or other risk factors have been researched. World J Nephrol Urol. 2015;4(1):186-188 doi: http://dx.doi.org/10.14740/wjnu208w
{"title":"Prostatic Calculi: A Harbor for Infections, a Case Report and Review of Literature","authors":"Rafay Khan, W. Jehangir, Shilpi Singh, Shuvendu Sen, A. Yousif","doi":"10.14740/WJNU208W","DOIUrl":"https://doi.org/10.14740/WJNU208W","url":null,"abstract":"Prostatic calculi can be common but are usually found incidentaly. In most cases, they are asymptomatic; however, they have been associated with various symptoms, some of which are well documented. We report a case of an 85-year-old male who initially presented with dyspnea but also a complaint of urinary retention, and was found to have prostalithiasis after transurethral resection of the prostate (TURP). The association of prostatic calculi, benign prostatic hypertrophy, and urinary tract infection has been reported but not well documented in the literature. Although they are discovered in patients with benign prostatic hypertrophy (BPH) or those being evaluated with prostate cancer, no well etiology or other risk factors have been researched. World J Nephrol Urol. 2015;4(1):186-188 doi: http://dx.doi.org/10.14740/wjnu208w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"4 1","pages":"186-188"},"PeriodicalIF":0.0,"publicationDate":"2015-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67238180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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