ABSTRACT

Colorectal cancer continues to remain one of the most common and lethal cancers, with well-established locations for metastases to the liver, lung, and peritoneum. Improved chemotherapy regimens have resulted in patients with advanced disease experiencing prolonged survival resulting in these patients experiencing new atypical locations for metastases. We report the first case of primary colorectal carcinoma metachronously metastasizing to the kidneys bilaterally in a patient who presented with stage II colorectal cancer 8 years prior to kidney metastasis. The appropriate management of patients with renal lesions in the setting of advanced systemic disease may be challenging. Treatment should be based on preventing dialysis dependence during palliative therapy, performing potentially curative surgery in the setting of decreased systemic disease after neoadjuvant chemotherapy, and providing options for palliative intervention for the symptomatic patient.

Zachary Klaassen, Radhika Prabhakar, Rabii Madi, W. Bruce Shingleton, Martha K. Terris

Submitted November 23, 2012 - Accepted for Publication January 6, 2013

KEYWORDS: Colon cancer, renal metastasis, nephron-sparing surgery

CORRESPONDENCE: Zachary Klaassen, MD, Department of Surgery, Section of Urology, Georgia Health Sciences University, 1120 15th Street, Augusta, GA 30912 (zklaassen@georgiahealth.edu)

CITATION: UroToday Int J. 2013 February;6(1):art 11. http://dx.doi.org/10.3834/uij.1944-5784.2013.02.11

ABSTRACT

Introduction: Renal cell carcinoma (RCC) is the most frequent renal tumor in adults, and chromophobe represents the third most frequent subtype, following clear cell and papillary. However, they are extraordinarily rare in childhood, accounting for less than 2% of all renal tumors, and chromophobe subtype in particular is almost anecdotal.

Methods and results: We report the case of a 14-year-old child presenting with hematuria. Imaging tests revealed a large renal mass. After a percutaneous biopsy to exclude other entities, the patient underwent radical nephrectomy with lymphadenectomy and was diagnosed with an eosinophilic chromophobe RCC. At the 6-year follow-up, there was no evidence of recurrence.

Conclusions: RCC in childhood may represent a different entity from adult RCC, with distinct morphologic characteristics and unique genetic abnormalities. The role of the pathologist is crucial, as the diagnosis and classification of RCC in children is still a matter of discussion. New protocols are being tested that will provide more accurate knowledge and therefore may change the clinical management of pediatric RCC.

Ignacio Puche-Sanz, Fernando Vázquez-Alonso, Carmen Carreras-Blesa, José Flores-Martín, José Manuel Cózar-Olmo

Submitted November 23, 2012 - Accepted for Publication January 6, 2013

KEYWORDS: Renal cell carcinoma, chromophobe renal cell carcinoma, pediatric oncology

CORRESPONDENCE: Ignacio Puche-Sanz, MD, Urology Department, Hospital Universitario Virgen de las Nieves, Av Fuerzas

Armadas 2, 18014, Granada, Spain (nacho.puchesanz@gmail.com)

CITATION: UroToday Int J. 2013 February;6(1):art 12. http://dx.doi.org/10.3834/uij.1944-5784.2013.02.12

ABSTRACT

Objectives: Tuberculosis of the prostate is a very rare disease. Most urologists are not familiar with it. Here, we wish to present our experience with 4 cases of this disease and a review of literature.

Methods: This was a retrospective study in a tertiary care center from January 2001 to December 2009.

Results: All the patients were in their fourth or fifth decade of life. Irritative voiding (100%) followed by hemospermia (50%) were the common presenting symptoms. A history of pulmonary tuberculosis was absent in all cases. Three out of 4 cases (75%) had a suspicious prostate on the digital rectal examination. PSA assays were slightly elevated with a mean of 8.26 ng/ml. Urine analysis revealed sterile pyuria in all patients, and the urine culture was negative. The urine and seminal fluid positivity rate was 33.33% for the AFB test, 66.6% for the M. tuberculosis culture test, and 100% for PCR. The transrectal ultrasonogram showed hypoechoic areas with irregular outlines in 3 cases (75%) and calcification in 2 cases (50%). All patients were scheduled to receive 6 months of chemotherapy with isoniazid, rifampicin, and Ethambutol or pyrazinamide.

Conclusions: A high index of suspicion with a wide range of investigations may be required to achieve a complete diagnosis of prostatic tuberculosis. Although short-term multi-drug chemotherapy is an ideal mainstay of treatment, surgery has a definitive role in advanced disease.

Jitendra Singh, Pramod Sharma, Mukesh Kumar Vijay, Anup Kumar Kundu, Dilip Kumar Pal

Submitted September 17, 2012 - Accepted for Publication December 16, 2012

KEYWORDS: Chemothearpy, genitourinary, prostate, tuberculosis

CORRESPONDENCE: Ignacio Puche-Sanz, MD, Urology Departament, Hospital Universitario Virgen de las Nieves, Av Fuerzas Armadas 2, 18014, Granada, Spain (nacho.puchesanz@gmail.com)

CITATION: UroToday Int J. 2013 February;6(1):art 13. http://dx.doi.org/10.3834/uij.1944-5784.2013.02.13

ABSTRACT

Congenital bladder diverticulum is usually found in childhood, and its presentation in adults is very rare. We present a case of large congenital bladder diverticulum in a 60-year-old male, with a successful outcome after a diverticulectomy.

Nipun Kumar Awasthi, Hemant Kumar Goel, Vinod Priyadarshi, Praveen Kumar Pandey, Dilip Kumar Pal

Submitted October 16, 2012 - Accepted for Publication December 16, 2012

KEYWORDS: Congenital diverticulum, adult

CORRESPONDENCE: Dr. Nipun Kumar Awasthi, Department of Urology, Institute of Post Graduate Medical Education & Research, House no 135, Gayatri Nagar, Bareilly, Uttar Pradesh, India 243002 (drnipunawasthi@gmail.com)

CITATION: UroToday Int J. 2013 February;6(1):art 9. http://dx.doi.org/10.3834/uij.1944-5784.2013.02.09

ABSTRACT

Globally, both female hypospadias and female urethral stricture are uncommon conditions. Female genital mutilation, on the other hand, is a common practice in the West African sub-region, with up to half of the female population circumcised. We report a case of female hypospadias with stricture in an elderly West African lady who had also been subjected to female genital mutilation during childhood. Urethral dilatation with long-term clean intermittent self-catheterization may suffice in these situations, with scarred vaginas avoiding the need for invasive, cumbersome, and difficult surgical reconstruction of the urethra. 

Jibril Oyekunle Bello, Bernard Itopa Ododo, Halima Sani Bello

Submitted October 3, 2012 - Accepted for Publication December 16, 2012 

KEYWORDS: Female hypospadias; female urethral stricture; female genital mutilation

CORRESPONDENCE: Jibril Oyekunle Bello, MD, Urology Division, Department of Surgery, University of Ilorin Teaching Hospital, Nigeria (jabarng@yahoo.com)

CITATION: UroToday Int J. 2013 February;6(1):art 10. http://dx.doi.org/10.3834/uij.1944-5784.2013.02.10