Volume 9, Number 2Reviews in UrologyAngiomyolipoma of the Left Ureterovesical JunctionCase ReviewElias S HyamsJohn ProvetAngiomyolipoma (AML) is a benign tumor that typically consists of 3 tissue elements: thick-walled blood vessels, smooth muscle cells, and adipocytes. The most common location for AML is renal; however, extrarenal AML has been described. Reports of extrarenal AML within the genitourinary tract are rare. We report a case of AML at the left ureterovesical junction and the evaluation and management decisions regarding this lesion. [Rev Urol. 2007;9(2):84-88]AngiomyolipomaImmunohistochemical stainingUreterovesical junction
Volume 11, Number 1Case ReviewRenal Involvement by Chronic Myelomonocytic Leukemia Requiring NephroureterectomySamir S TanejaJonathan MelamedOjas D ShahElias S HyamsRaavi GuptaChronic monomyelocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Renal impairment from CMML is infrequent and can result from both direct (ie, infiltrative) and indirect (eg, vasculitis, infarction) mechanisms. This case report describes a patient with refractory gross hematuria requiring nephroureterectomy with diffuse involvement of the upper tract by CMML and accompanying extramedullary hematopoiesis. Underscored are the need to maintain a broad differential diagnosis for upper tract lesions in the setting of gross hematuria, and the potential need for drastic measures to control upper tract bleeding if conservative measures fail.[Rev Urol. 2009;11(1):33-37]Gross hematuriaSecondary malignancy of kidneyLeukemia
Volume 14, Number 1Review ArticlesActive Surveillance for Small Renal MassesManagement UpdatePhillip M PierorazioJeffrey K MullinsMohamad E AllafElias S HyamsSmall renal masses (SRMs; # 4 cm in dimension) have rapidly risen in incidence in recent decades and pose an increasingly common management dilemma in urology. SRMs are biologically heterogeneous and a wide variety of treatments exist with favorable oncologic outcomes. Active surveillance (AS) has emerged as a viable option for those not desiring surgery or those who are suboptimal candidates for surgery, with < 2% of patients progressing to metastatic disease in retrospective and prospective studies. This article reviews the current data regarding AS for SRM, operational considerations for an AS program, and criteria for safely selecting patients for this treatment strategy. [ Rev Urol. 2012;14(1/2):13-19 doi: 10.3909/riu0545] © 2012 MedReviews®, LLCRenal cell carcinomaSmall renal massActive surveillance