Volume 11, Number 1Case ReviewRenal Involvement by Chronic Myelomonocytic Leukemia Requiring NephroureterectomyRaavi GuptaSamir S TanejaJonathan MelamedOjas D ShahElias S HyamsChronic 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 12, Number 4Case ReviewChronic Spontaneous Nephrocutaneous Fistula Associated With Renal Replacement LipomatosisMohamed Fadl TaziAbdelhak KhalloukMoulay Hassan FarihChronic spontaneous nephrocutaneous fistula is a rare renal disease. Renal replacement lipomatosis (RRL) is the result of the atrophy and destruction of renal parenchyma with massive increases in the amount of fat in the sinus and perirenal space. The 2 conditions can be associated because they may have the same etiology. Indeed, urolithiasis is the most common cause of these diseases. We report a case of chronic nephrocutaneous fistula associated with RRL due to both urolithiasis and renal tuberculosis.[Rev Urol. 2010;12(4):e190-e192 doi: 10.3909/riu0458]© 2010 MedReviews®, LLCNephrocutaneous fistulaRenal replacement lipomatosisRenal tuberculosis
Volume 12, Number 4Case ReviewSpontaneous Rupture of a Renal Artery Aneurysm Presenting as Gross HematuriaShawn EL WasonThomas SchwaabRenal artery aneurysms (RAAs) are localized dilations of the renal artery and/or its branches. They are being found with increasing frequency as a result of unrelated abdominal imaging or on workup for hypertension. They are rarely symptomatic; however, they can be a cause of life-threatening hematuria. Discussed is the case of a previously healthy 46-year-old man presenting with flank pain and gross hematuria. It is imperative for the practicing urologist to be aware of the appropriate evaluation and management of RAAs.[Rev Urol. 2010;12(4):e193-e196 doi: 10.3909/riu0489]© 2010 MedReviews®, LLCRenal artery aneurysmAbdominal aortographyGross hematuria
Volume 12, Number 4Case ReviewNeuroendocrine Tumor of the BladderShailen S SehgalZhanyong BingThomas J GuzzoAlan J WeinSmall cell carcinoma (SCC) of the bladder is a rare and aggressive tumor associated with a poor prognosis. It often presents at a later stage than urothelial carcinoma of the bladder, and comprises less than 1% of bladder malignancies. A number of treatment algorithms have been used to treat bladder SCC, including cystectomy, partial cystectomy, radiotherapy, chemoradiotherapy, chemotherapy alone, and neoadjuvant/adjuvant chemotherapy. Presented is a case of SCC of the bladder, and the epidemiology, prognosis, and current treatment algorithms for patients with bladder SCC are reviewed.[Rev Urol. 2010;12(4):e197-e201 doi: 10.3909/riu0492]©2010 MedReviews®, LLCBladder cancerNeuroendocrine tumorsSmall cell carcinoma
Volume 12, Number 3Case ReviewRisk Factor Analysis and Management of Ureteral Double-J Stent ComplicationsCase ReviewAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiMoulay Hassan FarihDouble-J ureteral stents are commonly used to manage urinary obstructions. Pain, bladder irritative symptoms, and fever are usually signs of early complications related to double-J stents; late complications are more troublesome. We review 4 cases that highlight a variety of late complications with double- J stents (encrustation, migration, and fragmentation). Following a review of the literature, guidelines are established for monitoring potential risk factors as well as management strategies for prevention of possible complications when using double-J stents. [Rev Urol. 2010;12(2/3):e147-e151 doi:10.3909/riu0447]Double-J stentExtracorporeal shock wave lithotripsyStent migrationFragmentationEncrustation
Volume 12, Number 1Case ReviewTransitional Cell Carcinoma Within a Calyceal Diverticulum Associated With Stone DiseaseCase ReviewCorey PassmanJack M ZuckermanDean G AssimosWe report a case of transitional cell carcinoma (TCC) discovered within a calyceal diverticulum at the time of percutaneous nephrolithotomy. The stones and tumor were endoscopically removed and the diverticular cavity fulgurated. Pathologic analysis demonstrated low-grade TCC. A subsequent laparoscopic radical nephroureterectomy was performed and high-grade TCC invading the parenchyma was found. This case demonstrates the potential for TCC to develop in stone-containing calyceal diverticula and also the potential for coexistence of different grades of TCC within the involved renal unit.[Rev Urol. 2010;12(1):52-55 doi: 10.3909/riu0446]Percutaneous nephrolithotomyUrinary tract infectionTransitional cell carcinomaUrolithiasisCalyceal diverticulumStone
Volume 12, Number 1Case ReviewDiagnostic and Therapeutic Options for the Management of Ischemic and Nonischemic PriapismCase ReviewJeffrey BassettJacob RajferPriapism is defined as persistent penile erection continuing beyond, or unrelated to, sexual stimulation. Proper diagnosis encompasses at least 2 very different pathophysiologic processes. Ischemic priapism (“low flow”) is a disorder of venous outflow and/or stasis. Nonischemic priapism (“high flow”) is a disorder of arterial flow. We present 2 cases that review each condition. The first case highlights a 32-year-old man with a medical history of sickle cell disease who presented to the emergency department complaining of a persistent, painful erection that had continued for 18 hours. The second case describes a 24-year-old man with no significant medical history who sustained trauma to his pelvis while skateboarding. Although the initial evaluation of both types of priapism is similar, pathophysiology and resulting interventions differ for each, underscoring the importance of proper diagnosis.[Rev Urol. 2010;12(1):56-63 doi: 10.3909/riu0457]Erectile dysfunctionIschemic priapismNonischemic priapismIntracorporeal pressureCavernosal hypoxiaPhosphodiesterase type 5Distal shunts
Volume 13, Number 4Case ReviewBenign Paratesticular Fibrous Pseudotumor With Malignant Clinical FeaturesElmehdi TaziMohamed Fadl TaziAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiMoulay Hassan FarihParatesticular tumors are rare intrascrotal masses that grow mainly in structures containing connective tissue around the testis, epididymis, or spermatic cord. We report here on a case of a 55-year-old man with a mass in the hemiscrotum that was found to be a paratesticular fibrous pseudotumor in the orchiectomy specimen pathologic examination. From this case report and literature review, a diagnostic and therapeutic strategy is demonstrated for the management of this uncommon lesion. [Rev Urol. 2011;13(4):e203-e205 doi: 10.3909/riu0509] © 2011 MedReviews®, LLCParatesticular fibrous pseudotumorEpididymisSpermatic cord
Volume 13, Number 3Case ReviewAn Unusual Presentation of Primary Male Genital TuberculosisImane KamaouiMohamed AmineBrahim EddafaliA Ibn SellamZakaria DahamiSaid Mohamed MoudouniIsmail SarfUrogenital tuberculosis is a rare disease; however, it is the second most common location for tuberculosis after the lung. Currently, incidence of urogenital tuberculosis is increasing due to factors such as a higher prevalence of immunosuppression (especially that caused by human immunodeficiency virus infection) and drug abuse. Herein a new case of male genital primary tuberculosis is reported presenting as a scrotal tumor; the originality of this observation lies in its unusual pseudotumor form. [Rev Urol. 2011;13(3):176-178 doi: 10.3909/riu0525] © 2011 MedReviews®, LLCUrogenital tuberculosisEpididymal tuberculosisMale genital tuberculosis
Volume 13, Number 3Case ReviewConcomitant Sertoli and Leydig Cell Tumor of the Testis: A Case ReportElmehdi TaziMohamed Fadl TaziHinde ElfatemiMohcine BendahouAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiMoulay Hassan FarihA rare intratubular gonadal stromal tumor was present in the testis of a 45-year-old man who was admitted to our hospital with the chief complaint of gradual enlargement of the left testis. Tumoral markers were negative and no extension was observed. The tumor comprised an intratubular mixture of two types of tumor cells with intercellular junctions: the predominant tumor cells were consistent with a Sertoli cell origin and cells comprising the minor population consistent with a Leydig cell origin. The patient is disease free after 6-month follow-up. The case is considered to be a testicular mixed tubular Sertoli-Leydig cell tumor. It highlights a rare type of primary tumor of the testis that features a good prognosis. [Rev Urol. 2011;13(3):173-175 doi:10.3909/riu0495] © 2011 MedReviews®, LLC