Volume 16, Number 2Case ReviewSolitary Candida albicans Infection Causing Fournier Gangrene and Review of Fungal EtiologiesJoel M SumfestJared M BieniekTiffany A PerkinsPolymicrobial bacterial infections are commonly found in cases of Fournier gangrene (FG), although fungal growth may occur occasionally. Solitary fungal organisms causing FG have rarely been reported. The authors describe a case of an elderly man with a history of diabetes who presented with a necrotizing scrotal and perineal soft tissue infection. He underwent emergent surgical debridement with findings of diffuse urethral stricture disease and urinary extravasation requiring suprapubic tube placement. Candida albicans was found to be the single causative organism on culture, and the patient recovered well following antifungal treatment. Fungal infections should be considered as rare causes of necrotizing fasciitis and antifungal treatment considered in at-risk immunodeficient individuals. [Rev Urol. 2014;16(2):95-98 doi: 10.3909/riu0595] © 2014 MedReviews®, LLCFournier gangreneFournier’s Gangrene Severity IndexCandida albicans
Volume 16, Number 1Case ReviewMetastatic Urethral Melanoma: Case Report and Review of the LiteratureRafaela Saint-Clair Pimentel Mafra De OliveiraBruno Moraes VasconcelosLuiz Ronaldo AlbertiMelanoma is a cancer that originates from melanocytes, is predominant in adults with white skin, represents 4% of skin cancers, and has high possibility of forming metastasis. This review reports on the case of a young man, age 36 years, previously diagnosed with melanoma. The patient complained of obstructive urinary symptoms and, while he was undergoing a cystoscopy, it was discovered that he had a lesion corresponding with metastatic melanoma of the prostatic urethra, which occluded almost the entire urethra and resulted in blocked urinary flow. He underwent a transurethral resection of the prostate, followed by resection of the lesion. After the procedure, he had good urinary flow and is currently on follow-up. [Rev Urol. 2014;16(1):47-49 doi: 10.3909/riu0584] © 2014 MedReviews®, LLCUrethraMetastasisMelanomaUrinary obstructionUrethral melanoma
Volume 16, Number 1Case ReviewBladder Leiomyoma Presenting With LUTS and Coexisting Bladder and Uterine Leiomyomata: A Review of Two CasesAparajita MitraRaman TanwarSudhir Kumar JainMesenchymal tumors of the urinary bladder are a rare occurrence, the most common among them being leiomyoma of the bladder. These tumors commonly present with irritative urinary symptoms progressing gradually to obstructive symptoms as the size increases. We report on two patients who presented with lower urinary tract symptoms (LUTS). One of the patients also had concomitant bladder and uterine leiomyomata, which is the first such case to be reported in the literature. It is essential to differentiate leiomyoma from other common causes of LUTS. Cold cup biopsy has a significant false-negative rate and, in such cases, a wide local excision provides an optimal cure with excellent results. [Rev Urol. 2014;16(1):50-54 doi: 10.3909/riu0586] © 2014 MedReviews®, LLCLower urinary tract symptomsBladder leiomyomaUterine fibroid
Volume 17, Number 4Case ReviewEffectiveness of Antegrade Access in Bladder Tumors With Inaccessible UrethraTanveer Iqbal DarBaldev Singh WazirMohdSaleem WaniArif Hameed BhatAshiq BhatJavaid MagraySajad MaikAbdul Rouf KhawajaInaccessible urethra with no retrograde endoscopic access due to multiple/diffuse strictures or multiple urethrocutaneous fistulas with acute urinary retention due to posturethral instrumentation (transurethral resection of bladder tumor [TURBT], or TURBT with transurethral resection of the prostate [TURP]), is a rare entity. Management of such a case with a bladder tumor for TURBT/surveillance cystoscopy poses a great challenge. The authors present 12 cases of bladder tumor with inaccessible urethra, 10 cases due to multiple strictures (post-TURBT and/or TURP), and 2 cases due to urethrocutaneous fistulas (post-TURBT), who presented to our emergency department with acute urinary retention. Emergent suprapubic catheterization was used as a temporary treatment method. [Rev Urol. 2015;17(4):241-245 doi: 10.3909/riu0677] © 2016 MedReviews®, LLCBladder tumorsSuprapubic cystostomyInaccessible urethraTract seedling
Volume 17, Number 4Case ReviewAcromegaly Presenting as Erectile Dysfunction: Case Reports and Review of the LiteratureRousseau GamaJohn A InglisKate E ShipmanJerry A RajuErectile dysfunction (ED) is a common yet complex condition. The authors report two cases of acromegaly presenting with ED and hypogonadotropic hypogonadism. Surgical cure of the acromegaly was associated with either an improvement or resolution of hypogonadotropic hypogonadism-associated ED. Active acromegaly should be considered in the differential diagnosis of ED presenting with supporting clinical features, particularly hypogonadotropic hypogonadism. [Rev Urol. 2015;17(4):246-249 doi: 10.3909/riu0676] © 2016 MedReviews®, LLCErectile dysfunctionEndocrine dysfunctionEndocrinologyAcromegalyGrowth hormone
Volume 17, Number 4Case ReviewSorafenib-induced Scrotal EczemaSelahattin CaliskanSorafenib is an orally active, small-molecule multikinase inhibitor that blocks tumor cell proliferation and angiogenesis. Studies have shown that it is a highly potent, selective inhibitor of vascular endothelial growth factor receptors 2 and 3, platelet-derived growth factor-β, RAF, FLT-3, and c-Kit. This drug was recently approved for the treatment of metastatic renal cell carcinoma and hepatocellular carcinoma. We report a case of a patient treated with sorafenib for metastatic renal cell carcinoma who developed scrotal eczema. [Rev Urol. 2015;17(4):250-251 doi: 10.3909/riu0648] © 2016 MedReviews®, LLCSorafenibScrotal eczemaHand-foot skin reaction
Volume 17, Number 3Case ReviewRetroperitoneal Ancient Schwannoma: A Case ReportCevdet KayaGülistan GümrükçüSelahattin ÇalIiskanSchwannomas are extremely rare tumors that are composed of Schwann cells. Retroperitoneal localization comprises 0.7% to 2.6% of all schwannomas. Patients usually present with nonspecific symptoms. There are no pathognomonic features on radiologic evaluation. Preoperative biopsy is not recommended because of complication risks; however, surgery is necessary for diagnosis and treatment. Although most schwannomas are benign tumors, those that are associated with von Recklinghausen disease are malignant. Schwannomas exhibit regions of high and low cellularity, termed Antoni A and Antoni B areas, with a diffuse positivity of S100 protein on pathologic evaluation. If there are degenerative changes, such as cyst formation, hemorrhage, calcification, and hyalinization, these tumors are termed ancient schwannomas. We present a case of retroperitoneal ancient schwannoma. [Rev Urol. 2015;17(3):190-193 doi: 10.3909/riu0638] © 2015 MedReviews®, LLCRetroperitoneal schwannomaNeurilemmomaSchwannomaRetroperitoneal tumor
Volume 17, Number 3Case ReviewTreatment of Colonic Injury During Percutaneous NephrolithotomyHakan ÖztürkColonic injury during percutaneous nephrolithotomy (PCNL) persists despite the advances in technical equipment and interventional radiology techniques. According to the Clavien-Dindo classification of surgical complications, colonic injury is regarded as a stage IVa complication. Currently, the rate of colonic injury ranges between 0.3% and 0.5%, with an unremarkable difference in incidence between supine and prone PCNL procedures. Colon injury is the most significant complication of PCNL. Colonic injury can result in more complicated open exploration of the abdomen, involving colostomy construction. The necessity of a second operation for the closure of the colostomy causes financial and emotional burden on the patients, patients’ relatives, and surgeons. Currently, the majority of colonic injuries occurring during PCNL are retroperitoneal. The primary treatment option is a conservative approach. It must be kept in mind that the time of diagnosis is as important as the diagnosis itself in colonic injury. Surgeons performing PCNL are advised to be conservative when considering exploratory laparotomy and colostomy construction during treatment of colonic injury. We present the case of a 49-year-old woman who underwent left prone PCNL that resulted in retroperitoneal colonic injury, along with a review of the current literature. [Rev Urol. 2015;17(3):194-201 doi: 10.3909/riu0641] © 2015 MedReviews®, LLCPercutaneous nephrolithotomyPreventionUrolithiasisColonic injuryClavienComplicationManagement
Volume 17, Number 2Case ReviewJuxta-adrenal Ancient Schwannoma: A Rare Retroperitoneal TumorWilliam C HuangJonathan MelamedPratibha ShuklaDaniel A WollinGanesh SivarajanRetroperitoneal schwannoma is a rare tumor that is often misdiagnosed as malignancy due to a concerning appearance on cross-sectional imaging. Pathology and immunohistochemistry form the gold standard for diagnosis; as such, local excision is the treatment of choice for this disease. We present two cases of juxta-adrenal ancient schwannoma that were treated with adrenalectomy and discuss the current literature regarding this entity. [Rev Urol. 2015;17(2):97-101 doi: 10.3909/riu0669] © 2015 MedReviews®, LLCAncient schwannomaAdrenal tumorAdrenalectomy
Volume 17, Number 2Case ReviewGenitourinary Presentation of TuberculosisJerry YuanTuberculosis (TB) is less common in developed countries; however, the incidence of TB—especially resistant strains—is on the rise worldwide. Cases of TB manifesting as urologic complications are rare in the United States. Urologists should be aware of this potential manifestation, especially in patients who have recently immigrated to the United States or have traveled abroad for prolonged periods. Two cases are presented here to illustrate this entity. [Rev Urol. 2015;17(2):102-105 doi: 10.3909/riu0679] © 2015 MedReviews®, LLCTuberculosisGenitourinary complications