Case Review - Reviews in Urology

All articles from this category are listed below.

Tubulocystic Renal Cell Carcinoma: A Great Imitator

Tubulocystic renal cell carcinoma (TCRC) is a rare renal tumor. Patients are usually asymptomatic; it is usually detected incidentally, during imaging studies for Bosniak type III and type IV renal cysts. These tumors rarely metastasize. The role of targeted therapy in such rare tumors is still controversial. We report a case of TCRC initially presented as a Bosniak type II renal cyst and was discovered ultimately to be a metastatic disease. This type of presentation might broaden our understanding of this rare disease. [Rev Urol. 2016;18(2):118-121 doi: 10.3909/riu0692] © 2016 MedReviews®, LLC

Tubulocystic renal cell carcinoma Bosniak type II cyst Targeted therapy

Volume 18, Number 4 Case Review

Gossypiboma Manifesting as Urachal Mass

Vitaly Margulis Christopher Cefalu Ahmed Q Haddad Nirmish Singla

Gossypiboma (retained surgical sponge) occurs between 1 in 1000 and 1 in 1500 of all intra-abdominal operations. Patients with gossypibomas may present asymptomatically or with nonspecific symptoms, such as abdominal pain or bloating; identification frequently relies on imaging. Results of imaging alone, however, may appear nonspecific, and the gossypiboma may mimic other masses, such as neoplasms, hematomas, or abscesses. They require surgical removal for definitive diagnosis and treatment. Herein we present an unusual case of gossypiboma masquerading as an urachal mass in a 75-year-old woman. Diagnostic evaluation, natural history, and prevention of retained surgical materials are discussed. [Rev Urol. 2016;18(4):239-241 doi: 10.3909/riu0703] © 2016 MedReviews®, LLC

Gossypiboma Urachal mass Surgical errors Patient safety

Volume 18, Number 4 Case Review

Collateral Urethral Duplication in an Adult With Adult Polycystic Kidney Disease

Lester Joesph Prats Amanda Feige Saltzman Dunia Taufiq Khaled

Duplications of the lower urinary tract are rare congenital anomalies that are usually accompanied by concomitant nonurologic anomalies; they are typically diagnosed in early childhood. In more rare cases these are isolated, leading to diagnosis later. We describe a 50-year-old man who remained asymptomatic and therefore undiagnosed for five decades. His is one of fewer than 20 cases in the literature describing urethral duplication in the coronal (collateral) plane, the more common variant being sagittal (dorsal-ventral) duplication. He is one of only four cases reported without concomitant midline anomaly. Furthermore, he is the sole case associated with adult polycystic kidney disease. [Rev Urol. 2016;18(4):242-245 doi: 10.3909/riu0705] © 2016 MedReviews®, LLC

Collateral duplication Coronal duplication Duplicate urethra Urethral anomaly Duplication of lower urinary tract

Volume 19, Number 1 Case Review

Xanthogranulomatous Pyelonephritis Presenting as a Type IV Renal Cyst

Bosniak class IV renal cyst • Radical nephrectomy • Xanthogranulomatous pyelonephritis

Shyam Talreja Nachiket Vyas Vinay Tomar Indraneel Banerjee Sher Singh Yadav

A 20-year-old woman presented to our outpatient clinic with a 5-week history of recurrent right lumbar back pain. Contrast-enhanced computed tomography scan showed a Bosniak class IV renal cyst. She was treated with radical nephrectomy. Histopathology revealed xanthogranulomatous pyelonephritis. [Rev Urol. 2017;19(1):60-63 doi: 10.3909/riu0715] © 2017 MedReviews®, LLC

Radical nephrectomy Bosniak class IV renal cyst Xanthogranulomatous pyelonephritis

Volume 19, Number 1 Case Review

Perineal Urethrostomy: Still Essential in the Armamentarium for Transurethral Surgery

Leslie A Deane Dimitri Papagiannopoulos

A 69-year-old morbidly obese man presented with hematuria caused by a large anterior wall bladder tumor. The mass was inaccessible for resection by standard means due to the patient’s obesity and phallic length. A perineal urethrostomy was required to enable complete resection. This age-old technique is revisited for the benefit of this generation’s urologists. [Rev Urol. 2017;19(1):72-75 doi: 10.3909/riu0742] © 2017 MedReviews®, LLC

Bladder tumors Transurethral resection Perineal urethrostomy

Volume 19, Number 1 Case Review

Bladder Cancer That Metastasized to the Skin: A Unique Presentation That Signifies Poor Prognosis

Daniel Ricchiuti Mark Memo Tal Cohen

In the United States in 2015, an estimated 74,000 new cases of bladder cancer were diagnosed and approximately 16,000 deaths were due to bladder cancer. We present a rare case of a patient with aggressive bladder cancer who presented with multiple inguinal and scrotal skin lesions that were proven to be metastatic urothelial malignancy. Bladder malignancy can involve the skin by direct tumor invasion, hematogenous routes, lymphatic spread, and direct seeding due to iatrogenic implantation. The cutaneous lesions have an extremely variable appearance, are resistant to therapies, and signify a dismal prognosis. [Rev Urol. 2017;19(1):68-71 doi: 10.3909/riu0740] © 2017 MedReviews®, LLC

Bladder cancer Cutaneous metastasis Urothelial malignancy

Volume 19, Number 1 Case Review

Penile Ossification: A Reconstructive Challenge

Allen F Morey Arthi Satyanarayan Nirmish Singla

Penile ossification is a rare condition that occurs most commonly in acquired cases of penile deformity. We report the case of a 43-year-old man with Peyronie disease who was incidentally found to have significant ossified tissue in his penile corpora during complex placement of an inflatable penile prosthesis (IPP). His clinical course was later complicated by impending distal extrusion of his IPP laterally, necessitating corporoplasty. Penile ossification remains a poorly understood, unusual entity that may pose a reconstructive challenge for urologists. We discuss evaluation and management of this condition, focusing on important considerations for preoperative counseling and intraoperative pearls. [Rev Urol. 2017;19(1):64-67 doi: 10.3909/riu0722] © 2017 MedReviews®, LLC

Peyronie’s disease Penile ossification Inflatable penile prosthesis Corporoplasty

Volume 19, Number 2 Case Review

Transitional Cell Carcinoma of the Renal Pelvis With Venous Tumor Thrombus

Antony Devasia J Chandra Singh Arun Jacob Phillip George Onkar Singh

Renal cell carcinoma (RCC) is the most common malignancy that results in venous tumor thrombosis. Transitional cell carcinoma of the renal pelvis with renal or vena cava thrombus is extremely rare. Fewer than 40 cases have been reported. We report a similar case of a patient who underwent radical nephrectomy with a preoperative diagnosis of RCC. [Rev Urol. 2017;19(2):145–148 doi: 10.3909/riu0743] © 2017 MedReviews®, LLC

Urothelial carcinoma Transitional cell carcinoma Kidney Inferior vena cava Thrombus

Volume 19, Number 3 Case Review

High Postprostatectomy Prostate-specific Antigen Level Prior to Salvage Radiation Therapy Is Not Always a Bad Sign

Steven C Eberhardt Thomas M Schroeder John T Rathbun

Although radical prostatectomy is a popular treatment modality for clinically localized prostate cancer, 10-year biochemical recurrence can reach 28%. Before salvage radiation therapy (SRT), prostate-specific antigen (PSA) values alone should be used cautiously in predicting SRT eligibility. A long, slow PSA rise may suggest locally confined disease still amenable to SRT; corresponding imaging to identify potential gross recurrence is useful. Patients with local disease may safely benefit from higher doses of radiation. [Rev Urol. 2017;19(3):190–194 doi: 10.3909/riu0754] © 2017 MedReviews®, LLC

Prostate-specific antigen Radical prostatectomy Salvage radiation therapy

Volume 19, Number 3 Case Review

Surgical Solution to an Intracorporeal Nickel Allergy

Jared Brandenberger Paul Kozlowski Andrew Stamm

A previously healthy 30-year-old man with a symptomatic varicocele underwent gonadal vein embolization using nickel vascular plugs. He developed a painful hypersensitivity to his nickel plugs and elected to pursue laparoscopic excision and proximal gonadal vein ligation. In the operating room, the gonadal vein was isolated from the ureter, and ligated proximal to the cephalad plug and distal to the caudal coil. His pain is completely resolved 5 months after surgery. Metal allergies are well documented in orthopedics and cardiology implants, but there are a limited number of case reports of metal allergies after varicocele embolization. Interestingly, nickel is the most common type of metal hypersensitivity. [Rev Urol. 2017;19(3):195–197 doi: 10.3909/riu0769] © 2017 MedReviews®, LLC

Varicocele Metal allergy Nickel Coil embolization Gonadal vein

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Bosniak class IV renal cyst • Radical nephrectomy • Xanthogranulomatous pyelonephritis

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