ABSTRACT
Since Paget`s first description in 1874 of what is presently known as Paget`s disease of the nipple, similar lesions have been reported rarely on the penis and scrotum, vulva, perineum, axilla and the eyelids. Because it is often associated with a subjacent or visceral malignancy and recurrence, extramammary Paget`s disease(EPD) is considered as malignant condition. This case report describes two patients with extramammary Paget`s disease of the penoscrotal area. One of them had renal cell carcinoma in left kidney and was managed by radical nephrectomy. Treatments for EPD were initiated by CO2 laser 3 or 4 times, but failed and then we excised the lesion widely and closed primarily with split thickness skin graft in one of the cases.
Subject(s)
Humans , Male , Axilla , Carcinoma, Renal Cell , Eyelids , Kidney , Lasers, Gas , Nephrectomy , Nipples , Penis , Perineum , Recurrence , Scrotum , Skin , Transplants , VulvaABSTRACT
In recent years, with the increasing use of ultrasonography and computed tomography (CT), a large number of renal cell carcinoma has been founded incidentally for a variety of occasions. We reviewed 107 cases of renal cell carcinoma treated surgically from 1988 to 1995, and compared symptomatically suspected group (62 cases) to incidentally detected group (45 cases). The groups were compared according to stage, grade, tumor size, age, sex, laterality and survival rate. The chief imaging methods of detection were ultrasonography (80%), IVP (11%), CT (9%). The main reasons for examination leading to the diagnosis in incidentally detected group were follow-up of other diseases (58%), general health check (31%), and follow-up of unrelated symptoms (11%). The frequency of incidentally detected renal cell carcinoma was increased from 29% (1988-1991) to 48% (1992-1995). The tumor stage and grade were lower in incidentally detected group than suspected group, and tumor size was smaller in incidentally detected group. The 2-year disease free survival rate in incidentally detected group tended to be better (95% vs 68%). So screening test with ultrasonography to detect renal cell carcinoma at an early stage, may be essential.
Subject(s)
Carcinoma, Renal Cell , Diagnosis , Disease-Free Survival , Follow-Up Studies , Mass Screening , Survival Rate , UltrasonographyABSTRACT
We report a case of spontaneous renal rupture in a 63 year-old woman as a complication of diabetes mellitus. She experienced a sudden onset of severe pain and bulging mass on the left flank. She had been suffered from diabetes mellitus for 30 years without any specific treatment, and she had no history of specific associated diseases or factors such as trauma, stone, tumor, hydronephrosis or vascular lesion of the kidney. Grossly this ruptured kidney showed a characteristic necrosis and infarcted lesions extended from papilla to cortex of the upper pole kidney and surrounding tissues of the kidney showed interstitial fibrosis, tubular atrophy and mononuclear cell infiltration. Microscopically the atherosclerotic medium-sized blood vessels and small vessels around the infarcted lesion also showed hyaline sclerosis. This pathologically defined spontaneous renal rupture is thought to be caused by focal renal infarction due to atherosclerosis or fat emboli-associated renovascular occlusion in diabetic patient. This report emphasizes the importance of diabetic nephropathy as a new cause of the spontaneous renal rupture in patients of diabetes mellitus.