Primary renal angiosarcoma

Primary renal Angiosarcoma is a rare neoplasm and only 24 cases have been reported in specialized literature. We describe a case of primary renal angiosarcoma in a patient presenting with hematuria, palpable abdominal mass, left flank pain and anemia. A computerized tomography of the abdomen with contrast medium showed a tumor with 15 cm diameter, in the upper pole of the left kidney, with a low-density central area, suggesting necrosis or hemorrhage. Diagnosis was given in a morphologic base and proven by an immunohistochemical study. Primary renal angiosarcoma should be included among differential diagnosis of retroperitoneal hematoma and hemorrhagic renal tumors.

Male perineal sling with autologous aponeurosis and bone fixation: description of a technical modification

Post-prostatectomy urinary incontinence is an uncommon complication of adenomectomies, occurring in approximately 1 percent of cases and being more frequent following radical prostatectomies. There is a significant implication in the quality of life for these patients. The surgical techniques employed for its treatment are the implantation of an artificial sphincter, peri-urethral injections and suburethral slings. Considering the low efficacy of peri-urethral injections and the high cost of artificial sphincters, we present in this work a technical modification of the suburethral sling, whose preliminary results are satisfactory. The fundamental modification in this technique is due to the replacement of the synthetic material usually employed for making the sling for autologous tissue, constituted by an aponeurotic strip taken from the rectus muscle of abdomen. This modification aims to minimize risks of urethral erosion that, despite it was not described in this population due to the use of synthetic materials, is a possibility when facing the tension that is used over the bulbar urethra. In addition to such aspects the autologous aponeurosis does not have a cost except for a short prolongation of the surgical act.