[Multilocular cystic renal cell carcinoma]

Multilocular cystic renal cell carcinoma is an uncommon variant recently described of renal cell carcinoma. Analyze clinicopathological features, imaging findings and prognosis and therapeutic options of this tumor. The authors reported two cases of multilocular cystic renal cell carcinoma arising in 68 and 39 year old men. They were admitted with pain in the lumbar region and/or haematuria. The imaging findings were a renal neoplasm with cystic and solid areas. The pathologic findings confirm the diagnosis of multilocular cystic renal cell carcinoma. Multilocular cystic renal cell carcinoma, usually identified at earlier stages, had slower growth rate and was therefore associated with a better prognosis and longer survival than conventionnal renal cell carcinoma

[Small cell carcinoma of the urinary bladder]

Pancreatic pseudocysts [PC] are a common complication of both acute and chronic pancreatitis. Most pancreatic pseudocysts are located within the head and the body of the pancreas, but 20%of them are extrapanereatic [pleura, mediastinum, pelvis and spleen]. The location of a pseudocyst in the liver is an exceptional event, only thirty three cases are reported in the literature. This article aimed to report a new case of PC located in the liver combined with a systematic review of reported cases published in peer-reviewed journals. A new case of PC located in the liver was reported. An extensive electronic search of the relevant literature since 1990 was carried out using Medline. We retained only the articles reporting one or several cases. When the article was unavailable, we considered the relevant abstracts which should report clinical patterns and therapeutic modalities. Reviews of the literature, systemic reviews, letters to editors and incomplete abstracts were excluded. A descriptive analysis of the collected sample including our case was performed. Morphological, therapeutic and outcome variables were reported. Tile analysis of 22 cases reported in the literature and our observation provided the following data: 17 men and 6 women with a mean age of 51 +/- 3,2 years. Seventeen patients presented an acute pancreatitis, complicating a chronic pancreatitis in seven cases, alcoholic in six cases, biliary in three cases and traumatic in one case, Six patients presented a chronic pancreatitis. The PC was located in the left lobe of the liver in 5 cases, in the right lobe in 6 cases and interested the two lobes in 5 eases. The lesion was unique in patients and multiple in 13 patients. Fifteen patients were treated by Ultrasound or CT guided percutaneous drainage. Four patients were managed surgically. Three patients had no specific treatment. One patient was successfully treated by endoscopic transpapiltary drainage. The evolution was favourable for alt patients except in three patients who died. Pancreatic pseudocyst located in the liver is an exceptional event, commonly following acute pancreatitis, rising in older male, involving the left lobe of the liver and treated by percutaneous drainage

[Lumboscopic treatment of ureteral stones. About 31 cases]

The aim of our study is to state the efficiency and the place of lumboscopy in the treatment of ureteral stones. We report 31 cases of patients operated by lumboscopy for ureteral stones from January 2001 to December 2005. In most of cases, the indication is stone which size is higher than 15 mm. The mean operating time is 91 min and the rate of conversion to open surgery is 9, 7%. 9 [29%] postoperative complication is noted. The mean hospital stay is 5 days. No ureteral stricture or kidney destruction is noted with a mean follow-up of 34 months. Lumboscopy is a safe and effective technique in the treatment of the ureteral stones with a low rate of complications. It can replace open surgery in most of cases

[US guided biopsy in the early diagnosis of prostatic cancer: a series of 66 cases]

Our study's aim is to evaluate the reliability of digital rectal examination and serum PSA in the indication of prostatic biopsy. 66 patients with abnormal digital rectal examination and arised PSA levels had prostatic biopsies. The sextant technique was practiced. The digital rectal examination had a sensitivity of 65%, a specificity of 45% and a positive predictive value [PPV] of 34.3%. The serum PSA had a PPV of 25%. The association if these two parameters arised the PPV to 395%. Cancer detection rate was estimated to 30.3%. Prostatic biopsies should be indicated according to the result of digital rectal examination and serum PSA

Retroperitoneal ganglioneuroma: a case report

Ganglioneuroma is a rare, benign, neurogenic tumor originating from the neural sheath and frequently localized in the retroperitoneum. Report of a new case. We report a case of a 36-year-old woman presenting isolated right lumbar pain. Computed tomography revealed a heterogeneous, right, retroperitoneal mass, 13 cm in diameter. Complete resection of the tumor and right nephrectomy were performed. Histology confirmed the diagnosis of ganglioneuroma. Follow-up was 10 months with no recurrence. Through this case, we discuss diagnostic, therapeutic and prognostic aspects of this disease

[Lumboscopic treatment of simple renal cysts]

To assess feasibility and efficiency of lomboscopy in the treatment of simple renal cysts. We report 12 cases of patients presenting symptomatic simple renal cysts treated by lumboscopy from January 2000 to December 2004. The mean age was 57 years [43-72]. They were 11 women and one man. The main revealing sign was pain in each case. A mass was found in 2 cases [16%]. Ultrasonography was realized in all cases. Computed Tomography was realized in 4 cases [33%]. It was a unique cyst in 9 cases [75%], a double cysts in 2 cases [17%] and 4 cysts in 1 case [8%]. The mean size of the cysts was 7.7 cm [5-16]. A parapyelic cyst was found in one case. All the patients were operated through a retroperitoneal approach. Excision of cyst dome was made. The mean operating time was 80 mm [50-160]. No intraoperative complication was noted. The mean hospital stay was 3 days [1-4]. All the cysts were found to be benign histologically. No recurrence is noted with a mean follow-up of 21 months [5-31]. Lumboscopy is a safe and effective technique in the treatment of the symptomatic simple renal cysts with a low rate of complications and recurrence

Retroperitoneal leiomyosarcoma: report of 3 cases

Retroperitoneal leiomyosarcomas are neoplasma which are best treated with complete exeresis. We reported three new cases of retroperitoneal Leiomyosarcoma operated during last ten years. The authors reported 3 cases of Retroperitoneal leiomyosarcomas in 3 patients [2 men and a woman] aged respectively 53, 55 and 57 year-old .Incomplete resection was performed in the 3 cases because of the important local extension. All patients died 18,19 et 51 months after diagnosis

Prognostic value of the immunohistochemical expression of: KI67, p53, pcna and bcl2 in the superficial tumors of the bladder

To study a serie of superficial tumors of the bladder and to assess the prognostic significance of p53, Ki67, PCNA and bc!2 in these tumors. We studied 59 bladder tumors: 43 pTa and 16 pTl. All Patients had cystoscopy 3 months after the resection and tumors that did not recur had a minimum follow up of 5 years. Age more than 65 years [p = 0,001], multifocality [p=0,022] and tumoral size > 3 cm [p = 0,022] were correlated with the recurrence. The expression of p53 was correlated with the recurrence in the year following the tumoral resection [p = 0,035]. That of of Ki67 was correlated with the histological grade [p = 0,03] and stage [p=0,002]. Our results suggest to practise regular endoscopic controls during the first year following the resection of the primitive tumor if it expresses p53. The immunohistochemical expression of Ki67 being correlated with the grade, this marker could help to better classify the tumors of intermediate grade

Post traumatic rupture in patients with uretero pelvic Junction obstruction: a Case Report

Authors report a case of post traumatic pelvic rupture occurring in an unknown ureteropelvic junction [UPJ] obstruction. Ultrasonography showed pyelectasia and fluid effusion in the anterior perirenal space. CT scan confirmed the diagnosis of UPJ obstruction and showed the rupture of the anterior pelvic wall communicating with a perirenal urinoma. The patient underwent a retrograde stenting for decompression and surgical drainage of the urinoma. Pyeloplasty was performed 4 months after injury. A follow up intravenous pyelogram showed good flow through the repair and the patient remaines asymptomatic 2 years after treatment Post traumatic rupture of UPJ obstruction is a rare event with few reported cases in literature Diagnosis is suggested on imaging studies. CT scan shows the rupture site in the ureteropelvic tract and guides percutaneous drainage

[Prognostic value of clinicopathologic factors in superficial bladder: a retrospective analysis of 59]

To study, through a series of superficial bladder tumors, the prognostic factors of recurrence and tumoral progression. this is a retrospective study of a series of 59 urothelial tumors of the bladder at stage pTa or pTl. The following parameters were considered: age, sex, treatment, stage and grade. The chi square test was used in search of a correlation between the different parameters and the course [recurrence and progress] of the disease. A multivariate analysis was undertaken by integrating factors correlated with the course. Thirty two tumors [54%] had recurred versus 27 [46%] without recurrence. Light tumors [25%] progressed in grade and 4 [12,5%] had become infiltrative. Age beyond 65 years. tumoral size > 3 cm and rnultifocality were predictive factors of recurrence with a relative risks of 2.36, 3,28 and 3,88 respectively. In a multivariate analysis, these factors remained significant with adjusted relative risks respectively of 1,36, 1,6 and 1,7