Primary hydatid cyst of the psoas: report of 2 cases

We report two patients with hydatid cyst of the right psoas muscle who presented with lower back pain and a palpable mass on the right side. The diagnosis was confirmed by computed tomography [CT] in both patients and by positive hydatid serology in one case. Intervention consisted of a pericystectomy in both cases. After a follow-up of 24 and 30 months, respectively, the hydatid serology is negative in both patients and the findings on control CT are normal. Based on these two cases and a review of the literature the authors discuss the diagnosis and treatment of this rare entity

[HIV infection revealed during the treatment of a unilateral abscess of the psoas muscle]

We report the case of a 25-year-old unmarried male patient who presented with painful swelling of the right lumbar area of one month's duration, associated with fever and general debility, but without any urological or gastro-intestinal symptoms. He admitted having had unprotected sexual intercourse. Abdominal radiography revealed an abscess in the right psoas muscle, which was drained by lumbotomy. Analysis of the pus revealed Staphylococcus aureus. Histological examination of the abscess wall found non-specific inflammation. A test for tuberculosis was negative, while serological examination revealed HIV. The patient was treated with antiretroviral drugs

[Diagnosis and treatment of penile tumors, report of 2 cases and review of the literature]

Squamous cell carcinoma of the penis is rare, representing less than 1% of all adult cancers. The etiology of this cancer is still unknown, but many risk factors have been suggested, above all the human papilloma virus. The authors describe two cases of infiltrating penile tumors. The first patient presented with a glandular tumor of 5 cm which was treated by a distal penile amputation. The second patient had a ventrally located penile tumor associated with a urethral fistula. He was subjected to total penectomy with bilateral inguinal lymphadenectomy. Postoperatively, he developed lymphorrhea which resolved spontaneously. Surgery remains the treatment of choice for penile tumors and consists - depending on the case - of wide excision, partial or total penectomy with perineal urethrostomy

use of isolated sigmoid colon segment for vaginal replacement in young adults

Objectives: Vaginoplasty for congenital atresia, a component of the Mayer-Rokitansky Kuster syndrome, or for gender confirmation may be achieved by several techniques. This report focuses· on the efficacy of rectosigmoid neocolporrhaphy [RSNC] for primary vaginal replacement

Patients and Methods: From 1990 to 2002 we evaluated six patients 16 to 33 years old [average age 23 years] who required vaginal replacement. The diagnosis included the Mayer-Rokitansky syndrome in two cases, classic bladder exstrophy in one and male pseudohermaphrodism in three cases. The vagina was reconstructed using a 15-cm isolated sigmoid segment placed between the bladder and the rectum and anastomosed to the introitus in four patients. The Frank procedure was used in two patients

Results: A minimum of one year follow-up [mean: 32 months] was available in 5/6 patients. The patients treated with sigmoid vaginoplasty had a functional neovagina with excellent cosmetic results and without excessive mucus production or the need for routine dilation. Stenosis at the mucocutaneous junction in one patient with a sigmoid vagina was treated with Y-V plasty. In two patients managed by nonoperative perineal self-dilation, little success could be noted, and they became candidates for surgery

Conclusion: Our limited experience with this group of patients leads us to believe that the isolated sigmoid segment provides a self-lubricating neovagina with a low rate of failure and revision, with very good cosmetic results and without the need for routine dilation

[Primitive cancer of the urethra]

Objective: We report six cases of primitive cancer of the urethra out of a total of 1109 cases of urologic cancers hospitalized during a period of 12 years

Patients and Methods: From 1990 to 2001 six patients [four males, two females] were hospitalized for cancer of the urethra. The tumors were analyzed according to the classification of Grabstald. All the patients were explored by retrograde urethrocystography showing an irregular image of the urethra and at times opacifying the sinus ways. Urethrocystoscopy showed the site of the tumor and its aspect and allowed for diagnostic biopsies. In five cases it revealed an epidermoid cancer and an adenocarcinoma in one case. The treatment used depended on the stage of the disease and the general condition of the patients. Two patients underwent radical pelvectomy without any adjuvant treatment. Two patients with disseminated disease received palliative treatment by radiotherapy. The two remaining patients having refused surgical treatment were also treated by radiotherapy alone

Results: Overall, the average rate of survival was 17.5 months [3 to 60 months]. The best results were achieved with surgical treatment. Two of the patients referred to the oncologist for palliative radiotherapy died within 3 and 6 months, respectively. One patient treated by radiotherapy alone after having refused surgical treatment presented 6 months later with a long post-radiation stenosis of the urethra. Since the patient still refused surgical treatment, he was treated by final cystostomy. The last patient also treated by exclusive radiotherapy is being followed up by the radiologists

Conclusion: Primitive cancer of the urethra is rare. Its semiology is not very specific which explains the frequently delayed diagnosis. It is the meticulous examination of the urethra which allows the diagnosis. The treatment of choice is surgery and/or radiotherapy