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1.
BMJ Case Rep ; 14(11)2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1522934

ABSTRACT

Renal arteriovenous malformation is a primarily congenital renal vascular abnormality. It is usually diagnosed incidentally on imaging, and the most common subtype is 'cirsoid', consisting of multiple, enlarged arterial feeders interconnecting with draining veins. We present a 74-year-old woman with an incidental finding of what was at first considered a hypervascularised kidney tumour but turned out to be a left intrarenal arteriovenous malformation associated with a left renal vein thrombosis. Selective endovascular embolisation was performed. The cause-consequence relationship between the arteriovenous malformation and the thrombosis is unique. To our knowledge, no such case has ever been reported.


Subject(s)
Arteriovenous Malformations , Kidney Neoplasms , Urologic Diseases , Venous Thrombosis , Aged , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnostic imaging , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/diagnostic imaging , Renal Veins/diagnostic imaging , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology
2.
Front Immunol ; 12: 627186, 2021.
Article in English | MEDLINE | ID: covidwho-1094168

ABSTRACT

After the COVID-19 outbreak, non-evidence based guidelines were published to advise clinicians on the adjustment of oncological treatment during this pandemic. As immune checkpoint inhibitors directly affect the immune system, concerns have arisen about the safety of immunotherapy during this pandemic. However, data on the immune response in oncology patients treated with immunotherapy are still lacking. Here, we present the adaptive immune response in a SARS-CoV-2 infected patient who was treated with immune checkpoint inhibitors for advanced renal cell cancer. To evaluate the immune response in this patient, the number of T cells and their major subsets were measured according to expression of markers for co-signalling, maturation, and chemotaxis at baseline, during therapy, and during the SARS-CoV-2 infection. In addition, plasma samples were analyzed for IgM and IgG antibodies and the ability of these antibodies to neutralise SARS-CoV-2. Despite several risk factors for an impaired immune response to SARS-CoV-2, both T- and B-cell responses were observed. Moreover, after treatment with immune checkpoint inhibitors, a sufficient cellular and humoral immune response was achieved in this SARS-CoV-2 infected patient. These findings warrant renewed discussion on withholding of immune checkpoint inhibitors during an ongoing COVID-19 pandemic.


Subject(s)
Antibiotics, Antineoplastic/therapeutic use , B-Lymphocytes/immunology , COVID-19/diagnosis , Carcinoma, Renal Cell/diagnosis , Immunotherapy/methods , Ipilimumab/therapeutic use , Kidney Neoplasms/diagnosis , Nivolumab/therapeutic use , SARS-CoV-2/physiology , T-Lymphocytes/immunology , Antibodies, Viral/blood , Carcinoma, Renal Cell/drug therapy , Cells, Cultured , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Kidney Neoplasms/drug therapy , Lymphocyte Activation , Male , Middle Aged , Neoplasm Staging
3.
Urologia ; 88(3): 218-222, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1069489

ABSTRACT

INTRODUCTION: The Coronavirus disease-2019 (COVID-19) has been declared as a pandemic in March 2020 by the World Health Organization (WHO). Since then, this pandemic has dramatically affected the entire world, even radically influencing the way patients are framed at triage. Symptoms and tests in most cases lead to a correct diagnosis; however, error may be around the corner. CASE REPORT: A 60 years old patient was referred with weight loss, fatigue and mild fever for 3 weeks as he was working in a COVID-19 ward. After a positive swab and chest CT scan, he was admitted in the hospital and treated as mild COVID-19 patient. A CT scan performed after the patient was discharged revealed a renal lesion misidentified as a tumor then clarified to be an abscess which retrospectively appears to be the main cause of his symptoms. CONCLUSION: Clinicians should consider other life-threatening disease in the differential diagnosis of patients presenting with similar symptoms to minimize mistakes and avoid further unnecessary investigations.


Subject(s)
Abdominal Abscess/diagnosis , COVID-19/diagnosis , Diagnostic Errors , Pandemics , SARS-CoV-2 , Abdominal Abscess/complications , Abdominal Abscess/diagnostic imaging , Abdominal Abscess/surgery , Abdominal Pain/etiology , Anesthetists , COVID-19/complications , COVID-19/diagnostic imaging , Diabetes Complications , Drainage , Fatigue/etiology , Fever/etiology , Humans , Kidney Neoplasms/diagnosis , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/etiology , Male , Middle Aged , Occupational Exposure , Tomography, X-Ray Computed , Weight Loss
4.
Anticancer Res ; 41(1): 335-340, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1068194

ABSTRACT

BACKGROUND/AIM: Large or bilateral multiple renal cell carcinoma (RCC) without/with tumor thrombus (TT) in the renal vein (RV) or inferior vena cava (IVC) poses a challenge to the surgeon due to the potential for massive hemorrhage, tumor thromboemboli and dialysis, and the situation is more critical due to Covid-19 pandemic. We report our experience and measures in dealing with challenging cases of large or multiple RCCs without/with TT during the ongoing Covid-19 pandemic. PATIENTS AND METHODS: Between 4/2020-10/2020, five patients underwent RCC resection with/without TT. Patients 1 and 2 had RCCs/TT in RV; Patient 3 had RCC/TT supradiaphragmatic below right atrium; Patient-4 had a 26 cm RCC; Patient-5 had multiple RCCS as part of Birt-Hogg-Dube syndrome. RESULTS: Patients were preoperatively tested negative for Covid-19. Operation times were 105, 85, 255, 200 and 247 minutes for Patients 1-5. Estimated blood loss was: 100, 50, 3,900,100 and 50 ml, respectively. Patient 3 underwent RCC resection en bloc with IVC/TT. Patients 1 and 2 underwent resections of RCC/TT in RV. Patient 4 underwent a 26 cm RCC resection. Patient 5 underwent laparoscopic bilateral radical nephrectomies. No immediate postoperative complications were reported. CONCLUSION: We successfully managed 5 challenging cases of RCCs despite the recommendations imposed by hospitals due to Covid-19 pandemic, with favorable outcomes.


Subject(s)
COVID-19/complications , Carcinoma, Renal Cell/complications , Carcinoma, Renal Cell/diagnosis , Kidney Neoplasms/complications , Kidney Neoplasms/diagnosis , SARS-CoV-2 , Thrombosis/diagnosis , Thrombosis/etiology , Aged , Biopsy , COVID-19/virology , Carcinoma, Renal Cell/surgery , Humans , Kidney Neoplasms/surgery , Male , Middle Aged , Neoplastic Cells, Circulating , Nephrectomy , Renal Veins/pathology , Tomography, X-Ray Computed , Treatment Outcome
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