Testicular teratoma with nephroblastoma component.

We report the development of Wilms' tumor in an atrophic testis and review the potential molecular pathogenesis. An 18-year-old man presented with 2 days of right testicular pain and growth in his atrophic testis. Ultrasonography revealed a heterogeneous mass. The chest radiographic findings and testicular tumor marker levels were normal. He underwent radical orchiectomy, with the pathologic examination showing teratoma with a nephroblastoma component, focal embryonal carcinoma, and minute yolk sac tumor. The development of Wilms' tumor in the testis is rare and can be explained by the activation of the WT1 gene during embryogenesis.

Laparoscopically assisted vaginal extraction of the kidney after laparoscopic radical nephrectomy.

BACKGROUND: Gynecologists have long used a vaginal incision for surgical treatment of pelvic pathology. More recently, however, laparoscopy has allowed gynecologists and other specialists to replace laparotomy with minimally invasive surgical techniques. The combination of laparoscopic and vaginal approaches has increased the surgical armamentarium of both the gynecologist and the urologist. CASE: A gynecologist found a renal cell carcinoma in a 52-year-old woman. The Urology and Gynecol-ogy Departments of the Kaiser Permanente (KP) Hawaii Region (KP Hawaii) planned a combined minimally invasive surgical procedure that became Hawaii's first reported retroperitoneal radical nephrectomy followed by laparoscopically assisted vaginal extraction of an intact kidney. CONCLUSION: Collaboration between laparoscopic surgeons in the Departments of Urology and Gynecology has allowed us to share surgical techniques and approaches to perform minimally invasive surgery instead of using more morbid large incisions of the abdomen or flank as required previously.