ABSTRACT
The authors report the case of a very large, obstructive malignant melanoma (MM.) of the prepuce, encasing all of the distal extremity of the penis, and discovered at a late metastatic stage (regional lymph node metastasis). Palliative treatment, consisting of partial penectomy associated with a complementary induction and maintenance chemotherapy did not achieve any objective response at one year. MM. of the penis are rare urological tumours, including MM of the penis and MM of the male urethra (exclusively mucosal involvement). The diagnosis of MM of the penis must be considered in any case of black or brown lesion of the glans, which is the most frequent site. The prognosis is determined by the clinical stage (BRACKEN and DIOKNO classification) and by the depth and level of tumour invasion (BRESLOW index and CLARK's degree of dermal invasion). The 5-year survival is inversely proportional to the tumour thickness. The treatment of MM of the penis is surgical; the extent of resection and the indication for lymph node dissection depend on the patient's age, sexuality, and the stage of the disease and depth of tumour invasion.
Subject(s)
Melanoma/pathology , Penile Neoplasms/pathology , Humans , Male , Melanoma/secondary , Middle AgedABSTRACT
OBJECTIVES: BCG therapy is the reference adjuvant treatment for multiple and voluminous or recurrent superficial bladder cancer and can cause specific complications. We assessed the frequency and therapeutic modalities involved associated with such complications in a personal retrospective series of patients. PATIENTS AND METHODS: BCG therapy was given to 148 patients who were followed for a mean 40 months. RESULTS: Forty-six percent of the patients developed a follicular reaction in the bladder wall: 14 developed complications requiring anti-tuberculosis treatment. The frequency of BCG therapy complications was higher in patients who had had tuberculosis previously (50%) than those who did not (13.8%). Complications were more frequent after early treatment. In the patients who developed BCGitis with fever, a 3-month regimen of rifampicin and isoniazine appeared to be sufficient. DISCUSSION: The frequency of BCG therapy complications (bladder anomalies excluded) was 7.8% with only 2.8% major complications. The development of a follicular reaction of the bladder wall does not appear to have any prognostic value. Special surveillance is needed in patients with a past history of tuberculosis. CONCLUSION: Adjuvant BCG therapy requires careful follow-up because of the risk of BCGitis which can be effectively treated with a 3-month double-antibiotic regimen.
Subject(s)
Adjuvants, Immunologic/adverse effects , BCG Vaccine/adverse effects , Urinary Bladder Neoplasms/therapy , Adjuvants, Immunologic/administration & dosage , Administration, Intravesical , Adult , Aged , Aged, 80 and over , BCG Vaccine/administration & dosage , Chemotherapy, Adjuvant , Contraindications , Female , Follow-Up Studies , Humans , Male , Middle Aged , Risk FactorsABSTRACT
Pheochromocytoma rarely occurs in the bladder. We report a fortuitously observed case and review the main clinical, biological and radiological features.
Subject(s)
Pheochromocytoma/diagnosis , Urinary Bladder Neoplasms/diagnosis , Aged , Cystoscopy , Female , Humans , Tomography, X-Ray Computed , Ultrasonography, Interventional , Ureteral Neoplasms/diagnosis , UrographyABSTRACT
A cystic dilatation of the right seminal vesicle due to an ectopic implantation of the right ureter was observed in a patient with ipsilateral renal agenesia. The embryology, symptomatology and radiological diagnosis, including magnetic resonance imaging, and treatment of this malformation are reported.
Subject(s)
Genital Diseases, Male/complications , Kidney/abnormalities , Seminal Vesicles/pathology , Ureter/abnormalities , Ureteral Diseases/complications , Adult , Genital Diseases, Male/diagnosis , Genital Diseases, Male/surgery , Humans , Kidney/diagnostic imaging , Kidney Diseases/complications , Kidney Diseases/diagnosis , Magnetic Resonance Imaging , Male , Seminal Vesicles/diagnostic imaging , Seminal Vesicles/surgery , Ureter/diagnostic imaging , Ureter/surgery , Ureteral Diseases/diagnosis , Ureteral Diseases/surgery , UrographyABSTRACT
We report our recent experience in the surgical treatment of severe closed renal trauma, describing the value of the initial tomography scan, the problems encountered with indications for surgery, and use of a resorbable peri-renal prosthesis made of polyglactine 910. During the last 4 years, 41 patients were hospitalized for renal trauma. Eleven of these patients were operated for severe lesions (Chatelain stage 3 and 4). Surgical treatment was as conservative as possible: total organ repair was possible in 5 cases and partial repair in 3, the kidney was lost in 3 cases.
