Renal hemangiopericytoma in 15 year old female-treated laparoscopically.

Hemangiopericytoma (HPC) is rare in the urogenital system, most frequently occurs in the pelvis, head and neck, and meninges, it is extremely rare in the kidney. US, CT, or MRI do not show any specific sign of renal HPC that might aid in the differential diagnosis with other renal tumors, that's why almost all cases are diagnosed after pathological results. The majority of cases are identified in patients with an unspecific clinical manifestations associated with hematuria or hypertension, hypoglycemia or additional paraneoplastic syndromes. Here we present a rare case of hemangiopericytoma in 15 year old female, with drug refractory hypertension.

Bladder leiomyosarcoma with total laparoscopic intracoropreal orthotopic managment- case report.

Bladder leiomyosarcoma is a rare malignancy, it's nonurothelial tumors and account less than 5% of all bladder malignancies. Because of the very low incidence less than 200 cases reported in the literature, etiology is still little know, also there is lack of consensus regarding definitive treatment for this rare tumors. The most common clinical presentation is gross hematuria, which is reported in 81% of cases, followed by pollakiuria (28%) and dysuria (19%), respectively. Herein, we present the case of a patient diagnosed with a bladder leiomyosarcoma and treated with laparoscopic radical cystoprostatectomy and totally intracorporal orthotopic ileal diversion.

Heterotopic adrenal gland in undescendent testis - Case report.

Heterotopic adrenal cortex is usually found in the kidney, retroperitoneum and spermatic cord. The adrenal gland has a dual embryonic origin: the cortex arises from the mesoderm and the medulla from ectoderm of the neural crest. Adrenal cortex and gonads both arise from genital ridge, because of that adrenal tissue with descending gonads may migrate in early embryonic period. We report a case of adrenal rest in upper pole of testes.

Laparoscopic management of congenital mesoblastic nephroma- case report.

Congenital mesoblastic nephroma (CMN) also called leimyomatous harmartoma is a mesenchymal renal tumor. CMN is the most common solid tumor in newborns and young infants which is basically benign. Pathologically there are three variants of CMN - classic (conventional), cellular (which is more aggressive) and mixed. In a complete surgical removal of the tumor (nephrectomy), the literature results are excellent.

Validation of pre- and postoperative nomograms used to predict the pathological stage and prostate cancer recurrence after radical prostatectomy: a multi-institutional study.

PURPOSE: To validate the preoperative and postoperative predictive tables of Johns Hopkins hospital, Baltimore, Maryland (JHH) and the prostate nomograms of Memorial Sloan Kettering Cancer Center, New York (MSKCC), most commonly used to predict the pathological tumor stage and postoperative freedom from recurrence, in a mixed cohort of Bulgarian prostate cancer patients. METHODS: Clinical and laboratory data of 282 prostate cancer patients, who underwent radical prostatectomy, were supplied from three different institutions in Bulgaria. Preoperative prostate specific antigen (PSA) values, clinical stage, biopsy Gleason score and the pathological features of the radical prostatectomy specimens were collected from each center and evaluated. Nomogram-predicted probabilities for the presence of unfavorable pathological parameters (extracapsular extension, seminal vesicle invasion/SVI, and lymph node involvement/LNI), and the 5-year freedom from recurrence were compared with actual patient outcomes. Areas under the receiver operating characteristic (ROC) curves (AUC) were determined for each variable to assess the predictive accuracy of the nomograms applied. RESULTS: The MSKCC prostate cancer nomograms showed superior accuracy for all parameters studied, as compared with the JHH predictive tables. AUC values for organ-confined disease (OCD), SVI and LNI were calculated as 0.763, 0.750, 0.756 and 0.868, 0.787, 0.874 for JHH and MSKCC nomograms, respectively. The AUC values for 5-year freedom from recurrent disease were 0.751, 0.812, 0.813 and 0.894 for pre- and postoperative JHH and MSKCC nomograms, respectively. CONCLUSION: Despite the potential for heterogeneity in patient selection and management, most predictions demonstrated high concordance with actual observations. All studied nomograms showed reasonable predictive values for the fi nal pathological features, like OCD, SVI and LNI, and for the 5-year freedom from recurrent disease. This multi-institutional study showed that each of the predictive tools studied could be used in Bulgarian patients with comparable accuracy. Compared with the JHH tables, the MSKCC prostate cancer nomograms showed higher predictive accuracy and should therefore be preferred.

Radioisotopic detection of sentinel lymph nodes in clinically localized high-risk prostate cancer.

PURPOSE: To explore the efficacy of a radioisotopic (RI) method in detecting sentinel lymph nodes (SLNs), known as sites of harboring metastases, in localized high-risk prostate cancer (HRPC). METHODS: The RI method was applied to 26 males with clinically localized HRPC, subjected to radical prostatectomy in 2006-2008. All had poor pathological characteristics: initial PSA > 15 ng/ml, Gleason score > 7, clinically suspected extracapsular extension, seminal vesicle invasion, and/or positive pelvic lymph nodes (LNs). The radiopharmaceutical (Tc-99m) was injected preoperatively at 4 zones of the periphery of the prostate. Tc-99m-nanocolloid particles were