ABSTRACT
This case report presents a unique manifestation of complications in a 71-year-old man following blunt renal trauma. Initially, computed tomography (CT) revealed a traumatic left kidney laceration. Hematuria ceased quickly after ureteral stent placement. One week later, hematuria reoccurred while the patient was treated for pulmonary embolism. Multiphase CT revealed two renal pseudoaneurysms as the underlying cause. Renal pseudoaneurysms are commonly associated with surgery or inflammation and rarely seen after trauma. Selective angiographic embolization successfully stopped hematuria. Thereafter, the patient was hemodynamically stable to continue therapeutic thrombolysis. After discharge, the patient remained symptom-free and had an unremarkable follow up assessment.
ABSTRACT
This case report describes a unique manifestation of a primary urethral squamous cell carcinoma (SCC) as the underlying pathology in an 80-year-old male patient who underwent partial penectomy due to an enlarging penile mass. Persistent pain in the right knee was discovered to be a pathologic fracture using magnetic resonance imaging. Computed tomography-guided biopsy confirmed metastatic SCC. Whole-body positron emission tomography revealed systemic dissemination to multiple sites. Orthopedic knee replacement was performed in combination with local radiotherapy. Palliative chemotherapy was rejected due to poor performance status. Primary urethral SCC is rare and an uncommon cause of advanced penile cancer. These findings could be of great interest to clinicians for two reasons. First, a tumor's appearance can be misleading. Consequently, histological work-up in accordance with clinical guidelines is necessary for accurate diagnosis. Second, a more comprehensive investigation is required when clinical symptoms persist despite the use of conventional treatment. Our case is an instance in which persistent pain masked the presence of downstream metastasis. We believe that these aforementioned points are of significant clinical importance and present a salient learning opportunity.
Subject(s)
Carcinoma, Squamous Cell/secondary , Penile Neoplasms/surgery , Postoperative Complications , Urethral Neoplasms/pathology , Urologic Surgical Procedures, Male/adverse effects , Aged, 80 and over , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy , Humans , Male , Penile Neoplasms/complications , Penile Neoplasms/pathology , Positron-Emission Tomography , Prognosis , Urethral Neoplasms/etiology , Urethral Neoplasms/therapyABSTRACT
OBJECTIVE: This study aimed to know the outcome of delayed-interval delivery for twin and triplet pregnancies at 22+0 to 25+0 weeks of gestation. STUDY DESIGN: A retrospective cohort of twin and triplet deliveries at the 23rd to 26th weeks of gestation were managed with delayed interval delivery from 2005 to 2011. RESULTS: From 2005 until 2011, delayed delivery in five twin pregnancies and two triplet pregnancies were performed. The interval between delivery of the first fetus and the remaining twin/triplets was 1-18 days (mean, 9.7 days). In all cases, the first fetus was born vaginally. Survival of the first twin/triplet was 14.3%, whereas 57.1% of the second born twin/triplets survived. Birth weight gained due to delayed delivery was 131 g on average. No severe maternal complications were observed. When compared with a gestation age-matched group, where the delay was not possible, the delayed twin/triplet had a higher survival rate (57.1% vs. 0%, P=0.05). CONCLUSION: In multiple pregnancies with preterm delivery between completed 22 and completed 25 weeks of gestational age, delayed delivery seems to be a useful therapeutic option to achieve a better outcome of the remaining fetus or fetuses.
