ABSTRACT
We describe a case of a 55-year-old woman with polycystic kidney disease who received a living donor kidney transplant 16 years earlier and was on immunosuppressive therapy with satisfactory renal function. The donor was her mother. The patient presented with flank pain on the right side and macrohematuria, and noncontrast computed tomography and magnetic resonance imaging led to the diagnosis of tumors in the remaining right native polycystic kidney and ureter, as well as secondary retroperitoneal dissemination. We performed right radical nephrectomy and ureterectomy with extirpation of 2 metastases; the left native kidney remained intact. Histology showed squamous metaplastic changes and invasive epithelial neoplasm in the lumen of the renal pelvis and ureter with extensive squamous differentiation positive for nuclear p63 as squamous cell immunohistochemical marker. After surgery, an immunosuppressive therapy with methylprednisolone was administered, without calcineurin inhibitors and mycophenolate mofetil. Twelve months later the patient was still alive, with a glomerular filtration rate of 29 mL/min. Needs remain for further treatment modalities in patients with primary squamous cell carcinoma in nonfunctioning kidneys and improvements in imaging technique accuracy.
Subject(s)
Carcinoma, Renal Cell , Carcinoma, Squamous Cell , Kidney Neoplasms , Kidney Transplantation , Polycystic Kidney Diseases , Ureter , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Female , Humans , Kidney/pathology , Kidney/physiology , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Kidney Transplantation/adverse effects , Living Donors , Male , Middle Aged , Nephrectomy/methods , Polycystic Kidney Diseases/surgery , Treatment OutcomeABSTRACT
We describe here the case of a 16-year-old boy successfully treated at our hospital for intramuscular cavernous hemangioma in the left soleus muscle. The patient was diagnosed using magnetic resonance imaging and open biopsy after attempted/failed surgery at another institution. We performed lower leg phlebography in order to identify all the feeding and draining veins of the cavernous hemangioma. Our surgical approach of ligation of the feeding and draining veins of the intramuscular cavernous hemangioma with subsequent thrombosis of the hemangioma proved successful, resulting in cure with no operative or postoperative complications, a minimal hospital stay and a good functional and cosmetic outcome.
