ABSTRACT
Dent's disease is a rare cause of hypercalciuria and recurring urolithiasis. Patients with this disease have elevated bone resorption due to the presence of parathormone (PTH) in the urine. We describe the case of a 21-year-old male with hypercalciuria, elevated bone resorption and recurring bilateral urolithiasis that achieves radiological and clinical stability with percutaneous nephrolithotomy (PNL) and medical treatment with hydrochlorothiazide, potassium-citrate and phytate.
ABSTRACT
La granulomatosis con poliangeítis (GPA) es una vasculitis autoinmune que raramente afecta al tracto genitourinario inferior. Presentamos el caso de un varón de 53 años que debutó con una masa retroperitoneal y posteriormente desarrolló un hidrocele multiseptado izquierdo que condicionó un infarto testicular. El informe anatomopatológico de la orquiectomía reveló hallazgos sugestivos de GPA.(AU)
Granulomatosis with polyangiitis (GPA) is an autoimmune vasculitis which rarely affects the lower genitourinary tract. We share the case of a 53-year-old man who presented with a retroperitoneal mass and thereafter developed a left multiseptated hydrocele that conditioned a testicular infarction. The pathology report of the orchidectomy was consistent with GPA.(AU)
Subject(s)
Humans , Male , Middle Aged , Granulomatosis with Polyangiitis , Spermatic Cord Torsion , Vasculitis , Orchiectomy , Inpatients , Physical Examination , ColectomyABSTRACT
Granulomatosis with polyangiitis (GPA) is an autoimmune vasculitis which rarely affects the lower genitourinary tract. We share the case of a 53-year-old man who presented with a retroperitoneal mass and thereafter developed a left multiseptated hydrocele that conditioned a testicular infarction. The pathology report of the orchidectomy was consistent with GPA.
Subject(s)
Granulomatosis with Polyangiitis , Polyarteritis Nodosa , Spermatic Cord Torsion , Vascular Diseases , Male , Humans , Middle Aged , Spermatic Cord Torsion/diagnosis , Granulomatosis with Polyangiitis/complications , Granulomatosis with Polyangiitis/diagnosisABSTRACT
OBJECTIVE: To report our step-by-step technique and provide tips and tricks for robotic partial nephrectomy (RPN) in a highly complex renal mass. Robotic surgery has widened the indications of the conservative treatment for renal masses. With increasing experience, larger deeply infiltrative tumors, or tumors involving the renal hilum can be treated with robotic partial nephrectomy. MATERIALS AND METHODS: A 78-year-old male came to our attention for a complex right renal mass. Past medical history included severe hypertension and a myocardial infarction with subsequent stent placement in 2014. Baseline renal function assessed by serum creatinine was 0.93 mg/dl. The preoperative computed tomography scan and magnetic resonance showed a right enhancing posterior renal mass, 7.6 cm in diameter, cT2a, and RENAL score 12. The patient was scheduled for robotic partial nephrectomy. Transperitoneal approach with three arms robotic configuration was chosen. RESULTS: Operative time including robot's docking was 195 minutes. Warm ischemia time was 19 minutes. Blood losses were negligible, with no transfusions required. Serum creatinine at discharge was 1.15 mg/dl. Final pathology revealed a clear cell renal cell carcinoma, pT3b, and ISUP grade 3, involving the sinus fat and the renal vein. Surgical margins were negative. CONCLUSION: Robotic partial nephrectomy can be successfully performed in cases of completely endophytic central, hilar masses. Consistent experience is needed before embarking on this surgery. Future studies are needed to determine the long-term outcomes for partial nephrectomy for these complex tumors.
