[Renal cell carcinoma secondary to tuberculous nephritis]. / Adénocarcinome rénal sur néphrite tuberculeuse.

The combination of renal tuberculosis and renal cancer is rare. The authors report the case of a patient who was followed for multifocal pulmonary, hepatic and renal tuberculosis. The diagnosis of associated renal tumour was raised in the presence of suggestive radiological images. Tumourectomy was performed after tuberculostatic therapy, and histological examination revealed renal cell carcinoma associated with caseo-follicular tuberculous granulomas. The outcome was favourable after a follow-up of 2 years. The objective of this study is to analyse the pathogenesis, diagnostic features and treatment modalities of this exceptional combination.

[Orbital metastasis of prostatic carcinoma]. / Métastase orbitaire d'un adénocarcinome prostatique.

Prostate cancer is frequently complicated by bone metastases. However some metastatic sites remain rare and unusual. The authors report an exceptional case of prostatic carcinoma presenting with orbital metastasis. A 71-year-old man was admitted with ocular protrusion and decreased visual acuity of the left eye. In addition to the ophthalmological disorders, clinical examination revealed a left temporoparietal swelling with a suspicious prostate on digital rectal examination. Brain MRI revealed an osteolytic process involving the left sphenoid bone with intra-orbital invasion. Another osteolytic site was observed in the left temporoparietal region with intracranial and extracranial components. PSA was 13,327 ng/ml. Prostatic biopsy confirmed the diagnosis of prostatic carcinoma. Treatment comprised cranial radiotherapy combined with anti-androgen endocrine therapy and corticosteroids. Six weeks after treatment, the patient obtained an improvement of visual acuity and regression of exophthalmos and the temporoparietal swelling. Orbital metastasis of prostatic carcinoma raises the problem of ophthalmic emergency. Cranial radiotherapy and anti-androgen endocrine therapy allowed regression of the symptoms without modifying the unfavourable course of the disease.

[Appendicular ureteroplasty to repair a ureteric lesion during disk surgery]. / Urétéroplastie appendiculaire pour lésion urétérale au cours de la chirurgie discale.

Extensive ureteric lesions raise difficult problems of surgical repair. This is also the case for upper ureteric lesions that often require replacement of the damaged segment or even autologous transplantation. The authors report a case of iatrogenic ureteric lesion resulting in a large defect in a patient operated 6 months previously for an L4-L5 disk hernia, which was treated successfully by interposition of an appendicular graft between the two ureteric stumps. In the light of this case, the authors discuss the various appearances of iatrogenic ureteric lesions with particular emphasis on the value of appendicular ureteroplasty due to its simplicity and low morbidity, while waiting for progress in the field of biocompatible substitutes.

[Intravesical migration of an intrauterine contraceptive device complicated by stones]. / Migration intravésicale d'un dispositif intra-utérin compliquée d'une lithiase.

Transuterine migration of an intrauterine contraceptive device (IUCD) is a rare complication. The authors report a case of IUCD that migrated into the bladder and subsequently became calcified, leading to a false diagnosis of bladder stones. A 38-year-old woman with an IUCD for 3 years presented with haematuria and signs of bladder irritation. Ultrasound and plain abdominal x-rays suggested a diagnosis of bladder stones. The positive diagnosis of migrated and calcified IUCD was only established after surgical extraction of the stone.

[Ductal adenocarcinoma of the prostate: case report and review of the literature]. / Adénocarcinome ductal de la prostate.

Ductal adenocarcinoma is a histological variant of prostate cancer. The authors report the case of a 53-year-old man, in whom the tumour was revealed by acute urinary retention and haematuria. In the light of this case and a review of the recent literature, the authors discuss the histological, clinical and therapeutic aspects of this rare entity.

[Laparoscopic treatment of retroperitoneal fibrosis]. / Traitement laparoscopique de la fibrose rétropéritonéale.

The authors report a case of idiopathic retroperitoneal fibrosis (RPF) in a 38-year-old man presenting with obstructive acute renal failure. The initial management consisted of urinary diversion by bilateral double-J ureteric stenting. After restoration of normal renal function, CT urography demonstrated retroperitoneal fibrosis surrounding the two ureters. Surgical treatment was performed by laparoscopy using four trocars. The operation consisted of detachment of the ascending and descending colon followed by release of the ureters from the lumbar segment to the pelvic segment and finally intraperitonealization of the ureters. The operating time was six hours, the postoperative course was uneventful and the double-J stents were removed at the third week. Laparoscopic treatment of RPF is a treatment option providing all of the benefits of minimally invasive surgery. In the light of this case and a review of the literature, the authors describe the laparoscopic treatment of idiopathic retroperitoneal fibrosis.

[Urogenital lymphoma presenting with obstructive anuria]. / Anurie obstructive révélatrice d'un lymphome uro-génital.

The authors report a case of urogenital lymphoma with multiple sites in a patient presenting with oligo-anuria. Clinical examination revealed a hard hypogastric and prostatic mass and an enlarged left scrotum. Abdominopelvic and scrotal ultrasound demonstrated a prostatic tumour, a hypogastric mass, hepatic nodular lesions and coeliac lymphadenopathy with bilateral ureterohydronephrosis and a heterogeneous intrascrotal mass in contact with the lower pole of the left testis. The laboratory assessment revealed severe renal failure. After a haemodialysis session and ultrasound-guided right percutaneous nephrostomy, pelvic magnetic resonance imaging (MRI) showed a very large pelvic mass between the bladder and the rectum and transrectal biopsy of the mass confirmed the diagnosis of high-grade malignant non-Hodgkin's lymphoma (NHL) with a type B lymphoblastic phenotype. Treatment consisted of chemotherapy according to the LMB 93 protocol. The course was favourable with return of normal renal function and complete remission 1 month after induction. The patient is currently in complete remission with a follow-up of 12 months. In the light of this case and a review of the literature, the authors discuss the diagnostic, therapeutic and prognostic aspects of this rare site of lymphoma.

[Management of horseshoe kidney based on a series of 36 cases]. / Le rein en fer à cheval pathologique: aspects thérapeutiques.

OBJECTIVE: Horseshoe kidney is a malformation of the upper urinary tract that usually remains asymptomatic. The authors report the various therapeutic modalities for urological diseases associated with horseshoe kidney. MATERIAL AND METHOD: Review of a series of 36 pathological horseshoe kidneys, associated with renal stones in 19 cases, ureteropelvic junction syndrome in 8 cases, tumour in 5 cases, pyonephrosis in 2 cases and trauma in 2 cases. RESULTS: The authors stress the very specific characteristics of this rare malformation and review the therapeutic approach to each type of urological disease associated with horseshoe kidney. CONCLUSION: The topographic and vascular characteristics must be taken into account before treating any urological disease associated with horseshoe kidney.

[Genital self-mutilation. Report of 3 cases]. / L'automutilation génitale: à propos de 3 cas.

Self-mutilation, a very unusual situation in routine urology, is a rare phenomenon. It is generally observed in a psychotic context, but can be secondary to drug or alcohol abuse. Treatment and management vary according to the severity of the lesions, the time to presentation and the patient's mental state. The authors report 3 cases of self-mutilation, including 1 case of penis amputation, 1 case of strangulation by a metal ring and 1 case of bilateral castration. In the light of these cases and a review of the recent literature, the authors analyse the various psychiatric medicolegal and urological aspects of this deliberate self-injury.

[Small cell prostatic carcinoma detected at the stage of metastases]. / Carcinome à petite cellule prostatique révélé au stade de métastases.

Small cell prostatic carcinoma is rare, with a poor prognosis. The authors report a case of small cell prostatic carcinoma in a 30-year-old patient diagnosed at the stage of metastases. Immunohistochemistry showed positive anti-neuron-specific enolase (NSE.) and anti-synaptophysin antibodies, while serum PSA was normal (1.2 ng/ml). The patient was treated by cisplatin-etoposide combination chemotherapy, but died 20 days after the first course.

[Hemorrhagic bilateral renal angiomyolipoma]. / Angiomyolipome rénal bilatéral hémorragique.

Renal angiomyolipoma is a rare benign tumour, often associated with congenital diseases especially de Bourneville's tuberous sclerosis. Bilateral angiomyolipoma is exceptional. The authors report a case of bilateral renal angiomyolipoma in a 33-year-old patient presenting with haemorrhagic shock. In the light of this case and a review of the literature, the authors discuss the diagnostic and therapeutic aspects of this disease.

[Tumor of upper urinary tract in renal polycystic disease]. / Tumeur des voies excrétrices supérieures sur polykystose rénale.

Upper urinary tract tumours are exceptional in the context of renal polycystic disease. The authors report the case of Mrs B. F., 56 years old, who presented with left loin pain associated with haematuria. Clinical examination was normal and ultrasound examination revealed bilateral renal polycystic disease with a mass in the left renal sinus. CT urography showed a tumour arising from the renal pelvis suggestive of an upper urinary tract tumour. The laboratory assessment revealed normal renal function and normal urine cytology. Treatment consisted of radical nephroureterectomy with resection of a bladder cuff. Histological examination revealed a urothelial tumour of the renal pelvis with negative surgical margins. In the light of this case, the authors discuss the diagnostic difficulties and specificities, the treatment and the outcome of this unusual clinical association.

[Post-traumatic urethral diverticulum in an adult]. / Diverticule de l'urèthre post-traumatique chez l'adulte.

The male urethral diverticulum is a rare affection. The authors report one case of traumatic urethral diverticula. The diagnosis was confirmed by urethrocystography. The postoperative follow-up was good after resection of the diverticulum and urethrography. On the basis of this case, the authors discuss the diagnosis and therapeutic aspects of this disease.

[Lumboscopic treatment of simple renal cysts: initial experience with 17 cases]. / Traitement lomboscopique des kystes simples du rein: expérience initiale à propos de 17 cas.

OBJECTIVE: To evaluate the feasibility of lumboscopic treatment of simple renal cysts. MATERIAL AND METHODS: From January 1999 to January 2002, 17 patients with a mean age of 40 years were operated for symptomatic renal cysts via a retroperitoneal approach. All patients were evaluated by preoperative ultrasonography and CT. A Bosniak type I cyst was diagnosed in 10 cases and a Bosniak type II cyst was diagnosed in 7 cases. The mean cyst diameter was 7 cm (range: 5 to 15 cm). RESULTS: All patients were operated via an exclusively retroperitoneal approach. The mean operating time was 50 min (range: 40 mm-120 mm). The estimated mean blood loss was 80 cc. No conversion was necessary and the mean length of hospital stay was 1.5 days. All cysts were histologically benign. All 17 patients are asymptomatic (mean follow-up = 11 months) with no radiological signs of recurrence. CONCLUSION: Lumboscopic treatment of simple renal cysts appears to be a feasible, safe, effective and satisfactory technique in terms of morbidity, operating time, complications and blood loss.

[Pseudotumor form of urinary tuberculosis]. / Forme pseudotumorale d'une tuberculose urinaire.

Urogenital tuberculosis is an increasingly frequent serious disease. The diagnosis is often delayed due to the marked clinical polymorphism, leading to serious sequelae. The diagnosis of typical forms is easy, but some forms are misleading and can lead to an incorrect diagnosis. The authors report a pseudoneoplastic form of urogenital tuberculosis in a young patient that was initially diagnosed as lymphoma. In the light of this case and a review of the literature, the authors emphasize the diagnostic difficulties of these forms and the treatment modalities.