Rare metastatic sites of renal cell carcinoma: a case series.

Renal Cell Carcinoma (RCC) is a lethal cancer with a propensity for wide metastasis. The patterns of metastases are not clearly defined, and patients can present with metastasis to unusual sites at the time of diagnosis of the primary tumor or years after radical nephrectomy. Individual diagnostic and surgical approaches are needed to achieve complete resection with disease-free margins, even in the presence of unusual metastatic sites, multifocality, or history of previous metastasectomy. This provides palliation for symptoms and an opportunity for meaningful disease-free and overall survival. Here we present five cases of RCC with metastasis to unusual sites (scalp, jaw, forearm, parotid, breast, and skeletal muscle). Patients were treated with cytoreductive nephrectomy and/or metastasectomy wherever feasible and/or targeted therapy. In conclusion, a high index of suspicion and accurate diagnosis is important as metastasis to unusual sites presents with atypical manifestations and may masquerade as local pathology, misleading the clinician and directly affecting prognosis and survival.

[Benign prostatic hyperplasia related content on YouTube: unregulated and concerning].

INTRODUCTION: Information derived from social media sources is being used to save lives and take vital life altering decisions. You Tube is one of the most widely used social media for seeking medical information. Quality of information available to patients and medical professionals on YouTube with regards to benign prostatic hyperplasia (BPH), a common urological condition, w.as assessed. MATERIALS AND METHODS: First 1 00 videos results on BPH were analysed by three independent observers and graded based on the quality of information provided using an indigenous grading system of five points ranging from not useful to Informative for the Medical Professional. Correlation of this score with rank, number of views and "likes" was performed. Source of videos was identified along with analysis of comments. RESULTS: A large proportion of videos (63%) was found to be irrelevant to the search, projected wrong facts or provided very basic · information about prostate and the disease. A small but significant number of videos contained useful and relevant information. Only a handful of videos were useful for the urologist and adequate to guide the patient. A negative correlation between the quality of videos and their ranking on search was observed. CONCLUSIONS: YouTube offers very few high quality resources for patients and physicians. There is a significant negative correlation between useful videos and higher ranks in search results, but no correlation with number of views and likes. The first video in such results should be issued by a governing body that serves as the gold standard for patients and physicians.