Enterovesical Fistula Revealing Crohn's Disease: A Case Report.

Crohn's disease is an inflammatory bowel disease of unknown etiology. It is characterized by intra- and extra-intestinal complications. It is a frequent cause of uroenteric fistulas. They are mostly symptomatic and occur after several years of the evolution of Crohn's disease. The pneumaturia and fecaluria are the most significant symptoms for their presence. They are usually poorly tolerated and require surgical treatment. We report the case of an enterovesical fistula revealing Crohn's disease during endoscopic resection of a bladder pseudotumor in a generally impaired patient. Crohn's disease should be evocated when histology is not relevant for a bladder pseudotumor or a rectovesical fistula. The discovery of an isolated bladder pseudotumor should suggest the diagnosis in the context of weight loss and chronic diarrhea. Enterovesical fistulas are uncommon but potentially dangerous complications of Crohn's disease. Abdominal CT scans and cystoscopy are the most commonly used diagnostic modalities. Surgical treatment seems to be unavoidable in most cases although medical treatment could also benefit a small cohort of patients.

Klippel-Trenaunay Syndrome Associated With Urinary Tract Hemangiomas: A Case Report.

The association between Klippel-Trenauney syndrome (KTS) and bladder hemangiomas is rare. The most common clinical manifestation is hematuria. The diagnosis is made from the characteristic cystoscopic appearance of the tumor. We report the case of a patient presenting recurrent macroscopic hematuria in the context of KTS. A cystoscopic evaluation revealed bladder hemangiomas. A conservative approach consisting of bladder irrigation and close follow-up was chosen as therapy. Conservative treatment of bladder irrigation and close follow-up is the recommended initial treatment of moderate and infrequent episodes of hematuria in this context. The more invasive therapeutic options have to be considered especially for frequent or life-threatening episodes of hematuria. This case suggests that conservative treatment may be effective in treating moderate and infrequent episodes of hematuria due to bladder hemangioma in the context of KTS. Further studies are required to adequately establish the effectiveness, limitations, and complications of each approach.

Pelvic hydatid cyst revealed by acute retention of urine: A case report.

We report the rare case of a primary pelvic hydatid cyst in a 37-years old from a rural area. The diagnosis was suspected preoperatively based on the origin of the patient, and CT findings and it was confirmed intraoperatively by finding the typical cystic content. A total excision of the cyst without causing or contamination of the field was carried out by median incision. Our work aims to point to an unusual localization of hydatid disease, clinical and radiological characteristics, and above all to discuss the different ethnic-pathogenic theories and surgical treatment.

Unusual Presentation of Embryonal Carcinoma of the Testis: A Case Report.

Embryonal carcinoma is a rare and aggressive type of non-seminomatous germ cell tumor that typically affects young to middle-aged individuals. It is often discovered by the patient or during routine medical exams as a painless or occasionally painful lump. Other revealing symptoms, such as lumbar pain or renal colic, are very uncommon in the literature. In this case report, we aim to highlight a case of embryonal carcinoma in a 21-year-old patient, which was discovered following the diagnostic workup of a left lumbar pain episode.

Penile Metastases After Cystoprostatectomy for Urothelial Carcinoma of the Bladder: A Case Report.

Penile metastases from urothelial carcinoma are rare (1-8%). They most often (65%) occur within 18 months of diagnosis of the primary lesion and their prognosis is poor, with survival rarely exceeding 20 months. Treatment of cavernous metastases is multidisciplinary. The best results in terms of overall survival have been obtained with amputation of the penis combined with chemotherapy. We present a case of a 62-year-old male who presented with a metastasis of the penis. This was confirmed by MRI and biopsy, which confirmed the urothelial origin of the metastasis. The patient had undergone radical cystoprostatectomy for an invasive bladder tumor six months earlier. The patient died 10 days after the biopsy due to a significant deterioration in his general condition and the onset of consciousness disorders.

Concurrent Urachal Abscess and Urinary Bladder Tumour: Case Report.

The urachus is an embryological remnant that normally regresses before birth. Failure in this regression may give rise to different pathologies. Among these, a urachal abscess may be difficult to diagnose based on the clinical presentation alone since this condition can mimic different pathologies. We report the first case of concurrent urachal abscess and invasive low-grade urothelial carcinoma of the urinary bladder.

Ureteral Endometriosis Presenting As Left Ureteral Obstruction: A Case Report.

Ureteral endometriosis is a very rare but serious form of infiltrating endometriosis since the risk of urinary tract obstruction and secondary loss of renal function exists. Although not always possible, the clinical and radiologic assessment may help in obtaining a preoperative diagnosis. We report the case of a 42-year-old woman with left ureteral endometriosis, revealed by left flank pain. Imaging revealed left obstructive uropathy with an endometriotic cyst of the left ovary and a spiculated lesion of the left parametrium. She underwent laparotomy, resection of the diseased ureter with primary re-anastomosis, resection of a left parametrial lesion and an endometriotic left ovarian cystectomy. The pathological assessment confirmed the diagnosis of ureteral endometriosis. Follow-up of the patient showed complete resolution with a stable, normal kidney function. In conclusion, ureteral endometriosis involvement is infrequent but should be included in the differential diagnosis in a premenopausal woman with ureteral obstruction of unknown cause. An early diagnosis and obstruction relief are critical to a successful outcome.

Rare case of gangrenous cystitis revealed by acute peritonitis.

Gangrenous cystitis complicated by intraperitoneal perforation is an extremely rare pathology, the major etiopathogenic factor is ischemia of the bladder wall, it has disappeared with the advent of antibiotic therapy and the development of means of bladder drainage. We report a case of a 17-year-old patient, who had a medical history of spinal cord transection by stabbing, who presented a chronic urinary retention leading to a gangrenous cystitis, a surgical exploration was performed and excision of necrotic tissues and reconstruction of the wall bladder with a well recovery.

Pyoperitoneum revealing a spontaneous renal forniceal rupture due to ureteropelvic junction syndrome: About a rare case report.

Extravasation of urine following forniceal rupture of a pelviureteric junction is a rare complication; the existence of pyonephrosis can result to retroperitoneal abscess but its fistulization into peritoneal cavity is exceptional. We report a case of a 22-year-old men who presented a clinical aspects of peritonitis, abdominal CT scan findings suggested retroperitoneal peritonitis by rupture of the fornix. This case emphasizes an unusual presentation of pyonephrosis with peritonitis and pyoperitoneum caused by a ureteropelvic junction syndrome.

Acute pyelonephritis revealing a rare renal collision tumor of papillary and chromophobe cell carcinoma with sarcomatoid features.

A 59-year-old male patient was admitted to the emergency room with febrile right flank pain. The computed tomography scan and the magnetic resonance imaging had objectified lesion image occupying the upper half of the right kidney, measuring 82 mm, suggesting an infectious origin without excluding the infected tumor. He was put under antibiotics. A percutaneous biopsy revealed renal cell carcinoma with suppurative tumor necrosis. He underwent a right radical nephrectomy. The histopathological study revealed a collision tumor of papillary, chromophobe renal cell carcinoma and sarcomatoid dedifferentiation. It is the second case reported in English literature to date.

Acute abdomen revealing a testicular torsion of an undescended testis "case report".

Undescended testis is a common situation in pediatric age groups, often asymptomatic. Torsion of an undescended testis remains an exceptional condition. Delayed diagnosis in many cases involves the prognosis of the testis, hence the importance of a correct clinical assessment including the examination of the external genitalia. Immediate surgical exploration should be performed without delay for testicular salvage. This paper aims to report the first case of torsion of an undescended testis in a 16 years old patient with bilateral testicular ectopy.

Acute renal infarction due to left ventricular thrombus: About a rare case and literature analysis.

Renal infarction is a rare pathology, with a serious threat to the functional prognosis of the kidney. Because of its nonspecific clinic presentation, renal infarction is often misdiagnosed as renal colic and pyelonephritis or any etiology of abdominal pain. Embolic Renal infarction occurs commonly in a patient with the risk factors of thromboembolic with heart diseases especially atrial fibrillation. It's important to be aware of this condition to initiate treatment to increase the chance of renal salvage. We report a patient with a renal infarction due to the emboli from left ventricular thrombus with a brief review of the literature.

Ureteral Injury by a Retained Knife After Abdominal Trauma: A Case Report.

Isolated ureteral injuries are rare, occurring particularly in gunshot wounds to the abdomen. These are much rarer in the context of stab wounds. These lesions are usually silent. We report a 30-year-old man with a history of abdominal penetrating trauma with a knife, 11 years ago before the actual admission to the urology department. The patient's report describes a retained metallic foreign body in the right lumbar area. At admission, the patient presented with a four-months history of right lumbago. An abdominal computed tomography scan revealed the presence of a right para-renal small urinoma and identified the 52 x 20 mm metallic foreign body at the level of L3 and L4 vertebral bodies, with the presence of mild right ureterohydronephrosis. Ureteral injuries can lead to significant morbidity and mortality when unrecognized or mismanaged. The basis of therapy for patients with ureteral injuries is to maintain renal drainage with options depending on individual cases.

Penile Squamous Cell Carcinoma in a 95-Year-Old Patient: Case Report and Literature Review.

Penile cancer is a rare disease. Delay in diagnosis and treatment frequently occurs and high morbidity can be observed in affected patients. The management is based on surgical resection. The inguinal node staging depends on the disease-related risk. We herein report a 95-year-old male patient, with a history of a right inguinal hernia, surgically treated. He presented with a swollen painful glans penis. The glans biopsy identified a moderately differentiated invasive squamous cell carcinoma. We have performed a complete penectomy with a bilateral inguinal lymph node dissection. The patient is currently receiving adjuvant chemotherapy based on cisplatin.

Coexistence of Emphysematous Pyelonephritis and Cystitis in a Patient with COVID-19 Complicated with Spontaneous Pneumomediastinum.

We report the first case of a 52-year-old nondiabetic male admitted for management of uremic syndrome associated with emphysematous pyelonephritis (EPN), renal and perinephric abscess, and emphysematous cystitis (EC) on a single functional kidney with a large abundance of spontaneous pneumomediastinum (SP) complicating a SARS-CoV-2 pneumonia. The patient has benefited from several dialysis sessions, intravenous antibiotics, and percutaneous drainage. His clinical course was complicated by acute respiratory distress syndrome, and unfortunately, he died nine days following admission.

Management of bilateral adrenal myelolipoma without endocrine disorder: About a rare case report.

Adrenal gland myelolipomas are benign, hormonally inactive, and mostly asymptomatic and unilateral tumors. However, it could be symptomatic and bilateral in rare cases. The diagnosis is based on a CT scan and a histological study. We present a rare case of a surgically managed bilateral adrenal gland myelolipoma with a giant mass on the left side in a 40-year-old man who presented in our department for atypical abdominal pain. The patient underwent surgical resection of the left adrenal mass. Due to the resolution of the abdominal pain, a close follow-up for the right mass by CT scan was chosen.

Spermatocytic seminoma of testis associated with undifferentiated sarcoma revealed in metastatic disease: A review and case report analysis.

Spermatocytic seminoma is a relatively rare testicular tumor and is characterized by a good prognosis. The discovery of a sarcomatous contingent modifies the prognosis of the indolent neoplasm. Only 20 cases being reported in English literature. We present the case of a 66-year-old man with a two-year history of left-sided scrotal pain and swelling. Tumor markers were normal. Ultrasound demonstrated a very large solid-cystic testicular mass. Orchidectomy was performed. Further imaging investigations revealed lung, vertebra, and retroperitoneal lymph node metastases. Histological examination and immunohistochemistry of the orchidectomy specimen concluded on spermatocytic seminoma associated with undifferentiated sarcoma component.

Kidney metastasis in a case of Merkel cell carcinoma.

Merkel cell carcinoma is a rare neuroendocrine skin tumor with a poor prognosis. Metastasis is frequent and is seen in the first few years after diagnosis. This report describes a case of renal metastasis from Merkel cell carcinoma which is an unusual clinical presentation.

Emphysematous pyelonephritis on a single anatomic kidney: About a case report and literature analysis.

Emphysematous pyelonephritis (EPN) on a single kidney is an extremely uncommon necrosing infection of renal parenchyma due often to infection by a gas-producing bacteria in a patient with uncontrolled diabetes mellitus. The management associate aggressive fluid and electrolyte resuscitation with several dialysis sessions, control of blood sugar levels, and broad-spectrum antibiotics with an urgent drainage. This paper aims to describe a case of a 68-year-old diabetic male patient who presented with EPN on a single kidney managed by conservative treatment.

A Giant Solitary Adrenal Plasmacytoma in a Patient with HIV: A Rare Case Report and Review of the Literature.

Solitary extramedullary plasmacytoma (EMP) involving the adrenal gland is an extremely rare malignancy. We report a case of a solitary adrenal plasmacytoma in an HIV-positive 50-year-old woman on antiretroviral therapy who presented with a rapidly progressing lumbar left masse. A CT scan objectified a locally advanced left adrenal mass measuring 135mm long axis. A biopsy was taken, and the histopathology with the immunohistochemical study objectified an adrenal gland plasmacytoma. The skeletal survey and the sternal suction biopsy did not show any abnormalities. The diagnosis of a solitary EMP of the adrenal gland was made. There are only 10 cases of solitary adrenal plasmacytoma with only one case associated with an HIV-positive patient reported in the literature. Therefore, this paper is aimed at presenting the second case of an HIV-positive patient diagnosed with solitary adrenal plasmacytoma.