ABSTRACT
Urologists use intravenous dyes in diagnosing genitourinary fistulas and in investigating ureteral patency. Methylene blue and indigo carmine are the most common dyes used today. Generally, patients with clinically normal renal function demonstrate dye in their urine after several minutes. We report on 2 patients in whom methylene blue was not visualized after intravenous injection. A review of urologic and pharmacologic published reports led to a possible explanation for this phenomenon. Methylene blue can metabolize into leukomethylene blue, which is colorless in urine. Indigo carmine, however, is not readily metabolized but is rather freely filterable by the kidneys. Therefore, it is important to appreciate that nonvisualization of methylene blue may be a metabolism effect and not an anatomic one.
Subject(s)
Methylene Blue/analysis , Renal Insufficiency/diagnosis , Female , Humans , Injections, Intravenous , Kidney Function Tests , Methylene Blue/administration & dosage , Middle Aged , Predictive Value of Tests , Reproducibility of ResultsABSTRACT
Sarcomatous lesions of the kidney comprise less than 2% of all primary renal malignancies. Angiosarcomas are an exquisitely infrequent histologic type in this setting and are associated with a universally poor prognosis. We report the eighth known case of primary renal angiosarcoma and review the available literature on this rare entity.
Subject(s)
Hemangiosarcoma/pathology , Kidney Neoplasms/pathology , Aged , Antibiotics, Antineoplastic/administration & dosage , Antineoplastic Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dacarbazine/administration & dosage , Doxorubicin/administration & dosage , Hemangiosarcoma/drug therapy , Hemangiosarcoma/secondary , Humans , Kidney Neoplasms/drug therapy , Male , Mouth Neoplasms/secondary , Neoplasm Invasiveness , Omentum/pathology , Peritoneal Neoplasms/pathology , Prognosis , Splenic Neoplasms/pathologyABSTRACT
We describe a patient who initially presented with asymptomatic hydronephrosis. He underwent extensive radiologic evaluation which led to the diagnosis of pelvic lipomatosis. The possible etiology, workup, and treatment options of this unusual entity are discussed.
Subject(s)
Hydronephrosis/diagnostic imaging , Lipomatosis/diagnostic imaging , Pelvis , Diagnosis, Differential , Humans , Hydronephrosis/diagnosis , Lipomatosis/diagnosis , Male , Middle Aged , Tomography, X-Ray Computed , UrographyABSTRACT
The staging and treatment of prostate cancer are complex, particularly in patients with clinical disease that has advanced locally beyond the confines of the gland. Management choices are made more difficult by a paucity of quality randomized and controlled studies. Staging has traditionally relied on digital rectal examination, which is now being augmented by improved noninvasive radiologic studies. Radiation is the most common form of treatment today, and newer techniques are being examined and compared to external-beam therapy. Surgical intervention as monotherapy has failed to show a survival advantage. Current approaches treatment appear to be evolving toward combination therapies, potentially incorporating hormonal manipulation. Patients with locally advanced disease should be encouraged to enter prospective clinical trials.
Subject(s)
Prostatic Neoplasms/therapy , Combined Modality Therapy , Humans , Magnetic Resonance Imaging , Male , Neoplasm Staging/methods , Palliative Care , Palpation , Prostate-Specific Antigen/blood , Prostatectomy , Prostatic Neoplasms/diagnosis , Radiotherapy/methods , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
Plasmacytoma is an unusual soft-tissue collection of neoplastic monoclonal plasma cells. The most common site of presentation is the upper respiratory tract, although any site of disease is theoretically possible. We report the fifth known case of primary urethral plasmacytoma. This case is unique in that the patient received only radiation as definitive treatment and has remained well, without recurrence for more than 12 years.
Subject(s)
Plasmacytoma/radiotherapy , Urethral Neoplasms/radiotherapy , Adult , Disease-Free Survival , Humans , Male , Plasmacytoma/mortality , Time Factors , Urethral Neoplasms/mortalityABSTRACT
OBJECTIVES: During the last decade, the number of patients undergoing radical retropubic prostatectomy (RRP) has substantially increased. Over this same time period, we have noted that a significant number of these patients have developed postoperative inguinal hernias. We sought to identify the incidence of postoperative inguinal hernias after RRP and compared this with the stated 5% incidence in the general adult male population. METHODS: Ninety-two consecutive RRPs performed by three surgeons (I.J.S., N.L.C., S.W.D.) were retrospectively reviewed. The operative reports for each patient who subsequently underwent inguinal herniorrhaphy were analyzed to determine whether the hernias were direct or indirect. RESULTS: The overall incidence of postoperative inguinal hernias was 12% (11 of 92). All hernias were found within approximately 6 months of the prostatectomy. Ninety-one percent (10 of 11) of these hernias were indirect, and only 9% (1 of 11) were direct. CONCLUSIONS: We believe this to be the first report in the English literature describing postoperative inguinal hernias following retropubic prostatectomy. A significantly higher incidence (12%) of inguinal hernias was noted in the postprostatectomy population compared with the general adult male population (5%). This finding suggests that inguinal hernias can be a consequence of RRP. Urologists should be cognizant of this possibility in order to screen all patients carefully prior to surgery for subtle weakness in the inguinal canal, as well as to inform patients properly of the possibility of developing an inguinal hernia after surgery.
