ABSTRACT
We present the case of a 25-year-old male who came to the emergency room for pain and abdominal distension following trauma to the mesogastrium. A CT scan was performed, revealing a voluminous retroperitoneal hematoma with laceration of both inferior renal poles with regard to rupture of the isthmus of a horseshoe kidney. The patient presented anemization and increased pain, requiring selective embolization by means of arteriography of a branch of the right renal artery and placement of a double J stent due to urinary extravasation in the lower left kidney pole. Following 1 year of monitoring, the patient has maintained normal renal function. Renal affection in blunt abdominal trauma is frequent, occurring in 7% of previously pathological kidneys. The traumatic rupture of horseshoe kidney is facilitated by its particular anatomical characteristics, constituting an infrequent entity, knowledge of which is necessary to achieve conservative management that renders it possible to preserve renal function.
Subject(s)
Abdominal Injuries/etiology , Kidney/injuries , Renal Artery/injuries , Soccer/injuries , Vascular System Injuries/etiology , Abdominal Injuries/diagnostic imaging , Abdominal Injuries/therapy , Abdominal Pain/etiology , Adult , Embolization, Therapeutic , Hematoma/etiology , Humans , Kidney/abnormalities , Kidney/blood supply , Kidney/diagnostic imaging , Male , Renal Artery/abnormalities , Renal Artery/diagnostic imaging , Rupture , Stents , Tomography, X-Ray Computed , Treatment Outcome , Vascular System Injuries/diagnostic imaging , Vascular System Injuries/therapyABSTRACT
OBJECTIVE: To review the presentation, diagnosis and treatment of primary renal lymphoma through a new case report. METHODS: We report the case of a 73-year-old man who presented at A&E with constitutional symptoms and weight loss of 9 kilograms over 3 months RESULTS: Laboratory analysis showed impaired renal function, anemia and hypercalcemia. Imaging tests showed a large solid mass in the right perirenal area with infiltration of the parenchyma and Gerota's fascia surrounding the hilum of the kidney, as well as a solid mass in the inferior pole of the left kidney. Pathology showed the presence of lymphoid-like monomorphic cells. After establishing the diagnosis of bilateral primary renal lymphoma it was decided to start treatment with CHOP-Rituximab-type combination chemotherapy. CONCLUSIONS: Primary renal lymphoma is a rare entity and the diagnostic technique of choice is CT. Definitive diagnosis is confirmed on histology. In view of its aggressive nature and poor prognosis, it is important to make an early diagnosis in order to start treatment promptly. The treatment of choice is systemic chemotherapy using a CHOP regimen.
Subject(s)
Kidney Neoplasms , Lymphoma , Aged , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Lymphoma/diagnosis , Lymphoma/therapy , MaleSubject(s)
Hydronephrosis , Aged , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/pathology , Male , Tomography, X-Ray ComputedABSTRACT
Radical surgery is the only feasible and successful treatment for paratesticular sarcomas, with the exception of rabdomyosarcoma. The inguinal approach is the ideal and obligatory one, including excision of the spermatic cord and adjacent testicle. Long-term periodic follow-up visits are mandatory because relapses may ocurre even long time after diagnosis: In the case of relapse, surgery is again the only tool we have to control this type of tumor. We present two cases of paratesticular leiomyosarcoma, a tumor un common.
