Case series - Prioritizing bladder-sparing treatments in patients with urinary tract leiomyoma: A report of three cases and updated literature review.

Urinary tract leiomyomas are rare, benign mesenchymal tumors that are traditionally treated with complete surgical excision. We present three cases of urinary tract leiomyoma - two located in the bladder and one in the ureter. Both bladder leiomyomas were treated with transurethral resection of bladder tumor (TURBT) with no evidence of recurrent disease, while the upper tract leiomyoma was managed with surveillance by patient preference, which to our knowledge, has not been previously described. The ureteral leiomyoma has remained stable at five years followup from initial diagnosis. Given the benign nature of leiomyomas and the overall low recurrence rate reported in the literature, bladder-sparing options should be emphasized when feasible, with active surveillance potentially applicable for highly select patients.

Ectopic hepatocellular carcinoma presenting as a right adrenal mass with IVC thrombus: Case report and review of the literature.

Hepatocellular carcinoma (HCC) arises from several different etiologies and carries a poor prognosis. Extrahepatic metastases of HCC are most frequently found in the lungs, lymph nodes, and bones, with adrenal metastases reported in less than 15% of metastatic cases. Herein, we report a case of a 71-year-old man without prior liver disease who presented with a 9-cm right adrenal mass extending into the IVC consistent with HCC on subsequent surgical pathology and immunohistochemical staining. Etiological possibilities for an adrenal tumor as the first presentation of HCC include metastasis from occult primary liver HCC, intra-adrenal hepatic heterotopia, and adrenohepatic fusion.