RESUMEN
Renal hypertension can occur with unilateral ureteropelvic junction obstruction and consecutive hydronephrosis. It is rarely the main symptom, normally in adults flank pain is in the foreground. We report a case of renal hypertension with ureteropelvic junction obstruction successfully corrected by laparoscopic pyeloplasty and discuss the pathophysiology.
Asunto(s)
Hidronefrosis/diagnóstico , Hipertensión Renal/diagnóstico , Obstrucción Ureteral/diagnóstico , Anciano , Enfermedad Crónica , Creatinina/sangre , Dolor en el Flanco/etiología , Humanos , Hidronefrosis/cirugía , Hipertensión Renal/etiología , Hipertensión Renal/cirugía , Laparoscopía , Masculino , Nefrostomía Percutánea , Uréter/cirugía , Obstrucción Ureteral/cirugía , Ureteroscopía , UrografíaRESUMEN
In patients younger than 40 years, renal cell carcinoma and metastases to the bladder are rare. Comparative genomic hybridisation (CGH) may be useful to differentiate between metastatic renal cell carcinoma and secondary malignancies of the genitourinary tract, which can occur in all histologic types. We report the case of a 35-year-old patient with renal cell carcinoma in whom only CGH could help differentiate between a second primary malignancy in the bladder and an atypical bladder metastasis.
Asunto(s)
Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/secundario , Neoplasias Renales/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/secundario , Adulto , Femenino , HumanosRESUMEN
Squamous cell carcinoma (SCC) of the upper urinary tract is a rare condition. The late stage of the tumour at diagnosis and the absence of evidence-based guidelines for therapy give rise to a poor prognosis in most cases. The patient with SCC described here showed an above-average survival of 18 months after adjuvant radiochemotherapy. Treatment was initiated according to the guidelines for squamous cell carcinoma in non-urological localisations.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Renales/cirugía , Pelvis Renal , Recurrencia Local de Neoplasia/cirugía , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Quimioterapia Adyuvante , Terapia Combinada , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , Neoplasias Renales/radioterapia , Pelvis Renal/patología , Escisión del Ganglio Linfático , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/radioterapia , Estadificación de Neoplasias , Nefrectomía , Radioterapia Adyuvante , Reoperación , Tomografía Computarizada por Rayos X , UrografíaRESUMEN
Localized amyloidosis of the ureter is a rare condition. Because of the difficulty in differentiating between localized amyloidosis and an obstruction due to other benign or malignant conditions of the urinary tract, in some cases even an unnecessary nephroureterectomy is performed. We describe a patient with obstructive amyloidosis of the right ureter. Diagnosis was confirmed by endoscopy with biopsies. The patient was treated successfully by partial ureterectomy and ureteroneocystostomy. No systemic involvement of other organs was detected and after a 2-year follow-up no local recurrence developed.
Asunto(s)
Amiloidosis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Cálculos Ureterales/diagnóstico por imagen , Enfermedades Ureterales/diagnóstico por imagen , Obstrucción Ureteral/diagnóstico por imagen , Urografía , Anciano de 80 o más Años , Amiloidosis/patología , Amiloidosis/cirugía , Biopsia , Diagnóstico Diferencial , Humanos , Masculino , Nefrostomía Percutánea , Proteína Amiloide A Sérica , Uréter/diagnóstico por imagen , Uréter/patología , Uréter/cirugía , Cálculos Ureterales/patología , Cálculos Ureterales/cirugía , Enfermedades Ureterales/patología , Enfermedades Ureterales/cirugía , Obstrucción Ureteral/patología , Obstrucción Ureteral/cirugía , UreteroscopíaRESUMEN
INTRODUCTION: Spontaneous hemorrhage is a rare cause of masses in the adrenal gland and must be differentiated from hemorrhage caused by trauma, neoplasm or metastases. CASE REPORT: A 41-year-old pregnant woman presented with nausea and right flank pain. Under suspicion of a pyelonephritis she was referred to the urological department with a normal obstetric evaluation. Ultrasound revealed an inhomogeneous mass above the right kidney, which seemed to be an abscess. An MRI scan showed an adrenal hemorrhage, but a bleeding caused by a neoplasm was excluded by a post-partum MRI control only. Upon conservative therapy the clinical condition improved and the parameters of inflammation normalized. There was no evidence of a hormone-producing adrenal tumor, an adrenal insufficiency caused by the hemorrhage, or a coagulopathy. CONCLUSION: Spontaneous hemorrhage in the adrenal gland is a rare condition in pregnancy. The diagnosis is confirmed by MRI. If conservative treatment fails, adrenalectomy will be necessary. Adrenal function should be controlled during pregnancy and post-partum. Recurrent hemorrhage and a neoplasm must be excluded by a post-partum MRI.