Vaginal pedicled flap for closure of vesicovaginal fistula.

A 22-year-old woman presented with chronic urinary tract infections and was found to have an ectopic ureter. Repair involved ligation of the distal ectopic ureter via a vaginal approach. She developed an iatrogenic vesicovaginal fistula which was repaired with a vaginal pedicled flap.

Elevated alpha-fetoprotein secondary to Hodgkin's lymphoma.

We describe the case of a 26-year-old man with an elevated level of alpha-fetoprotein who had no evidence of intragonadal or extragonadal germ cell tumor. The patient was found to have Hodgkin's lymphoma within an anterior mediastinal mass. We review the significance of elevated alpha-fetoprotein levels and discuss the clinical relevance of this unusual presentation of a possible primary Hodgkin's lymphoma.

Bilateral primary non-Hodgkin's lymphoma of the testis.

We report the case of a 72-year-old man with bilateral testicular masses that, on histologic section, were found to be synchronous non-Hodgkin's lymphomas. Workup was negative for systemic disease, indicating the possibility of bilateral primary testicular lymphomas. We discuss the evaluation and treatment of this lesion and review the literature concerning this subject.

Adenocarcinoma of the prostate presenting initially as an intracerebral tumor.

BACKGROUND: The authors report a patient who was admitted to the hospital with neurologic symptoms and signs that were thought to be caused by a primary intracranial tumor. METHODS: Craniotomy resulted in successful resection of an occipital lobe tumor reported histologically as a papillary adenocarcinoma, probably metastatic from the kidney. However, a complete diagnostic study failed to demonstrate the primary focus. RESULTS AND CONCLUSIONS: Thirteen months later, the patient was readmitted to the hospital and found to have metastatic prostatic carcinoma. Immunoperoxidase staining for prostatic acid phosphatase of the prostatic tissue and of the previously resected brain tumor tissue indicated that the brain lesion was metastatic from the prostate.

Penile carcinoma in renal transplant recipient.

A case of squamous cell carcinoma of the penis occurring in a renal transplant recipient is presented. Despite a markedly increased incidence of epidermoid carcinoma in the transplant population, this is the first reported case of penile carcinoma occurring in a renal transplant recipient. As with other superficial epithelial tumors in this population, conventional therapeutic techniques are recommended. However, excisional biopsy is recommended for penile lesions at the time of initial presentation or if any clinical suspicion exists.

Hematuria in renal transplant recipients.

This study is a retrospective analysis of microscopic and gross hematuria in 127 male renal transplant recipients. The incidence of hematuria was 12%. The causes of hematuria were similar to those in the general population with inflammatory conditions predominating. Urologic malignancy was not found. Hematuria heralded rejection episodes in three instances. Complete evaluation of hematuria revealed pathology of the urinary tract in every instance.

Idiopathic pelviureteric varices.

Pelviureteric varices are well-documented sequelae of renal vein thrombosis, but there have been only 10 prior reports of idiopathic renal vein varicosities. Herein we report 3 more cases and review the literature. Two thirds of the patients presented with hematuria; one-fourth had flank pain, and one-third had saphenous vein varicosities. Pyelographic findings include scalloped deformities of the upper ureter and pelvis with displacement and intraluminal filling defects. The diagnosis may be suspected from the excretory urogram, but venography is definitive. Excision and ligation of the varicose veins were curative in all but 3 patients who required nephrectomy for life-threatening hemorrhage.