RESUMO
BACKGROUND: The association of renal cell carcinoma and Kartagener's syndrome is unusual, and only eleven cases have been reported in the literature. The purpose of this work is to analyze this unusual association of Kartagener's syndrome and renal cell tumor and to study the main diagnostic and therapeutic aspects through our observation and review of the literature. Case Presentation. We report the case of a 50-year-old patient, with a history of recurrent respiratory infections, in whom a renal tumor was simultaneously diagnosed with Kartagener's syndrome, represented by situs inversus, bronchiectasia, and chronic sinusitis. The patient was treated by partial nephrectomy, and the histological examination showed a clear cell carcinoma. Through this observation and a review of the literature, we try to analyze this association as well as the main diagnostic and therapeutic aspects. CONCLUSION: The association of situs inversus and renal cell carcinoma is very rare-preoperative assessment and anatomy knowledge are crucial for a better adaptation of the surgical technique.
RESUMO
We here report the case of a 75 year old patient, with lower urinary tract obstructive syndrome such as dysuria, nocturnal pollakiuria and dribbling. Clinical examination showed good general condition by examining the rectum with the finger, soft, painless prostate increased in volume with obliteration of the median sulcus. PSA level was 2,1ng/ml, prostatic weight was 240 g on ultrasound. The patient underwent surgery: transvesical adenomectomy with extraction of a giant adenoma weighing 246 g. Histologic examination showed adenomyofibroma.
Assuntos
Adenoma/diagnóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Adenoma/cirurgia , Idoso , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Neoplasias da Próstata/cirurgiaRESUMO
Scrotales fistulas are rare and often represent secondary lesions of tuberculosis. Mucinous adenocarcinomas are tumors containing at least 50% of extracellular mucus. They occur most commonly in the rectosigmoid; scrotal location is rare. We report the case of a 54-year old patient, with no particular past medical history, with secondary mucinous adenocarcinoma of the scrotum revealed by scrotal fistulas. The patient had suffered from recurrent scrotal fistulas for two years, with no other associated signs. Clinical examination showed multiple scrotal fistulas with discharge of thick pus. Rectal examination was normal. Urological examinations (IVU, UCRM, cystoscopy, ) were normal, the assessment of infectious diseases as well as the detection of BK virus in urine and sputum were negative. Biopsy of sample of scrotal tissue was in favor of moderately differentiated mucinous adenocarcinoma. Immunohistochemical examination was in favor of primary colorectal cancer. Patient's evolution was marked by the occurrence of complex anal fistulas, which appeared on MRI as active, supplying several pelvic peritoneal collections resulting in fleshy buds. There is no consensus on the therapeutic approach due to the rarity of this cancer. Surgical resection is the treatment of choice for this disease. Preoperative chemotherapy and radiation therapy are recommended for this type of cancer, but their role is not well established. The patient underwent primary neoadjuvant chemotherapy and radiation therapy, before abdominoperineal excision.