The Transition From Localized to Metastatic: A Case Report of Adult TFE3-Positive Xp11.2 Translocation Renal Cell Carcinoma.

Xp11.2 translocation renal cell carcinoma (Xp11.2 RCC) is a rare tumor, occurring more frequently in childhood than in adulthood. It results from Xp11.2 chromosome translocations and the fusion of the transcription factor E3 (TFE3) gene. In this context, we present a case report of an 18-year-old female who was diagnosed with Xp11.2 RCC following open radical nephrectomy and lymph node dissection on the left side. The histopathological analysis indicated stage T3aN1Mx disease, which was confirmed through immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). The patient remained under observation until March 2023 when systemic scans uncovered the presence of ascites, peritoneal carcinomatosis, and left supraclavicular lymphadenopathy. A subsequent biopsy reaffirmed the primary disease, leading to the planning of systemic treatment involving tyrosine kinase inhibitors (TKIs) and immunotherapy. However, due to financial constraints, the patient's treatment options were limited to sunitinib initially. The current plan involves reevaluation after three months using scans to determine the subsequent course of treatment. Our case report offers crucial insights into the clinical presentation, diagnosis, and treatment of this rare malignancy. This enhances medical understanding, guides research, and improves the management of similar cases. Case reports like this share practical experiences, shaping future studies and patient care.

Foreign Body in Kidney Presenting as Renal Stone.

Retained foreign bodies in the urinary system are commonly found in the urinary bladder but are a rare finding in the renal pelvis. Foreign objects can reach the renal pelvis via different pathways. The presence of a foreign body could be iatrogenic, or via direct penetration from the gastrointestinal tract. Presentation could mimic tumor, abscess, hematoma, or even renal stone. We report an unusual case of intrarenal foreign body presenting as renal stone. The patient presented with flank pain and symptoms suggestive of renal stone and a non-contrast CT scan was also indicative of stone, however on endoscopy a foreign body was identified and retrieved.

Pheochromocytoma associated with von Hippel-lindau disease in a Pakistani family.

OBJECTIVES: The aim was to study the presentation, disease characteristics, operative outcome, and prognosis in patients with familial Pheochromocytoma associated with von Hippel-Lindau (VHL) disease. MATERIALS AND METHODS: There were six patients belonging to two generations of a single family who developed features of VHL over a period of 13 years and were treated at our institute. Patients' characteristics, that is, age, gender, presenting complaints and clinical signs, laboratory and biochemical evaluation, and the presence of associated conditions was gathered from medical records. The preoperative and postoperative radiological imaging and histopathological results were also collected. RESULTS: Out of six cases, five were male, and one was female. The mean age at first presentation was 25 years (16-40). All patients presented with uncontrolled hypertension and were found to have Pheochromocytoma on workup. Three patients had unilateral adrenal tumor, and three had bilateral disease. None of the patients had extra-adrenal Pheochromocytoma. All patients were managed with adrenalectomy and had benign pathology. Two patients subsequently had craniotomy for excision of cerebellar hemangioma, and one patient had bilateral partial nephrectomy at the time of adrenalectomy. There was no peri- post-operative mortality and all patients are being followed by the surgeon(s) and endocrinologist. CONCLUSION: Pheochromocytoma can be a part of familial conditions including VHL. Other associated features should be suspected, investigated, and treated in these patients that can influence patients' clinical course and prognosis. Family members should also be screened to achieve early diagnosis.

The accuracy of three-dimensional bladder ultrasonography in determining the residual urinary volume compared with conventional catheterisation.

OBJECTIVE: To determine the accuracy of three-dimensional bladder ultrasonography (US, using the BVI 3000, Verathon, WA, USA) for determining the residual urinary volume, compared with the conventional catheterisation method. PATIENTS AND METHODS: We conducted a cross-sectional study at day-care unit of a University hospital after obtaining approval from the Ethics Review Committee of the hospital. Thirty-four patients with lower urinary tract symptoms requiring cystometrography were included. The postvoid volume was measured by bladder US, with three readings taken, and then patient was catheterised using a 12-F Nelaton catheter to measure the urinary volume. The mean of the three readings was compared with the catheterisation volume. RESULTS: The mean (SD) urinary volumes by US and catheterisation were 261 (186) and 260 (175) mL, respectively, and the correlation (r (2)) was 0.97. There was no effect of age, gender or body mass index on the accuracy of bladder US, which was accurate even when the urinary volume was ⩽100 mL. CONCLUSION: The bladder US estimate is as accurate as catheterisation for determining the postvoid residual urinary volume. Its accuracy was also comparable when the urinary volume is <100 mL, and there was no significant effect of age, gender and body mass index. This system could replace the more invasive catheterisation, and with excellent accuracy.

Sarcomatoid carcinoma of prostate involving the whole lower urinary tract and rectum.

Sarcomatoid carcinoma of prostate is an extremely rare but aggressive neoplasm. It is generally associated with a poor prognosis. About 100 cases have so far been reported in the English literature. We report the case of a 64-year-old male with a very rapidly progressive disease that ultimately involved the whole lower urinary tract and rectum. The management of this case along with etio-pathogenesis and literature review is discussed.