RESUMO
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.
Assuntos
Hidronefrose/diagnóstico , Hipertensão Renal/diagnóstico , Obstrução Ureteral/diagnóstico , Idoso , Doença Crônica , Creatinina/sangue , Dor no Flanco/etiologia , Humanos , Hidronefrose/cirurgia , Hipertensão Renal/etiologia , Hipertensão Renal/cirurgia , Laparoscopia , Masculino , Nefrostomia Percutânea , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Ureteroscopia , UrografiaRESUMO
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.
Assuntos
Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/secundário , Neoplasias Renais/diagnóstico , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/secundário , Adulto , Feminino , HumanosRESUMO
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.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Renais/cirurgia , Pelve Renal , Recidiva Local de Neoplasia/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Quimioterapia Adjuvante , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/patologia , Neoplasias Renais/radioterapia , Pelve Renal/patologia , Excisão de Linfonodo , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Estadiamento de Neoplasias , Nefrectomia , Radioterapia Adjuvante , Reoperação , Tomografia Computadorizada por Raios X , UrografiaRESUMO
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.
Assuntos
Amiloidose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Cálculos Ureterais/diagnóstico por imagem , Doenças Ureterais/diagnóstico por imagem , Obstrução Ureteral/diagnóstico por imagem , Urografia , Idoso de 80 Anos ou mais , Amiloidose/patologia , Amiloidose/cirurgia , Biópsia , Diagnóstico Diferencial , Humanos , Masculino , Nefrostomia Percutânea , Proteína Amiloide A Sérica , Ureter/diagnóstico por imagem , Ureter/patologia , Ureter/cirurgia , Cálculos Ureterais/patologia , Cálculos Ureterais/cirurgia , Doenças Ureterais/patologia , Doenças Ureterais/cirurgia , Obstrução Ureteral/patologia , Obstrução Ureteral/cirurgia , UreteroscopiaRESUMO
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.