Right-sided intrarenal splenosis mimicking a renal carcinoma.

We describe a patient who underwent nephrectomy for an enhancing right renal mass that was subsequently pathologically confirmed as right renal splenosis. Since renal splenosis is quite rare and has previously been reported only in the left kidney, we did not consider splenosis in our differential diagnosis during the evaluation of the renal mass. Magnetic resonance imaging, as well as radionucleotide scan using 99mTc-labelled red blood cells, has been utilized for identifying ectopic splenic tissue. An elevated index of suspicion must be present in patients with a history of splenectomy or traumatic splenic rupture to avoid undue nephrectomy.

Percutaneous nephrolithotomy of an intrathoracic kidney.

We present a 35-year-old woman with symptomatic urolithiasis in an intrathoracic kidney. Percutaneous nephrolithotomy was successfully performed after ureteroscopy failed because of the unusual length of the ureter associated with the kidney position. We report the first case of percutaneous nephrolithotomy of an intrathoracic kidney.

Urothelial carcinoma in a man with hereditary nonpolyposis colon cancer.

Although most upper tract urothelial carcinomas are believed to be acquired, patients with hereditary nonpolyposis colon cancer (HNPCC) may have more than 20 times the risk of the normal population for these cancers. Certain mismatch repair mutations are now known to be associated with the disease. Screening and surveillance regimens are still evolving, but urinalysis, urine cytology, cystoscopy, and periodic upper tract imaging are the mainstays. HNPCC should be considered in any patient who develops an upper tract urothelial cancer or has a suggestive family history.