scholarly journals Colorectal Microcarcinoids in Association with Long-Term Exposure to Urinary Content: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Grace W. Weyant ◽  
Dipti M. Karamchandani ◽  
Negar Rassaei
Keyword(s):  
Case Report ◽  
Urinary Tract ◽  
Colonic Mucosa ◽  
Case Reports ◽  
Urothelial Cell Carcinoma ◽  
Cell Hyperplasia ◽  
Increased Risk ◽  
Urinary Content ◽  
Risk Of Malignancy

Long-term exposure of colonic mucosa to urinary content and its association with increased risk of infection, mechanical and biochemical irritation, and malignancy have been described in the literature. Existing case reports and studies depict the low but distinct risk of malignancy in gastrointestinal segments which come in contact with urinary content as a result of surgical correction of urinary tract abnormalities. However, these reports are largely limited to colonic adenocarcinoma and urothelial cell carcinoma. Late urointestinal carcinoma in patients with ileal incorporation into the urinary tract has also been reported. To the best of our knowledge, however, there is only one case report documenting neuroendocrine (NE) cell hyperplasia in colonic mucosa after long-term cystoplasty. Our case is the first to describe microcarcinoids and diffuse NE hyperplasia occurring in a patient with congenital anorectal anomalies, resulting in long-term exposure of colonic mucosa to fecal stream and urinary content. This case, in conjunction with the reported cases in the literature, raises the distinct possibility of an association between exposure of colonic mucosa to urine and long-term development of malignancy, including NE neoplasms.

Mucinous Cystadenocarcinoma of the Pancreas in an Adolescent with Cystic Fibrosis

2005 ◽  
Vol 8 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Christopher M. Oermann ◽  
Qasem Al-Salmi ◽  
Dan K. Seilheimer ◽  
Milton Finegold ◽  
Nina Tatevian
Keyword(s):  
Cystic Fibrosis ◽  
Case Reports ◽  
Epidemiologic Studies ◽  
Therapeutic Interventions ◽  
Mucinous Cystadenocarcinoma ◽  
Pancreatic Cysts ◽  
Pancreatic Cancers ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
Biliary Tracts

Epidemiologic studies indicate that the overall risk of malignancy among patients with cystic fibrosis (CF) is similar to that of the general population. However, these studies and a number of case reports suggest that patients with CF may be at increased risk for the development of specific gastrointestinal cancers. Tumors of the esophagus, stomach, small and large bowels, liver and biliary tracts, and pancreas have been described. Previous reports of pancreatic cancers among patients with CF have included only adenocarcinoma in adults. This is the first description of a mucinous cystadenocarcinoma of the pancreas in an adolescent with CF. The tumor developed within a pancreatic cyst that had been initially identified 13 years before resection. Our report highlights the increased risk of pancreatic malignancy among patients who have CF and illustrates the premalignant potential of pancreatic cysts in this at-risk population. Further, it reinforces the need for careful surveillance and suggests a role for more aggressive diagnostic and therapeutic interventions for patients with atypical findings on pancreatic imaging studies.

scholarly journals A Distinctive Approach to Venous Thromboembolism Treatment in a Pediatric, Hemodialysis Patient: A Case Report

2021 ◽  
Vol 26 (1) ◽  
pp. 104-106
Author(s):  
Jason Koury ◽  
Cintia Schnakenberg ◽  
Charlotte Villasenor ◽  
Shirley Abraham
Keyword(s):  
Case Report ◽  
Venous Thromboembolism ◽  
Renal Insufficiency ◽  
Pediatric Patients ◽  
Population Data ◽  
Low Molecular Weight ◽  
Limited Information ◽  
Increased Risk ◽  
Pediatric Hemodialysis

Enoxaparin is a low molecular weight heparin (LMWH) that is the mainstay for treatment of pediatric patients with a venous thromboembolism, which provides better compliance compared with the use of unfractionated heparin (UFH) in long-term anticoagulation. Although data are limited in pediatric patients with renal insufficiency, enoxaparin can be used in this population. Data related to its use in hemodialysis (HD) pediatric patients is almost non-existent. A major concern for enoxaparin use in patients with renal insufficiency or for those on HD is bleeding. A few studies in adults showed an increased risk of bleeding, but the risk was similar to that of UFH when the two were compared. This case report describes the use of enoxaparin in an 8-year-old female who is on hemodialysis, without any bleeding or clotting complications. Although systematic trials are needed to support the safety and efficacy of LMWH in pediatric patients with renal dysfunction or on HD, this case will provide limited information for enoxaparin use in this population.

scholarly journals Challenges in Management of Bartholin gland Leiomyoma: A Case Report

2020 ◽  
Author(s):  
Angela Vinturache ◽  
Lamiese Ismail ◽  
Stephen Damato ◽  
Hooman Soleymani Maid
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Symptom Control ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Postoperative Recovery ◽  
Long Term Follow Up ◽  
Vulvar Mass

Abstract Background: Leiomyomas are uncommon vulvar neoplasms often misdiagnosed as other Bartholin gland pathology. Due to their rarity and the absence of guidelines, their diagnosis and management remain challenging, largely based on expert opinion and evidence from case reports. Case Presentation: This case report describes a 44-year-old woman presenting with accelerating growth of a vulvar mass. Based on clinical signs and symptoms, the initial diagnosis was Bartholin cyst. Surgical excision was provided for symptom control and aesthetic reasons. The histopathologic diagnosis was vulvar leiomyoma. The postoperative recovery was complicated by secondary haematoma and dehiscence of the surgical site. There was no recurrence at two years follow up. Therefore, we discuss the dilemma posed by physical examination of a vulvar mass, the challenges of the management, and report on secondary morbidity and long-term follow up, aspects of care for patients with vulvar pathology not commonly addressed in the literature. Conclusions: Bartholin gland neoplasms are rare tumors, commonly misdiagnosed as Bartholin’s cysts. Excision is the treatment of choice. Short time follow up allows prompt management of potential postoperative complications. Continuing long term follow up is recommended due to recurrence risk.

scholarly journals KIDNEY STONE DISEASE WITH SPECIAL REGARD TO DRUG-INDUCED KIDNEY STONES – A CONTEMPORARY SYNOPSIS

2020 ◽  
Vol 73 (9) ◽  
pp. 2031-2039
Author(s):  
Łukasz Dobrek
Keyword(s):  
Urinary Tract ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Stone Disease ◽  
Urinary Stones ◽  
Drug Induced ◽  
Kidney Stone Disease ◽  
Increased Risk ◽  
Endogenous Compounds

Kidney stone disease (nephrolithiasis; urolithiasis) is a clinical entity with long-term course and recurrence, primarily affecting mature and ageing men, involving the formation and presence of urinary stones in the kidneys and urinary tract. The pathogenesis of this disorder is complex and still not fully understood. A rare, potentially modifiable, form of kidney stone disease takes the form of drug-induced urinary stones. The aim of the review was a brief description of the classification and pathophysiology of kidney stone disease, along with the short characteristics of drug-induced urinary stones. This type of stones is formed as a result of crystallisation in the kidneys and urinary tract of sparingly soluble drugs and their metabolites, or as a result of metabolic changes caused by drugs, predestinating the development of stones containing endogenous compounds. Conclusion: Therefore, during treatment with the use of drugs with high lithogenic potential, the safety of pharmacotherapy should be monitored in the context of its increased risk of developing urinary stones.

Primary vesicoureteric reflux and reflux nephropathy

2018 ◽  
Author(s):  
Heather Lambert
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Vesicoureteric Reflux ◽  
Reflux Nephropathy ◽  
Ureterovesical Junction ◽  
Increased Risk ◽  
History Of ◽  
Tract Infections

Vesicoureteric reflux (VUR) describes the flow of urine from the bladder into the upper urinary tract when the ureterovesical junction fails to perform as a one-way valve. Most commonly, VUR is primary, though it can be secondary to bladder outflow obstruction and can occur in several multiorgan congenital disorders. There is good evidence of a genetic basis with a greatly increased risk of VUR in children with a family history of VUR. VUR is a congenital disorder, which largely shows improvement or complete resolution with age. Fetal VUR may be associated with parenchymal developmental defects (dysplasia). Postnatally non-infected, non-obstructed VUR does not appear to have a detrimental effect on the kidneys. However there is an association of VUR with urinary tract infection and acquired renal parenchymal defects (scarring). The parenchymal abnormalities detected on imaging, often termed reflux nephropathy, may be as a result of reflux-associated dysplasia or acquired renal scarring or both. It is difficult to distinguish between the two on routine imaging. Higher grades of VUR are associated with more severe reflux nephropathy. The precise role of VUR in pyelonephritis and scarring is not clear and it may be that VUR simply increases the risk of acute pyelonephritis. Whilst most VUR resolves during childhood, it is associated with an increased risk of urinary tract infection and burden of acute disease. Investigation strategies vary considerably, related to uncertainties about the natural history of the condition and the effectiveness of various interventions. The long-term prognosis is chiefly related to the morbidity of reflux nephropathy leading in some cases to impairment of glomerular filtration rate, hypertension, proteinuria, and pregnancy-related conditions including hypertension, pre-eclampsia, and recurrent urinary tract infection. Management is controversial and ranges from simple observation with or without provision of rapid access to diagnosis and treatment of urinary tract infections; to long-term prophylactic antibiotics or various antireflux surgical procedures.

Vesicoureteric reflux

2017 ◽  
Author(s):  
David F.M. Thomas
Keyword(s):  
Urinary Tract ◽  
Renal Damage ◽  
Surgical Intervention ◽  
Vesicoureteric Reflux ◽  
Upper Urinary Tract ◽  
Retrograde Flow ◽  
Increased Risk ◽  
Endoscopic Correction ◽  
Transport Of Bacteria

The term vesicoureteric reflux (VUR) describes the retrograde flow of urine from the bladder into the upper urinary tract. VUR is not a disease entity in its own right. Nevertheless, it has the potential to cause significant morbidity by preventing effective emptying of the urinary tract and by facilitating the transport of bacteria into the upper tract and renal parenchyma. Mechanisms of renal damage associated with VUR include pyelonephritic scarring and congenital dysplasia or hypoplasia. The long-term complications of pyelonephritic scarring may include hypertension, renal failure, and an increased risk of complications during pregnancy. VUR of mild or moderate severity is best managed conservatively and surgical intervention is generally reserved for failed medical management and high grade or complex VUR. Although the introduction of endoscopic correction has revolutionized surgical management, there remains a role for open surgery for the correction of higher grades of reflux.

Displasia ossea con scarsa crescita

2020 ◽  
Vol 23 (10) ◽  
pp. 257-258 ◽  
Author(s):  
Andrea Trombetta
Keyword(s):  
Clinical Monitoring ◽  
Increased Risk ◽  
Risk Of Malignancy

A case of a short girl affected by multiple familial osteochondrosis (MFO) is described. The Author underlines the need of a strict, long term clinical monitoring in all MFO children and in their affected parents because of a significantly increased risk of malignancy.

FETAL UROLOGY AND PRENATAL DIAGNOSIS: CURRENT THEMES

2004 ◽  
Vol 15 (4) ◽  
pp. 343-364
Author(s):  
DFM THOMAS
Keyword(s):  
Prenatal Diagnosis ◽  
Urinary Tract ◽  
Case Reports ◽  
Rapid Development ◽  
Posterior Urethral Valves ◽  
High Incidence ◽  
History Of ◽  
Urinary Tract Malformations ◽  
Developed World

Isolated case reports of the prenatal detection of urinary tract malformations first appeared in the literature in the late 1970s and by the mid 1980s prenatal diagnosis had already become a firmly established feature of paediatric urological practice throughout the developed world. The rapid development of prenatal diagnosis of urinary tract malformations can be attributed to the relatively high incidence of congenital anomalies within this system and the fact that the common anomalies are usually associated with dilatation or cystic pathology which is readily visualised by ultrasound. Although many aspects of prenatal diagnosis have been clarified by studies undertaken over the last twenty years some important questions have yet to be fully resolved – for example the long term natural history of asymptomatic uropathies such as pelvi ureteric obstruction and the benefit (if any) of prenatal diagnosis in reducing long term burden of chronic renal failure associated with posterior urethral valves.

scholarly journals Aggressive Colorectal Cancer in an Inflammatory Bowel Disease Patient following Treatment with Vedolizumab: A Case Report

2021 ◽  
pp. 1-6
Author(s):  
Catarina Nascimento ◽  
Helena Oliveira ◽  
Catarina Fidalgo ◽  
Lídia Roque Ramos ◽  
Luísa Glória ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Case Report ◽  
Bowel Disease ◽  
Disease Patient ◽  
Immunosuppressive Drugs ◽  
Lymphocyte Migration ◽  
Steroid Dependent ◽  
Increased Risk ◽  
Inflammatory Bowel

<b><i>Introduction:</i></b> The increased risk of bowel cancer in patients with inflammatory bowel disease can be related with the extent, duration and severity of inflammation or with the cancer immune surveillance interference of immunosuppressive drugs used in inflammatory bowel disease treatment. Therefore, the risk-benefit ratio associated with long-term therapeutic strategies should be based on the patient’s age, sex, comorbidities and disease phenotype. <b><i>Case Report:</i></b> We present the case of a 76-year-old man with a history of melanoma stage Clark III and steroid-dependent left-sided colitis, refractory to mesalamine and thiopurines, with a diagnosis of a multifocal colorectal adenocarcinoma shortly after clinical and endoscopic remission 1 year after starting vedolizumab. <b><i>Discussion:</i></b> Vedolizumab is a gut-selective monoclonal anti-α<sub>4</sub>β<sub>7</sub>-integrin antibody that inhibits lymphocyte migration into the gastrointestinal submucosa. Its effectiveness for induction and maintenance of remission and its favorable safety profile make it an alternative in patients with chronic refractory colitis and contraindications to anti-TNF-α. However, there is the hypothesis that, by reducing the migration of activated leukocytes to the gastrointestinal tract, it may also reduce immunosurveillance, increasing the colorectal malignancy risk in the long term. More studies are necessary to address this issue.

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