scholarly journals Primary Large-Cell Undifferentiated Carcinoma of the Ureter

2019 ◽  
Vol 28 (5) ◽  
pp. 481-484
Author(s):  
Levent Isikay ◽  
Senol Tonyali ◽  
Gulden Aydog
Keyword(s):  
Clinical Presentation ◽  
Large Cell ◽  
Undifferentiated Carcinoma ◽  
Flank Pain ◽  
Proliferation Index ◽  
Macroscopic Hematuria ◽  
First Case ◽  
Dismal Prognosis ◽  
History Of ◽  
Aggressive Tumor

Objective: To report the first case in the literature of a primary large-cell undifferentiated carcinoma (LCUC) of the ureter with a very aggressive behavior and dismal prognosis. Clinical Presentation and Intervention: A 60-year-old woman with a history of intermittent macroscopic hematuria and mild to moderate right flank pain was admitted to the Department of Urology. Tissue biopsies and cytological samples were taken. Pathologic examination was consistent with LCUC. Conclusion: LCUC of the ureter is an aggressive tumor with a high proliferation index. Patients might be diagnosed at an advanced stage. LCUC must be considered in the differential diagnosis of urinary tract pathologies.

scholarly journals Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Sofia Santos Lopes ◽  
Andrea Furtado ◽  
Rita Oliveira ◽  
Ana Cebola ◽  
Bruno Graça ◽  
...  
Keyword(s):  
Inflammatory Myofibroblastic Tumor ◽  
Clinical Presentation ◽  
Treatment Approach ◽  
Pathological Condition ◽  
Partial Cystectomy ◽  
Pathological Features ◽  
Macroscopic Hematuria ◽  
Voiding Symptoms ◽  
First Case

Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.

Microcystic Transitional Cell Carcinoma

2002 ◽  
Vol 126 (7) ◽  
pp. 859-861 ◽  
Author(s):  
Xavier Leroy ◽  
Emmanuelle Leteurtre ◽  
Alexandre De La Taille ◽  
David Augusto ◽  
Jacques Biserte ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Macroscopic Hematuria ◽  
Computed Tomographic ◽  
First Case ◽  
History Of ◽  
Invasive Transitional Cell Carcinoma

Abstract Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.

SURGICAL MANAGEMENT OF A PARACLINOID ANEURYSM CONTAINING A DISPLACED NEUROFORM MICROSTENT

Neurosurgery ◽  
2008 ◽  
Vol 63 (4) ◽  
pp. E817-E817 ◽  
Author(s):  
J. Alex Thomas ◽  
Vance E. Watson ◽  
Kevin M. McGrail
Keyword(s):  
Internal Carotid ◽  
Clinical Presentation ◽  
Aneurysm Neck ◽  
Computed Tomographic ◽  
Proximal Half ◽  
Paraclinoid Aneurysm ◽  
First Case ◽  
Computed Tomographic Scan ◽  
History Of ◽  
The Ideal

ABSTRACT OBJECTIVE We report the first case of clip obliteration of a cerebral aneurysm containing a displaced microstent. CLINICAL PRESENTATION A 63-year-old woman presented with a 6-month history of headaches. She had no other neurological symptoms, and her examination was normal. A computed tomographic scan showed no evidence of hemorrhage. Angiography confirmed the presence of a large left paraclinoid aneurysm. INTERVENTION The patient initially underwent attempted endovascular repair of the aneurysm. A Neuroform microstent (Boston Scientific, Natick, MA), which was placed across the aneurysm neck, migrated into the aneurysm upon passing through it with the microcatheter to be used to place coils. This left the proximal half of the stent in the aneurysm and the distal half in the internal carotid artery. Attempts to remove the stent and to place a second stent across the neck of the aneurysm failed, and any plans to place coils were aborted. Three months after the failed endovascular procedure, the patient consented to a craniotomy. The aneurysm was successfully obliterated by placing several clips directly across the neck of the aneurysm and leaving the stent in place. CONCLUSION The patient experienced an excellent clinical and angiographic outcome. Although not the ideal treatment strategy, this report illustrates that clip obliteration of aneurysms containing displaced microstents can be performed successfully for this complication of endovascular treatment.

scholarly journals Acute Renal Failure During a Trial of Spinal Cord Stimulation: Theories as to a Possible Connection

2008 ◽  
Vol 3;11 (5;3) ◽  
pp. 681-686
Author(s):  
Thomas M. Larkin
Keyword(s):  
Spinal Cord ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Spinal Cord Stimulation ◽  
Clinical Presentation ◽  
Urinary Catheter ◽  
Spinal Cord Stimulator ◽  
Secondary Effects ◽  
First Case ◽  
History Of

Objective: This is the first case describing an episode of acute renal failure occurring during a spinal cord stimulation trial. Clinical Presentation: A 48-year-old male with a history of hypertension and 3 prior failed spine surgeries underwent a trial of spinal cord stimulation for uncontrolled bilateral lower extremity neuropathic pain. Two days after the placement of the percutaneous stimulator lead the patient returned complaining of 3 syncopal episodes. He was found to be hypotensive and in acute renal failure with a creatinine of 8.1 and a BUN of 83. Intervention: The stimulator lead was immediately removed. The patient was admitted to the intensive care unit and responded promptly to rehydration and placement of a urinary catheter. His renal and urological work-ups revealed no significant abnormalities. Conclusion: The development of the episode of acute renal failure may have been influenced by the secondary effects of spinal cord stimulation. Since acute renal failure has never been associated with the use of spinal cord stimulation, this singular example does not by itself demonstrate a relationship. However, if future episodes are seen, a link between the 2 events could be drawn. For now, it is not clear if the development of this patient’s acute renal failure could, in part, be attributed to the use of the spinal cord stimulator or if it was merely coincidental in nature. We do feel it is useful for the clinician to understand the pathophysiologic changes associated with spinal cord stimulation and to see how, at least in theory, there could be a connection. Key words: acute renal failure, spinal cord stimulation

The first case of fungal endogenous endophthalmitis caused by Aspergillus nidulans: Diagnostic and therapeutic challenge

2020 ◽  
pp. 112067212093208
Author(s):  
Lucia Mata-Moret ◽  
Clara Monferrer-Adsuara ◽  
Laura Hernández-Bel ◽  
Marisa Hernández-Garfella ◽  
Miriam Torrecillas-Muelas ◽  
...  
Keyword(s):  
Vision Loss ◽  
Visual Outcome ◽  
Endogenous Endophthalmitis ◽  
Pcr Analysis ◽  
Causative Organism ◽  
Systemic Corticosteroids ◽  
First Case ◽  
Dismal Prognosis ◽  
History Of ◽  
High Index Of Suspicion

Significance: Fungal endogenous endophthalmitis is an uncommon and potentially blinding infection. Aspergillus is a causative organism in immunocompromized although is virulent enough to afflict immunocompetents. Their propensity to affect macula usually results in a dismal prognosis; thus, improving visual outcome has always been challenging to clinicians. A. nidulans has only rarely been implicated in exogenous endophthalmitis. Purpose: To report the first case of A. nidulans endogenous endophthalmitis. Case report: An asthmatic 42-year-old female presented with sudden unilateral vision loss due to a submacular abscess that progressively worsened in a matter of days. Vitreous PCR analysis after an urgent vitrectomy was positive for A. nidulans with no active systemic foci found. Oral and intravitreal Voriconazole was prescribed but multiple reactivations led to three vitrectomies in total alongside with subretinal Voriconazole, abscess aspiration, and endolaser. There was complete resolution of the infection and, although visual acuity was poor due to macular scar, enucleation was avoided. Conclusion: Although uncommon, we must consider Aspergillus as the causative organism in apparently immunocompetent patients with history of recent systemic corticosteroids treatment, especially if they suffer a broncopulmonary disorder. Aspergillus is an aggressive organism so a high index of suspicion along with early diagnosis and prompt treatment is the key for better outcomes. We highlight A. nidulans as the causative agent as there are no other reported cases.

Ampullary Mixed Adenoneuroendocrine Carcinoma: Surprise Histology, Familiar Management

2017 ◽  
Vol 25 (7) ◽  
pp. 585-591 ◽  
Author(s):  
Shyam Sunder Mahansaria ◽  
Nikhil Agrawal ◽  
Asit Arora ◽  
Chhagan Bihari ◽  
Murali Appukuttan ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Large Cell ◽  
World Health ◽  
Resected Specimen ◽  
Ampullary Adenocarcinoma ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Rare Tumors ◽  
First Case ◽  
Grade 3 ◽  
Health Organization

Introduction. Mixed adenoneuroendocrine carcinoma (MANEC) has recently been defined by the World Health Organization in 2010. These are rare tumors and MANECs of ampullary region are even rarer. Only 19 cases have been reported in literature. We present 3 cases; the largest series, second case of amphicrine tumor and first case associated with chronic pancreatitis. Methods. Retrospective review of 3 patients who were diagnosed to have ampullary MANEC. Results. All 3 patients were diagnosed preoperatively as neuroendocrine carcinoma and underwent margin negative pancreaticoduodenectomy. The histopathology revealed MANECs of small cell, mixed type in 2 patients and large cell, amphicrine type in 1 patient. The neuroendocrine component was grade 3 in all, the tumor was T3 in 2 and T2 in 1 and all had nodal metastases. Two patients received adjuvant chemotherapy and 2 of them had recurrence at 13 and 16 months. The median survival was 15 months. Conclusion. Ampullary MANECs are rare tumors. They are diagnosed on histopathologic examination of the resected specimen. Clinical presentation, management, and prognosis is similar to ampullary adenocarcinoma in literature.

scholarly journals Right ectopic intrathoracic kidney: Unusual clinical presentation in a young patient affected by scrotal varicocele

2017 ◽  
Vol 89 (4) ◽  
pp. 323 ◽  
Author(s):  
Lucio Dell'Atti ◽  
Andrea Benedetto Galosi
Keyword(s):  
Computed Tomography ◽  
Renal Function ◽  
Clinical Presentation ◽  
Incidental Finding ◽  
Abdominal Ultrasound ◽  
Kidney Tumors ◽  
First Case ◽  
History Of ◽  
Intrathoracic Kidney ◽  
Good Drainage

Intrathoracic kidney is a partial or complete displacement of the kidney above the hemidiaphragm into the mediastinal compartment of the thorax. It is usually seen as an incidental finding discovered on chest radiograph or abdominal ultrasound. However computed tomography consents the correct detection of intrathoracic masses and defines their shape, size, and extent. We here report a case of ectopic thoracic kidney in a 22-year-old man who had a long history of scrotal discomfort associated with right varicocele. Frequently, this ectopia does not affect renal function and the stretched ureter provides good drainage. In literature, a small number of cases shows that varicocele is a possible mode of presentation of kidney tumors, but this is the first case of varicocele secondary to intrathoracic kidney ectopia.

scholarly journals MON-916 Pure Large Cell Neuroendocrine Carcinoma (LCNEC) of the Gall Bladder in a Patient with Down Syndrome - a Rare Case of an Aggressive Tumor of the Gall Bladder

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Misbah Azmath ◽  
Ashley Dunbar ◽  
Imran Siddiqui
Keyword(s):  
Down Syndrome ◽  
Small Bowel ◽  
Gall Bladder ◽  
Biliary Atresia ◽  
Neuroendocrine Carcinoma ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Rare Entity ◽  
History Of ◽  
Aggressive Tumor

Abstract Background: Pure large cell neuroendocrine carcinoma of the gall bladder (LCNEC-GB) is an extremely rare entity, with only 12 such cases reported in literature to date. None has been reported in a patient with genetic disorders. We describe the case of a patient with pure LCNEC-GB in the presence of Down syndrome and prior biliary atresia. Case: A 49-year-old female with Down Syndrome and history of neonatal surgery for congenital duodenal atresia presented with fever, vague abdominal discomfort and 6 month history of 15 pound weight loss. CT abdomen revealed a 5 X 4.2 cm exophytic, heterogeneously enhancing mass in the gall bladder fossa extending into segment 4B-5 of liver with mild intrahepatic biliary dilation, along with a 9 cm cystic lesion in continuity with the duodenum which was confirmed to a dilated duodenal anastomosis (from prior biliary surgery) on endoscopy. There was high suspicion for malignancy (gall bladder carcinoma versus intrahepatic cholangiocarcinoma) and subsequent metastatic workup including tumor markers, staging CT chest, MRI of the abdomen and diagnostic laparoscopy was negative. The patient underwent robotic converted to open en bloc resection of the gallbladder mass with segment 4B-5 liver resection and adherent loops of small bowel as well as resection of the dilated duodenal anastomosis followed by reconstruction with a gastrojejunostomy and Roux-en-Y/small bowel entero-enterostomy and closure of duodenotomy. Pathology demonstrated poorly differentiated “pure” large cell neuroendocrine carcinoma (G3), 6 cm in greatest dimension, with invasion of liver, duodenum and stomach, negative liver and gastric/small bowel margins. Lymphovascular invasion (LVI) was present with no perineural invasion (PNI), and 3/15 lymph nodes involved. Staging was determined to be pT4pN1. Patient was considered for adjuvant chemotherapy based on few case reports (platinum/etoposide) but unfortunately developed systemic complaints of fevers, fatigue, pain in bones and joints 2 months post operatively. Workup revealed metastatic disease which was confirmed on biopsy. Several small satellite liver lesions were also identified which was consistent with metastatic hepatic disease. Patient and family elected to proceed with hospice. Patient died within 4 months of surgery. Conclusion: Pure LCNEC-GB is an extremely rare and aggressive tumor with a poor prognosis as seen in our patient. This is the first reported case of pure LCNEC-GB in a patient with a genetic syndrome, although it is unknown if it had any causal relationship with the tumor. Prior biliary atresia/post -surgical inflammation may have also contributed to its pathogenesis by plausible development of metaplasia and expression of neuroendocrine cells which are normally absent in the gall bladder. Our case might help shed some light into pathogenesis and genetic basis if any of this rare entity.

scholarly journals Ureteritis cystica associated with xanthogranulom atouspyelonephritis

2015 ◽  
Vol 62 (2) ◽  
pp. 65-69
Author(s):  
Slobodan Ristovski ◽  
A. Sofronievska ◽  
Maja Glavinov
Keyword(s):  
Recurrent Urinary Tract Infection ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Left Kidney ◽  
Flank Pain ◽  
Macroscopic Hematuria ◽  
Left Flank ◽  
History Of ◽  
Renal Infection ◽  
Left Flank Pain

Ureteritis cystica (UC) and xanthogranulomatous pyelonephritis (XP) are rare, benign conditions that uncommonly appear together. The first one has not well established etiology yet and can affect ureter, renal pelvis and bladder. The second one is a chronic renal infection resulting in severe kidney deterioration and destruction. Both of these entities are usually unilateral. They both cause wide spectrum of symtoms so the diagnose can be difficult to establish. We report the case of a 68 year old male with a history of intermittent macroscopic hematuria, left flank pain, recurrent urinary tract infection and calculosis of left kidney. We describe the imaging and endoscopic investigations leading to the diagnosis of ureteritis cystica as well as the treatment options.

Large cell neuroendocrine carcinoma arising from the anterior mediastinum

2021 ◽  
Vol 14 (5) ◽  
pp. e240453
Author(s):  
Annalisa Montebello ◽  
Elizier Zahra Bianco ◽  
Darko Babic ◽  
Nicholas Paul Delicata ◽  
Neville Azzopardi
Keyword(s):  
Ct Scan ◽  
Neuroendocrine Carcinoma ◽  
Epigastric Pain ◽  
Large Cell ◽  
Anterior Mediastinum ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Anterior Mediastinal Mass ◽  
Dismal Prognosis ◽  
History Of ◽  
Primary Origin

Anterior mediastinal large cell neuroendocrine carcinomas (LCNECs) are extremely rare, extremely aggressive malignancies that carry a dismal prognosis. We discuss a woman aged 60 years who presented with a 2-month history of recurrent severe constant epigastric pain. Abdominal examination revealed massive hepatomegaly and a CT scan of the liver confirmed coarse liver lesions. Histology from a liver biopsy was consistent with a large cell (non-small cell) neuroendocrine carcinoma. A CT scan of the chest showed a large anterior mediastinal mass unrelated to the lung, suggesting that the anterior mediastinum was the primary origin of the tumour. The patient was planned to receive platinum/etoposide chemotherapy for a metastatic mediastinal large cell neuroendocrine carcinoma. Unfortunately, her health deteriorated, and she was unfit to undergo any further treatment. She was treated palliatively and died 2 months after the diagnosis.

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