• Blaabjerg Jansen posted an update 7 months ago

    Giant adrenal cysts represent rare clinical entities that are usually discovered incidentally. Here, we describe a patient who presented with nonspecific upper abdominal left pain. Imaging studies revealed a huge left adrenal cyst. Routine laboratory tests and endocrine function tests were all normal. The patient underwent surgery, and the cyst was completely removed with total adrenalectomy. Histological examination revealed a benign epithelial adrenal cyst.The postoperative course was uneventful and the patient had no evidence of recurrence during a 3-year follow-up. We discuss the diagnosis and management of adrenal cysts.To describe the endovascular treatment of a traumatic rupture of a renal artery aneurysm (RAA) in an unstable patient using a stent-graft. A 49-year-old patient presented following trauma to her right chest and flank. The patient was unstable on arrival and following resuscitation, contrast CT angiogram identified a rupture of a left RAA. To occlude the aneurysm, a graft-stent was placed successfully to arrest the haemorrhage. In this case of ruptured RAA, an endovascular approach allowed rapid control of bleeding and preservation of the kidney function, whilst avoiding open surgery and possible nephrectomy.Adult Granulosa Cell Tumor of the Testis (AGCTT) is a rare sex-cord stromal tumor. About 73 cases have been previously reported in the literature. We report a case of AGCTT in a 64 years old male, located in the left testis. We performed left radical inguinal orchiectomy. A sagittal section of orchiectomy specimen showed a solid yellowish-white mass measuring 1cm of long axis. On microscopic examination, we noted a well-limited tumor proliferation of solid architecture. The proliferation was made up of cells with scant cytoplasm and incised oval nuclei in a fibrous stroma. Rare Call-Exner bodies were noted.Horseshoe kidney (HSK) is a common congenital kidney anomaly that is encountered frequently by urologists. It is rare for HSK to be affected by xanthogranulomatous pyelonephritis (XGP), a potentially life-threatening condition. The standard of care for XGP is open nephrectomy, but recently a few case reports have been published showing the feasibility of minimally invasive surgery to deal with XGP. We present a case of HSK affected by XGP treated successfully with modified laparoscopic transperitoneal heminephrectomy. The rarity of such a combination, the modified approach, and the successful outcome encouraged us to report it.Penile granulomas has been rarely reported in the setting of BCG instillations. We present a 70 year-old male with multiple penile granulomas during BCG instillations due a high-grade urothelial bladder cancer. Histopathological study revealed granulomatous structures with central necrosis as seen after BCG therapy. Local treatment with cryotherapy has been shown to be effective. This case emphasizes the importance to suspect this adverse effect in patients under BCG treatment.Amyloidosis is known as a group of diseases that causes various disorders because of deposition of amyloid protein in various organs. Amyloidosis occurring in the retroperitoneum is a rare disease. We report a 75-year-old male patient presented to our hospital because he was identified with a retroperitoneal mass incidentally by CT. Laparoscopic surgery was performed to resect the tumor. In the histopathological specimen, amyloid was found in the fibrous soft tissue by Congo red staining. This is the first report to document a primary solitary amyloidosis of the retroperitoneum without systemic amyloidosis, which was resected using the laparoscopic approach.Bladder cancer is one of the common urologic malignant diseases. Cutaneous metastasis of bladder cancer is rare, with only a few case reports. The pattern of metastasis from bladder cancer is not well described. We report a patient with muscle-invasive bladder cancer who developed skin metastases after neoadjuvant chemotherapy and robot-assisted laparoscopic radical cystoprostatectomy. Skin metastases were confirmed histopathologically by skin biopsy. This case reminds us of the need to consider the possibility of skin metastasis in the differential diagnosis of skin symptoms in patients with malignant diseases.Prostatic calculi are often found incidentally during a clinical and radiological examination. However, in some instances, large or multiple calculi may cause severe lower urinary tract symptoms (LUTS). Its current significance concerning urological diseases and symptoms remains obscure. Minimal awareness regarding the disease among physicians could lead to improper assessment and treatment. In Indonesia, reports regarding prostatic calculi are still limited. We report a 50-year-old male with symptomatic multiple prostatic calculi.Situs inversus totalis is a rare anatomical variant in which all major organs and blood vessels are mirrored from left to right. find protocol We present a case of upper tract urothelial carcinoma in a patient with situs inversus who underwent robotic-assisted laparoscopic nephroureterectomy. We utilized conventional surgical approaches and a successful oncologic outcome was achieved.A 43-year-old man was brought to our hospital with fever. The initial diagnosis was bacterial pneumonia, and ampicillin/sulbactam was administered. However, defervescence was not achieved, and relative bradycardia was observed. Detailed history-taking revealed that the patient had been involved in caring for a wild pigeon before hospitalization. We changed the antimicrobial therapy to minocycline and the patient’ s condition improved. Chlamydophila psittaci antibody was subsequently found to be increased four-fold, and psittacosis was diagnosed. This case acts a reminder to clinicians of the importance of both the history of exposure to any birds and vital signs, including relative bradycardia.Many different pulmonary diseases occur in human immunodeficiency virus-infected patients. This was a case of a cavity lesion, although differentiation was extremely difficult pictorially. This was a rare case that led to a definitive diagnosis because the cavity lesions were complicated by pneumothorax, and we could perform a biopsy.

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