Issue 6: December 2009

UIJ Volume 2 Issue 6 December 2009

Solitary Metastasis of Cervical Carcinoma to the Kidney: A Case Report and Review of the Literature

ABSTRACT

A 47-year-old female presented with a history of hematuria and right loin pain 18 months after receiving chemoradiotherapy for advanced cervical carcinoma. A CT scan demonstrated a grossly abnormal right kidney suggestive of either inflammatory or malignant change. A percutaneous biopsy under CT guidance demonstrated squamous cell carcinoma in keeping with metastatic cervical carcinoma. Metastasis of cervical carcinoma to the kidney is extremely rare, with only 8 previous cases reported in the literature.

KEYWORDS: Cervical carcinoma; Renal metastasis; Biopsy; Caval thombus

CORRESPONDENCE: Dr. David C. Hutchings, Department of Urology, Churchill Hospital, Oxford, OX3 7LJ, UK ().

CITATION: Urotoday Int J. 2009 Dec;2(6). doi:10.3834/uij.1944-5784.2009.12.05

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Outcome of Patients with Abnormal Upper Tract Cytology and Negative Initial Workup

ABSTRACT

INTRODUCTION: Patients with pathologically confirmed upper tract transitional cell carcinoma (TCC) currently undergo surveillance according to well described protocols. The literature offers little guidance for monitoring patients with abnormal upper tract cytology without prior upper tract TCC. The purpose of the present study was to assess the risk of upper tract TCC based on cytology and determine a reasonable observation strategy for this abnormal finding.

METHODS: The authors performed a 10-year retrospective cohort study of 204 patients (366 renal units) within the New England Veterans Administration Healthcare System. Upper tract cytology was collected: (1) as a consequence of lateralizing hematuria during cystoscopy in 2 patients; (2) following abnormal upper tract imaging in 27 patients; (3) from the bladder in the presence of a suspected bladder tumor and/or carcinoma in-situ (CIS) in 16 patients; (4) from the bladder despite a negative workup for lower tract tumor in 159 patients. Cytology results reported as negative or atypical were categorized as normal; suspicious or positive results were categorized as abnormal. Odds ratios (OR) were calculated and hazard curves plotted to determine risk and time span of tumor development among the cohorts.

RESULTS: Twenty-six renal units had upper tract TCC over a median follow up of 38 months. The OR for development of upper tract TCC with abnormal upper tract cytology was 3.27 and did not change with a previous history of lower tract disease. The accumulation rate differed with normal and abnormal upper tract cytology among those who developed upper tract TCC.

CONCLUSION: Upper tract cytology has a poor sensitivity for tumors of the upper urinary tract. Patients with abnormal upper tract cytology are 3 times more likely to develop TCC than patients with normal upper tract cytology and should be carefully monitored for at least 6 years. However, the exact method and frequency of monitoring remains undetermined.

KEYWORDS: Transitional cell carcinoma; Urothelial carcinoma; Cytology; Upper tract; Renal pelvis; Ureter

CORRESPONDENCE: Rian Dickstein, MD, Department of Urology, 720 Harrison Avenue, Suite 606, Boston, MA 02118 ()

CITATION: UroToday Int J. 2009 Dec;2(6). doi:10.3834/uij.1944-5784.2009.12.01

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Squamous Cell Carcinoma in the Meatus of a Distal Hypospadia

ABSTRACT

A 39-year-old male presented with a tumor in the urethral orifice. A papillary tumor (1 cm × 1 cm) was found at the meatus of a distal hypospadia. The patient underwent tumor resection without urethroplasty. The pathological diagnosis was squamous cell carcinoma. No recurrence or metastasis was found during 2 years of follow-up. Squamous cell carcinoma in the urethral orifice of hypospadias is extremely rare. To the authors’ knowledge, this is only the second case reported in the literature.

KEYWORDS: Urethral cancer; Squamous cell carcinoma; Meatus; Hypospadia

CORRESPONDENCE: Yoshiyuki Kojima MD, Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan ().

CITATION: Urotoday Int J. 2009 Dec;2(6). doi:10.3834/uij.1944-5784.2009.12.13

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A Case of Textiloma Mimicking a Retroperitoneal Tumor

ABSTRACT

Foreign bodies left inside the patient following surgical procedures are infrequently reported in the literature. Incidence figures might be underestimated because of medico-legal implications. A 56-year-old male had a right ureterolithotomy for a lumbar ureteral stone. He was asymtomatic for 3 years before presenting with intermittent right flank pain. Imaging showed a tumor-like mass in the right lumbar region. Surgical exploration revealed a textiloma.

KEYWORDS: Urinary surgery; Retroperitoneal space; Postoperative complication; Foreign body; Textiloma.

CORRESPONDENCE: Dr. Sallami Satâa, Department of Urology, La Rabta Hospital-University, Tunis 1007, Tunisia ().

CITATION: UroToday Int J. 2009 Dec;2(6). doi:10.3834/uij.1944-5784.2009.12.09

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