1/451. Bilateral renal masses after local bacillus Calmette-Guerin therapy for postcystectomy ureteral cancer. bacillus Calmette-Guerin was administered through the ileal conduit of a 63-year-old man with upper tract recurrence of transitional cell carcinoma. Subsequent computed tomography showed bilateral renal masses, which were granulomatous at pathologic examination. The bacilli likely reached the kidneys via proven ileoureteral reflux. patients with reflux may benefit from antituberculous prophylaxis. ( info) |
2/451. Fine needle biopsy of metastases at retrograde pyelography, directed by fluoroscopy. Report of a case with malignant teratoma of the testis. Percutaneous fine needle aspiration biopsy was performed at retrograde pyelography in order to differentiate between metastatic and scarry involvement of a strictured ureter in a patient earlier operated upon because of malignant teratoma. The method is recommended in patients with malignant diseases where the differential diagnosis is impossible to establish at retrograde pyelography or urography. ( info) |
3/451. Hodgkin's lymphoma: an isolated case of involvement of the ureter. We report the case of a man in which a Hodgkin's lymphoma involved the ureter as the very first clinical situs of the disease. Ureteral involvement in lymphomas is very rare (0.86%-7% and 1%-16%, found in two studies, respectively, of cases of patients with lymphoma examined post mortem) and when it does occur it is secondary to renal involvement or retroperitoneal adenopathies. It is by all means exceptional as an isolated situs of disease. Those cases reported in the literature as presenting lymphomatous involvement of the ureter have always been diagnosed as Non-Hodgkin's lymphomas. ( info) |
4/451. An ureteric polyp removed by ureteroscopy. A case of benign ureteric polyp resected in one piece endoscopically is reported. The authors emphasize the role of ureteroscopy in the differential diagnosis of ureteric tumours. Unnecessary nephroureterectomies or open explorations can be avoided by the use of this procedure. ( info) |
5/451. Radiographic features of ureteral endometriosis. The urographic findings in seven patients with ureteral endometriosis were reviewed. These consisted of short strictures (0.5-2.2 cm) located for the most part in that portion of the pelvic ureter projected within 3 cm of the inferior margin of the sacroiliac joint. Although the appearance is judged to be nonspecific, the diagnosis of ureteral endometriosis should be considered in any female patient of child-bearing age who has obstructive uropathy attributable to extrinsic obstruction of the pelvic portion of the ureter. ( info) |
6/451. Primary tumor of the ureteral stump following a nephrectomy for renal cell carcinoma. BACKGROUND: A 64-year-old man presented with asymptomatic macroscopic hematuria during a follow up for a localized renal cell carcinoma (RCC), which was treated by a right radical nephrectomy 6 years earlier. methods: x-rays and a ureteroscopic examination revealed multiple papillary tumors filling the right ureteral stump. Surgery was performed to excise the ureteral stump and bladder cuff. The tumor was histologically a grade 2-3 transitional cell carcinoma without muscle invasion. RESULTS/CONCLUSIONS: Only four patients with a ureteral stump carcinoma, including the present case, have been reported after a nephrectomy for RCC. Considering that this patient had a past history of multiple cancers, genetic or environmental factors may have contributed to the etiology of the ureteral stump tumor. ( info) |
7/451. Renal adenomatosis associated with carcinoma of the lower urinary tract: a case report with immunohistochemical study. A case of renal adenomatosis of the left kidney associated with a carcinoma of the ipsilateral ureter in a 49-year-old man is examined. One hundred and eight adenomas, which were smaller than 15 mm in diameter, and a single microcarcinoma, which measured 1 mm in diameter, were found in the kidney. Further, there were more than 800 hyperplastic lesions which could be classified into three groups: (i) 792 of distal origin; (ii) 24 of proximal origin; and 10 of collecting duct origin. The serial sections obtained from 19 paraffin blocks were stained using Leu M1 as the proximal marker and epithelial membrane antigen (EMA) as the distal/collecting marker to assist in determining the origins. Ten of the small adenomas (15 lesions), which did not exceed 3 mm in diameter, were predominantly positive for EMA and five were predominantly positive for Leu M1. Further, hyperplastic lesions of distal and collecting duct origins were diffusely positive for EMA and sporadically positive for Leu M1. The lesions of proximal origin were predominantly positive for Leu M1 and sporadically positive for EMA. These findings suggest that a progression from hyperplasia and a direct transition from a single tubule to adenoma occurred multifocally in different segments of the nephrons throughout the left kidney. ( info) |
8/451. Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding. Twenty-one multifocal urinary tract transitional cell carcinomas, mostly bladder tumours, from a total of six patients were processed for cytogenetic analysis after short-term culturing of the tumour cells. Karyotypically related, often identical, cytogenetically complex clones were found in all informative tumours from each case, including the recurrent tumours. Rearrangement of chromosome 9, leading to loss of material from the short and/or the long arm, was seen in all cases, indicating that this is an early, pathogenetically important event in transitional cell carcinogenesis. The presence of related clones with great karyotypic similarity in anatomically distinct tumours from the same bladder indicates that multifocal uroepithelial tumours have a monoclonal origin and arise via intraluminal seeding of viable cancer cells shed from the original tumour. Later lesions may develop also from cells shed from the so called second primary tumours. The relatively complex karyotypes seen in all lesions from most cases argue that the seeding of tumour cells is a late event that succeeds the acquisition by them of multiple secondary genetic abnormalities. ( info) |
| We report two cases of ventricular fibrillation during noncardiac surgery. Although an emergency coronary angiogram showed no significant coronary stenosis, coronary artery spasm was induced by the intracoronary injection of acetylcholine. It is possible that ventricular fibrillation is caused by coronary artery spasm during noncardiac surgery in patients without overt coronary artery disease. ( info) |
10/451. Augmentation ileocystoplasty and ileal ureter replacement for distal ureteral cancer in a patient with a contracted bladder. BACKGROUND: A male patient with a solitary kidney and contracted bladder due to urinary tuberculosis presented ureteral obstruction caused by primary lower ureteral cancer. methods: Distal ureterectomy and urinary tract reconstruction consisting of ileal bladder augmentation and ileal ureter replacement with an antireflux procedure was performed. RESULTS/CONCLUSIONS: Postoperatively satisfactory voiding without residual urine was achieved. ( info) |