1/111. carboplatin-related hematuria and acute renal failure.cisplatin is a potent tubular toxin with a high incidence of nephrotoxicity. carboplatin is considered less nephrotoxic but can still cause tubular injury and interstitial nephritis in patients who have been previously treated with cisplatin. The affected individuals usually have nonoliguric renal failure with a urine output of more than a liter per day. We present a 57-year-old white woman with no history of renal disease who underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for stage IC ovarian carcinoma. One month later, she received chemotherapy with paclitaxel (Taxol) and carboplatin. On the following day, she developed frank hematuria and flank pain associated with a diminished urine output. Intravenous pyelogram (IVP) showed bilateral hydronephrosis with a total blockage of dye flow at the level of intraureteral lucencies consistent with bilateral blood clots. Her coagulation profile and uric acid was normal. Her acute renal failure (ARF) spontaneously resolved in the following 24 hours, with a brisk diuresis presumably due to clot lysis. The follow-up IVP showed a resolution of obstructive changes. A review of the literature shows a previous case in which high doses of carboplatin were implicated as the cause of hemorrhagic cystitis, presumably by toxicity to transitional epithelium of the bladder. We believe that the current case represents carboplatin-induced damage to the transitional epithelium in the renal pelvi and ureters causing gross hematuria and blood clots, resulting in bilateral ureteral obstruction and hydronephrosis.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/111. Cytologic diagnosis of metastatic ovarian adenocarcinoma in the urinary bladder: a case report and review of the literature.A 53-yr-old woman with a 13-mo history of recurrent ovarian papillary serous adenocarcinoma presented with persistent microscopic hematuria. The patient was undergoing chemotherapy for her recurrent ovarian tumor when she was referred to the urology service for microscopic hematuria. An intravenous pyelogram was normal. cystoscopy was performed, as well as a urinary bladder washing and mucosal biopsies for examination. adenocarcinoma similar to the patient's primary ovarian tumor was detected in both cytology and histopathology specimens. Ovarian carcinoma comprises 1.3-4.0% of all metastatic neoplasms to the urinary bladder and is an important consideration in the differential diagnosis of a cytologic finding of adenocarcinoma in urine specimens of female patients, where it accounts for an even higher percentage of cases (1 of 3 adenocarcinoma diagnoses in a series of 4,677 urine specimens from female patients).- - - - - - - - - - ranking = 9keywords = carcinoma (Clic here for more details about this article) |
3/111. A case of perirenal hemangioma mimicking renal cell carcinoma.PURPOSE: We present a rare case of perirenal hemangioma that was detected incidentally. methods/RESULTS: Radiographic examinations revealed a 3.5 cm mass at the left renal hilum adjacent to the left renal parenchyma, which was difficult to differentially diagnose from renal cell carcinoma. Tumor resection was performed successfully. CONCLUSIONS: There was no recurrence observed 14 months after surgery.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
4/111. Metastatic merkel cell tumor to bladder presenting as an encroachment tumor with gross hematuria.Merkel cell carcinoma is an uncommon and aggressive tumor of neuroendocrine and epithelial origin. A case of metastatic Merkel cell tumor with hematuria secondary to invasion into the bladder is presented. This is the second reported case of metastatic Merkel cell tumor to the bladder and the first published cystoscopic image of such a lesion.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
5/111. Small cell carcinoma of the bladder. Two cases diagnosed by urinary cytology.BACKGROUND: Primary small cell carcinoma (SCC) of the bladder is a rare but important entity. We report two cases of SCC of the bladder diagnosed by urinary cytology. CASES: A 71-year-old male (case 1) and a 79-year-old female (case 2) presented with asymptomatic gross hematuria. Urinary cytology in case 1 showed the presence of a few undifferentiated malignant small cells and many transitional cell carcinoma (TCC) cells with a bloody and necrotic background. The former cells were small and round, with naked, hyperchromatic nuclei and finely granular chromatin. Pathologic diagnosis after total cystectomy was TCC > SCC > adenocarcinoma, T2M0N0. Urinary cytology of case 2 showed the presence of many undifferentiated malignant small cells and many TCC cells with or without squamous metaplasia. Cytologic features of the former cells were almost the same as those in case 1. Moreover, these cells were neuroendocrine marker positive by immunocytochemistry. Pathologic diagnosis after tumor resection was SCC and TCC > squamous cell carcinoma, T1b. CONCLUSION: The prognosis of primary SCC of the bladder is usually poor. Because our cases were found by urinary cytology at a relatively early stage, both have been well, without any evidence of recurrence, 30 and 25 months after surgery even without adjuvant therapy.- - - - - - - - - - ranking = 8keywords = carcinoma (Clic here for more details about this article) |
6/111. radiation-induced pseudocarcinomatous proliferations of the urinary bladder: a report of 4 cases.Four cases of radiation cystitis that caused diagnostic difficulty because of an epithelial proliferation with architectural complexity and reactive cytologic atypia are described. The patients, 2 male, 2 female, were from 43 to 77 years of age. Two presented with hematuria. cystoscopy disclosed abnormalities in 3 patients. Microscopic examination showed irregularly shaped and arranged aggregates of epithelial cells in the upper and mid zones of the lamina propria. The cells, which typically showed at least mild, and sometimes severe, pleomorphism, were usually transitional, but squamous differentiation was seen focally in 3 cases. Ulceration of the overlying epithelium was present in all cases and was prominent and associated with conspicuous fibrin and hemorrhage in one of them. edema of the lamina propria was present in 3 cases, whereas lamina propria fibrosis and chronic inflammation were present in all cases. The presence in all 4 cases of vascular ectasia and other changes characteristic of radiation injury, such as atypical fibroblasts, prompted investigation of the clinical history in 2 cases in which the pathologist was unaware that the patient had received radiation. Pseudocarcinomatous proliferations in the bladder caused by radiation injury have received limited attention in the literature. Our cases illustrate the potential diagnostic errors with which these lesions may be associated.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
7/111. Papillary renal carcinoma (clear cell type) arising in the escretory urothelial district: a very unusual feature.A case of renal cell carcinoma, clear cell type, originating from the calyceal renal mucosa, is described.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
8/111. Inverted papilloma as a cause of high-grade ureteral obstruction.Inverted papilloma of the urinary tract is a rare benign lesion. We report, to our knowledge, the first case of high-grade ureteral obstruction caused by an inverted papilloma with coexistent carcinomatous elements. Our patient was referred for evaluation of painless, gross hematuria. Imaging studies demonstrated a left proximal ureteral filling defect causing severe left-sided hydroureteronephrosis. ureteroscopy demonstrated a 1-cm papillary lesion on the medial aspect of the proximal ureteral wall. Pathologic examination documented a lesion with elements of inverted papilloma and a small focus of well-differentiated transitional cell carcinoma. We discuss the management and significance of this rare urothelial lesion.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
9/111. Segmental multicystic dysplastic kidney in an adult woman.We report a case of unilateral segmental multicystic dysplastic kidney (SMCDK) in an adult woman. A 42-year-old woman presented with abdominal distension and gross hematuria. The preoperative diagnosis was cystic renal cell carcinoma, and a radical nephrectomy was performed. Histopathologically, the resected kidney was SMCDK with severe hydronephrosis.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
10/111. The use of a lithoclast probe for ureterorenoscopic coagulation of bleeding ureteral cancer.PURPOSE: We describe use of the lithoclast device, normally used for electrohydraulic stone fragmentation, for safe ureteroscopic intraureteral coagulation of a bleeding tumor. MATERIALS AND methods: Intraureteral ureteroscopic coagulation of a bleeding transitional cell carcinoma was performed in an 86-year-old high risk patient. A 0.8 mm. probe of the lithoclast device was connected to high frequency current. To avoid short circuit to the ureteroscope the probe was covered with a standard 5Fr ureteral catheter, which served as a perfect isolator. RESULTS: The bleeding intraureteral tumor was coagulated successfully under direct vision. CONCLUSIONS: The lithoclast probe in combination with a standard ureteral catheter can be used for intraureteral coagulation of bleeding tumors. It is an inexpensive device that is often available in nonuniversity departments.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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