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BJR Case Reports Sep 2022Ductal adenocarcinoma of the prostate (DCa) is the histological variant of prostatic carcinoma. The macroscopic finding of DCa arising from primary duct by urethroscopy...
Ductal adenocarcinoma of the prostate (DCa) is the histological variant of prostatic carcinoma. The macroscopic finding of DCa arising from primary duct by urethroscopy is papillary excrescences in the prostatic urethra. But the finding of MRI remains poorly understood, since there is no coherent report on the MRI finding of DCa arising from primary duct. We herein report a case of DCa arising from primary duct and forming papillary excrescences in the prostatic urethra. The patient was a male in his 70s and presented with gross hematuria a few days ago. Blood test showed elevated prostate specific antigen (PSA). Prostate MRI was performed. There were two lesions in the prostatic urethra and the right transition zone (TZ). On -weighted image (T2WI), the lesion in the prostatic urethra was identifiable, but the lesion in the right TZ was difficult to identify. On diffusion-weighted image (DWI), both lesions showed hyperintense signal and could be identified, and there was continuity between them. Urethroscopy was performed, there was the lesion with papillary excrescences developing from the right dorsal side of prostatic urethra. Transurethral resection of the prostate was performed. The pathological diagnosis was DCa (pure type). A review of previous literature showed that DCa had a slightly hypointense signal on T2WI. It may be difficult to identify DCa in the TZ because DCa and the TZ show similar signals on T2WI. DWI may be useful to accurately assess DCa arising from primary duct.
PubMed: 36211603
DOI: 10.1259/bjrcr.20210234 -
The American Journal of Case Reports Oct 2022BACKGROUND Lupus anticoagulant-hypoprothrombinemia syndrome (LAHPS) is an exceptionally rare disease caused by prothrombin antibodies, resulting in reduced factor II... (Review)
Review
Lupus Anticoagulant-Hypoprothrombinemia Syndrome and Pseudotumor Cerebri as an Initial Presentation of Systemic Lupus Erythematosus in a 16-Year-Old Male Patient: A Case Report and Literature Review.
BACKGROUND Lupus anticoagulant-hypoprothrombinemia syndrome (LAHPS) is an exceptionally rare disease caused by prothrombin antibodies, resulting in reduced factor II levels. This disease can present with significant bleeding and is usually associated with autoimmune disorders, particularly systemic lupus erythematosus (SLE). There are currently no guidelines for the treatment of LAHPS, and corticosteroids remain the criterion standard therapy. Pseudotumor cerebri is a disease that involves an idiopathic rise in intracranial pressure in association with papilledema. The coexistence of pseudotumor cerebri with SLE is rare, with an overall incidence of 0.7%. CASE REPORT A 16-year-old male initially presented to our hospital with nausea, headaches, and decreased visual acuity. He was diagnosed with pseudotumor cerebri based on the findings of papilledema and a raised opening pressure on lumbar puncture. Three months later, he presented with macroscopic hematuria and persistent epistaxis. Further investigation revealed a prolonged activated partial thromboplastin time and prothrombin time, along with positive LA and reduced Factor II levels, resulting in a diagnosis of LAHPS. The patient received a dose of 1 mg/kg/day of prednisolone along with hydroxychloroquine, and he had a complete recovery with cessation of bleeding and normalization of laboratory parameters. CONCLUSIONS We are reporting a case of pseudotumor cerebri with a further presentation of LAHPS in a patient found to have SLE. As both associations are rare in the presence of SLE, it is vital to recognize them early to initiate adequate management and intervention to avoid life-threatening complications.
Topics: Adolescent; Adrenal Cortex Hormones; Antiphospholipid Syndrome; Hemorrhage; Humans; Hydroxychloroquine; Hypoprothrombinemias; Lupus Coagulation Inhibitor; Lupus Erythematosus, Systemic; Male; Papilledema; Prednisolone; Prothrombin; Pseudotumor Cerebri
PubMed: 36207805
DOI: 10.12659/AJCR.938051 -
Cureus Sep 2022Ureteral hematoma is a rare complication occurring during anticoagulant therapy, with fewer than 10 cases reported in the literature. Bleeding complications are...
Ureteral hematoma is a rare complication occurring during anticoagulant therapy, with fewer than 10 cases reported in the literature. Bleeding complications are underestimated. They affect about 10% of patients treated with long-term anti-vitamin K (AVK). The appearance of macroscopic hematuria may indicate the presence of underlying organic damage. Clinically, ureteral hematoma is manifested by lumbar or abdominal pain often associated with macroscopic hematuria. Imaging plays a major role in its diagnosis. Clinical and radiological evolution is always rapidly favorable after the correction of coagulation disorders and the immediate discontinuation of anticoagulant treatment. We report in this work the case of a patient in her 50s who presented a ureteral hematoma during her anticoagulant treatment.
PubMed: 36196282
DOI: 10.7759/cureus.28666 -
British Journal of Cancer Nov 2022Non-invasive urine-based biomarkers can potentially improve current diagnostic and monitoring protocols for bladder cancer (BC). Here we assess the performance of...
BACKGROUND
Non-invasive urine-based biomarkers can potentially improve current diagnostic and monitoring protocols for bladder cancer (BC). Here we assess the performance of earlier published biomarker panels for BC detection (BC-116) and monitoring of recurrence (BC-106) in combination with cytology, in two prospectively collected patient cohorts.
METHODS
Of the 602 patients screened for BC, 551 were found eligible. For the primary setting, 73 patients diagnosed with primary BC (n = 27) and benign urological disorders, including patients with macroscopic haematuria, cystitis and/or nephrolithiasis (n = 46) were included. In total, 478 patients under surveillance were additionally considered (83 BC recurrences; 395 negative for recurrence). Urine samples were analysed with capillary electrophoresis-mass spectrometry. The biomarker score was estimated via support vector machine-based software.
RESULTS
Validation of BC-116 biomarker panel resulted in 89% sensitivity and 67% specificity (AUC = 0.82). A diagnostic score based on cytology and BC-116 resulted in good (AUC = 0.85) but not significantly better performance (P = 0.5672). A diagnostic score including BC-106 and cytology was evaluated (AUC = 0.82), significantly outperforming both cytology (AUC = 0.72; P = 0.0022) and BC-106 (AUC = 0.67; P = 0.0012).
CONCLUSIONS
BC-116 biomarker panel is a useful test for detecting primary BC. BC-106 classifier integrated with cytology showing >95% negative predictive value, might be useful for decreasing the number of cystoscopies during surveillance.
Topics: Humans; Urinary Bladder Neoplasms; Biomarkers, Tumor; Prospective Studies; Diagnostic Tests, Routine; Neoplasm Recurrence, Local; Peptides; Sensitivity and Specificity
PubMed: 36192490
DOI: 10.1038/s41416-022-01992-3 -
Journal of Personalized Medicine Sep 2022Nutcracker and Wilkie syndromes are rare mesoaortic compression entities, and their association is even less common. Data on interventional treatment of these... (Review)
Review
Nutcracker and Wilkie syndromes are rare mesoaortic compression entities, and their association is even less common. Data on interventional treatment of these pathologies are still scarce, but results from limited case series are encouraging. We report the case of a previously healthy 45-year-old woman diagnosed with nutcracker and Wilkie syndromes who presented with macroscopic hematuria, intermittent pain in the left flank and hypogastric region, postprandial nausea, and unexplained significant weight loss. A successful endovascular approach with stent implantation in the left renal vein was performed, but the stent migrated toward the left kidney, and this acute complication was managed through an interventional strategy as well. At the three-month follow-up, the patient described a marked improvement in all symptoms, except for the macroscopic hematuria. As it was our strong belief that the approach was efficient, we further investigated the "hematuria", which eventually led to the diagnosis of endometrial carcinoma. A hysterectomy and bilateral adnexectomy were planned, and chemoradiotherapy was initiated with the goal of preoperative tumor reduction. To our knowledge, this is the first reported case in which both Wilkie and nutcracker syndromes were effectively treated by stent implantation in the left renal vein, complicated with very early stent migration due to inadequate apposition to the less compliant venous lumen. The treatment of the duodenal compression was indirectly included in the stenting of the left renal vein, as reclaiming the venous lumen widened the aortomesenteric angle. The aim of this review is to discuss our center's transcatheter experience with these rare disorders and explore the literature in order to establish the benefits and limitations of such an approach.
PubMed: 36143249
DOI: 10.3390/jpm12091461 -
International Journal of Surgery Case... Oct 2022Renal biopsy performed in native or transplanted kidney is considered a safe procedure. However, as it is an invasive procedure bleeding related complications do occur....
INTRODUCTION AND IMPORTANCE
Renal biopsy performed in native or transplanted kidney is considered a safe procedure. However, as it is an invasive procedure bleeding related complications do occur. Bleeding complications such as macroscopic hematuria, renal hematoma, blood transfusion, and rarely nephrectomy and death have been reported in various studies. Acute Page kidney (APK) is a rare complication of post renal biopsy bleeding.
CASE PRESENTATION
In this case report we present a case history of a 46-year-old patient complicated with APK, following a native kidney biopsy. Early surgical exploration and evacuation of large hematoma resulted in a favorable outcome.
CLINICAL DISCUSSION
APK results from external compression of kidney and compression of the parenchyma can compromise the intra renal blood flow and cause renal impairment, activation of Renin-Angiotensin-Aldosterone System (RAAS) leads to systemic hypertension.
CONCLUSION
Awareness, early recognition and timely intervention in APK, in a post renal biopsy bleeding is necessary to prevent poorer outcomes, especially progressively large hematoma is present and response to medical management inadequate.
PubMed: 36122422
DOI: 10.1016/j.ijscr.2022.107641 -
IJU Case Reports Sep 2022Most seminal vesicle malignancies are secondary to prostate or bladder cancer. Herein, we report a case of primary clear cell carcinoma of the seminal vesicle.
INTRODUCTION
Most seminal vesicle malignancies are secondary to prostate or bladder cancer. Herein, we report a case of primary clear cell carcinoma of the seminal vesicle.
CASE PRESENTATION
A 27-year-old man was referred to our department for hematospermia and macroscopic hematuria. A digital rectal examination showed a soft elastic prostatic mass. Cystoscopy showed no bladder abnormalities, and tumor marker tests were unremarkable. Contrast-enhanced computed tomography and magnetic resonance imaging revealed a cystic tumor containing an enhanced nodule near the prostate and seminal vesicle. The tumor was removed en bloc with the prostate and seminal vesicle through a laparoscopic radical prostatectomy. A histopathologic examination confirmed the diagnosis, with the tumor likely arising from a remnant Müllerian epithelium. A 1-year follow-up revealed local tumor recurrence, prompting laparoscopy.
CONCLUSION
A standard therapy for primary seminal vesicle carcinoma has not been established. Further studies are necessary to determine the optimal treatment strategy.
PubMed: 36090927
DOI: 10.1002/iju5.12502 -
Turkish Archives of Pediatrics Sep 2022The kidney is the second most commonly affected organ by severe acute respiratory syndrome coronavirus-2, characterized by hematuria, proteinuria, and acute kidney...
OBJECTIVE
The kidney is the second most commonly affected organ by severe acute respiratory syndrome coronavirus-2, characterized by hematuria, proteinuria, and acute kidney injury. There are few studies describing renal involvement in pediatric cases.
MATERIALS AND METHODS
This retrospective study evaluated the prevalence of hematuria, proteinuria, and acute kidney injury in severe acute respiratory syndrome coronavirus-2-positive pediatric cases (1-18 years old) who visited emergency department between March and November 2020. Patients with urinary tract infections were excluded. An age-specific upper limit of reference interval was used to define "elevated serum creatinine" (greater than upper limit of reference interval) and acute kidney injury (>1.5 times upper limit of reference interval).
RESULTS
A total of 228 patients were evaluated, median age was 12.7 years (interquartile range: 7.5; 16.1), and 51.3% were male. The prevalence of asymptomatic, mild, and moderate-to-severe disease was 12.7% (29/228), 77.2% (176/228), and 10.1% (23/228), respectively. The prevalence of hematuria, proteinuria, and elevated serum creatinine was 15.8% (36/228), 6% (14/228), and 3% (7/228), respectively. Kidney involvement (i.e., at least 1 of these findings) was 23.2% (53/228) and significantly higher in the moderate-to-severe disease (43.5%). None of the patients met the acute kidney injury criterion. In logistic regression analysis, female sex (odds ratio: 1.97, 95 CI%: 1.03; 3.70, P = .040) and fever (odds ratio: 2.28, 95% CI: 1.19; 4.36, P = .012) were independent predictors of kidney involvement. Three patients demonstrated a kidney presentation (macroscopic hematuria) on admission, and another patient was diagnosed with C3 glomerulonephritis during hospitalization.
CONCLUSION
Kidney involvement was found about in 1 quarter of children with coronavirus disease 2019. Awareness and recognition of kidney involvement and follow-up are important in the management.
PubMed: 36062444
DOI: 10.5152/TurkArchPediatr.2022.22012 -
Urology Case Reports Nov 2022Pseudomelanosis (PM) is a rare, benign, condition that is characterized by deposition of melanin and/or melanin-like pigment in mucosal cells and macrophages and is best...
Pseudomelanosis (PM) is a rare, benign, condition that is characterized by deposition of melanin and/or melanin-like pigment in mucosal cells and macrophages and is best known as the entity pseudomelanosis coli. Pseudomelanosis primary of the urinary bladder has been reported only in a handful of cases worldwide. This article reports an extremely rare case of pseudomelanosis of the urinary bladder in a 79-year-old male with a history of macroscopic painless hematuria.
PubMed: 36039179
DOI: 10.1016/j.eucr.2022.102193 -
Sudanese Journal of Paediatrics 2022Khalawi are one of the most ancient non-governmental educational institutions that are commonly found all over Sudan playing a major role in the Sudanese society. The...
Khalawi are one of the most ancient non-governmental educational institutions that are commonly found all over Sudan playing a major role in the Sudanese society. The majority of Khalwa students are children. This study was part of a mixed methods project, conducted by Khartoum Medical Students' Association, aiming to investigate the health status of Khalwa students. It is a cross-sectional study carried out in Mustafa Alfadni Khalwa, Sharg Al-Neel suburb in Khartoum State. The participants were clinically assessed by a doctor and data were collected by using a data entry tool made specially to screen for major infectious diseases among students. The results showed a mean age of 13.7 years. Most of the students (47.7%) were originally from Darfur, and 27.5% of them had only Khalwa education. Respiratory clinic results revealed that 10% were complaining of cough, and 3.4% were diagnosed with pneumonia. Additionally, 44.6% of the students had tinea capitis and 21% had scabies. On examination, 2.3% and 1.1% had mild splenomegaly and hepatomegaly, respectively. Infectious conjunctivitis and trachoma were reported among 11.7% and 10.9%, respectively. Blood films for malaria were positive in 51.3%. Macroscopic and microscopic haematuria was evident among 13.4% and 10.8% of the participants, respectively. Stool examination results showed that 1.4% of the students had worms, 1.5% had ova and 18.8% had red blood cells in stools. Infectious diseases are very common among Khalwa students and their living environment is facilitating the transmission of these diseases. Agent control and sanitation improvement are crucial to decrease such infectious diseases.
PubMed: 35958082
DOI: 10.24911/SJP.106-1611150286