Bilateral adrenal metastasis from renal cell carcinoma. A case report.
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Biomedical subjects
Publications and source records attributed to F Aragona.
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A case of a forty-five-year-old woman with fused kidneys and intercommunicating pelves drained by a single ureter crossing the midline is reported. A review of the literature is presented.
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Ureterocele without corresponding renal tissue (blind ureterocele) represents a very rare malformation which is of special interest for the understanding of the embryogenesis of this anomaly. Two cases, the first without corresponding kidney seen in an adult and the second in connection with a small multicystic kidney observed in a boy, are considered. In light of the observation of the disappearance of antenatally diagnosed multicystic kidney, these lesions are considered to represent two different stages of the same anomaly. A somewhat functioning renal tissue is supposed to be necessary for the development of a ureterocele. In the case of blind ureterocele, it is supposed that the renal tissue might subsequently disappear. Ureterocele may result from a combined ureteral bud anomaly and obstruction during fetal development.
The authors report on two rare case urachal residue disease of late onset. They define the pathogenic factors contributing to the disease and describe the semeiological and radiological methods used in diagnosing the condition.
The authors report the observation of a five year old boy who presents recurrent urinary tract infections with infrequent voiding and without residual urine. Uroradiologic investigations show a megaureter-megabladder syndrome. Pathogenesis and management of this syndrome are then discussed.
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2 children with upper urinary tract obstruction from Candida fungus balls are reported. A presumptive diagnosis, made on the basis of clinical and radiological findings, was confirmed by microscopic examination of urinary sediment. Medical treatment was successful in both patients. Since Candida infections can occur in patients with altered host resistance, this should alert clinicians to the possibility of fungal involvement when radiolucent filling defects are found in the renal pelvis. Such a presumptive diagnosis can then lead to a correct approach with conservation of renal function.
A child with massive hematuria, produced by cyclophosphamide-induced cystitis, was treated with open bladder instillation of formalin. To prevent vesicoureteral reflux, we inserted two Fogarty catheters. Intraoperative retrograde cystography was made to confirm that there was no reflux, extravasation or passage of contrast per urethra. The postoperative result was good with cessation of hematuria.
A neurogenic bladder was the presenting syndrome in three cases of spinal cord traction. Of the typical symptomatic triad: neuro-orthopedic, cutaneous and urologic, the latter was of primary importance. Symptoms in the first case were incomplete bladder retention with distention of upper urinary tract, right-sided vesicorenal reflux and renal insufficiency. Six months after excision of a sacral lipoma and freeing of the filum terminale, micturition had become normal without residue, and renal function normalized. Right-sided reflux was corrected by submucosal advancement surgery with good results. The clinical history was more suggestive in the second case. Although inaugural symptoms were mictional, there was foot paralysis and a retrosacral lipoma above an abnormal hairy tuft in the upper part of the gluteal cleft. Operation revealed the presence of a dermoid cyst and a lipoma. Their excision combined with section of the filum terminale allowing ascension of the medullary cone. Marked clinical and urodynamic improvement was obtained with normal micturition and disappearance of incontinence. An anti-reflux operation suppressed residual reflux with good urographic results. Marked improvement in mictional disorders was obtained also in the 3rd case after excision of a sacral extradural lipoma and section of the filum terminale, allowing objective ascension of the medullary cone by 4 cm. A very detailed analysis was conducted of similar cases reported in the literature, about 2% of neurogenic bladders in children being affected. The importance of early diagnosis is emphasized as well as the essential need to establish a precise diagnosis of the lipoma of cauda equina and of medullary fixation. Early neurosurgery is justified by the high frequency of improvement in cases treated in this way.
Three cases of prostatic leiomyosarcoma and a brief review of the literature are presented. The authors emphasize the differences in clinical features, management and prognosis between the sarcomas occurring in childhood and the rarest leiomyosarcoma of elderly patients.
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