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Adenocarcinoma in the Exstrophic Bladder
Organ-Sparing Surgery for Bilateral Leydig Cell Tumor of the Testis
P. Paulhac, F. Maisonnette, S. Bourg, J. P. Dumas, and P. Colombeau
Jonathan F. Masoudi, Keith Van Arsdalen, and Eric S. Rovner
We report 2 cases of cancerous transformation in an exstrophic bladder. The histology of these tumors, methods of surveillance, and treatment are discussed in conjunction with a review of published reports. These rare tumors are almost entirely adenocarcinomas. Their treatment is surgical (radical cystectomy) with or without associated radiation therapy. Surveillance for patients with bladder exstrophy, whether surgically corrected or not, is indispensable and rests on cystoscopy and urine cytology.
Leydig cell tumors of the testis are uncommon, and bilateral lesions are extremely rare. We report a case of bilateral Leydig cell tumor of the testis treated with radical orchiectomy and contralateral subtotal orchiectomy with the intent of preservation of hormonal function and fertility.
Squamous Cell Carcinoma at the Prostatectomy Site: Squamous Differentiation of Recurrent Prostate Carcinoma Farifteh Rahmanou, Jaik Koo, Alexander Y. Marinbakh, Michael P. Solliday, B. Mayer Grob, and Nena W. Chin Adenosquamous carcinoma of the prostate is rare. Even rarer is the subsequent squamous metastasis or recurrence in which only the malignant squamous component is observed in some sites, with the adenocarcinoma present in other sites. We describe a case of squamous cell carcinoma presenting at the prostatic bed 6 years after radical retropubic prostatectomy was performed for adenocarcinoma. Even though the primary tumor showed adenocarcinoma with foci of squamous differentiation, there was no morphologic evidence of adenocarcinoma in the current tissue examined. The suspected origin of the squamous tumor from a recurrence of the prostate tumor is discussed.
Xanthogranulomatous Pyelonephritis in an Infant with an Obstructed Upper Pole Renal Moiety Luis M. Pe´rez, Jose´ Murillo B. Netto, Ramaiah Induhara, and Elizabeth Mroczek-Musulman We report a case of xanthogranulomatous pyelonephritis in an infant involving the upper renal pole moiety of a duplicated system associated with an obstructed ectopic ureter. It was successfully managed by an upper pole heminephroureterectomy. We also review the published reports of xanthogranulomatous pyelonephritis in pediatric patients. 744
Retrograde Endopyelotomy in Association with Active Distal Ureteral Dilation: A Contraindication for the Use of the 7F Ureteral “Tail” Stent Cathy K. Naughton, Arieh L. Shalhav, and Ralph V. Clayman Since its introduction in 1997, the 7F “Tail” stent has been used after a variety of endourologic procedures. We describe 2 patients who underwent retrograde endopyelotomy with distal ureteral dilation; in both patients, after placement of a 7F “Tail” stent, a clinically significant urinoma developed. We believe that in the setting of extensive distal ureteral manipulation or distal active ureteral dilation to greater than 10F, placement of a “Tail” stent is contraindicated.
Traumatic Testicular Dislocation: A Case Report and Review of Published Reports S. Shefi, Y. Mor, Z. A. Dotan, and J. Ramon Testicular dislocation after blunt scrotal trauma is a rare event. Its diagnosis depends on the awareness of the physician of its possible occurrence. It is usually a late finding during treatment of a motorcyclist brought to the emergency room because of multitrauma injury and is sometimes demonstrated in an abdominal computed tomography scan. We describe a typical case and discuss the chain of events leading toward the correct diagnosis and treatment based on a review of published reports.
Drug-Seeking Behavior in Urolithiasis in the Noncontrast Computed Tomography Era: 2 Cases Christine L. Gray and Christopher J. Kane Symptomatic urolithiasis is usually treated with narcotic pain management. This leads to the potential for use of its symptoms for personal gain. Historically, the typical presentation of a narcotic-seeking “stone pa-
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UROLOGY 54: 744 –745, 1999