Expression of human epidermal growth factor receptor 2 in bladder urothelial carcinoma.

BACKGROUND: Urothelial bladder carcinoma (UBC) is one of the most prevalent cancers in men worldwide. Human epidermal growth factor receptor 2 (HER2) expression has been detected in a wide range of urothelial carcinoma. Despite many reports in the literature, the prognostic significance of this overexpression remains unclear. The aim of this study was to assess the expression of HER2 in urothelial bladder carcinomas and its association with clinical and pathological parameters. METHODS: 103 cases of UBC were diagnosed in our department between January 2014 and December 2015. The tumor specimens obtained by transurethral resection or cystectomy were evaluated by immunohistochemistry using HER2 antibody. RESULTS: HER2 protein overexpression was present in 11.7% of cases and associated with tumor grade (p = 0.003) and pathological stage (p = 0.015). In multivariate analysis, HER2 overexpression was associated only with tumor grade (P = 0.04). CONCLUSION: HER2 protein overexpression is noted in patients with high grade cancer. This expression may select patients for anti HER2 targeted therapy. Future larger and prospective studies will verify the frequency of HER2 alteration and the role of HER2 in the aggressive behavior.

Upper urinary tract lipoma: A case report.

Upper urinary tract (UUT) benign tumours are rare. We present a case of UUT lipoma in a 41-year-old man with left flank pain. A computed tomographic urography scan revealed an irregular thickening of the left renal collecting system wall extending from the upper calices to the renal pelvis. The diagnosis of UUT was made and the patient underwent a nephroureterectomy with bladder cuff excision, as standard treatment. However, macroscopic and histological examination revealed a lipomatous tumour with no sign of malignancy. To our knowledge this is the first reported case of its kind of a UUT managed first with a minimally invasive approach.

The usefulness of stone density and patient stoutness in predicting extracorporeal shock wave efficiency: Results in a North African ethnic group.

INTRODUCTION: We determine the role of stone density and skin-to-stone distance (SSD) by non-contrast computed tomography of the kidneys, ureters and bladder (CT-KUB) in predicting the success of extracorporeal shock wave lithotripsy (ESWL). METHODS: We evaluated 89 patients who received ESWL for renal and upper ureteric calculi measuring 5 to 20 mm, over a 12-month period. The mean stone density in Hounsfield units (HU) and mean SSD in mm was determined on pre-treatment CT-KUB at the CT workstation. ESWL was successful if post-treatment residual stone fragments were ≤3 mm. RESULTS: ESWL success was observed in 68.5% of patients. Mean stone densities were 505 ± 153 and 803 ± 93 HU in the ESWL successful and failure groups, respectively (p < 0.001, student's t-test). The mean SSD were 10.6 ± 2.0 and 11.2 ± 2.6 cm in ESWL successful and failure groups, respectively; this was not statistically significant. CONCLUSIONS: This study shows that stone density can help to predict the outcome of ESWL. We propose that stone density <500 HU are highly likely to result in successful ESWL. Conversely, stone densities >800 HU are less likely to be successful.

Usefulness of adjunctive alpha1-adrenergic antagonists after single extracorporeal shock wave lithotripsy session in ureteral stone expulsion.

INTRODUCTION: We evaluate the efficiency of α-adrenergic antagonists on stone clearance after extracorporeal shock wave lithotripsy (ESWL) in patients with lower ureteral stones. METHODS: A total of 356 patients with solitary lower ureteral stones who underwent single ESWL sessions were divided into 2 groups. Group 1 received our standard medical therapy, and Group 2 was treated with 0.4 mg/day tamsulosin for a maximum of 2 weeks. All patients were re-evaluated with plain film radiography and ultrasound each week during the treatment period. A computed tomography scan was systematically performed 3 months after ESWL. RESULTS: In total, 82 of the 170 patients in Group 1 (48.2%) and 144 of the 186 patients in Group 2 (77.4%) (p = 0.002) were stone-free. Among the patients with stones 10 to 15 mm in diameter, the stone-free rate was 38.4% in Group 1 and 77.1% in Group 2 (p = 0.003). Average stone expulsion time was 10.6 days and 8.4 days in Groups 1 and 2, respectively. Ureteral colic occurred in 40 patients (23.5%) in Group 1, but only in 10 patients (5.3%) in Group 2 (p = 0.043). The only side effect of tamsulosin was slight dizziness in 5 of the 186 patients in Group 2 (2.6%). CONCLUSION: Adjunctive therapy with α1-adrenergic antagonists after ESWL is more efficient than, and equally as safe as, lithotripsy alone to manage patients with lower ureteral stones. The adding of α-blockers is more reliable and helpful for stones with a large dimension, and can also decrease stone elimination time and episodes of ureteral colic.

WITHDRAWN: Endorectal MRI accuracy in auguring tumour location, tumour extent, capsular perforation and seminal vesicle invasion of prostate cancer in north-African men.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

[Nutcracker syndrome managed by simple surveillance]. / Actitud expectante en el síndrome del cascanueces.

Nutcracker syndrome is caused by compression of the left renal vein between the aorta and the superior mesenteric artery where it passes in the fork formed at the bifurcation of these arteries. The phenomenon results in left renal venous hypertension. The syndrome is manifested by left flank and abdominal pain, with or without unilateral haematuria. The nutcracker syndrome has been treated in various ways. We report one case of the syndrome and discuss the place of surveillance in its management.

[Hydatid cyst of the kidney based on a series of 34 cases]. / Le kyste hydatique du rein. Traitement à propos de 34 cas.

AIM: Hydatid disease is endemic in some countries, where it constitutes a real public health problem. It can affect any, but the kidney is a relatively rare site, representing 2% to 4% of all visceral sites. Renal hydatid cyst only presents at the stage of complications. Laboratory tests may suggest the diagnosis, which is confirmed by radiology. Renal hydatid cyst raises therapeutic problems making conservative surgery difficult. The objective of this paper is the find the best adapted treatment. MATERIAL AND METHOD: 34 consecutive cases of renal hydatid cyst (1980-2001) were observed in 23 men and 11 women with a mean age of 42 years (range: 15-73 years). The clinical features were dominated by pain (63%), a mass (26%), hydaturia (11.4%), haematuria (31.4%), prolonged fever (23%) and hypertension (3%). Intravenous urography performed in all patients showed calcifications in 5 cases, a mass syndrome in 11 cases and silent kidney in 2 cases. Abdominal CT, performed in 8 patients, was necessary whenever the diagnosis remained uncertain, particularly in the case of pseudoneoplastic cysts. However, ultrasonography, performed in 30 patients, remains the preferred diagnostic examination. RESULTS: Treatment consisted of resection of the prominent dome in 23 cases, pericystectomy in 5 cases, 1 partial nephrectomy and 6 total nephrectomies. An associated procedure was performed during the same operation (hepatic, peritoneal hydatid cyst) in 3 cases, and was deferred (pulmonary hydatid cyst) in 1 case. The postoperative course was marked by urinary fistula in 2 cases and suppuration of the residual cavity in 1 case, treated by ultrasound-guided aspiration-drainage. CONCLUSION: The resection of the prominent dome is the most adapted treatment whenever possible.

[Hydronephrosis arterial hypertension. Report of 4 cases]. / Hydronéphrose et hypertension artérielle. A propos de quatre observations.

Four cases of ureteropelvic junction syndrome associated with arterial hypertension were reported. The authors discuss the ethiopathogenic of hypertension, on the basis of these observations and a review of the literature. They conclude that union bilateral hydronephrosis can lead to hypertension and renal failure by both inappropriate production of renin and water chronic retention. The correction of ureteropelvic junction should return blood pressure to normal levels.

[Genital Buschke Loewenstein tumors. Report of 4 cases]. / Tumeurs de Buschke Loewenstein à localisation génitale. A propos de quatre observations.

The authors present four cases of Buschke Loewenstein tumor. In three cases, the outcome was good despite areas of anaplasic change are seen in one of them. The outcome of the fourth patient was fatal because of multiples recurrences. Clinical features, diagnosis and treatment of this rare disease are discussed.

[Dermoid cyst of the testis]. / Le kyste dermoïde du testicule.

The authors report a case of a 30-year-old patient presenting with a right testicular mass. The presumptive diagnosis was that of a malignant tumour. The definitive diagnosis, confirmed by histological examination of the orchidectomy specimen, was that of a dermoid cyst. The aetiopathogenic, diagnostic and therapeutic characteristics of this exceptional disease are reported.