Synchronous ipsilateral papillary renal cell carcinoma and urothelial carcinoma: A case report.

Concurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) in the same kidney is a rare phenomenon. It is critical to define this unusual disease to avoid a delay in diagnosis and improve the prognosis. The present study describes a case of a 71-year-old patient with synchronous ipsilateral RCC and UC of the renal pelvis and ureter. The patient presented with intermittent attacks of left loin pain with frank hematuria for 3 months and a weight loss of 5 kg over the same period of time. The patient had been a chronic heavy smoker for >45 years. Physical examination revealed stable vital signs; however, a mobile, non-tender mass was palpated in the left upper abdomen. A left nephroureterectomy with the removal of a bladder cuff was performed. Histopathological examination revealed a papillary RCC with a pathological stage of pT1N0Mx and a high-grade UC of the renal pelvis and ureter with a pathological stage of pT3-pN1-pMx. The postoperative recovery was good, and the patient was referred to an oncology center for further management. Previous reports have failed to identify definitive risk factors for the concurrence of RCC and UC. However, 24% of the patients in the various case reports in the literature were smokers. The most common presenting complaints included weight loss and painless hematuria. The concurrence of RCC and UC in the same kidney is a rare entity, and it frequently leads to a worse prognosis than the occurrence of RCC alone. Radical nephroureterectomy is the main line of treatment for patients with upper tract UC.

Typical leiomyoma of the scrotum: A rare case report.

INTRODUCTION: Scrotal leiomyomas are benign tumors arising from the dartos layer of the scrotal wall. The exact cause of this tumor is not yet clear. Malignant transformation to leiomyosarcomas has been reported. CASE PRESENTATION: A 52-year-old male who complained of a painless lump on the right side of the scrotum that lasted 12 years. Physical examination revealed a single, firm, and non-tender, mobile lump on the anterior aspect of the right scrotum. Both testes were normal and no inguinal lymph nodes could be palpated. Ultrasound scan of the scrotum showed a 40 mm × 20 mm hypoechoic, poorly vascular lesion in the scrotum. Under spinal anesthesia, the mass has been excised. Histopathological and immunohistochemical findings were consistent with the diagnosis of scrotal leiomyoma. DISCUSSION: Leiomyomas may originate from any location in the genitourinary system where there is smooth muscle. Scrotal smooth muscle tumors can be categorized into Leiomyomas, atypical or symplastic leiomyomas, which are not hypercellular and lack mitotic activity, and leiomyosarcomas. Ultrasound is the first-line imaging investigation in patients with suspected scrotal masses. Typical leiomyomas and atypical ones behave similarly. Therefore, they are managed only with surgical excision, while leiomyosarcomas need a wide 3-5 cm margin resection. Both recurrence and malignancy have been described. Close follow-up is required to detect recurrence. CONCLUSION: Scrotal leiomyoma is a rare benign mesenchymal tumor of the middle-aged men. The current report describes the clinical and histopathological characteristics to help reduce erroneous diagnoses of this rare tumor.