Inguinal polypropylene plug: a cause of unusual testicular tumor pelvic metastasis.

We report the case of a patient who had undergone polypropylene plug placement 3 years before and referred to our institution with testicular tumor. CT scan demonstrated an enlargement of pelvic lymph nodes on the tumor side while retroperitoneal nodes were normal. Orchifunicolectomy was performed and histopathological examination showed a mixed germ cell tumor involving the tunica vaginalis, rete testis, epididymis and spermatic cord. After surgery the patient was addressed to adjuvant chemotherapy according to PEB scheme. Clinical re-staging showed a decrease of the pelvic bulk disease whereas retroperitoneal nodes were still normal and tumor markers were negative. Left external, internal and common iliac lymphadenectomy as well as left modified template nervesparing retroperitoneal lymph node dissection was performed. Intraoperatively the node bulk was firmly adherent to the external iliac artery and extended until the common iliac bifurcation. In the deeper part of this enlarged and firm lymphatic chain the polypropylene plug placed at the time of hernioplasty was found. Behind the plug all retroperitoneal nodes appeared normal and resulted negative on histopathologic examination. The patient had an unusual metastatization, probably due to the plug.

Simultaneous management of renal carcinoma with caval vein thrombosis and double coronary artery disease.

INTRODUCTION: Recent advances in surgical and anesthesiology techniques allow simultaneous thoracic and abdominal operations to be performed for severe heart disease and benignant or malignant abdominal diseases. CASE REPORT: The simultaneous surgical management in a 75-year-old patient suffering from severe double coronary artery disease and a renal cell carcinoma with extended intravascular growth into the inferior vena cava is reported. CONCLUSION: The postoperative course was uneventful. Simultaneous surgery proved to be beneficial and safe, showing optimal results in our patient.

Etiology, diagnosis and treatment of renal colic during pregnancy.

OBJECTIVES: To assess the incidence and causes of renal stones in pregnant women, investigate the reliability and accuracy of diagnostic investigations and to consider the various therapeutic options available. METHODS: A review of the literature was conducted, searching for relevant papers on the physiology of urinary apparatus changes during pregnancy, as well as the etiology, diagnosis and management of renal colic in pregnant women. RESULTS: Standards of care in renal colic during pregnancy include accurate diagnosis primarily with ultrasound, or MRI if necessary, conservative therapy and careful surgical approach for urinary drainage in the first place or ureterorenoscopy when needed. CONCLUSIONS: Renal colic during pregnancy is potentially troublesome and likely to lead to serious adverse effects on both mother and fetus. A multi-disciplinary approach is needed, which includes experts in the fields of Urology, Obstetrics, Radiology and Anesthesiology, to ensure the optimal care of this delicate cohort of patients.

Relationship between sun exposure and kidney cancer: preliminary experience with the evaluation of recreational UV exposure.

INTRODUCTION: Recent findings reported an inverse relationship between solar ultraviolet-B (UV-B) exposure and mortality from various types of cancers, including renal cancer. METHODS: We reviewed the literature concerning the relationship between sun exposure and incidence of kidney cancer. We performed a case-control study, evaluating recreational sun exposure in 50 kidney cancer patients and 50 controls.A questionnaire concerning sun exposure habits during childhood, adult life and in the previous 2 years was filled in by every patient. The questionnaire focused on: hours/day spent in the sun during summer; hours/day spent sunbathing (considering as well which kind of UV protection was used); sunburns; holidays in tropical countries. RESULTS: We found and analyzed few articles concerning the relationship between kidney cancer and sunlight exposure. The two cohorts of patients we evaluated were homogeneous for age, phototype, origin and living area.We found no statistically significant differences between sun exposure in patients affected by kidney cancer and controls, both during childhood and adult life; no differences were found in the use of sunscreens either. CONCLUSIONS: Recreational sunlight exposure does not differ in our cohorts of patients and controls; studies on greater cohorts are needed to evaluate the effect of recreational sun exposure in the development of kidney cancer.