RESUMO
Xanthogranulomatous pyelonephritis (XGP) is an uncommon condition representing 1% of all renal infections. XGP due to complicated pyelonephritis associated with hepatic abscess is an extremely rare complication and has rarely been reported in the literature. We report a rare case of a 54-year-old female with a history of diabetes and recurrent urinary tract infections (UTI) who presented with acute right flank pain and fever which had been ongoing for four days. CT scan showed multiple bilateral obstructive nephrolithiasis associated with a liver abscess. Given the patient's high risk of nephron loss, a bilateral renal and liver abscess drainage followed by a two-stage flexible ureterorenoscopy (FURS) was performed. One week later, a CT scan showed a typical radiological aspect of XGP on the right kidney invading the liver. She urgently underwent a right nephrectomy with an uneventful outcome. In conclusion, the diagnosis of XGP should be considered in the presence of complicated pyelonephritis associated with hepatic abscess.
RESUMO
Leiomyosarcoma of the prostate is an extremely rare neoplasm. It represents less than 0.1% of all prostate malignancies. It is considered to have a poor prognosis, an aggressive nature, and high metastatic potential. Additionally, the relationship between radiation exposure for the treatment of primary prostatic cancer and the occurrence of leiomyosarcoma as second cancer at the irradiated site is rare, with unknown etiology. We reported a 72-year-old male known case of prostate adenocarcinoma with radio-hormonotherapy for six years who presented with acute urinary retention. Magnetic resonance imaging revealed a large malignant obstructive prostate with direct invasion of surrounding organs and multiple metastases. Trans-urethral resection of the prostate was performed, and the histopathology result showed high-grade leiomyosarcoma. The patient passed away after four months due to multiorgan failure. In conclusion, there may be a causal relationship between radiation therapy to the prostate and the development of prostate leiomyosarcoma.
Assuntos
Leiomiossarcoma , Hiperplasia Prostática , Neoplasias da Próstata , Masculino , Humanos , Idoso , Próstata/patologia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/etiologia , Leiomiossarcoma/radioterapia , Neoplasias da Próstata/patologiaRESUMO
Penile calciphylaxis is a rare and highly morbid condition mainly affecting diabetic patients with chronic renal failure (CRF). It is characterized by ischemic skin ulceration and necrosis secondary to dystrophic calcification of the subcutaneous penile tissue and penile arterioles. We report a 52-year-old male with a 6-year history of diabetes mellitus and CRF on hemodialysis, who presented with a painful penile necrotic lesion in the last three weeks. He firstly treated with medical treatment, which was failed. Then underwent total penectomy. The histopathology result confirmed the diagnosis of penile calciphylaxis. Unfortunately, he passed away due to septic shock and multisystem organ failure ten days after surgery. In conclusion, the diagnosis of penile calciphylaxis must be evoked in the presence of any minimal necrotic penile lesion in a patient with CRF; this will initiate quick medical and/or minimally invasive surgical treatment to improve the patient's prognosis and avoid serious complications.