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Introduction and importance: Retroperitoneal liposarcomas (RPLPSs) are rare tumors that arise from mesenchymal cells in the peritoneum cavity. The sites of PRLPSs vary a lot, but renal PRLPSs are extremely rare (there are only 45 cases of Renal retroperitoneal liposarcomas on PubMed). In this case, the authors present a rare renal retroperitoneal liposarcoma case, describe the major concepts, and raise awareness about this rare tumor. Case presentation: A 44-year-old woman presented to the clinic with hirsutism and irregular menstruation; upon physical examination, a large abdominal mass was accidentally identified; the patient had Doppler ultrasound (Doppler US) and MRI, which both showed a mass arising from the right upper pole of the kidney, fine needle aspiration (FNA) confirmed the diagnosis of retroperitoneal liposarcoma, patient underwent surgical removal and her symptoms disappeared. Clinical discussion: The retroperitoneum is a cavity behind the abdominal wall containing organs like the pancreas and kidneys. Retroperitoneal tumors (RPTs) are rare neoplasms, primarily of mesenchymal origin. Retroperitoneal liposarcomas (RPLPS) are the most common RPT, often asymptomatic until large, and rarely metastasize but frequently recur. Liposarcomas are classified into five subtypes, with well-differentiated liposarcoma being the most common and characterized by high local recurrence. The presence of specific oncologic mutations affects the prognosis and the response to treatment. Conclusion: In rare cases, retroperitoneal liposarcomas can arise from sites near the kidney and compress the adjoining adrenal gland.
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Paratesticular rhabdomyosarcoma (RMS) is a rare aggressive tumor manifesting in children and young adults. This tumor derives from mesenchymal elements of the Tunica vaginalis, epididymis, and spermatic cord. It is a very metastatic lesion that can spread by lymphatics to the iliac, para-aortic nodes, lung, and bone. Case presentation: In this paper, the authors report a case of a 6-year-old child who presented to the clinic with a painless mass in the right side of the scrotum. The mass was misdiagnosed and had evolved rapidly over 2 weeks. The mass measured 16×32 mm on ultrasound, and therefore, an orchiectomy was performed. The histological examination of the excised tissue confirmed the diagnosis of paratesticular RMS. Discussion: Paratesticular RMS mainly presented as a painless mass in the scrotum. It was a very metastatic lesion that required an immediate management. However, a lot of cases of paratesticular RMS misdiagnosed at first time, which worsens the overall prognosis. Conclusion: Eventually, paratesticular RMS should be always taken into consideration when a scrotal mass is suspected. Due to its extremely serious metastatic potential, this condition requires early diagnosis and management. The treatment is currently well codified combining surgery, chemotherapy, and radiotherapy.
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Background: Obstructive uropathy due to stone disease is seen every day in urological practice. Percutaneous nephrostomy and double j ureteral stent procedures are used. Methodology: A randomized controlled trial was conducted in one center from January 2021 to January 2022. A total of 104 patients of age ≥18 years who had unilateral or bilateral obstructive uropathy due to stone disease were divided into two groups. In Group A, 50 patients underwent to double j stent while in Group B, 54 patients who underwent percutaneous nephrostomy insertion tube. Under local anesthesia, the stent was inserted by cystoscopy. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate postoperative period and on follow up. Results: Mean age of Group A was 35 ± 12.7 years whereas mean age in Group B was 36.7 ± 12.5 years and 49 out of patients were male. The most common complication in double j group and nephrostomy group was hematuria (16% and 5.5% respectively). Post DJ stent, complications like septicemia, painful trigon irritation, and stent encrustation were seen in 8.0%, 10.0%, 10.0% and 4.0% patients respectively. On the other hand, post-PCN septicemia, tube dislodgment or blockage, and injury to adjacent organs were seen in 3.7%, 5.5% and 1.8% respectively. In our trial, overall success rate for double j stenting was up to 84.0% and for percutaneous nephrostomy (PCN) was 96.29% (p < 0.0001). Conclusion: We found percutaneous nephrostomy is better and had overall higher success rate with less complications post procedure.
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Introduction: Aggressive angiomyxoma is a rare benign mesenchymal tumor and occurs rarely in males. This study aimed to review all the cases of AAM in men in the English literature up to September 2020 and investigate the clinical, histochemical, and radiological characteristics of AAM and discuss the best treatment choices according to available data. Methods: A comprehensive search of the PubMed, Google Scholar, and Embase databases up to September 2020 was performed looking for reported cases of male patients with AAM. The search excluded articles in languages other than English, reported female cases, and superficial angiomyxoma cases. Results: Among the 97 patients, the mean age was 48.2 years with an incidence peak between 40 and 60 years. The sites commonly involved were the scrotum (42.3%). On ultrasound, the tumor was hypoechoic (85.7%) with a well-defined margin (100%), whereas on MRI, most cases were isointense on T1-weighted images (53.8%), and hyperintense on T2-weighted images (85.7%). Immunohistochemistry revealed that the tumor tended to be positive for vimentin (100%), CD34 (63.4%), ER (50%), and PR (53.3%) while S-100 showed 91% negativity. Wide and complete surgical excision was conducted in most cases (72%), and follow-up duration ranged from 1 month to 144 months with a recurrence rate of 11.8%. Conclusion: Although the occurrence of AAM is rare in men, consideration should be taken in the differential diagnosis of a mass in the genitourinary region. According to our review, the most decisive immunohistochemistry profile is the positivity of Vimentin and CD34 with the negativity of S-100. Although hormonal treatment is controversial, we suggest a novel algorithm for the management of aggressive angiomyxoma.