ABSTRACT
We present a case of an iatrogenic complete left proximal ureteric injury after a lumbar 1 laminectomy and intradural tumour excision and lumbar 4/5 transforaminal lumbar interbody fusion. Initial management included a percutaneous nephrostomy for urinary diversion followed by definitive urinary reconstruction with an ileal ureter.
Subject(s)
Nephrostomy, Percutaneous , Spinal Fusion , Ureter , Flank Pain , Humans , Laminectomy/adverse effects , Lumbar Vertebrae/surgery , Lumbosacral Region , Nephrostomy, Percutaneous/adverse effects , Ureter/diagnostic imaging , Ureter/surgeryABSTRACT
Synovial sarcomas are most commonly localised in extremities, especially in the lower thigh and knee areas. Comprising less than 1% of all malignancies, retroperitoneal synovial sarcoma is very rare with primary synovial sarcoma of the kidney being even more infrequent and difficult to diagnose. We describe a case report of a renal synovial sarcoma in a young adult who was initially managed as a case of Wunderlich's syndrome secondary to what was believed to be a ruptured renal angiomyolipoma. After biopsy confirmation, the patient was eventually managed with neo-adjuvant chemotherapy followed by a right radical nephrectomy and right hepatectomy. Despite its rarity, synovial sarcoma should be considered as differential diagnosis of a bleeding retroperitoneal soft tissue mass detected in young adults.
Subject(s)
Angiomyolipoma , Kidney Neoplasms , Sarcoma, Synovial , Angiomyolipoma/surgery , Humans , Kidney Neoplasms/complications , Kidney Neoplasms/diagnosis , Kidney Neoplasms/surgery , Nephrectomy , Retroperitoneal Space/diagnostic imaging , Sarcoma, Synovial/complications , Sarcoma, Synovial/diagnosis , Sarcoma, Synovial/surgeryABSTRACT
In the context of a post-treatment testicular germ cell tumour, an abdominal lesion found on surveillance CT studies led to a differential diagnosis, including recurrent germ cell tumour. We report the case of a 48-year-old man who was noted to have a new interval soft tissue lesion on a surveillance CT scan, 5 years after initial orchidectomy and chemotherapy. Excision of this lesion and histopathological review revealed an intra-abdominal desmoid.