Giant intravesical prostatic protrusion mimicking bladder carcinoma: Navigating diagnostic and management challenges.

INTRODUCTION AND IMPORTANCE: Benign prostate hyperplasia is common condition among elderly men, but giant intravesical prostatic protrusion is rare and may be confused with bladder carcinoma. CASE PRESENTATION: We report an unusual case of giant intravesical prostatic protrusion mimicking bladder carcinoma. A diagnosis of giant intravesical prostatic protrusion was confirmed with the assistance of cystoscopy and patient was managed by transvesical simple open prostatectomy where he had uneventfully recovery. CLINICAL DISCUSSION: Both bladder carcinoma and benign prostate hyperplasia are more prevalent in elderly men and they all present with lower urinary tract symptoms. Ultrasound and computer tomography may all suggest bladder carcinoma. The two conditions are treated differently, and therefore having correct diagnosis is mandatory. Cystoscopy is an important investigation that can act as a tiebreaker in differentiating giant intravesical prostatic protrusion from bladder carcinoma. Transvesical simple open prostatectomy is the preferred surgical approach with good postoperative outcome. CONCLUSION: This case report reminds urology surgeons on the possibility of having giant intravesical prostate mimicking bladder carcinoma and the importance of cystoscopy in differentiating the two. Transvesical simple open prostatectomy has promising result.

Hydrometrocolpos in an infant with urological complications: a rare case and review of literature.

Hydrometrocolpos is a rare congenital anomaly characterized by gross distension of the uterus and vagina with fluid, which may result in obstruction to the urine flow. The insertion of Foley catheter into the uterus can relieve the obstruction to the flow of urine and improve renal function. Herein we present a case of infant who was diagnosed with an abdominal mass and renal insufficiency that was managed by the placement of Foley catheter into the dilated uterus and the renal function recovered.

Primary diffuse large B-cell lymphoma of the kidney: A rare case report and review of literature.

INTRODUCTION AND IMPORTANCE: Lymphoma can either be Hodgkin or non-Hodgkin (NHL) with diffuse large B cell lymphoma (DLBL) being a type of the latter with an aggressive behavior. Although it is common for NHL to involve the kidney in its advanced stages, disease that primarily originates from the kidney is rare and therefore poses a diagnostic challenge. CASE PRESENTATION: We presented a case of NHL that was initially thought to be Renal Cell Carcinoma (RCC) but later confirmed histologically to be diffuse large B cell Lymphoma. The patient was kept on doxorubicin, cyclophosphamide and dexamethasone. However, on day five of the treatment he succumbed. CLINICAL DISCUSSION: Lymphoma can be broadly grouped into Hodgkin and non-Hodgkin Lymphoma. Primary kidney lymphoma accounts for <1 % with non-specific symptoms hence can be challenging in the diagnosis. Biopsy yields in the diagnosis and management is primarily chemotherapy. CONCLUSION: This case reminds health care professional on the possibility of having primary Lymphoma of the kidney in a patients with renal mass. Treatment of lymphoma is different from RCC, a common renal malignancy in adult. Therefore, tissue biopsy for definitive diagnosis is mandatory before initiation of treatment.

Triple penile fracture: A rare case report and review of literature.

INTRODUCTION AND IMPORTANCE: Penile fracture is uncommon entity that rarely involves all the three erectile bodies (the two corpora carvenosa and corpus spongiosum). The diagnosis is clinical as most cases presents with typical signs and symptoms. CASE PRESENTATION: We present a case of young man who sustained penile fracture involving the two corpora cavernosum and corpus spongiosum with associated urethral injury that was successfully repaired primarily. CLINICAL DISCUSSION: In this case apart from MRI confirming the diagnosis it showed the injury to involve all the three corpora bodies as well as the urethral. Although MRI is reserved for controversial cases, when available, apart from just confirming the diagnosis, it can help in showing the extent of the injury and assist surgeon in management. Primary repair of the erectile bodies as well as the urethral gives excellent outcome. CONCLUSION: This case reminds surgeons the possibility of having such extensive injury with promising outcome if properly managed.

Giant perineal epidermoid cyst in adult man: a rare case report and review of literature.

An epidermoid cyst is a common benign cutaneous mass that mostly occurs on the neck, face and trunk. The majority of epidermoid cysts are small and asymptomatic with the giant perineal epidermal cyst being rare and more liable to develop complications such as malignant transformation. The treatment of an epidermal cyst involves total excision of the cyst along with its wall to prevent recurrence. We present an unusual case of a giant perineal epidermal cyst in a 52-year-old male.

A large infected urachal mass in an adult: A case report in Tanzania.

INTRODUCTION AND IMPORTANCE: Urachal Mass results from a failure of obliteration of the urachal canal during fetal growth. The aetiology of urachal masses is ambiguous, being either of a cancerous or benign origin. Much literature is stipulated in children presenting with urachal-associated diseases but few in adult patients. This study aims at elucidating the existence of urachal mass with an abscess in a patient and the management modalities. PRESENTATION OF CASE: We present a case report of a 52-year-old female patient with a two months history of abdominal pain and discomfort associated with intermittent low-grade fevers, anorexia and marked weight loss throughout her illness. An abdominal ultrasound revealed the presence of an intra-abdominal mass. A CT scan showed a multilobulated urachal mass. She eventually had a successful operation and quick recovery postoperatively. DISCUSSION: In the adult population, most urachal-associated diseases are malignant, with few being of benign origin. With different presentations between the two aetiologies, the most benign urachal masses may lead to infection and inflammation that typically present with a lower abdominal mass and fever. Diagnosis is made by ultrasound or CT scan of the abdomen. Surgical drainage and excision of the mass are the mainstay treatment modalities. CONCLUSION: Urachal masses are rare in the adult population and are often missed in initial presentations. This will constitute poor management and outcome for patients. Physicians are to be alerted of the knowledge and make a clear assessment of patients perioperatively to avoid the delayed diagnosis, which may have consequent poor outcomes.

Perineal ectopic testis in adult: Experience from tertiary hospital, northern Tanzania.

INTRODUCTION AND IMPORTANCE: Perineal ectopic testis is a rare congenital abnormality mostly diagnosed during childhood period. The diagnosis can be easily reached by physical examination. The treatment of choice is either orchidopexy or orchiectomy through scrotal or inguinal approach. CASE PRESENTATION: We report a case of 30 year old male with painful perineal mass and empty right hemiscrotum. Ultrasound of the mass was done prior to operative procedure and the ectopic testis was the working diagnosis ever since. At exploration there was no abnormality found on the testis; thus, orchidopexy was done with uneventful postoperative period. CLINICAL DISCUSSION: Ectopic testis is rare congenital anomaly with perineal ectopic testis accounting for only 1% of all cases. Most cases of ectopic testis are diagnosed during childhood period. Our case presented at the age of 30 years, the reason could be either late diagnosis by physician or lack of insight of parents/care takers or both. The late presentation might pose a diagnostic challenge but also the testis may be atrophic or undergo malignant changes. In this case the testis was normal and therefore it was successfully relocated surgically through trans-inguinal approach. CONCLUSION: It is suggested to make perineal ectopic testis one of the differential diagnoses on painful perineal swelling without ipsilateral testis on any man.