Concomitant large renal cancer and abdominal aortic aneurysm. An original multidisciplinar approach to solve both pathologies saving residual kidney.

A 65-year-old male patient presented a large mass of the left kidney and a concomitant saccular abdominal aortic aneurysm (AAA) of the infrarenal aorta. Due to the particular vascularization of the right kidney in order to allow an endovascular Aneurysm Repair (EVAR), a hybrid staged repair was planned. Through a median laparotomy, a left radical nephrectomy and an ilio-renal bypass were performed, thus creating the anatomical feasibility for subsequent EVAR. Two days later the AAA was excluded by positioning of an abdominal straight stent graft. This original surgical strategy showed to be effective and reduced invasiveness of traditional approach.

A rare case of muscle invasive bladder cancer in a Vescical inguinal hernia.

A 81-year-old male patient presented macroscopic hematuria. Flexible cystoscopy didn't give any diagnosis and urinary citology was negative. Total body CT showed a bladder inguinal hernia with diffuse thickening of the bladder wall, while abdomen bladder was regular. Diagnosis was difficult because flexible cystoscope could not reach the lesion, preventing diagnosis and bladder resection. We decided to reduce inguinal hernia surgically and perform a partial cystectomy removing the suspect neoplastic part of the bladder. Histologic examination showed muscle invasive squamous cell carcinoma with negative margins. After two years follow up, patient was free from bladder cancer, without any significative LUTS.