RESUMEN
Pelvic leiomyoma in male patients is a very rare occurrence and its association with prostate cancer is a unique clinical situation. This study reports a new case of a 9 cm pelvic Leiomyoma associated with intermediate-risk localized prostate cancer in a 68-year-old patient. The leiomyoma was discovered fortuitously after an MRI was performed in the context of prostate cancer work-up. Surgical excision of the pelvic mass along with a radical prostatectomy were performed and the diagnosis of leiomyoma was confirmed by histopathology.
RESUMEN
Renal vein thrombosis is not a common manifestation in the context of acute pyelonephritis. We report the case of a 29-year-old female diabetic patient that was admitted to our department for an episode of complicated acute pyelonephritis. Initial imaging showed a left lower polar abscess of 27 mm and urine cultures grew community acquired K. Pneumoniae. Two days after the patient was discharged, she was readmitted with worsening symptoms. Repeat imaging showed stability in the size of the abscess and revealed a left lower segmental vein thrombosis. The patient responded favorably to antibiotics and heparin-warfarin therapy.
RESUMEN
INTRODUCTION AND IMPORTANCE: The association of bilateral renal hydatid cysts and complex urolithiasis is unprecedented. We herein report the case of a patient presenting with both diseases. CASE PRESENTATION: A 56-year-old female patient with a history of chronic kidney disease presented with right flank pain. Imaging revealed bilateral kidney cystic lesions associated with right spontaneous large ureteric streinstrasse and multiple calyceal stones. The right sided mass was exophytic and measured 56 mm and the left sided lesion measured 35 mm. Semi rigid right ureteroscopy was performed along with a right partial nephrectomy and a right pyelotomy which allowed for renal and ureteral stone extraction. Histopathology report concluded to a hydatid cyst. The decision was to monitor the left-sided lesion. CLINICAL DISCUSSION: The association of bilateral renal hydatidosis and right urolithiasis is unprecedented in literature. The lesion presented a differential diagnosis problem with a cystic malignancy. Thus, the decision was to perform a right partial nephrectomy. The combination of ureteroscopy and a single right flank incision was sufficient to treat the renal lesion as well as to obtain stone free status. Once the histopathological report concluded to a hydatid cyst, the decision was to monitor the left sided lesion. A more aggressive approach could be proposed however it would have been detrimental to the patient's renal function. CONCLUSION: When presented with an association of bilateral renal masses and urolithiasis, a methodical step-by-step approach is necessary in order to treat both diseases while minimizing patient morbidity.
