RESUMO
Rectovesical fistulas are rare and typically result from inflammatory or neoplastic conditions in the small pelvis. They occur within a pelvic region that has been altered by local inflammatory or neoplastic processes. This explains the challenges in detecting these fistulas using conventional imaging techniques, despite the effectiveness of CT and MRI. Colonic diverticulosis is the primary cause of colovesical fistulas. To date, there have been no reported cases of a rectovesical fistula associated with a bladder diverticulum in the literature. We present a case of a patient who presented with a large stone within a bladder diverticulum. The migration of this stone into the rectum revealed an advanced rectal tumor. The unique aspect of our case is primarily the presence of a rectovesical fistula arising from a lateral bladder diverticulum. Additionally, we observed the migration of the diverticular calculus from the bladder to the rectum.
RESUMO
Melanoma of the penis is a rare tumor with a poor prognosis. We report the case of a 73-year-old patient with no significant medical history, admitted for deterioration of the general condition and bilateral inguinal lymph nodes. An abdominal ultrasound and thoraco-abdomino-pelvic CT (computed tomography) scan revealed metastatic liver nodules, the tumoral nature of which was confirmed by an anatomopathological examination. Further clinical examination revealed papular and ulcerated lesions of the penis located at the urethral meatus and glans penis. These lesions were biopsied and histologically assessed as melanoma. The contribution of imaging in penile tumors is generally not useful for diagnosis as clinical examination is key. However, it has its place in the assessment of locoregional and distant extension. In our case, it was the distant lesions that helped orient the diagnosis. The patient underwent immunotherapical treatment and is still alive 19 months after the diagnosis.
