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Introduction: and importance: Urethral cancer is a rare condition. It represents less than 1% of all cancers and the clinical signs are not very specific and confusing, which explains the often-late diagnosis. The prognosis can be poor. The objective of our observation is to discuss, through a review of the literature, the diagnostic and therapeutic means of tumors of the male anterior urethra. Case presentation: This is a 54-year-old patient, smoker, followed for urinary lithiasis. He initially consulted us for right nephritic colic, with an obstructive iliac ureteral stone on a CT scan. He had drainage by JJ stent followed by extracorporeal lithotripsy. After three months, it was decided to remove the JJ Stent. During urethrocystoscopy, a papillary tumor of the anterior urethra was found, measuring 0.5 cm on the long axis. Endoscopic resection of the tumor was performed. Pathological examination revealed a low-grade malignant urothelial carcinoma. No tumor recurrence was noted after one year of follow-up. Discussion: Primary urethral cancer is a rare condition. Most series in the literature show a male predominance. The main risk factors are chronic inflammation, history of urethritis, and urethral stricture. The clinical signs of urethral cancer are usually discrete and not very specific. The reference examination for positive diagnosis remains urethroscopy, which allows a more precise diagnosis thanks to a direct view of the urethral mucosa. The management of tumors of the anterior urethra consisted of aggressive excisional surgery. The main goal was to achieve satisfactory local control. conservative treatment by resection, fulguration or laser vaporization is indicated for small lesions (<1 cm). Conclusion: Tumors of the anterior urethra in men are often diagnosed late. More effort should be made to diagnose this disease earlier, especially in high-risk groups. Conservative treatment can be offered in patients with a small lesion.
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INTRODUCTION: and importance: Vesical varices are a rare condition. they are an exceptional cause of hematuria. The most common cause of vesical varices reported in literature is portal hypertension. Usually, varices due to portal hypertension develop in the gastroesophageal region. A multidisciplinary team approach is required, with input from gastroenterologists, interventional radiologists, and urologists. CASE PRESENTATION: We present a case of A 38 -year- old man presented to our office for 2 episodes of total macroscopic gross hematuria. The detailed general physical examination revealed: a patient in a good condition, without pallor or icterus. Laboratory investigations are normal. Cystoscopy under locoregional anesthesia was performed. It revealed a group of dilated sub mucosal veins, in the trigone. After discussing the case with gastroenterologists, we had presumed that the etiology of vesical varices may be the portal hypertension. CLINICAL DISCUSSION: Vesical varices are an extremely rare cause of hematuria. The most common cause of vesical varices reported in literature is portal hypertension. The vesical varices may remain asymptomatic for a long period and manifest with hematuria in some cases. In order to organize the management of bleeding vesical varices, a detailed cartography of vesical vascularization have to be performed, including cystoscopy and abdominal contrast tomography (10). No definitive treatment has been established for bleeding vesical varices. In case of gross hematuria, surgical devascularization, laser sclerosis and coagulation are often only of temporary effectiveness. CONCLUSION: Vesical varices are an extremely rare pathology. Its main etiology is Portal hypertension. The hematuria due to vesical varices could be life threatening. It requires energetic treatment. The goal of the treatment is portal decompression.
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The causes of isolated solid splenic lesions are wide and varied, and as such can present a diagnostic challenge. Splenic metastases were previously considered exceptionally rare. We report a case of a patient who had isolated splenic metastases with a previous history of left nephrectomy due to a renal cell carcinoma 3 years before. This report represents the first case reported in our country and wants to add to literature one more case of splenic metastasis from renal cell carcinoma.
