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2.
Ir J Med Sci ; 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38546952

RESUMO

PURPOSE: Multiparametric MRI and the transperineal approach have become standard in the diagnostic pathway for suspected prostate cancer. Targeting of MRI lesions is performed at most centers, but the routine use of systematic cores is controversial. We aim to assess the value of obtaining systematic cores in patients undergoing cognitive fusion targeted double-freehand transperineal prostate biopsy. MATERIALS AND METHODS: Patients who underwent a cognitive fusion, freehand TPB at a single tertiary urology service (Perth, Australia) between November 2020 and November 2021 were retrospectively reviewed. Patients were included if they were biopsy naive and had a clinical suspicion of prostate cancer, based on their mpMRI results. Both targeted and systematic cores were taken at the time of their biopsy. RESULTS: One hundred forty patients suited the selection criteria. Clinically significant cancer was identified in 63% of patients. Of those that had clinically significant cancer, the target lesion identified 91% of the disease, missing 9% of patients whom the target biopsy detected non-clinically significant cancer but was identified in the systematic cores. Higher PI-RADS category patients were also found to be associated with an increasing likelihood of identifying clinically significant cancer within the target. CONCLUSIONS: In patients with PI-RADS 3 and higher, the target biopsy can miss up to 9% of clinically significant cancer. Systematic cores can add value as they can also change management by identifying a high-risk disease where only intermediate cancer was identified in the target. A combination of targeted and systematic cores is still required to detect cancer.

3.
BMJ Case Rep ; 16(5)2023 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-37236676

RESUMO

We present a rare case of an extragonadal retroperitoneal yolk sac tumour in an adult male, who presented with severe abdominal pain to his local hospital. Imaging revealed a large retroperitoneal soft tissue mass with no evidence of metastases. Initial biopsy demonstrated poorly differentiated carcinoma, favoured to be renal cell carcinoma. The patient underwent surgical resection following re-presentation with severe abdominal pain and significant interval enlargement of the mass. Laparotomy revealed a renal tumour that had ruptured through the left mesocolon into the peritoneal cavity. Postoperative histopathological examination revealed a yolk sac tumour involving the kidney, perinephric fat, renal sinus fat, renal hilar lymph node and colonic mesentery. Immunohistochemical staining for alpha-fetoprotein and glypican 3 was positive in the tumour cells without evidence of other germ cell elements, confirming the diagnosis of a pure yolk sac tumour. To our knowledge, this is an extremely rare case of a primary pure yolk sac tumour arising from the kidney in an adult.


Assuntos
Carcinoma de Células Renais , Tumor do Seio Endodérmico , Neoplasias Renais , Humanos , Masculino , Adulto , Tumor do Seio Endodérmico/diagnóstico , Tumor do Seio Endodérmico/cirurgia , Tumor do Seio Endodérmico/patologia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Pelve Renal/patologia , Dor Abdominal
4.
Urol Case Rep ; 47: 102361, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36873046

RESUMO

Visible haematuria is a common presentation for investigation. Haematuria should be investigated thoroughly to exclude malignancy. Renal papillary hyperplasia is a rare, benign condition that can cause problematic haematuria. There are no currently management guidelines, as there are only few cases reported. We report a case of NSAID induced visible haematuria due to bilateral renal papillary hyperplasia and managed conservatively.

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