Surgical treatment of kidney tumor on a patient with second case of staghorn calculus and associated renal hydronephrosis: case report.

Staghorn, struvite or coral calculus are the ones that completely or partially occupies the renal pelvis and branches to the renal calices. The presence of renal calculi of any kind in the urinary tracts is related to the appearing of malign tumor in the kidneys, especially in the absence or failed treatment. A male patient, 51 years old, native of Manaus, reports about dysuria and polyuria associated with constant fever episodes and urinary tract infections with improvement by using several antibiotics but returning the symptoms after suspending it. The patient return was in a month and no improvement of the pain in the patient's feeling, with the tomography image tests result showing atrophy in the right kidney, which presents dilatation of the collector system, that it's filled with material with density varying between thick liquid and soft parts (average of 45 UH), in addition to calculus in the pelvis and ureteropelvic junction, suggesting a pattern for xanthogranulomatous pyelonephritis and matching previous history of right staghorn calculus. The association between kidney cancer and staghorn calculus should be consider through the treatment. Patients with renal diseases of severe prognosis in both kidneys must be kept under constant surveillance by the urology and nephrology team, the association of both clinics is essential to a fortunate ending like the case reported.

Large verrucous penis cancer in a young patient in the Brazilian Amazon: Case report and discussion on the region's reality.

INTRODUCTION: Penile cancer is a rare malignant tumour top in urology, especially in developed countries or in a favourable cultural habit. However, in developing countries or with a low socio-economic population, the incidence increases considerably, as does the stage at which the patient arrives for the first care. CASE PRESENTATION: Male patient, 20 years old, from the interior of Amazonas - Brazil, has been referred to a Urological Service in the Emergency Room due to a vegetative lesion of approximately 10 centimetres, with an ulcerated centre and irregular borders in penile glans. An incisional biopsy was performed, which revealed invasive squamous cell carcinoma and was referred to the elective surgery service. CONCLUSIONS: The socioeconomic condition of the population influences in a relevant way in cases in the Amazon region, with little and difficult access to preventive information and to the public health system, mainly in the interior of the state. Young patients tend to maintain the confidentiality of the picture that leads to the progression of the disease, with negative outcomes, requiring intense psychological monitoring.

Videolaparoscopic treatment of total migration of double j stent to renal pelvis as a complication of rigid ureterolitotripsy in a university hospital at Amazon.

The insertion of a double-j catheter in patients with urinary lithiasis is currently important because it reduces the chances of obstructive complications such as hydronephrosis and renal functional loss. The following case aims to show the patient evolution which presented the complete migration of the catheter to the renal pelvis and how it could complicate its prognosis. Placing a dual-catheter for treatment of lithiasis is a routine procedure in urology services but is not beyond complications during the process. Even with exhaustive complementary imaging exams, we must maintain a constant evaluation of the patient.

Espectroscopia por ressonância magnética no diagnóstico do câncer de próstata: experiência inicial / Magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer: initial experience

OBJETIVO: Demonstrar a experiência na implantação de um protocolo de espectroscopia por ressonância magnética do 1H tridimensional (3D 1H MRSI), disponível comercialmente, aplicando-o em pacientes com suspeita de neoplasia prostática e com diagnóstico estabelecido de tumor prostático. MATERIAIS E MÉTODOS: Estudo realizado de forma prospectiva, em 41 pacientes com idades entre 51 e 80 anos (média de 67 anos). Dois grupos foram formados: pacientes com uma ou mais biópsias negativas para câncer e antígeno prostático específico elevado (grupo A) e pacientes com câncer confirmado por biópsia (grupo B). Procurou-se, a partir dos resultados da ressonância magnética e espectroscopia por ressonância magnética, determinar a área-alvo (grupo A) ou a extensão do câncer conhecido (grupo B). RESULTADOS: No diagnóstico de câncer de próstata a espectroscopia por ressonância magnética apresentou especificidade abaixo da descrita pela literatura, cerca de 47%. Já para o estadiamento do tumor diagnosticado, houve correspondência com a literatura. CONCLUSÃO: A implantação e padronização da espectroscopia por ressonância magnética permitiram a obtenção de informações importantes para o diagnóstico presuntivo da existência de câncer de próstata, combinando as imagens por ressonância magnética com os dados metabólicos da espectroscopia por ressonância magnética.

OBJECTIVE: To report an experiment involving the introduction of a protocol utilizing commercially available three-dimensional 1H magnetic resonance spectroscopy imaging (3D 1H MRSI) method in patients diagnosed with prostatic tumors under suspicion of neoplasm. MATERIALS AND METHODS: Forty-one patients in the age range between 51 and 80 years (mean, 67 years) were prospectively evaluated. The patients were divided into two groups: patients with one or more biopsies negative for cancer and high specific-prostatic antigen levels (group A), and patients with cancer confirmed by biopsy (group B). The determination of the target-area (group A) or the known cancer extent (group B) was based on magnetic resonance imaging and MRSI studies. RESULTS: The specificity of MRSI in the diagnosis of prostate cancer was lower than the specificity reported in the literature (about 47%). On the other hand, for tumor staging, it corresponded to the specificity reported in the literature. CONCLUSION: The introduction and standardization of 3D 1H MRSI has allowed the obtention of a presumable diagnosis of prostate cancer, by a combined analysis of magnetic resonance imaging and metabolic data from 3D 1H MRSI.