Xanthogranulomatous pyelonephritis: a report of two cases

Two cases of xanthogranulomatous pyelonephritis are reported in Negroes. The clinical findings are similar to those in previously reported cases. In 1 case nephrolithotomy was followed by the development of a perinephric abscess 8 months later. Late diagnosis has limited experience with more conservative management, which should be reserved for demonstrably focal disease (AU)

Renal carcinoma in pregnancy

Three cases of renal adeno-carcinoma in pregnant women are reported. Two have survived 5 years and the third, 4 years. These survival times are longer than those of adeno-carcinomas in non-pregnant women and in males at this hospital (Summary)

Circumcaval ureter: a new classification

The authors have studied the radiographic appearances of two of their patients with circumcaval ureter and reviewed the findings in a further 87 cases reported in the literature. They define two types of patterns: (a) The slightly commoner form has a moderate or severe hydronephrosis and an 'S' or 'fish-hook' deformity of the ureter at the point of obstruction. They demonstrate that the point of obstruction is placed some distance from the lateral margin of the inferior vena cava. (b) The second form has a mild hydronephrosis and a 'sickle-shaped' curve of the ureter at the point obstruction. The obstruction coincides with the lateral margin of the inferior vena cava in this type. The generally accepted explanation that pressure by the inferior vena cava explains the second type, but not the first. The cause of the hydronephrosis in the first form is not clear. The authors suggest that it is due to an associated anomaly in the development of the ureter where it crosses the lateral border of the psoas muscle. (AU)

Cancer of the bladder in Jamaica

The pattern of carcinoma of the bladder in Jamaica is presented. The high incidence squamous carcinoma in both sexes is discussed together with possible etiological factors. The incidence of urethral stricture in association with carcinoma is given (Summary)

Genito-Urinary tumours in Jamaica

The paper presents an account of genito-urinary tumours seen at the University of the West Indies during the period 1953-1966. There were 280 cases of carcinoma of the penis, which is an extremely high incidence. Carcinoma of the prostate appears to be more common than in Europe, although accurate figures for the University of the West Indies were not available. There were 46 tumours of the kidney, four of the pelvis and 42 of the parenchyma. Twenty-six occurred in adults and 16 in children. This corresponds to the pattern seen in Africa and probably reflects a lower incidence in adults and a higher incidence in children than is seen in Europe. There is also a reversal of the sex ratio male to female of 1:1.3 in children and 1:1.8 in adults (U.K. figures 2:1). There were 132 cases of carcinoma of the bladder. There was a low incidence of papillary lesions. There is a higher incidence in women to men (1:1.8) than in any other series except in that from Portuguese East Africa (U.K. ratio 1:4.1). The incidence of squamous carcinoma was 28 percent in men and 34 percent in women. This is high and follows the African patterns (Egypt 50 percent, Uganda 34 percent). There is no Bilharzia in Jamaica but 28.3 percent of male cancer is associated with urethral stricture and 45 percent of the squamous carcinoma with urethral stricture. Dietary factors, particularly banana and plantain, may be implicated in the high incidence. Ther were 13 cases of tumour of the urethra, with a female to male ratio of 2:1. There were only six cases of tumour of the testis, which represents a low incidence. Especially interesting is the fact that only one case was in the usual age group; two were in infancy and three in men over the age of 60 (AU)

Ureterocoele with reports of three unusual adult cases

Twelve cases of ureterocoele have been seen at the University Hospital of the West Indies, Jamaica. A general review of the subject is given. Three cases are described in detail because of the rarity of the associated anomalies - triple ureter, crossed renal ectopia without fusion and a double ureter entering directly an ectopic ureterocoele. Some of the pitfalls in diagnosis are discussed (AU)