Risk of Covid-19 infection after resection of high grade transitional cell carcinoma with renal impairment.

INTRODUCTION AND IMPORTANCE: Covid-19 pandemic has had huge impact on health care system and put the health care system under strain, so efforts made to minimize the elective surgeries however some surgeries especially those for high risk malignant tumors cannot be postponed.The aim of this case report is to highlight the importance of screening cancer patients and those with co-morbidities such as renal impairment for Covid-19 and encouraging them to get vaccinated before undergoing elective surgeries. CASE PRESENTATION: We report a case of an 80 year old male patient with renal impairment who developed Covid-19 infection after transurethral resection of high grade transitional cell carcinoma of urinary bladder. CLINICAL DISCUSSION: Although intra-hospital contagion of Covid-19 is not rare, increased risk of acquiring Covid-19 among cancer patient particularly if they have co-morbidities like renal impairment should be kept in mind and strict protective measures for Covid-19 for those patients should be done before, during and after the procedure. CONCLUSION: We theorized that patients with high grade transitional cell carcinoma of urinary bladder should be screened for Covid-19 and get vaccinated before the procedure.

Male Infertility and Somatic Health.

Somatic health is associated with male infertility; potential links between infertility and health may arise from genetic, developmental, and lifestyle factors. Studies have explored possible connections between male infertility and oncologic, cardiovascular, metabolic, chronic, and autoimmune diseases. Male infertility also may be a predictor of hospitalization and mortality. Additional research is required to elucidate the mechanisms by which male infertility affects overall health.

Leydig cell tumor in grey zone: A case report.

INTRODUCTION: Leydig cell tumor constitutes only about 1-3% of testicular neoplasms. There is apparently increased incidence in the last few years; one possible explanation for this phenomenon is the widespread use of ultrasound technology and the subsequent increased early detection of smaller lesions that have not been found in historical series. CASE PRESENTATION: We report a case of Leydig cell tumor of testis in a patient presenting with painless long standing slowly growing left scrotal mass who found to have intrapulmonary nodule and multiple enlarged retroperitoneal lymph nodes on staging work up. The mass was managed by radical orchiectomy. Pathological diagnosis was Leydig cell tumor. DISCUSSION: Orchiectomy is the accepted mode of treatment but follow-up every 3-6 months with physical examination, hormone assays, scrotal and abdominal ultrasonography, chest radiography, and CT scans is essential in such a case with a potential for malignant behavior. CONCLUSION: Inguinal orchiectomy is the therapeutic decision of choice and long-term follow-up is necessary to exclude recurrence or metastasis. Cases which fall in the grey zone like ours need to be followed up carefully for metastasis instead of rushing into an early retroperitoneal lymph node dissection, with its potential risks and complications.

Leiomyoma of Urinary Bladder Presenting with Febrile Urinary Tract Infection: A Case Report.

INTRODUCTION: Leiomyomas of urinary bladder constitute only about 0.43% of all bladder tumors. Only about 250 cases were reported in English literature. This is the first reported case of bladder leiomyoma to present with febrile urinary tract infection. CASE PRESENTATION: We report a case of a 37- year old male who presented with febrile urinary tract infection. Imaging showed a bladder lesion. This lesion was managed by transurethral resection. Pathologic diagnosis was bladder leiomyoma. DISCUSSION: Although bladder leiomyomas are benign, they can cause serious sequelae, including serious urinary tract infections as the case we present here shows. This is why it is important to early diagnose and treat this condition. CONCLUSION: This case highlights the importance of early introduction of imaging in patients presenting with severe urinary tract infections. Failure to diagnose this lesion as the underlying cause of infection may have easily led to recurrence of similar severe life-threatening infections.

Bilateral very large calcium oxalate stones in the seminal vesicles: case report and literature review.

A 29-year-old man with hypospadias and bilateral undescended testicles presented with recurrent attacks of lower urinary tract infections and painful ejaculation. He was diagnosed to have very large bilateral seminal vesicle stones. The pelvis X-ray showed two radio-densities located in the pelvis with symmetrical appearance while Ultrasound showed them as echogenic structures with posterior acoustic shadowing. In magnetic resonance imaging (MRI) of the pelvis they appeared hypointense in both T1-weighted and T2-weighted images while pelvic computed tomography scan (CT scan) showed bilateral huge stones in the seminal vesicles. The stones were extracted by open surgery through the bladder after transurethral excision of the ejaculatory ducts. Here, we report the first case of bilateral, large, heart-shaped, calcium oxalate monohydrate of seminal vesicle caliculi with brief literature review.