Generalized lymphadenopathy is a rare manifestation of metastatic prostate cancer. Here, we report the case of a 59-year-old male  patient with supraclavicular, mediastinal, hilar, and retroperitoneal and inguinal lymphadenopathy, which suggested the diagnosis of lymphoma. There were no urinary symptoms. A biopsy of the inguinal lymph node was compatible with adenocarcinoma, whose prostatic origin was shown by immunohistochemical staining with PSA. The origin of the primary tumor was confirmed by directed prostate biopsy. We emphasize that a suspicion of prostate cancer in men with adenocarcinoma of undetermined origin is important for an adequate diagnostic and therapeutic approach.

Bulent Cetin

Zeynep Cetin

Suleyman Buyukberber

Ipek Is&#305;k Gonul

Ilgin Sahiner

Ugur Coskun

Mustafa Benekli

Generalized Lymphadenopathy: Unusual Presentation of Prostate Adenocarcinoma

Synovial sarcomas  are generally deep-seated tumors that most often occur in the proximity of large joints of adolescents and young adults. We describe two cases of primary renal synovial sarcoma that were treated successfully by radical nephrectomy. Synovial sarcoma originating from the kidney is extremely rare and the histogenesis is uncertain. Surgical resection and ifosfamide based chemotherapy are the mainstay for the management of renal synovial sarcoma. Fewer than 40 patients have been described in the English literature. Physicians should be aware of the possibility of malignancy in cystic renal masses and raise the suspicion of synovial sarcoma, especially when patients with renal masses are a young adult.

Mehmet Gulum

Ercan Yeni

Murat Savas

Ilyas Ozardali

Ismail Ozdemir

Dilek Mil

Adem Altunkol

Halil Ciftci

Primary Renal Synovial Sarcoma

Polyarteritis nodosa (PAN) is a systemic vasculitis which may result in thrombosis or aneurysm formation in any organ of the body. We report a case polyarteritis nodosa (PAN) resulting in bilateral asynchronous testicular necrosis. A 55-year-old male developed acute onset of left testicular pain resulting in a left orchiectomy and right orchidopexy for an ischemic left testicle without evidence of torsion. Three weeks later, the patient developed acute right-sided scrotal pain, and surgical exploration revealed a right necrotic testicle resulting in a right orchiectomy. Pathologic evaluations demonstrated benign testes with acute interstitial hemorrhage and focal atrophy. The patient also experienced abdominal skin necrosis, penile pain and swelling, and temporary loss of vision. This is a unique case of PAN and the only case of asynchronous testicular necrosis in the medical literature.

Nicholas J. Toepfer

Nektarios I. Lountzis

Joseph C. Ugoeke

Tammie C. Ferringer

Polyarteritis Nodosa with Bilateral Asynchronous Testicular Necrosis: A Case Report

Retroperitoneal cystic lymphangioma is a rare benign tumor. Most patients eventually experience some symptoms that necessitate therapeutic intervention. Excision is the treatment of choice, and some cases of laparoscopic resection have been reported. We report another case of a huge retroperitoneal cystic lymphangioma that was successfully excised laparoscopically with the SAND balloon catheter. Large cystic lymphangioma was downsized by puncturing and aspirated with the SAND balloon catheter. Laparoscopic surgical technique should be considered for treatment of selected cystic lesions of retroperitoneal origin.

Yusuke Yagihashi

Keiji Kato

Kanji Nagahama

Masakazu Yamamoto

Hiroshi Kanamaru

A Case of Laparoscopic Excision of a Huge Retroperitoneal Cystic Lymphangioma

Sarcomatoid carcinoma (SC) of prostate gland is a rare biphasic tumour. In about half of cases, initial diagnosis is acinar adenocarcinoma, followed by nonsurgical therapy, with a subsequent diagnosis of SC. The survival rate is lower. We report a case of an 59-years-old man with unusual histopathologic finding of prostate sarcomatoid carcinoma, showing characteristics of ductal prostatic adenocarcinoma and prostatic stromal sarcoma-like appearance. Ductal adenocarcinoma was characterized by tall columnar cells with abundant amphophilic to eosinophil cytoplasm. Pleomorphic sarcoma was characterized to have overall glandular growth pattern, simulating a malignant phyllodes tumour. Estrogen and progesterone receptors showed nuclear immunostaining in mesenchymal multinucleated giant cells. In conclusion, SC of the prostate is an exceedingly rare tumour. Retrospective analyses render prostate SC as one of the most aggressive prostate malignancies. The prognosis is dismal regardless of other histologic or clinical findings.

David Parada

Karla B. Pe&#xf1;a

Francesc Riu

Sarcomatoid Carcinoma of the Prostate: Ductal Adenocarcinoma and Stromal Sarcoma-Like Appearance: A Rare Association

The case we report shows rapid progression and a very poor prognosis only for a month that differs from the clinical course reported in the literature. An 83-year-old man was referred to our hospital for macroscopic hematuria. Computed tomography (CT) revealed a large bladder tumor measuring 4&#x2009;cm&#x2009;&#x00D7;&#x2009;3&#x2009;cm and magnetic resonance imaging revealed extravesical invasion and pelvic wall invasion of the tumors. Chest CT and bone scintigraphy revealed no evidence of distant visceral metastases, and a clinical diagnosis of T4N0M0 was made. Transurethral resection of the bladder tumor (TUR-BT) was performed for histopathological diagnosis 18 days after admission, and no further adjuvant treatment was given. At 15 days after TUR-BT, the patient's clinical status worsened with symptoms of exertional dyspnea. CT showed multiple metastatic lesions in the lung, liver, and retroperitoneal lymphadenopathy. The patient died 2 days later and underwent autopsy. A final histopathological diagnosis of leiomyosarcoma was made based on immunohistochemical staining.

Toru Yamada

Shingo Nagai

Yusuke Kanimoto

Rapid Progression of a Urinary Bladder Leiomyosarcoma: Report of a Case

We describe an 80-year-old female with a left ureteroileal fistula and simultaneously a right ureteroiliac fistula. Her history highlights the predisposing factors of radiation, major surgery in the region, and presence of bilateral double-J-stents. She was successfully treated with an endovascular approach after being initially misdiagnosed. There seems to be an increase in reporting ureteral fistulas, however this entity remains a rare clinical condition that can lead to life-threatening situations. A fast and accurate diagnosis of an ureteroarterial fistula remains a challenge.

G. M. Veenstra

L. M. C. L. Fossion

G. Debonnaire

K. de Laet

Endovascular Treatment of a Right-Sided Ureteroiliac Fistula in a Patient with a Simultaneous Left-Sided Ureteroileal Fistula

Primary malignant tumours of spermatic cord are rare. The liposarcoma of spermatic cord is a rare entity and only a few cases have been reported in the literature. We report a case of forty five-year-old male with huge left inguinoscrotal swelling. Fine needle aspiration cytology (FNAC) of swelling revealed the diagnosis of a liposarcoma. The patient was subjected to radical orchidectomy and wide excision. Histopathological examination (HPE) of the resected specimen reported a well-differentiated liposarcoma of the spermatic cord and confirmed the diagnosis.

Fazl Qadir Parray

Rayees Ahmad Dar

Nisar  Ahmad Chowdri

Arif Hamid

Rayees Ahmed Malik

Liposarcoma of the Spermatic Cord: A Rare Entity

Carcinosarcoma of the bladder is an unusual tumour characterized by a combination of malignant epithelial and soft tissue elements. Most of the reported cases have been case reports or small series. Optimal treatment is uncertain. We herein report our experience in such a case treated with transurethral resection followed by radiotherapy with adverse final outcome. Treatment of bladder carcinosarcomas should be aggressive and multimodal but optional treatment is still unknown. Radiotherapy alone is insufficient as a treatment option of these aggressive tumors.

Christos Zachariadis

Ioannis Efthimiou

Stylianos Giannakopoulos

Athanasios Bantis

Alexandra Giatromanolaki

Efthimios Sivridis

Stavros Touloupidis

A Case Report of Urinary Bladder Carcinosarcoma and Review of the Literature

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Case Reports in Urology publishes case reports and case series focusing on the male and female urinary tract and the male reproductive organs.

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Case Reports in Urology - Table of contents 2011

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Case Reports in Urology publishes case reports and case series focusing on the male and female urinary tract and the male reproductive organs.

Case Reports in Urology