Case Reports in Urology The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Urothelial Carcinoma in a 22-Year-Old Female with Angelman Syndrome Tue, 11 Apr 2017 08:29:49 +0000 A 22-year-old nulligravid white female with Angelman syndrome was noted to have a 4-month history of premenstrual nausea, vomiting, and abdominal pain. She had an echogenic focus in her bladder noted on ultrasound. She was diagnosed with low grade urothelial carcinoma after cystoscopic evaluation with biopsy and was sent to urology for further treatment. Urothelial carcinoma is rare in individuals younger than age 40. Patients may present with gross hematuria. There is often a delay in diagnosis in younger individuals with different genetic mutations noted upon diagnosis. Jessica Pugh and R. Keith Huffaker Copyright © 2017 Jessica Pugh and R. Keith Huffaker. All rights reserved. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter Wed, 29 Mar 2017 00:00:00 +0000 Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent. Nicolas Merzeau, Hervé Riquet, Ioannis Nicolacopoulos, Abbas Alame, and Stéphane Larré Copyright © 2017 Nicolas Merzeau et al. All rights reserved. Delayed Infection of a Lymphocele following RARP in a Patient with Nonspecific Symptoms Wed, 15 Mar 2017 07:11:02 +0000 Pelvic lymphoceles are an infrequent complication after pelvic surgery and develop shortly after the surgery in most cases. We experienced a case of delayed infection of a lymphocele 6 months after robot-assisted radical prostatectomy (RARP) and pelvic lymphadenectomy. In this case, antimicrobial chemotherapy and percutaneous drainage were effective, and there was no recurrence of the disease. Most urologists do not recognize that infected lymphoceles can develop a long time after surgery; thus, infected lymphoceles should be kept in mind in patients with nonspecific infectious symptoms, regardless of the length of time after surgery. Tomoki Taniguchi, Yoshito Takahashi, Mitsuhiro Taniguchi, Toru Yamada, and Kenichiro Ishida Copyright © 2017 Tomoki Taniguchi et al. All rights reserved. PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings Wed, 15 Mar 2017 00:00:00 +0000 A 67-year-old man diagnosed with Gleason score clinically localized prostate cancer with 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease. Michael Froehner, Marieta Toma, Klaus Zöphel, Vladimir Novotny, Michael Laniado, and Manfred P. Wirth Copyright © 2017 Michael Froehner et al. All rights reserved. Intraparenchymal Renal Artery Pseudoaneurysm and Arteriovenous Fistula on a Solitary Kidney Occurring 38 Years after Blunt Trauma Mon, 13 Mar 2017 00:00:00 +0000 Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma. Those conditions were successfully treated by endovascular embolization followed by regular radiologic, biological, and clinical follow-up. To the best of our knowledge, few similar cases were reported more than 20 years after trauma. However, no case combining an arteriovenous fistula and a pseudoaneurysm revealing as late as 38 years after trauma was found. In addition, management of those conditions on a solitary kidney and outcomes has not been described. We believe that our case depicts the clinical presentation and management of this rare entity that should not be unrecognized due to its potential lethal implications. Daniel Benamran, Benedicte de Clippele, Frank Hammer, and Bertrand Tombal Copyright © 2017 Daniel Benamran et al. All rights reserved. Prostate Cancer Presenting with Parietal Bone Metastasis Thu, 09 Mar 2017 07:05:01 +0000 Bone metastases from prostate cancer are very common. They are usually located on the axial skeleton. However, cranial bone metastases especially to the parietal bone are rare. We report a case of metastatic prostate cancer presenting with left parietal bone metastasis in a patient with no urological symptoms or signs. We should consider prostate cancer in any man above 60 years presenting unusual bone lesions. Brahima Kirakoya, Abdoul Karim Pare, Babagana Mustapha Abubakar, and Moussa Kabore Copyright © 2017 Brahima Kirakoya et al. All rights reserved. Giant Perineal Solitary Fibrous Tumor: A Rare Case Report Thu, 02 Mar 2017 07:48:07 +0000 Background. Solitary fibrous tumor (SFT) is a fibroblastic mesenchymal tumor that was initially described from the pleura but currently arises at almost every anatomic site. It is usually benign, and surgical resection is curative. SFT involving the perineum is extremely rare. This is the third case report of a perineal SFT in the literature. Case Presentation. We reported an uncommon case of a 64-year-old man presenting with a huge perineal mass that started growing 3 years before his arrival in our service. He was asymptomatic. A contrast-enhanced CT scan revealed a heterogeneous well-circumscribed perineal mass with soft-tissue density. Invasion of the surrounding organs, distal metastasis, and lymph node swelling were absent. The complete resection of mass was done successfully. The specimen was a 23.0 14.0 8.0 cm encapsulated tumor. Mass weight was 1,170 g. After pathological analysis, we confirmed that the mass was a solitary fibrous tumor. The diagnosis was based on clinical findings and histological morphology and immunohistochemistry study. Conclusion. SFTs are usually indolent tumors with a favorable prognosis. The perineal location is extremely rare. Complete resection of the mass is the treatment of choice. Petronio Augusto de Souza Melo, Ana Maria Yoshino Bonifaci, Fabio da Silva Crochik, Claudio Bovolenta Murta, Joaquim Francisco de Almeida Claro, and Joao Padua Manzano Copyright © 2017 Petronio Augusto de Souza Melo et al. All rights reserved. Rare Case of a Well-Differentiated Paratesticular Sarcoma of the Spermatic Cord in a 60-Year-Old Patient Thu, 02 Mar 2017 00:00:00 +0000 Introduction. Liposarcomas are tumors that occur mostly in the retroperitoneum. Of all liposarcomas only 3 to 7% are found in the paratesticular region. The spermatic cord is the main site of origin in these cases. The patients ages range from 50 to 60 years. This malignant disease can result in a loss of fertility aside from life-threatening sequelae. Case. We present a case of a liposarcoma of the paratesticular region. A 60-year-old man was referred with a painless mass in the scrotum and the right inguinal region. The patient underwent surgery and the mass was removed along with the right testis, the spermatic cord, and the soft tissues to the internal inguinal ring. Histopathological examination found a well-differentiated liposarcoma of  mm. The surgical margins were negative. The adjuvant treatment consisted in radiation therapy of the right inguinoscrotal area to the dose of 54 Gray, 2 Gy per session, 5 times a week. Conclusion. Paratesticular liposarcomas are rare tumors. Surgery with large margin resections was the main treatment in all reported cases. The adjuvant treatment is still unclear especially when the surgical margins are negative. The main factor that indicated this adjuvant treatment was the size of the tumor and the histologic subtype. Marwen Benna, Semia Zarraâ, Asma Belaïd, Aziz Cherif, Lotfi Kochbati, Mohammed Chebil, and Farouk Benna Copyright © 2017 Marwen Benna et al. All rights reserved. Conversion of Low-Flow Priapism to High-Flow State Using T-Shunt with Tunneling Sun, 26 Feb 2017 07:13:37 +0000 Introduction. The three types of priapism are stuttering, arterial (high-flow, nonischemic), and venoocclusive (low-flow, ischemic). These are usually distinct entities and rarely occur in the same patient. T-shunts and other distal shunts are frequently combined with tunneling, but a seldom recognized potential complication is conversion to a high-flow state. Case Presentation. We describe 2 cases of men who presented with low-flow priapism episodes that were treated using T-shunts with tunneling that resulted with both men having recurrent erections shortly after surgery that were found to be consistent with high-flow states. Case was a 33-year-old male with sickle cell anemia and case was a 24-year-old male with idiopathic thrombocytopenic purpura. In both cases the men were observed over several weeks and both men returned to normal erectile function. Conclusions. Historically, proximal shunts were performed only in cases when distal shunts failed and carry a higher risk of serious complications. T-shunts and other distal shunts combined with tunneling are being used more frequently in place of proximal shunts. These cases illustrate how postoperative erections after T-shunts with tunneling can signify a conversion from low-flow to high-flow states and could potentially be misdiagnosed as an operative failure. Neil A. Mistry, Nicholas N. Tadros, and Jason C. Hedges Copyright © 2017 Neil A. Mistry et al. All rights reserved. Solitary Fibrous Tumor of the Prostate Which Was Initially Misdiagnosed as Prostate Cancer Sun, 26 Feb 2017 00:00:00 +0000 Solitary fibrous tumor (SFT) of the prostate is a very rare tumor. We report a case of 65-year-old man with SFT of the prostate which was initially misdiagnosed as prostate cancer. Finally, we performed total prostatectomy and the tumor was histologically diagnosed as SFT of the prostate. The patient’s clinical course has progressed favorably with no obvious recurrence 18 months postoperatively. Soma Osamu, Hiromi Murasawa, Atsushi Imai, Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, and Chikara Ohyama Copyright © 2017 Soma Osamu et al. All rights reserved. Extensive Renal Arteriovenous Malformations Treated by Transcatheter Arterial Embolization Thu, 23 Feb 2017 00:00:00 +0000 An 84-year-old woman was referred to our department due to gross hematuria. Enhanced computed tomography revealed early enhancement of the right renal vein and multiple tortuous vessels around the right renal hilus, part of which had invaded into the renal parenchyma and renal calix. We diagnosed her with arteriovenous malformations (AVMs) and performed transcatheter arterial embolization (TAE). Angiography showed extensive and complex AVMs located in the central and peripheral areas of her kidney. After TAE, the hematuria resolved and she became hemodynamically stable. Tadashi Tabei, Hironao Tajirika, Jun Yoshigi, and Kazuki Kobayashi Copyright © 2017 Tadashi Tabei et al. All rights reserved. An Extremely Rare Case of Lower Urinary Tract Symptoms: Floating Benign Mesenchymal Mass in Abdomen Thu, 23 Feb 2017 00:00:00 +0000 A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs) such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US) showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature. Bulent Kati, Yigit Akin, Eyyup Sabri Pelit, and Mehmet Ogur Yilmaz Copyright © 2017 Bulent Kati et al. All rights reserved. Mycotic Aneurysm after Bacillus Calmette-Guérin Treatment: Case Report and Review of the Literature Mon, 20 Feb 2017 00:00:00 +0000 Background. Intravesicular Bacillus Calmette-Guérin (BCG) is an effective adjunctive therapy for superficial bladder cancer that has been shown to delay recurrence and progression of disease. Serious side effects are relatively rare but are difficult to diagnosis and commonly overlooked. Case Presentation. We report the case of a patient who was found to have mycotic aortic aneurysms secondary to treatment with BCG after a prolonged course with multiple intervening hospitalizations. Conclusion. Through this report, we discuss our present understanding of BCG infection following treatment and review the literature regarding this particular rare manifestation. Nathaniel D. Coddington, Jesse K. Sandberg, Chen Yang, Jennifer K. Sehn, Eric H. Kim, and Seth A. Strope Copyright © 2017 Nathaniel D. Coddington et al. All rights reserved. Robotic Assisted Laparoscopic Prostatectomy after High Intensity Focused Ultrasound Failure Tue, 24 Jan 2017 00:00:00 +0000 Background. Prostate cancer is the most common cancer diagnosed in men. As new focal therapies become more popular in treatment of prostate cancer, failure cases requiring salvage therapy with either surgical or other techniques are being reported. Objective. To report the options in treatment of prostate cancer after recurrence or failure of the primary treatment modality. Methods. We report a salvage robotic assisted laparoscopic radical prostatectomy (RALP) for prostate cancer recurrence following high intensity focused ultrasound treatment (HIFU) in the United States. Results. A 67-year-old man who underwent HIFU treatment for prostate adenocarcinoma 2 years prior was presented with a rising prostate specific antigen of 6.1 ng/mL to our clinic. A biopsy proven recurrent disease in the area of previous treatment documented the failure of treatment. The patient elected to undergo a salvage RALP. The operation time was 159 minutes. The patient was discharged from the hospital on postoperative day 1 with no complications. The catheter was removed on post-op day 10. The patient reserved sexual function and urinary continence. The PSA levels on 6 months’ follow-up are undetectable. Conclusions. Salvage RALP is an effective and safe treatment choice for recurrent prostate adenocarcinoma following failed HIFU treatment if operated by an experienced surgeon. Leon Telis, Seyed Behzad Jazayeri, and David B. Samadi Copyright © 2017 Leon Telis et al. All rights reserved. Incidental Presacral Myelolipoma Resembling the Liposarcoma: A Case Report and Literature Review Wed, 28 Dec 2016 09:56:56 +0000 Presacral myelolipomas are rare, benign, asymptomatic tumors composed of mature adipose tissue and hematopoietic elements, but fewer than 50 cases have been reported in the literature. They are usually discovered incidentally during imaging studies and are often misdiagnosed as liposarcoma, which have a malignant nature, because the imaging findings of myelolipoma can be similar to those of liposarcoma. It is challenging to distinguish presacral myelolipomas from other presacral fat-containing tumors without performing a histological examination. We should consider the possibility of a malignant tumor, and imaging-guided biopsy carries a risk of tumor spread along the biopsy tract. Therefore, surgical management might sometimes be required; however, it is not necessary in all cases. We present an incidentally detected case of presacral myelolipoma that was difficult to differentiate from other malignant tumors in a 71-year-old male. Naoto Tokuyama, Hisashi Takeuchi, Isao Kuroda, and Teiichiro Aoyagi Copyright © 2016 Naoto Tokuyama et al. All rights reserved. Primary Mucinous Adenocarcinoma of the Urinary Bladder with Signet-Ring Cells: Description of an Uncommon Case and Critical Points in Its Management Sun, 18 Dec 2016 10:02:41 +0000 We present an uncommon case of mucinous adenocarcinoma of the bladder (MAB) with signet-ring cells extensively infiltrating prostate gland and pelvic/retroperitoneal lymph node stations and not responsive to usual systemic chemotherapy regimens. This case highlights the important features of MAB including the pattern of tumor spread, the tendency for initial misdiagnosis, and the importance of immunohistochemical study in order to define its primary origin from the bladder and choose the most appropriate treatment since the beginning. Fabrizio Di Maida, Giuliano Amorim Aita, and Daniele Amorim Aita Copyright © 2016 Fabrizio Di Maida et al. All rights reserved. Multilocular Cystic Renal Cell Carcinoma or Cystic Nephroma? Thu, 15 Dec 2016 08:27:05 +0000 The incidence of Multilocular cystic renal cell carcinoma (MCRCC) in literature is very low and confounding MCRCC with cystic nephroma (CN) is even more unusual. The aim of this report is to present a case of MCRCC and emphasize the importance of the preoperative radiologic evaluation and immunohistochemical staining confirmation to obtain an accurate diagnosis. A 73-year-old woman presented with a history of 4-month right flank pain. CT showed a Bosniak type III renal mass. After laparoscopic partial nephrectomy the initial report was cystic nephroma. Immunohistochemical staining was performed being positive for Epithelial Membrane Antigen thus changing the diagnosis to MCRCC. Multilocular cystic renal cell carcinoma cannot reliably be distinguished from cystic nephroma neither by physical examination nor by radiologic evaluation; immunohistochemical staining assay is useful to differentiate between these conditions allowing an accurate diagnosis and proper follow-up. Adolfo González-Serrano, Roberto Cortez-Betancourt, Alejandro Alías-Melgar, Pedro Jair Botello-Gómez, Emilio Ramírez-Garduño, Eric Iván Trujillo-Vázquez, Yosimart Torres-Santos, José Antonio Mata-Martínez, and Fernando Carreño- de la Rosa Copyright © 2016 Adolfo González-Serrano et al. All rights reserved. Partial Nephrectomy for a Massive Sporadic Renal Angiomyolipoma: Case Report and Review of the Literature Wed, 14 Dec 2016 06:12:06 +0000 Introduction. Angiomyolipomas are the most common benign tumor of the kidney, associated with Tuberous Sclerosis in 20% of cases and arising sporadically in 80% of cases. Renal angiomyolipomas are neoplasms of mesenchymal origin with varying proportions of vasculature, smooth muscle spindle cells, and adipocytes, making management of such neoplasms a challenging endeavor. Possible management options include partial or radical nephrectomy and segmental renal artery embolization. Case Presentation. A 61-year-old woman admitted for a large retroperitoneal hemorrhage was discovered to have a giant, sporadic, 3818.3 g, 30.0 × 26.5 × 18.0 cm left perinephric angiomyolipoma. Given her hemodynamic instability upon presentation, she underwent segmental arterial embolization, followed by an open left partial nephrectomy. Ten-month follow-up revealed no noticeable loss of renal function. Discussion. Literature review revealed occasional renal angiomyolipomas of comparable size, with all angiomyolipomas larger than this requiring treatment with radical nephrectomy. Conclusion. We show that nephron-sparing surgery may be considered in the treatment of even the largest of renal angiomyolipomas. Jacob Albersheim-Carter, Molly Klein, Paari Murugan, and Christopher J. Weight Copyright © 2016 Jacob Albersheim-Carter et al. All rights reserved. Surgical Management of Giant Genital Condyloma Acuminata by Using Double Keystone Flaps Wed, 16 Nov 2016 06:09:04 +0000 Condyloma acuminata in the external genitalia (genital warts) is a sexually transmitted disease that is often caused by human papillomavirus (HPV). We report a case of giant genital condyloma acuminata in a 35-year-old male patient with HIV comorbidity treated by wide surgical excision. Excision defect was covered with split thickness skin graft (STSG) and double keystone flaps. There was no complication after surgery. Ten months following surgery, there was no new condyloma lesion and the patient had normal voiding and erectile functions. Peri Eriad Yunir, Chaidir A. Mochtar, Agus Rizal A. H. Hamid, Chaula L. Sukasah, and Rainy Umbas Copyright © 2016 Peri Eriad Yunir et al. All rights reserved. Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy Tue, 15 Nov 2016 13:33:38 +0000 Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach. Sofia Santos Lopes, Andrea Furtado, Rita Oliveira, Ana Cebola, Bruno Graça, Manuel Ferreira Coelho, Fernando Ferrito, and Carrasquinho Gomes Copyright © 2016 Sofia Santos Lopes et al. All rights reserved. Intrascrotal Collection in an Acute Pancreatitis: A Case Report and Review of the Literature Tue, 01 Nov 2016 12:32:49 +0000 Context. An inguinoscrotal swelling occurring during an acute pancreatitis is very rare. Case Report. We report a case of right inguinoscrotal swelling appearing in connection with an interstitial edematous acute pancreatitis. We have noticed a spontaneous complete reduction of the right inguinoscrotal swelling after 10 days. Conclusion. The management of a scrotal swelling should be the least invasive possible method but also the most complete possible method to avoid unnecessary interventions. The exclusion of a pathology that could affect the vital prognosis of the testis remains the absolute priority. An acute scrotum swelling must be carried out by the clinical management by a professional and must be completed with an ultrasonography of the scrotum. Despite all that, if the original etiology of the acute scrotum remains unknown, an abdominopelvic CT scan could provide more details and so could offer a different diagnosis of exclusion, different from the diagnosis of acute idiopathic scrotal edema (AISE). This rare complication of acute pancreatitis reported could be mistaken for a more common pathology. If that complication is identified, it will not require a surgical intervention if there is a correct management of the acute pancreatitis which could justify a broader CT scan. L. Moens, P. Yengue Yengue, and C. Assenmacher Copyright © 2016 L. Moens et al. All rights reserved. Synchronous Malignant Peripheral Nerve Sheath Tumor and Adenocarcinoma of the Prostate: Case Report and Literature Review Mon, 31 Oct 2016 11:26:29 +0000 Malignant Peripheral Nerve Sheath Tumors (MPNSTs) of the prostate are extremely rare. A very unusual case of simultaneous adenocarcinoma and MPNST of the prostate is reported. A 60-year-old Caucasian male presented for annual urologic examination. Digital rectal examination revealed a painless, toughish, and asymmetrically enlarged prostate. Serum prostate-specific antigen was 1 ng/mL. Radiologic examinations demonstrated a large mass, which was arising from the left peripheral lobe of the prostate. The patient underwent transrectal ultrasound-guided biopsy of the prostate which revealed a smooth muscle tumor of uncertain malignant potential. Radical retropubic prostatectomy with en bloc removal of the mass and the seminal vesicles was performed and histology demonstrated low-grade MPNST and adenocarcinoma of the prostate. To the best of our knowledge, this is the first report of simultaneous prostatic adenocarcinoma and MPNST in the English literature. Nikolaos Ferakis, Antonios Katsimantas, Konstantinos Bouropoulos, and Antonios Farmakis Copyright © 2016 Nikolaos Ferakis et al. All rights reserved. Concomitant Laparoscopic Burch Urethropexy and Combined Vaginal-Laparoscopic Mesh Sling Removal (x2) for Pain and Persistent Stress Urinary Incontinence Mon, 31 Oct 2016 09:56:46 +0000 Although midurethral mesh tape slings are considered the standard of care in the treatment of female stress urinary incontinence (SUI), complications such as pain, dyspareunia, or erosion are known to occur in addition to persistent incontinence. The management of these types of mesh sling complications can be very complex, especially when the pain is not just isolated to the vagina but extends into other areas, such as the abdomen which requires a much more extensive dissection. Additionally, if a mesh sling needs to be removed, the patient will most likely have a return of her SUI that often necessitates subsequent treatment. Vaginal and/or laparoscopic removal or revision of mesh tape slings should be considered in patients presenting with complications such as vaginal pain, abdominal pain, dyspareunia, or urinary obstructive symptoms. In those patients who demonstrate persistent SUI, concomitant laparoscopic Burch urethropexy can be considered and can safely be performed at the time mesh removal. In this case report we present a patient who required a dual-approach removal of two painful midurethral slings in addition to concomitant treatment of persistent SUI with a laparoscopic Burch urethropexy procedure. Sarah A. Huber, LaChanda Dunlap-Wright, John R. Miklos, and Robert D. Moore Copyright © 2016 Sarah A. Huber et al. All rights reserved. Malignant Peripheral Nerve Sheath Tumor of Prostate: A Rare Case Report and Literature Review Sun, 30 Oct 2016 08:42:03 +0000 A mid-aged male presented with progressive lower urinary tract symptoms (LUTS) for years. Huge prostate with low serum prostate-specific antigen (PSA) level was detected. The specimen from transurethral resection revealed surprising pathology finding as malignant peripheral nerve sheath tumor (MPNST). Considering its huge size (more than 300 gm) and location, we prescribed neoadjuvant chemotherapy firstly. The tumor became regressive and then radical surgical resection was achieved. Adjuvant multimodality treatment including concurrent chemoradiotherapy (CCRT) and target therapy was given. However, he expired about one year later. MPNST originating from prostate is very rare and seldom reported before. We here present this extremely rare disease and share our treatment experience. Kun-Lin Hsieh, Chih-Cheng Lu, Chien-Feng Li, Yin-Hsun Feng, and Alex C. Liao Copyright © 2016 Kun-Lin Hsieh et al. All rights reserved. Postrenal Failure due to Urinary Stones Associated with Acute Viral Gastroenteritis: Three Case Reports Wed, 26 Oct 2016 09:11:28 +0000 Acute gastroenteritis with viral infection in infants causes severe diarrhea and often results in acute renal failure due to severe dehydration. However, a viral infection, particularly rotavirus, rarely induces postrenal failure due to bilateral stones in infants. Herein, we report three cases of postrenal failure in infants due to bilateral ureteral stones induced by acute gastroenteritis with rotavirus. Following immediately nephrostomy, chemical dissolution therapy succeeded to treat postrenal failure. Immediate nephrostomy for the release of upper urinary tract obstruction combined with urinary alkalization as a chemical dissolution therapy should be considered in such cases. Satoru Kira, Takahiko Mitsui, Hidenori Zakoji, Tadashi Aoki, Norifumi Sawada, Tatsuya Miyamoto, and Masayuki Takeda Copyright © 2016 Satoru Kira et al. All rights reserved. Erratum to “Primary Desmoplastic Melanoma of the Penis” Mon, 24 Oct 2016 10:59:36 +0000 Julia T. Chu, Michael A. Liss, William W. Wu, Atreya Dash, and Di Lu Copyright © 2016 Julia T. Chu et al. All rights reserved. Retroperitoneal Teratoma in an Adult: A Potential Pitfall in the Differential Diagnosis of Adrenal Myelolipoma Thu, 20 Oct 2016 06:03:50 +0000 We report a 32-year-old female case of a right adrenal gland mass detected on CT scan at medical checkup. CT and MRI showed a mass of 5.1 cm made of fat and calcification in the right adrenal gland, leading to the clinical diagnosis of adrenal myelolipoma. Because of its relatively large size and the patient’s desire, the patient underwent gasless single-port retroperitoneoscopic adrenalectomy using the RoboSurgeon system. Histopathological examination revealed that the cystic tumor is composed of keratinized epidermis, mature fat, nerve, cartilage, bone, and sebaceous glands compressing the normal adrenal gland, leading to the diagnosis of retroperitoneal mature cystic teratoma. The patient remains free of recurrence 29 months after surgery. Retroperitoneal teratoma is relatively rare but clinically important because of high possibility of malignancy. In a case of an adrenal mass difficult to clinically distinguish retroperitoneal teratoma from adrenal myelolipoma, surgical resection via a minimally invasive approach would be the best therapeutic option. Madoka Kataoka, Hiroshi Fukushima, Yasukazu Nakanishi, Minato Yokoyama, Nobuaki Funata, Toru Motoi, Ken-ichi Tobisu, and Fumitaka Koga Copyright © 2016 Madoka Kataoka et al. All rights reserved. A Case of Metastatic Melanoma in the Ureter Wed, 12 Oct 2016 09:36:24 +0000 Advances in the treatment of melanoma are resulting in patients living for extended periods after being diagnosed with metastatic disease. Metastases to the ureter are rare, but they have been described in the literature on a number of occasions. In this case report, we describe a patient with established metastatic melanoma who, whilst taking and responding to immunomodulatory therapy, was found to have an obstructive mass in the middle of his left ureter. Rather than performing either a nephroureterectomy or partial resection of the ureter, we opted to perform an endoscopic resection of the melanoma. Follow-up imaging at 12 months shows no evidence of local disease recurrence. We submit that primary endoscopic management of metastatic melanoma in the ureter is a viable alternative to a radical approach. James Macneil and Tania Hossack Copyright © 2016 James Macneil and Tania Hossack. All rights reserved. Two Cases of Solitary Fibrous Tumor Involving Urinary Bladder and a Review of the Literature Tue, 04 Oct 2016 07:07:04 +0000 Solitary fibrous tumor (SFT) is a rare neoplasia of mesenchymal origin, initially described in visceral pleura and lately discovered to have ubiquitous distribution. SFT of the urogenital tract is uncommon and appears to have similar morphologic features and biologic behaviors as SFTs found elsewhere. We present two new cases of SFT of the bladder and review 22 similar cases published in the literature. Due to the general indolent behavior of these lesions, a complete but organ sparing surgical excision should be considered when technically feasible. Therefore, proper identification and characterization of SFT through morphological and immunohistochemical criteria on biopsy specimens are mandatory in the differential diagnosis from other more aggressive spindle-cell tumors, thus avoiding unnecessary radical surgery. Eduardo Yukio Tanaka, Vitor Bonadia Buonfiglio, Joao Padua Manzano, Renée Zon Filippi, and Marcus Vinicius Sadi Copyright © 2016 Eduardo Yukio Tanaka et al. All rights reserved. Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate Mon, 26 Sep 2016 12:01:23 +0000 Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates. Antoinette S. Birs, Jose A. Perez, Mark A. Rich, and Hubert S. Swana Copyright © 2016 Antoinette S. Birs et al. All rights reserved.