We report a case of VURD syndrome in a three day old neonate who was diagnosed with hydronephrosis on a prenatal ultrasound. Severe tortuosity and dilation of the upper urinary tracts in the presence of progression of hydronephrosis or a persistently elevated creatinine may favor a proximal urinary diversion rather than primary valve ablation or cutaneous vesicostomy. Because of a persistently elevated serum creatinine, a nonfunctioning kidney with grade 4/5 vesicoureteral reflux and worsening contralateral hydronephrosis despite lower tract drainage, a left cutaneous pyelostomy was performed, contralateral to the kidney involved with VURD. Postoperatively the serum creatinine stabilized at 1.0 mg/dl and decreased to 0.3 mg/dl at one month of age.

Charles J. Rosser

Sam Auringer

R. L. Kroovand

VURD Syndrome Managed by Pyelostomy

S. De Stefani

R. Stubinski

F. Ferneti

A. Simonato

G. Carmignani

Penile Fracture and Associated Urethral Injury

Spontaneous perinephric hematoma in the absence of anticoagulation, arteritis, or trauma is uncommon. We report the case of a postpartum patient with nephrolithiasis who initially presented to the obstetric service with a spontaneous perinephric hemorrhage.

Leah P. McMann

Andrew C. Peterson

Sunil A. Ahuja

Spontaneous Perinephric Hemorrhage Associated with Urolithiasis in Pregnancy

Two cases are reported of patients with a single metastasis in the contralateral adrenal, one and nine years respectively after nephrectomy for localized cancer in the opposite kidney. These types of metastases are usually asymptomatic they do not appear with signs of adrenal insufficiency, they are detected incidentally and the diagnosis is confirmed mainly with CT scan, which comprises the method of choice for the detection of such types of metastases. Many adrenal metastases probably have been overlooked in the past when advanced imaging techniques were not available. Both patients underwent adrenalectomy and replacement therapy with corticosteroids. Approximately 50% of all patients with renal cell carcinoma either present with metastases at diagnosis or will have metastatic disease after nephrectomy11. In order of decreasing frequency, the most common metastatic sites are the lungs, lymph nodes, liver, bone, contralateral kidney and ipsilateral adrenal glands. Adrenal involvement has been reported in 7 to 19% of autopsystudies. 1,3 Solitary metachronous metastatic involvement of the contralateral adrenal from renal cell carcinoma is rarely diagnosed during life and only 4 cases have been reported. 4,5 Recent advances in imaging techniques have allowed the diagnosis of adrenal involvement by renal cancer. Two cases of contralateral adrenal metastasis are reported 1 and 9 years after radical nephrectomy for localized renal cell carcinoma. Both patients underwent adrenalectomy and steroid replacement therapy.

Nikolaos Antoniou

Demetrios Karanastasis

Solitary Contralateral Adrenal Metastases after Nephrectomy for Renal Cell Carcinoma

Lance Potter

S. Iskandar

R. Lawrence Kroovand

Prune Belly Syndrome and Tracheo-esophageal Fistula in a Premature Neonate

Peter E. Clark

Stevan B. Streem

Endourologic Management of Upper Tract Transitional Cell Carcinoma

Donald F. Lynch

Paul F. Schellhammer

Surgical Management of Squamous Cell Carcinoma of the Penis

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The Scientific World Journal publishes original research and review articles&nbsp;covering a wide range of subjects in science, technology, and medicine.

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The Scientific World Journal

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