Bowen's disease revealing a penile invasive squamous cell carcinoma: Case report and review of literature

INTRODUCTION

Bowen's disease (BD) represents an in situ squamous cell carcinoma that can progress to an invasive one without treatment. Various options for Bowen's disease have been delineated, each with its set of advantages and disadvantages.

CASE PRESENTATION

We report the case of a 60-year-old patient with a history of chronic smoking and a background of multiple partners and recurrent urethritis. The patient presented with a maculopapular lesion on the lateral aspect of the penis, evolving for 5 years. A biopsy confirmed the diagnosis of Bowen's disease. The patient underwent an excision of the lesion which the histology showed an infiltrating basosquamous cell carcinoma.

DISCUSSION

The diagnosis of Bowen's disease requires a biopsy and is based on histological examination. Only surgical treatment allows for the identification, through histological analysis of the excised specimen, of any potential invasive area that may not have been identified in the biopsy. Nonsurgical therapies are also an option with high recurrence rates.

CONCLUSION

Bowen's disease management requires a personalized approach, considering factors like lesion characteristics, patient-related variables and treatment efficacy. An adapted follow-up is recommended due to the recurrence risk associated with various treatments.

Generalized peritonitis secondary to a renal forniceal rupture in an obstructed pelvic kidney - A case report

Peritoneal fistulization of pyonephrosis is an uncommon condition, leading to a generalized peritonitis, considered as extreme life-threatening emergency. Secondary to an obstructive uropathy, increasing intra-renal pressure. In most cases, ureteral stones represent the underlying causes followed by stenosis, tumor, or connective tissue disease. Through this case report, we present a 60-year-old patient with a history of urolithiasis, admitted for an atypical instance of spontaneous renal pelvis rupture in an ectopic right kidney managed surgically. This case emphasizes the importance of considering renal etiology in cases of peritonitis and underscores the rarity of such occurrences.

Endothelial cyst of the adrenal gland: A surgical case report

INTRODUCTION AND IMPORTANCE

Advances in medical imaging have led to increased detection of rare adrenal cysts, typically asymptomatic. The article emphasizes their silent nature and the evolving diagnostic methods.

CASE PRESENTATION

Woman underwent successful laparoscopic removal of a 9 cm left adrenal cyst. Histological analysis identified it as an endothelial cyst.

CLINICAL DISCUSSION

Adrenal cysts, mostly unilateral, have diverse histological types. Diagnosis relies on imaging, and surgical intervention is required for symptomatic cases or those exceeding 5 cm. Minimally invasive techniques have improved outcomes.

CONCLUSIONS

Adrenal cysts, generally benign and asymptomatic, pose diagnostic challenges. Surgical intervention is recommended for larger or symptomatic lesions, with advancements in minimally invasive options improving outcomes.

A microsurgical approach to post-traumatic penile amputation: Towards standardizing the technique - A case report

INTRODUCTION

Penile amputation is an unusual situation reported globally as isolated cases and small series. It constitutes a urological emergency which requires microsurgical skills for the repair of the penis. We present a case of a penile amputation and discuss the management of this challenging condition.

CASE PRESENTATION

A 47-year-old patient presented to the emergency room with total amputation of corpora cavernosa of the penis resulting from knife aggression. The patient underwent successful microsurgical replantation, demonstrating positive progression and satisfactory results.

CLINICAL DISCUSSION

Microneurovascular repair of penile amputation is the gold standard. Recommendations include a meticulous anastomosis, and a focus on vein anastomoses for optimal outcomes as well as associating a psychiatric approach. The PENIS score classifies the severity of lesion and predict postoperative complications and main outcomes.

CONCLUSION

Penile amputation presents a distinctive challenge, necessitating microsurgical anastomosis, meticulous tissue management, and adherence to established protocols are imperative for effectively managing such intricate cases. Even in cases of posttraumatic partial penile amputation after a long period, can yield satisfactory morphofunctional outcomes.

Penoscrotal elephantiasis: A severe form of genital lymphedema

Penoscrotal lymphedema is a manifestation of disrupted lymphatic drainage, causing a significant increase in scrotal volume. impacting both aesthetics and quality of life. Elephantiasis, classified as stage III by the International Society of Lymphology, represents the advanced stage of scrotal lymphedema, often linked to parasitic diseases. The diagnosis is clinical, and the treatment involves mass excision. The lymphatic reconstruction is an innovative therapeutic approach that improves postoperative results and better quality of life. In this case report, we present the case of massive genital elephantiasis managed surgically, and we will focus on surgical techniques and reconstructive approaches.

Complex case of ureteropelvic junction obstruction with bifid renal pelvis in ectopic kidney: A rare combination

INTRODUCTION

Renal pelvis bifidity, ectopic pelvic kidney, and ureteropelvic junction obstruction are rare urinary tract anomalies resulting from embryological developmental variations. Their coexistence in one kidney is exceedingly uncommon.

CASE PRESENTATION

An 18-year-old male with no prior medical history presented with right-sided lumbar pain. A CT scan revealed bilateral hydronephrosis, with the left kidney being malrotated and ectopically positioned in the pelvis. Dynamic renal scintigraphy confirmed bilateral ureteropelvic junction obstruction. Surgical management involved laparoscopic pyeloplasty for the right UPJ and open surgery for the left ectopic kidney with bifid pelvis.

DISCUSSION

The combination of pelvic kidney, renal pelvis bifidity, and bilateral ureteropelvic junction obstruction is exceptionally rare. Diagnosis often occurs incidentally or when symptoms related to these anomalies emerge. Imaging and dynamic renal scintigraphy play crucial roles in diagnosis. Individualized surgical management is essential for positive outcomes.

CONCLUSION

This case highlights the need for individualized management in complex urological cases involving rare anatomical variations. Surgeon experience and a comprehensive understanding of such anomalies are crucial for successful outcomes.

Testicular lymphoma: Atypical presentation of acute scrotal swelling

INTRODUCTION

Primary testicular lymphoma (PTL) rarely presents as acute scrotal swelling. It is a very aggressive form of extra nodal non-Hodgkin's lymphoma. It accounts for less than 9 % of all testicular tumours. There are limited data characterizing this entity and this case report aim to add to existing literature.

CASE PRESENTATION

A 40-year-old patient, with a history of a pulmonary tuberculosis declared cured, presented a scrotal swelling that set rapidly in less than a week evolving in a context of weight loss and fever. The clinical examination was tender and hard on palpation while ultrasound revealed a suspicious oval formation not taking colour in Doppler. The patient underwent a right inguinal orchidectomy due to suspicious clinical presentation.

CLINICAL DISCUSSION

MHNL are very rare causes of acute scrotal swelling representing approximately 1 %. It's an aggressive tumour and remains rare in young men. Diagnosis is purely histological. Standard treatment includes orchidectomy, chemotherapy with a poor prognosis.

CONCLUSION

PTL can reoccur years after complete remission. It's related to an expression of diffuse lymphomatosis suggesting an aggressive approach. Its management is multidisciplinary based on the tumour's stage according to Ann Arbor classification.

Müllerian Cyst: An Uncommon Etiology of Chronic Pelvic Pain Syndrome in Men

Chronic pelvic pain syndrome (CPPS) in men is a complex pathological entity with a delicate nosological diagnosis and multiple etiological hypotheses dominated by urological causes. The Müllerian cyst has an embryological origin and is part of an organic anomaly of the male urogenital tract, incidentally detected during an initial infertility examination or in the presence of non-specific urinary symptoms. By its mass effect, it puts tension on the pelvic floor muscles and induces a stimulation of nerves which could explain its implication in the CPPS. Through this case report and literature review, we will clarify the etiopathogenesis and the diagnosis of CPPS as well as the approach to follow for better therapeutic management.

Primary diffuse large B-Cell lymphoma of the female urethra: A case report

Introduction

Primary diffuse large B-cell lymphoma (DLBCL) of the female urethra is a highly uncommon malignancy.

Case report

A 78-year-old woman presents with urethrorrhagia and dysuria. Clinical examination revealed a protruding mass at the urethral meatus, accompanied by bilateral inguinal adenopathies. Imaging studies confirmed the presence of a 2.2 cm mass and widespread adenopathies. Treatment involved surgical removal and adjuvant systemic chemotherapy with a favorable six-month follow-up outcome.

Conclusion

Our case report aims to raise awareness of this rare disease. Early diagnosis and treatment may improve the patient survival.

Angiomatous Urethral Caruncle After Ureteroscopy: A Case Report

Urethral caruncle is a rare condition. Although relatively common in postmenopausal women, its occurrence after a urological endoscopic procedure is unusual. Here, we report the case of a postmenopausal woman who presented with a symptomatic urethral caruncle two weeks after a ureteroscopy for a right ureteral calculus. Treatment consisted of surgical excision of the mass after the failure of local estrogen application, and the postoperative aesthetic and functional result was satisfactory. Through a review of the literature, the etiological, diagnostic, and therapeutic aspects of this pathology will be discussed.

Scrotal Trauma in a Hemophiliac: A Noisy Picture With a Minimalist Treatment

Post-traumatic hematoma is often associated with severe, extensive injuries. In patients with blood coagulation disorders, hematoma can occur even after innocuous injuries. Among these coagulation disorders is hemophilia, an X-linked recessive disorder characterized by hemorrhagic manifestations. The aim of this article is to report a case of massive scrotal hematoma following trauma in a 24-year-old hemophiliac with no signs of severity who benefited from medical treatment with infusion of coagulation factors with a good clinico-biological evolution.

Priapism associated with penile haematoma following a scorpion sting in a child: A rare case report

Priapism is a rare condition in paediatrics. Although its association with scorpion envenomation has been documented, cases involving an associated penile haematoma are extremely rare. To the best of our knowledge, we hereby present the first documented case of this unique association in a nine-year-old boy following a scorpion sting. The purpose of this observation is to discuss the diagnostic difficulties, management strategies, and possible mechanisms associated with this unusual manifestation, and to highlight the importance of prompt recognition and appropriate management of priapism and penile haematoma in children, particularly those living in areas where scorpion stings are endemic.

Periurethral abscess in corpus spongiosum caused by urinary tract infection: A case report and review of literature

Penile abscesses are rare and mainly interest the corpora cavernosa or soft tissue of the external genitalia, while involvement of the corpus spongiosum is unusual, with only a few cases published in the literature. We report the case of an abscess of the corpus spongiosum secondary to a documented urinary tract infection in a young immunocompetent patient with no particular pathological history. To our knowledge this is the first case reported in this context.

Spontaneous Iliopsoas Hematoma in a Patient on Acenocoumarol: Report of a Rare Case

Spontaneous hematoma of the iliopsoas is a rare pathological circumstance; in the majority of cases published in the literature, it is associated with disorders of hemostasis due to anticoagulant treatment or coagulopathies. We present a case of a 64-year-old man on acenocoumarol, an anticoagulant of the vitamin K antagonist family, for atrial fibrillation, who presented with a severe left hip and flank pain with a huge ecchymosis on the left flank and a partial inability to extend the left thigh. A CT scan confirmed the diagnosis of iliopsoas hematoma. Given the hemodynamic stability of the patient, he benefited from a conservative treatment with a favourable evolution. This case highlights the underlying conditions, diagnosis, and treatment of this uncommon complication.

[Primitive adenocarcinoma of the bladder: about 6 cases]

L´adénocarcinome primitif de la vessie est une variété rare de tumeurs vésicales qui représente moins de 2% des cancers de la vessie. Il semble atteindre préférentiellement le sexe masculin avec un sexe ratio de 3/1 et un âge moyen de survenu entre 60 ans et 70 ans. Sa présentation clinique est non spécifique et dominée par l´hématurie. La résection endoscopique de la vessie avec un examen anathomopathologique permet de poser le diagnostic. Le traitement de l´adénocarcinome primitif de la vessie reste sujet à de nombreuses controverses du fait de la rareté des cas rapportés dans la littérature. Cependant, le traitement de choix semble être une cystectomie totale avec curage ganglionnaire étendu. Nous rapportons une série de 6 cas d´adénocarcinome qui ont été traités et suivis au sein de notre formation. Notre analyse est basée sur l´évaluation des caractéristiques épidémiologiques, cliniques, anatomo-pathologiques, et thérapeutiques de l´adénocarcinome de la vessie, ainsi que sur l´étude des aspects évolutifs et des facteurs pronostiques.