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Gkekas C, Tsikopoulos I, Katsimperis S, Antoniadis G, Papadopoulos D. Malignant Transformation of Long-Standing Pseudoepitheliomatous Keratotic and Micaceous Balanitis (PKMB) Presenting as Urethral Obstruction. Cureus 2024; 16:e58671. [PMID: 38774183 PMCID: PMC11107396 DOI: 10.7759/cureus.58671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Hereby, we present a rare case of malignant transformation in a long-standing case of pseudoepitheliomatous keratotic and micaceous balanitis (PKMB), which typically affects older men. PKMB presents as whitish or silvery keratotic plaques on the glans and can remain stable for years, leading to potential confusion regarding its progression. The patient in this case experienced urinary obstruction due to tumorous ingrowth, prompting an investigation. Despite previous treatments, including fluorouracil (5-FU) and cryoablation, the lesion persisted, eventually growing in size and becoming malodorous. Initial biopsy showed PKMB without malignancy, but subsequent deeper biopsy revealed verrucous carcinoma. The patient underwent glansectomy and reconstruction with a full-thickness skin graft, achieving a disease-free state postoperatively. The paper underscores the importance of thorough investigation for malignancy in PKMB cases, the possibility of deeper malignancy missed by superficial biopsy, and the need for early diagnosis to enable organ-sparing treatments.
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Affiliation(s)
| | | | - Stamatios Katsimperis
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
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Al-Gburi S, Thonse V, Abdalla O, Kumar M. An Incidental Diagnosis of Extraosseous Ewing's Sarcoma in the Kidney. Cureus 2024; 16:e53916. [PMID: 38465176 PMCID: PMC10924782 DOI: 10.7759/cureus.53916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
Ewing's sarcoma is generally observed in the skeletal and connective tissues of paediatric individuals. The occurrence of extraosseous neuroectodermal tumours is uncommon. Renal Ewing's sarcoma usually presents with flank pain, haematuria, or as an abdominal mass. Immunohistochemistry and fluorescence in situ hybridization (FISH) techniques are essential in its diagnosis and differentiation from other tumours. We present asymptomatic renal Ewing's sarcoma in a 19-year-old female patient who was diagnosed incidentally, and the CT scan confirmed a 2.8 cm left mid-pole renal mass suggestive of malignancy. She was managed with a robotic partial nephrectomy. Tumour immunohistochemistry and the FISH technique confirmed the diagnosis of Ewing's sarcoma. The patient made an uneventful recovery and was referred for chemotherapy. This case report illustrates that despite the aggressiveness of the tumour, it can be detected earlier despite an asymptomatic presentation and be successfully treated with nephron-sparing surgery and chemotherapy.
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Affiliation(s)
- Saleh Al-Gburi
- Urology, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, GBR
- Urology, Mosul Medical College, University of Mosul, Mosul, IRQ
| | - Vinutha Thonse
- Pathology, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, GBR
| | - Omer Abdalla
- Urology, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, GBR
| | - Manal Kumar
- Urology, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, GBR
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Angelopoulos P, Kapsalos-Dedes S, Manolitsis I, Katsimperis S, Bellos T, Kyriazis I, Neofytou P, Tzelves L, Berdempes M, Skolarikos A. The Management of a Case With Mucin-Producing Adenocarcinoma Originating From the Urachus. Cureus 2024; 16:e52376. [PMID: 38361714 PMCID: PMC10868626 DOI: 10.7759/cureus.52376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
Urachal cancer is a rare and aggressive type of cancer, frequently characterized by a lack of prominent symptoms. We herein report a case of a 50-year-old female with mucin-producing adenocarcinoma originating from the urachus who underwent partial cystectomy and the patient remains disease-free for 30 months after treatment.
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Affiliation(s)
- Panagiotis Angelopoulos
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
| | - Sotirios Kapsalos-Dedes
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Athens, GRC
| | - Ioannis Manolitsis
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, Greece, Athens, GRC
| | - Stamatios Katsimperis
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
| | - Themistoklis Bellos
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
| | - Ioannis Kyriazis
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC
| | - Panagiotis Neofytou
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Athens, GRC
| | - Lazaros Tzelves
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
| | - Marinos Berdempes
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC, Athens, GRC
| | - Andreas Skolarikos
- Urology, Second Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
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Tsikopoulos I, Papadopoulos D, Symeonidis A, Katsimperis S, Gkekas C. Juxta-Vesical Urinary Stones: An Extremely Rare Finding Secondary to Bladder Rupture and Squamous Cell Carcinoma in a Patient on Clean Intermittent Self-Catheterization. Cureus 2023; 15:e38776. [PMID: 37303394 PMCID: PMC10250137 DOI: 10.7759/cureus.38776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/13/2023] Open
Abstract
We present a rare case of juxta-vesical urinary stones in the lesser pelvis, incidentally diagnosed during the investigation of a urinary tract infection (UTI). The patient (male) had a history of neurogenic bladder and performed self-catheterizations. After the initial workup, the patient was admitted with a complicated UTI diagnosis. CT scan of the abdomen and pelvis depicted multiple bladder stones, some calculi lying juxta- and retro-vesically, an abscess cavity, and diffuse thickening of the bladder. The abscess was adherent to the bladder wall, containing calculi, too. We presumed that the patient self-inflicted a bladder rupture when performing clean intermittent self-catheterization (CISC) and stones dislodged in the pelvis due to his poor bladder sensation. Flexible cystoscopy was attempted but was not completed due to stone obstruction and poor bladder compliance. The patient underwent open surgical exploration. Several calculi were removed, the abscess was drained, and bladder wall biopsies were taken. Pathology results revealed invasive squamous bladder carcinoma; the patient was listed for radical cystectomy. We aim to familiarize the clinician with rare complications that should be taken into consideration when treating patients on CISC and present an extremely rare clinical finding of juxta-vesical lithiasis.
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Affiliation(s)
| | | | - Asterios Symeonidis
- Department of Medicine and Surgery, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Stamatios Katsimperis
- Department of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GRC
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