Case Study

In this Case Study, the authors describe a patient with extensive family history of prostate cancer who was diagnosed with early-onset and aggressive prostate cancer. Genetic evaluation was undertaken in family members, revealing a familial French CanadianBRCA2founder mutation.

In this Case Study, the authors describe a patient presenting with metastatic bladder adenocarcinoma with intestinal metaplasia. Owing to the tumor's histologic similarities with colorectal cancer, the patient was treated with a FOLFOX chemotherapy regimen.

This Case Study describes the management of a patient with a fumarate hydratase (FH)-deficient type-2 papillary renal cell carcinoma. On the basis of results fromin vitro experiments, the authors decided to treat the patient with the glycolytic inhibitor 2DG (2-deoxy-D-glucose), a new anticancer drug that is currently in clinical development.

In this Case Study, the authors describe the successful management of a spontaneously ruptured adrenal artery aneurysm using only interventional radiology techniques. The case highlights the importance of multidetector CT for identifying the bleeding point and the effectiveness of endovascular embolization in the management of this type of vascular emergency.

In this Case Study, the authors describe a patient with metastatic renal cell carcinoma who was treated with neoadjuvant sunitinib before cytoreductive nephrectomy. Despite a good clinical response to therapy, the patient experienced progression of an unidentified spinal metastasis during the preoperative drug vacation.

In this Case Study, the authors describe a patient with Birt–Hogg–Dubé syndrome—a genetic disorder that confers increased susceptibility to renal cancer—who developed small-cell neuroendocrine carcinoma of prostatic or bladder origin. They outline the genetic and immunohistochemical analyses that were performed in an attempt to understand the behavior of this rare and highly malignant tumor.

Patients with carcinoma of unknown primary origin (CUP) pose a difficult diagnostic challenge, but a missed diagnosis of the primary tumor site is, unfortunately, a frequent occurrence. Musser and colleagues describe a patient with a large para-aortic mass that was initially diagnosed as CUP, but was subsequently identified as metastatic seminoma that showed remarkable spontaneous regression.

The authors describe a patient with a persistently elevated level of human chorionic gonadotropin (hCG) during chemotherapy for suspected low-risk, metastatic nonseminomatous germ cell tumor. His hCG level was found to have been falsely elevated owing to the presence of heterophile antibodies that interfered with the hCG immunoassay.

Renal medullary carcinoma has been almost exclusively diagnosed in patients with sickle cell anemia. O'Donnell et al. present a case of this rare and aggressive cancer in an adult with no detectable hemoglobinopathies. They describe both the histopathological features of the disease, and the systemic chemotherapies used to treat it.

Although rare, life-threatening hemorrhage remains a challenging complication of transurethral resection of the prostate (TURP). In this Case Study, authors from Singapore present a 74-year-old man with benign prostatic hyperplasia who experienced post-TURP hemorrhage, complicated by TURP syndrome, which was ultimately successfully treated by bilateral selective arterial prostatic embolization.

A 32-year-old man, with a left-to-right crossed fused kidney containing a 25 mm stone, underwent laparoscopic nephrolithotomy for calculus removal. The authors provide a comprehensive description of the procedure, focusing on its role in patients with renal fusion anomalies where the stone burden is too large for extracorporeal shock wave lithotripsy.

Zakaria and colleagues describe the case of a previously healthy 29-year-old man with renal infarction. The nonspecific nature of his presenting symptoms caused a delay in diagnosis. The authors provide a comprehensive account of the presenting features, and of diagnostic tests that can distinguish renal infarction from more common conditions.

In this Case Study, El Madhoun and colleagues describe the diagnosis and management of a patient with bilateral renal hemorrhage caused by polyarteritis nodosa. The perirenal bleeding was at first attributed to trauma experienced 1 week before the initial presentation, but review of the case at a subsequent hospital admission identified the true cause of the bilateral hemorrhage.

Chung et al. describe the case of a 7-year-old girl diagnosed with complete avulsion of the left ureteropelvic junction 3 weeks after injury, and treated by creation of a ureteropelvic anastomosis with stent. The authors emphasize the necessity for delayed imaging to ensure the timely diagnosis of ureteral injuries in blunt trauma patients.

This Case Study discusses the management of a female neonate in whom a large pelvic mass had been detected 9 weeks before birth. She was diagnosed with botryoid rhabdomyosarcoma of the bladder. Tumor eradication was achieved with chemotherapy alone, and she remained free from recurrence during 24 months of follow-up.

The authors describe a 57-year-old man with paraneoplastic leukocytosis, caused by overexpression of granulocyte-colony stimulating factor from a suprarenal tumor with rhabdoid-like differentiation. This case presented several diagnostic and treatment challenges to the pathologists, surgeons, and oncologists involved, and illustrates the difficulties encountered when diagnosing and treating unusual malignancies.

In this Case Study, Sahai and colleagues report on a 15-year-old boy who sustained grade V renal trauma, with associated splenic injury and renal vein thrombosis. The authors use the case to illustrate that conservative management of grade V blunt renal trauma is possible in a hemodynamically stable patient.

Here, Ooi and co-workers present a 40-year-old man who developed acute-onset bilateral painless swelling of the scrotum, and was diagnosed with acute idiopathic scrotal edema. Although rare in adult males, this condition should be considered in the differential diagnosis of acute scrotal swellings, in order to avoid unnecessary surgery.

The authors present a 57-year-old woman with advanced renal cell carcinoma (RCC) and a tumor thrombus extending into the vena cava. She received neoadjuvant sunitinib, which shrank the tumor thrombus, and enabled laparoscopic radical nephrectomy to be performed. The case highlights the potential of targeted agents before surgery in RCC.

This Case Study describes a 48-year-old man who was referred to a specialist oncology center for management of presumed angiosarcoma. Further investigation revealed high-risk penile epithelioid hemangioendothelioma. This article highlights the spectrum of clinical behavior of this atypical epithelioid vascular tumor, and provides possible treatment options for low-risk and high-risk forms of this cancer.