Background Renal leiomyomas are exceptionally rare, benign, mesenchymal tumours originating from smooth muscle in the kidney. Historically, because of their small size, most renal leiomyoma cases were discovered incidentally based on autopsy findings. However, since the advent and improved access to imaging modalities such as ultrasound and computed tomography (CT), renal leiomyomas are being discovered more frequently. Although usually incidental discoveries, clinical presenting signs and symptoms comprise abdominal or flank pain, a palpable flank mass, and haematuria in 20% of those with symptoms. Case presentation We study the case of an incidentally found, asymptomatic, left kidney mass that presented in a 60-year-old female. Initial suspicions on CT imaging of either renal cell carcinoma or oncocytoma resulted in a radical nephrectomy of the left kidney. Postoperative pathological examination of the mass revealed a renal leiomyoma; a rare, benign tumour that is mostly indistinguishable from malignant tumours on imaging. Conclusions With the current availability of ultrasonography and CT, they are often discovered incidentally, and the radiological differential diagnoses are often inadequate or challenging in such cases. The gold standard management of these suspicious cancer cases is still a radical nephrectomy with postoperative pathological and immunohistochemical analysis. Due to its benign nature, patients enjoy excellent prognoses without recurrence. We discuss and briefly review the relevant literature of the clinical, imaging and pathological features of renal leiomyomas and those of the differential diagnoses.
Background Globally, prostate cancer (PCa) is the commonest non-cutaneous male malignancy. It is more aggressive among black men with little known reasons as to the cause and continued trend among black men. This disproportionate pattern of PCa especially among black men of African ancestry resident in Africa calls for a closer look. Nigeria and South Africa, combined, have the highest cumulative risk incidence of PCa in Africa. The present study investigated the clinicopathologic behaviour of PCa among Nigerian and South African black men and the relationship between the disease and socio-demographic characteristics alongside medical co-morbidities. Methods A retrospective cross-sectional study was undertaken in which de-identified records of 234 black men with pathologically confirmed PCa between 2007 and 2017 from two tertiary hospitals, in Nigeria (National Hospital, Abuja) and South Africa (Tygerberg Hospital, Cape Town), were reviewed. Results Median age at presentation from both countries was 66 years (interquartile range, IQR 61–73 years) while the median PSA at presentation was 46 ng/ml (IQR 16–336.5 ng/ml). Half of the men (117/234) presented with locally advanced disease while metastatic disease was observed in 65.9% (27/41) of Nigerian men and 34.1% (14/41) of South African men. Thirty-three per cent of the men presented with organ-confined disease. Overall, Nigerian men presented with less organ-confined disease and significantly higher stage of disease (p < 0.001). Risk stratification using PSA, Gleason scores and T-staging showed that 84.2% (n = 197) of all the men presented with high-risk PCa disease. There was a statistically significant difference between Nigerian and South African black men (p = 0.003) in terms of disease risk at presentation. Logistic regression analysis showed that age (Adjusted OR 1.053 (95% CI 1.003–1.106), p = 0.003) and country of residence (Adjusted OR 4.281 (95% CI 1.690–10.844), p = 0.002) had a statistically significant relationship with high risk of PCa while disease co-morbidities (like diabetes and hypertension) and rural/urban location in both countries did not. Conclusions Disparities exist between PCa presentation and clinicopathologic behaviour among Nigerian and South African black men. Nigerian men showed higher disease risk at presentation. Environmental-genetic interactions need further exploration in the aetio-pathogenesis of PCa in black men of African ancestry.
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