Neuroendocrine tumours are usually located in the gastrointestinal or respiratory tract. A 23-year-old man was evaluated for loss of weight and a palpable left loin mass. CECT showed a large heterogeneously enhancing mass with calcification arising from the left kidney. He underwent an open radical nephrectomy. Histopathological examination revealed a large cell neuroendocrine carcinoma (LCNEC). LCNEC of the kidney is extremely rare and portends poor prognosis. It is usually a histopathological surprise and requires immunohistochemistry for confirmation.
Introduction: Urinary bladder stones comprise 5% of all urinary stones. Various modalities for the treatment of symptomatic bladder stones are available. They are open cystolithotomy, extra corporeal shock wave lithotripsy, cystolitholapaxy, suprapubic or transurethral cystolithotripsy using various energy sources. Presently transurethral Holmium laser cystolithotripsy is considered as the treatment of choice for symptomatic bladder stones. Aim: To report the experience of holmium laser cystolithotripsy for the treatment of symptomatic urinary bladder stones under local anaesthesia in adult patients. Materials and Methods: This prospective observational study was conducted on 86 patients at Department of Urology, NorthEastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, India, between June 2016 and August 2019. It included consecutive adult patients with symptomatic bladder stones of size upto 4 cm who underwent transurethral holmium laser cystolithotripsy under local anaesthesia during the study period. Laser energy was delivered through a 9.5F semi rigid ureteroscope using 365 µm or 550 µm end-firing fibre. Pain during the procedure was assessed using Visual Analogue Scale (VAS). Descriptive statistics was used for analysis of the results. Results: During the study period, 86 patients (84 men, 2 women) underwent transurethral Holmium laser cystolithotripsy under local anaesthesia. Complete fragmentation of the stones was achieved in all patients. The mean stone size was 15.04 mm and the mean operating time was 23.81 minutes. The procedure was well tolerated by the patients and the mean pain score was 3.26. It was associated with minor complications only. There was no major complication or mortality during the study. Conclusion: Transurethral holmium laser cystolithotripsy under local anaesthesia is a safe procedure. It is well tolerated by adult patients and it can be used for the treatment of bladder stones of size upto 4 cm.
Giant fibroepithelial polyp is a rare cause of ureteric/ureteropelvic junction (UPJ) obstruction. We report a rare case of giant fibroepithelial polyp in a 32-year-old woman involving the whole length of the ureter, reaching up to the UPJ which was clinically and radiologically considered to be urothelial carcinoma. Frozen section showed a polypoid lesion lined by urothelium with no evidence of dysplasia or malignancy. Subsequently, nephroureterectomy was done as there was marked renal hydronephrosis and it was impossible to separate the polyp from the wall of the ureter. Histopathological examination and immunohistochemistry confirmed the diagnosis of giant fibroepithelial polyp, ruling out malignancy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.