This article reports the case of a 22-year-old woman with right renal angiomyolipoma (AML) and inferior vena cava thrombus. Laparoscopic right nephrectomy and thrombectomy were performed. To the authors' knowledge there have been only 46 reported cases of renal AML with endovascular extension and this is the first case to be completely removed by a laparoscopic approach. Laparoscopic management of this kind of tumour is feasible in spite of the vascular involvement. The centre's experience and enlargement of the tumour are key points for this approach.
Intraoperative complications vary from different series. More scheduled reports should be done in order to better understand the real rates of complications.
Objectives:
We present a new surgery based on the round ligament anatomy that is called laparoscopic abdominopexy, which uses a synthetic mesh without fixation at any pelvic point. The aim of this study is to provide a step-by-step description of the laparoscopic abdominopexy technique and present the first anatomical and functional results of the procedure.
Methods:
This prospective cohort study included patients with apical and anterior vaginal prolapse who were subjected to laparoscopic abdominopexy. Before and after surgery, the Pelvic Organ Prolapse Quantification (POP-Q) scale, Overactive Bladder Questionnaire-Short Form (OABq-SF), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to evaluate the vaginal prolapse stage, storage, and sexual symptoms, respectively. The surgical technique is described step by step.
Results:
Twenty patients were included with follow-up times between 6 and 25 months. The mean surgical time was 78.4 minutes. A statistically significant improvement was observed in the Aa (
P
≤ 10
−5
), Ba (
P
≤ 10
−5
), C (
P
= 5 × 10
−5
), D (
P
= .002) and tvl (
P
= .02) POP-Q points and in OABq-SF (22.2%;
P
= .02). Successful surgery was observed in 100% of patients for the apical compartment and 90% of patients for the anterior compartment.
Conclusion:
Laparoscopic abdominopexy is a quick, safe, and reproducible surgical technique with beneficial anatomical and functional results that preserve the pelvic floor anatomy.
Schwannoma is a rare slow-growing neurogenic tumor of the nerve sheath origin. They are commonly seen in middle-aged with a female to male ratio of 1:1.2. Here we present three cases of retroperitoneal schwannoma in our urology department. In two cases, we decided surgery management and in one case, we used watchful waiting. After a 3-year follow-up, case 1 was asymptomatic without changes in the lesion.
Keywords: Schwannoma; Retroperitoneal malignance; Neurogenic tumor
IntroductionSchwannoma is a slow-growing neurogenic tumor of the nerve sheath origin. They are commonly seen in middle-aged with a female to male ratio of 1:1.2. Visceral schwannomas are infrequent. Computerized tomography (CT) images present areas of cystic degeneration, calcification or hemorrhage. Extension of the mass along the nerve may indicate the neural origin of the mass. It is important to exclude a malignant retroperitoneal tumor to choose the correct treatment.Here we present three cases of retroperitoneal schwannoma in our urology department.
Case Reports
Case 1A 54-year-old female smoker presented in our department with back pain on the right. Abdominal ultrasound and CT with contrast revealed a 4.2 × 3.2 cm mass located in the retrocaval area and medial to the right kidney (Fig. 1). The findings of the images were compatible with pheochromocytoma or paraganglioma. Biochemical workup included plasma and urine catecholamine. All studies were normal. The imagingguided biopsy was done. Microscopic findings showed a mass composed of fusiform cells with abundant collagen and spaces with macrophages. No mitoses were observed. Immunohistochemistry showed that the tumor cells were positive for S-100, BCL2, CD56, CD99 and negative for CD34 and muscle specific actin and desmin. The Ki67 activity was 1%. These findings were consistent with benign schwannoma.Because it was a benign case with small mass and the patient was asymptomatic, we decided watchful waiting with radiological periodic controls.
Case 2A 56-year-old woman smoker was dispatched to the hematology department with thrombocytopenia after a routine health
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