Primary renal lymphoma (PRL) is a rare event, while ureteric involvement by the lymphoma mimicking an UTUC is even rarer. A 30-year-old woman diagnosed for a 6-month history of right flank pain with presumed the UTUC of the right kidney. She underwent radical nephroureterectomy with bladder cuff excision, which reveals the infiltrating papillary mass of the ureter from the proximal region towards the ureterovesical junction. Kidney mass was found mostly solid in the parenchymal region, renal hilus was found adherent towards the wall of the inferior vena cava in which it reveals a similar pathology result of Non-Hodgkin's lymphoma.
Introduction: Resection of renal cell carcinoma liver metastases (RCCLM) is known to provide a good survival outcome. Simultaneous RCCLM resection with the primary tumor is commonly done in cases with direct extension of locally advanced RCC to liver parenchyma. Cases of safe simultaneous resection of liver and kidney in malignancy have not been reported before in Indonesia. Case Presentation: We aim to describe two cases of left-sided RCC with right-sided RCCLM who underwent simultaneous kidney and liver resection. Both patients had good short-term survival with no intra-operative and post-operative complications.Conclusion: Although simultaneous kidney and liver resection poses challenges of substantial morbidity, a safe surgical and multidisciplinary approach could be implemented in selected cases with a good surgical outcome.
Background: Bleomycin, etoposide, and cisplatin (BEP) is a standard first-line therapy for metastatic germ cell tumor (GCT), while paclitaxel, ifosfamide, and cisplatin (TIP) are commonly used as salvage therapy after failed BEP treatment. The unavailability of first-line drugs can be the reason for the use of second-line therapy. In this paper, we reviewed two initial cases of patients with metastatic GCT treated with TIP as first-line chemotherapy in our center.Case Presentation: We reviewed the medical record and followed up two patients who had been treated with TIP as first-line chemotherapy for metastatic GCT due to lack of BEP regiment. We evaluated efficacy and toxicity of this treatment. These two patients were diagnosed with seminoma, with intermediate-risk according to International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Both achieved complete response after four courses of TIP chemotherapy with toxicities mainly consisted of myelosuppression.Conclusions: TIP demonstrated efficacy serves as the first-line therapy for germ cell tumors with an acceptable safety profile. Further studies with larger subjects are still needed for evaluation. However, TIP is more expensive compared to BEP, making BEP is still superior to TIP in public hospital setting where cost-effectiveness of treatment is important.
Objective: This study aims to know the effects of giant adrenal cysts and their challenges for surgeons. Case(s) Presentation: A 41 years old female was referred with a chief complaint of growing palpable mass on the left side of the abdomen since five months ago. During the past five months, the patient has also had complaints of hard narrow-caliber stools. The general conditions and vital signs have been within normal limits. Discussion: Complete resection of the tissue remains the current best treatment of choice. When available, laparoscopic adrenalectomy is the gold standard for treating giant adrenal cysts. Open adrenalectomy is an alternative when laparoscopic adrenalectomy is not available, or when there is not enough diagnostic information preoperatively. For large cysts with a size of >6cm, open surgery is the favorable treatment, because it is difficult to control the mass via the laparoscopic approach. Conclusion: The giant adrenal cyst is a rare condition that, due to its size, it could lead to moderate-severe abdominal symptoms. Localizing the origin of the cysts preoperatively poses a challenge for surgeons and diagnosticians. Intraoperative diagnostic and therapeutic with laparoscopy or open surgery is recommended for these cases.
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