Bilateral ureteral complete obstruction with huge spontaneous urinoma formation in a patient with advanced bladder cancer (original) (raw)
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Spontaneous urinoma diagnosed before radical cystectomy: A case report
Medical review
Introduction. Rupture of the urinary collecting system, associated with perirenal or retroperitoneal extravasation of the urine, is a rare condition usually associated with the obstruction of the urinary system. A urinoma is a localized collection of urine in the retroperitoneum, outside the urinary tract, and occurs after injury to the wall of the urinary system. Ureteral obstruction caused by a bladder tumor is a rare cause of urinoma. Case Report. We report a case of a 62-year-old patient who was admitted to the Clinic of Urology of the Clinical Center of Serbia, due to an invasive bladder cancer. A computerized tomography scan of the abdomen and pelvis revealed a massive bladder tumor dominant on the left side, invading the vagina, uterus and significantly obstructing both kidneys. Intraoperatively, a mass of 18 cm in diameter was identified in the right retroperitoneal space and it was dissected from the peritoneum. Two liters of clear fluid were aspirated from the mass, and th...
An interesting presentation of invasive bladder carcinoma as pseudo renal failure
Brazilian Journal of Nephrology
Ascites and oliguria with an increasing serum creatinine level are often observed in patients with acute renal failure. However, these symptoms are also noted in individuals with intraperitoneal urinary leakage and can be mistaken for acute renal failure. This rise in creatinine in such patients is called pseudo renal failure and it happens by a process of reverse peritoneal dialysis. In literature, the most commonly described condition that leads to this clinical picture is following a spontaneous or missed bladder perforation. We, herein, report a case of carcinoma of the bladder that presented with features resembling acute renal failure, which later turned out to be pseudo renal failure due to intraperitoneal urinary extravasation from a forniceal rupture. The patient was managed with emergency with a percutaneous drain followed by a percutaneous nephrostomy, which led to normalization of creatinine. Cystoscopy revealed the bladder growth in an intact small capacity bladder and ...
Transitional cell carcinoma of ureter in a solitary functioning kidney
We present a 60 years old male with transitional cell carcinoma of the left ureter. The right kidney was non excretory while the left one was the solitary functioning kidney with multiple renal cysts. He had presented with significantly deranged renal profile and left obstructed ureter. The ureterorenoscope could not be negotiated so exploration of the left ureter was done. This showed a growth in left ureter, confirmed as transitional cell carcinoma (TCC) on histopathology. Subsequently excision of the distal left ureter alongwith the tumour and the cuff of bladder (segmental ureterectomy) was contemplated. Proximally transureteroureterostomy was performed. Postoperative recovery was smooth and the renal profile became normal within 3 months.
Metastasis of Renal Cell Carcinoma to the Urinary Bladder: Case Report
Zenodo (CERN European Organization for Nuclear Research), 2022
Renal cell carcinoma (RCC) is the most common malignant type among kidney tumors, with a rate of 90% in adults. Distant metastasis is seen in 30% of patients with Renal Cell Carcinoma at the time of diagnosis. In this study, we aimed to present two very rare cases of bladder metastases. Case 1; A 65-year-old male patient with nodular thickening and mass in the bladder wall around the right ureteral orifice. Case 2; The patient, who had undergone nephrectomy operation due to a mass in the left kidney, was hospitalized with the complaint of hematuria and a mass in the bladder was detected in the examination.Although metastasis of Renal Cell Carcinoma to the bladder is not common, it should be kept in mind in routine control examinations and investigated for metastasis.
Acta chirurgica iugoslavica, 2007
A 30-year-old female was admitted in emergency with acute urinary retention due to bladder tumour prolapsed from the external urethral orifice. The patient underwent immediate endoscopic surgery via suprapubic percutaneous approach. The histological examination confirmed a superficial highly differentiated transitional cell bladder carcinoma. During the 6-year follow-up no evidence of local recurrence or metastatic tumour spread was revealed. The comprehensive Medline search confirmed that this is the fourth case of bladder tumour prolapsed from the external urethral orifice, reported so far. The case deserves the interest of practising urologists because of the exceptional rarity of the entity and the unconventional treatment approach which involves using a percutaneous suprapubic endoscopic technique. Based on the results achieved, we can recommend this unconventional endoscopic approach as specifically indicated in certain situations.
The Journal of Urology, 1999
Perforation of the bladder during transurethral resection is a worrisome complication for most urologists. Little is known about the consequences of seeding of tumor cells into the peritoneum or retroperitoneum. We reviewed several hospital patient databases as well as the literature to determine the outcome of such situations. We performed a local multi-institutional case and MEDLINE review using key words, such as bladder neoplasm, neoplasm seeding, perforation, rupture, transurethral resection, peritonitis and tumor. We also contacted several urologists and oncologists at major cancer centers in the United States and Europe regarding the incidence and followup of perforated/violated bladder cancer cases. There were 16 bladder violations in the presence of transitional cell carcinoma, including 2 partial cystectomies that had negative margins and no subsequent metastatic recurrences, a bladder tumor that was detected during suprapubic prostatectomy and perforations during transurethral resection (extraperitoneal in 4 cases and intraperitoneal in 9). Two patients died of sepsis and existing metastatic disease, respectively. The only recurrence among the remaining 11 patients developed after intraperitoneal bladder perforation during transurethral resection for Ta grade 2 tumor. Several anecdotal reports discussed local and distal tumor recurrences, suggesting that even superficial transitional cell carcinoma can behave aggressively if grown in an environment outside the bladder. However, these reports are rare. Any benefit of prophylactic chemotherapy was not proved. While perforation of the bladder during transurethral resection for cancer and the possibility of tumor implantation are matters of concern, our review demonstrates that few patients return with an extravesical tumor recurrence either locally or distally compared to those with a nonruptured bladder after resection. Although our patient sample is small and there are a limited number of reports in the literature, the risk of recurrence still exists and the urologist should be aware of its possibility. Since recurrences are usually rapid, they may easily manifest to the urologist at followup. However, one should also consider chest x-rays and/or computerized tomography to rule out recurrences that are not clinically obvious.
Cancer, 1976
A retrospective analysis of 74 cases of transitional cell carcinoma of the renal pelvis and ureter treated at this institution over the past 30 years is presented. When nephrectomy alone or incomplete nephroureterectomy was performed, subsequent transitional cell carcinoma developed in 30% of the ureteral stumps. Subsequent bladder carcinoma occurred in 25% of the patients with primary upper urinary tract carcinoma. The type of initial surgery performed did not appear to influence this incidence of subsequent bladder tumors. Contralateral upper urinary tract carcinoma developed in only one patient. When nephroureterectomy is performed for carcinoma of the renal pelvis and ureter, a cuff of bladder that includes the ureteral orifice should be removed to obviate recurrent disease in the ureteral stump. Since single-incision nephroureterectomy did not include the intramural ureter in 50% of the cases in which it was performed, a second incision may be required for adequate exposure.
Metachronous metastasis of renal cell carcinoma to the urinary bladder: a case report
Therapeutic Advances in Urology
We report a case of intravesical metastasis of a clear cell renal cell carcinoma. In renal cell carcinoma 16% of patients present with metastatic disease. Renal cell carcinoma can metastasize to nearly every organ, although metastatic spread to the urinary bladder is rare, with fewer than 70 described cases. The route and pattern of metastatic spread is not yet fully understood and different pathways are suggested. Gross haematuria is the presenting symptom in the majority of cases. These intravesical metastases may be synchronous or metachronous and can be solitary or part of polymetastatic disease. No standard treatment can be suggested due to the rare nature of this phenomenon, and treatment varies from transurethral resection, partial or complete cystectomy to systemic therapy. Prognosis in patients with a solitary bladder lesion that developed metachronously is rather good, whereas poor prognosis can be expected in patients with synchronous and multiple metastases.
Asian Pacific journal of cancer care, 2024
Background: Metastatic urothelial carcinoma bladder at the time of diagnosis is a rare entity with lymph nodes, bones, lung and liver as common metastatic sites. Sometimes metastasis can be seen in various atypical sites. Case Presentation: Unusual location of metastasis can be seen in perinephric region, renal fascia and ovaries as seen in the described case. Primary urothelial carcinoma of ovary needs to be differentiated from the metastasis. There are no standard lines of management and the treatment needs to be individualised. Prognosis of metastatic urothelial carcinoma remains fatal with a limited life expectancy. Conclusion: We present a case of metastatic urothelial carcinoma bladder with metastasis to perinephric region and ovaries with her course of treatment.