The remaining Foley tubing then inadvertently obstructed the urethra, and therefore stopped all outflow of urine from the functioning left kidney. The case described here demonstrates a serendipitous method of diagnosis of ectopic ureter in an adult female. A high buy PCI-32765 level of suspicion for young girls with incontinence should raise thoughts of ectopic ureter and prompt the proper workup to prevent permanent renal damage. “
“The efficiency of chemotherapy on nonseminomatous germ cell tumors (NSGCTs) is no longer to be demonstrated.
The existence of a residual mass at the end of the treatment requires the excision of the former. That is, in fact, the only way to affirm the histologic nature conditioning the subsequent conduct of the treatment.1 The pathologic analysis of these residual masses might reveal either click here the persistence of malignant cells or the presence of a fibrosis, a necrosis, or finally, the existence of a mature teratoma.2 The latter situation has been encountered in our patient. A 19-year-old patient consulted for a swelling of the left testicular. The clinical examination found a large, firm abdominal mass, attached to the deep plane, localized at the left flank. The examination of the external genital organs found an enormous mass at the left testicular
of 15-cm long axis without associated inflammatory signs. An abdominal and pelvic computed tomography (CT) revealed a left retroperitoneal mass measuring 8 × 6 cm displacing the aorta to the right and compressing the left ureter (Fig. 1A) with bilateral hilar lymph nodes (maximum diameter 28 mm). It also showed a left testicular mass measuring 10 × 10 cm. Serum tumor markers were twice as high as the normal. Our patient
had an orchiectomy followed by 3 cycles of chemotherapy (bleomycin, cisplatin, and etoposide) for a stage IIC mixed NSGCT containing a teratomatous component and an embryonal carcinoma. Serum tumor markers were normalized after the first cycle of chemotherapy. At initial staging, hilar lymph nodes have regressed on CT data, instead the retroperitoneal mass has increased (maximum diameter 12 × 12 cm; Fig. 1B). Our patient had a second – line chemotherapy (ifosfamide plus etoposide and cisplatin). Two months later, a comparative abdominal Mephenoxalone scanner has shown that the retroperitoneal mass continued to increase (maximum diameter was 12 × 15 cm) and was responsible of a hydronephrosis. Clinically, the patient complained of an abdominal discomfort. Given the negative tumor marker and the imaging features, growing teratoma syndrome (GTS) was hypothesized. The patient underwent surgery that consisted of a complete resection of the mass. Pathologic examination of the resected lesion confirmed the diagnosis of mature teratoma in his multicystic form (Fig. 2) without viable tumor. Eighteen months later, our patient is in good health without any local or distant recurrence.