Complaint Of Gross Hematuria Research Articles

Pelvic ultrasound finding of late-onset bladder erosion after transobturator tape for female stress urinary incontinence: A case report.

Mid-urethral sling is a gold-standard procedure for stress urinary incontinence because of its high efficacy and low complication incidence. Moreover, mesh erosion into the bladder is a rare complication. The 63-year-old patient visited our gynecology clinic with complaints of gross hematuria and was diagnosed with bladder erosion by ultrasound 6 months after transobturator tape procedure. The 2D ultrasound found the sling in the bladder wall perforation, which can lead to the formation of bladder stones. Meanwhile, 3D ultrasound showed the left side of the sling crossed the bladder mucosa at 5 o'clock. The sling and bladder stones were removed by holmium laser. The patient underwent a follow-up pelvic ultrasound at 6 months, which showed no erosion mesh under the bladder mucosa. Pelvic ultrasound could accurately evaluate the location and shape of the tape, which is important for a reasonable surgical plan.

Non-penetrating traumatic psoas muscle hematoma presenting with gross hematuria: a case report

Psoas muscle hematoma is defined as a spontaneous or traumatic retroperitoneal collection of blood involving the psoas muscle. Early symptoms of an iliopsoas hematoma include lower abdominal or severe groin pain. Although psoas hematoma is a known complication of coagulopathy, psoas hematoma caused by non-penetrating trauma is the subject of only scattered reports and its significance has not been well described in the literature, so the aim of this study was to report a case of blunt traumatic psoas hematoma with the fracture of vertebral transverse process with the presentation of gross hematuria. A 65-year-old Iranian man slipped backward to the ground, and the patient complaint of gross hematuria and difficulty in walking. There was severe left costo-vertebral angle (CVA) tenderness, and mild groin tenderness, and the lower back area was painful, and he had some pain with the flexion of the vertebral column, and there was tenderness on lumbar spine, but there was no tingling, paresthesia, and weakness in left lower extremity. Hip flexion was 3/5 in the left lower. We used some diagnostic modalities as x-ray radiography, ultrasonography, computed tomography (CT) scan with intravenous (IV) contrast, CT cystography, and intravenous pyelogram (IVP) IVP to differentiate the diagnoses and also find skeletal and other organ injuries associated with this kind of injury. We can conclude that post-traumatic psoas hematoma is a rare condition. The diagnostic modality of choice is CT scan which allows rapid identification and measurement of the hematoma. The lesion usually treated with non-operative conservative management.

SLC14A1 (UT-B) gene rearrangement in urothelial carcinoma of the bladder: a case report

BackgroundBladder cancer (BC) is a common and deadly disease. Over the past decade, a number of genetic alterations have been reported in BC. Bladder urothelium expresses abundant urea transporter UT-B encoded by Slc14a1 gene at 18q12.3 locus, which plays an important role in preventing high concentrated urea-caused cell injury. Early genome-wide association studies (GWAS) showed that UT-B gene mutations are genetically linked to the urothelial bladder carcinoma (UBC). In this study, we examined whether Slc14a1 gene has been changed in UBC, which has never been reported.Case presentationA 59-year-old male was admitted to a hospital with the complaint of gross hematuria for 6 days. Ultrasonography revealed a size of 2.8 × 1.7 cm mass lesion located on the rear wall and dome of the bladder. In cystoscopic examination, papillary tumoral lesions 3.0-cm in total diameter were seen on the left wall of the bladder and 2 cm to the left ureteric orifice. Transurethral resection of bladder tumor (TURBT) was performed. Histology showed high-grade non-muscle invasive UBC. Immunostaining was negative for Syn, CK7, CK20, Villin, and positive for HER2, BRCA1, GATA3. Using a fluorescence in situ hybridization (FISH), Slc14a1 gene rearrangement was identified by a pair of break-apart DNA probes.ConclusionsWe for the first time report a patient diagnosed with urothelial carcinoma accompanied with split Slc14a1 gene abnormality, a crucial gene in bladder.

Cytological and Ultrastructural Findings of Mucinous Tubular and Spindle Cell Carcinoma: A Case Report

The 2016 World Health Organization Classification of Tumors recognized mucinous tubular and spindle cell carcinoma (MTSCC) as a rare histological variant of renal cell carcinoma (RCC). To date, a limited number of studies have reported this tumor concerning histology, and only a handful of those have reported cytological and ultrastructural features. This study aims to report a case of MTSCC in a female patient in her early 50s who presented with a chief complaint of gross hematuria, and to discuss relevant cytological and ultrastructural findings. Imaging revealed a 30 mm tumor in the left kidney, suggesting the presence of RCC, and left nephrectomy was performed. In addition, scratched cytology of tumor surface revealed clusters of tumor cells with clear cell boundaries extending two-dimensionally in papillary or dendritic arrangements with interspersed blood vessels and stromal components that were stained light green. Histologically, the tumor was composed of small and uniform cells arranged in elongated tubular architectures and spindle fascicles with occasional papillary structures; the stroma was acidophilic and contained colloidal substances that tested positive for Alcian blue and periodic acid-Schiff stain. Concordant with immunohistochemical results, the tumor was diagnosed with MTSCC. Furthermore, transmission electron microscopy revealed tubular structures with microvilli, abundance of mitochondria in the cytoplasm, cellular interdigitations and widened interstitium.

Causes of Gross Hematuria in Patient at a Tertiary Care Hospital

Objective: To determine the causes of hematuria in patients coming to a tertiary care hospital. Patients and Methods: This cross-sectional study was carried out at Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. Data was collected over a period of six months (June 2016 to December 2016). Data of all the adult male and female patients presenting with complaint of gross hematuria during the period were gathered and analyzed for etiological profile.Results: In the study the most common cause was urological malignancy, which was present in 29 (58%) of patients. This includes all the urological cancers. Among other causes, 11 (22%) patients had urolithiasis while 5 (10%) patients had gross hematuria due to trauma to renal tract. 3 (6%) males had hematuria due to enlarged vascular prostate and only 2 (4%) females had gross hematuria due to urinary tract infection. Conclusion: Urological malignancy was the most common cause of gross hematuria, which is associated with male gender, older age and history of smoking. Other causes were urolithiasis, trauma, BPH and UTI. We recommend screening for malignant disease of all the patients presenting to the departments of urology with the complaint of gross hematuria.

An Isolated Ureteropelvic Junction Injury Following a Low-impact Mechanical Fall

ObjectiveTo describe the presentation of a rare isolated ureteropelvic junction injury resulting from a mechanical fall on ice. Materials and MethodsA 71-year-old previously healthy man presented to the emergency department at the University of Massachusetts Medical School 3 hours following falling on ice with complaints of gross hematuria and flank pain. Patient records were accessed via the institution's electronic medical records system between March 22, 2018 and April 22, 2018. ResultsAbdominal imaging revealed urinary extravasation without evidence of accompanying injury to surrounding structures, confirming an isolated left ureteropelvic junction injury. ConclusionIsolated ureteral injury following low-impact blunt abdominal trauma is exceedingly rare. Furthermore, this patient's presentation challenges the accepted conventions for both mechanism of injury and accompanying clinical factors in ureteral trauma.

Metastases of Urothelial Carcinoma with Trophoblastic Differentiation that Responded to Combination Chemotherapy with Gemcitabine and Oxaliplatin : A Case Report

A 70-year-old man was admitted with complaint of gross hematuria. Cystoscopy and computed tomography (CT) revealed a 2.5 cm nodular tumor in the urinary bladder. Pathological diagnosis after the transurethral resection of bladder tumor (TURBT) was invasive urothelial cancer with trophoblastic differentiation of pT1. The tumor was positively stained with human chorionic gonadotropin (HCG). The serum HCG level was 12.8 IU/l in the fourth week after TURBT, and it increased to 35.7 IU/l in the 20th week after TURBT. However, radiological examination at this point did not reveal tumor recurrence or metastases. Three months later, the patient coughed up bloody sputum. Lung metastases (up to 2.4 cm) were identified, and they were surgically removed. The pathological specimen consisted of syncytiotrophoblastic giant cells with hemorrhage and necrosis, but no urothelial cancer element. Because the lung and lymph node metastases developed soon after surgery, chemotherapy was planned. Because the patient had impaired renal function with a creatinine clearance of 33.7 ml/min, we selected combination chemotherapy with gemcitabine and oxaliplatin (GEMOX) rather than cisplatin -based chemotherapy. CT after two courses of GEMOX showed stable disease, but HCG levels markedly decreased from 1,240 IU/l to 7.9 IU/l. This marker of response continued through six courses of GEMOX. Then, the chemotherapy was discontinued due to grade 2 neuropathy. He died of cancer 12 months after development of metastases. Autopsy revealed only tumor cells with trophoblastic differentiation, but no urothelial carcinoma in multiple metastatic sites.

Primary Mucinous Adenocarcinoma Of Urinary

A 60 year old male, chronic smoker and alcoholic since 30 years came with complaints of gross hematuria since 2 days. Clinically he was alright. CT scan showed a bladder mass reaching outside the serosa with no nodal involvement. Wide local excision was done with partial cystectomy. Growth was found on the dome of the bladder and was sent for histopathology. Sections showed tumour cells arranged in papillary pattern and lined by pseudostratified tall columnar epithelium filled with mucin and goblet cells at places. Intervening stroma shows abundant extracellular mucin, areas of necrosis and tumour cells showing malignant features with few areas with signet cells. Mucosal margins were also involved. Case diagnosed as Well differentiated mucinous Adenocarcinoma- Bladder. DOI: 10.21276/APALM.1610

Metastasis of renal cell carcinoma to the contralateral ureter

We herein report a rare case of renal cell carcinoma (RCC) that metastasized to the contralateral ureter. A 55-year-old man with a past history of right radical nephrectomy due to G3 pT1b clear cell RCC one year earlier presented to our department with a complaint of gross hematuria. On computed tomography, a ureteral tumor was found in both the left distal ureter and left hydronephrosis. The ureteral tumor was pathologically diagnosed by ureteroscopic biopsies as metastatic RCC, consistent with the primary renal tumor. Partial ureterectomy and end-to-end uretero-ureterostomy were performed. Pathologic examination of the resected tumor confirmed metastatic RCC. The post-operative course has been uneventful, and to date, the patient has remained disease-free.

61-Year-Old Man With Sudden Onset of Gross Hematuria

A 61-year-old man with a medical history of gastroesophageal reflux disease presented with complaints of gross hematuria for 2 days and occasional epistaxis for 1 week. The medication list included only ranitidine. Laboratory data showed significantly elevated prothrombin time and international normalized ratio. The liver panel was normal. On inspection, the patient's bottle of ranitidine, which was refilled 20 days before, contained 5-mg tablets of warfarin. The international normalized ratio and prothrombin time were reversed with FFP, vitamin K, and Novoseven.

Immunoglobulin G4–associated inflammatory pseudotumor of urinary bladder: a case report

A previously healthy 72-year old woman was admitted with a chief complaint of gross hematuria and fecaluria for 4 months. On initial computed tomographic examination, a lobulated shaped intravesical protruding mass with adhesion to the sigmoid colon was identified. Under a clinical diagnosis of bladder cancer with vesicosigmoid fistula vs sigmoid colon cancer with vesicosigmoid fistula, a frozen section evaluation of the bladder mass was performed to determine the origin of the tumor. Because the frozen section diagnosis of the bladder mass was an inflammatory origin, a partial cystectomy with segmental resection of the adherent sigmoid colon was elected. The microscopic examination of the partial resection of the urinary bladder revealed suburothelial inflammatory mass lesion, involving the entire wall of bladder with extension to the sigmoid colon, which was composed of spindle cells without significant atypia admixed with many lymphocytes, plasma cells, and some scattered eosinophils. Chronic inflammation around nerve bundles, sclerotic fibrosis, and prominent lymphoid follicles with plasma cells were the main features of the mass. No urothelial dysplasia or malignancy was seen. An average of 57 plasma cells per 1 high-power field was immunoreactive for immunoglobulin (Ig) G4 with IgG4/IgG ratio of more than 40%, a diagnostic feature of IgG4-associated inflammatory pseudotumor (IPT), arising in the bladder with the secondary involvement of the sigmoid colon. Recent studies reported many IPTs associated with IgG4 in other locations; however, to the best of our knowledge, IgG4-associated IPT in the urinary bladder has not been reported. We describe herein the first case of IgG4-associated IPT, lymphoplasmacytic type in the urinary bladder.

An experience of hyperbaric oxygen and transurethral coagulation combination therapy for abnormal vessels and intractable macrohematuria due to pelvic arteriovenous malformations

A 78-year-old man was admitted to our hospital with a chief complaint of gross hematuria. The patient was diagnosed with pelvic arteriovenous malformations and repeated arterial embolization. A cystoscopy demonstrated that bladder trigone was covered by many clots. At the same time, bleeding mucosa at the right side of the bladder dome was confirmed. We administered hyperbaric oxygen therapy 7 days after admission. Macrohematuria recovered gradually and we then performed transurethral coagulation at the dome with failed mucosa 14 days after admission. Macrohematuria recovered completely and there was no recurrence during hospitalization. Thirty days after admission, we performed cystoscopy and found clear mucosa in the trigone. The patient was discharged 32 days after admission.

集学的治療により長期生存が得られた転移性女性尿道淡明細胞癌の一例

We report a case of clear cell adenocarcinoma of the female urethra. A 57-year-old woman presented with complaint of gross hematuria. Abdominal ultrasonography, cystourethroscopy, computed tomography (CT) and magnetic resonance imaging (MRI) revealed the urethral tumor was invasive to bladder neck. Clinical stage was determined as cT3N1M0, then anterior pelvic exenteration and ileal conduit formation were performed. The pathological diagnosis was clear cell adenocarcinoma of urethra and the stage was pT3N1. The patient received TS-1 and cisplatin for postoperative recurrence, but she died from multiple lung metastasis 54 months after the operation. Clear cell adenocarcinoma of the female urethra is rare case in the Japanese literatures. Pathogenesis and management of this rare condition are discussed.

腎盂内破裂をきたした右腎動脈瘤の1例

We report a case of ruptured renal artery aneurysm into the renal pelvis. A 48-year-old woman presented with complaints of gross hematuria and right back pain. Abdominal ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) revealed the aneurysm, which was 5 x 5 cm in diameter. Enhansed CT revealed blood flow from the renal artery aneurysm into the renal pelvis. Radical nephrectomy was performed. Rupture of renal artery aneurysm into the renal pelvis is the 3rd case in the Japanese literatures. Pathogenesis and management of this rare condition are discussed.

Small-cell carcinoma of the kidney: Report of a case and review of the literature

Extrapulmonary small-cell carcinoma (EPSCC) is a rare small-cell carcinoma (SCC). It is recognized as a clinicopathological entity distinct from SCCs of the tracheobronchial tree. EPSCCs account for about 2.5% of all SCCs. SCCs of the kidney are an even rarer neoplasm. Abdominal pain and hematuria are the major clinical symptoms. Many cases are already advanced disease at diagnosis and have poor prognoses. Platinum-based chemotherapy seems to be beneficial for overall survival. We describe an 82-year-old male patient who was seen at the emergency room due to complaints of gross hematuria and right-flank pain. Computed tomography showed a large right renal tumor. Treatment modalities, pathologic features, survival outcome of this case, and a review of similar cases in the literature are presented and discussed. To the best of our knowledge, this is the 21st case of SCC of the kidney reported in the literature to date. It is also the first report in Taiwan of a primary SCC of the kidney with the tumor thrombus extending to the inferior vena cava which required a right radical nephrectomy.

膀胱肉腫様癌の1例

A 49-year-old female visited to our department with complaints of gross hematuria and micturition pain. Cystoscopic examination revealed a 5-cm diameter solid broad-based tumor located at the front wall of the bladder. Histologically, the tumor was composed of grade 2 urothelial carcinoma (UC) element and sarcomatous spindle cell element. Immunohistochemical examination demonstrated that both UC and spindle cells were positive for cytokeratin. In addition, spindle cells did not stain for S-100 protein or smooth muscle actin. We diagnosed the tumor as sarcomatoid carcinoma and performed total cystectomy and ileal conduit without chemotherapy and radiation. The patient has remained without any evidence of recurrence for 14 months after operation. Sarcomatoid carcinoma of the bladder has aggressive malignant potential and poor prognosis. An appropriate adjuvant therapy for sarcomatoid carcinoma with metastasis has not been established. Total cystectomy is recommended as soon as possible after pathological diagnosis in the same manner as conventional high grade UC.

Botryoid Wilms’ tumor of the renal pelvis extending into the bladder

We report a case of botryoid Wilms’ tumor that occupied the renal pelvis and extended into the bladder. A 3-year-old boy was referred to us with a chief complaint of gross hematuria and micturition pain. Computed tomography showed tumor occupying the right renal pelvis and ureter and extending into the bladder. Right radical nephroureterectomy was performed. The resected specimen showed a botryoid sarcoma-like appearance, occupied the right renal pelvis and ureter, and protruded into the bladder. Histologic findings showed typical triphasic Wilms’ tumor. Botryoid Wilms’ tumor has been reported in only 16 cases in the literature and in only 3 cases extended into the bladder.

Adénocarcinome à cellules en bague à chaton primitif de la vessie : à propos d'un cas

Primary signet ring cell carcinoma of urinary bladder is a rare tumor; accounting for approximately 0.24% of all bladder malignancies. In this study, we report a case of a 58-year old man who consulted for complaints of gross hematuria, the bladder biopsy showed signet ring cell carcinoma; the exploration of gastrointestinal tract did not reveal any other tumor localizations. A total cystoprostatectomy was performed followed by radiotherapy. The aim of this study is to determine the anatomoclinical, therapy and evolution characteristics of this rare tumor.

Transitional cell carcinoma in children: report of a case and review of the literature.

Transitional cell carcinoma (TCC) of the bladder is a rare condition in the first 2 decades of life, and it occurs nearly 9 times more frequently in males as it does in females. Since 1950, only 100 cases of TCC of the bladder have been reported in patients younger than 21 years.(1) TCC of the bladder in children under 10 years is extremely rare, and by 1983, it was reported in only 17 cases.(2) The aim of this study is to report TCC of the bladder in a 9-year-old girl, who was referred to our institution with a chief complaint of gross hematuria.

Primary signet ring cell carcinoma of the urinary bladder successfully treated with intra-arterial chemotherapy alone

A 65-year-old man presented with the complaint of gross hematuria. Cystoscopy revealed a sessile tumor on the left bladder wall. It was diagnosed as primary signet ring cell carcinoma of the bladder (T3bN0M0). The patient did not want surgical treatment. Therefore, three courses of arterial infusion of carboplatin were administered at 3-week intervals. Complete remission was obtained and has been maintained for 44 months. Our case appears to be the first report of successful treatment with chemotherapy alone of an infiltrating signet ring cell carcinoma of the bladder.