Ectopic Renal Tissue Research Articles

Zinner’s syndrome: to observe or to operate? a triplet of cases with varying clinical presentation

Zinner's syndrome is a rare condition that can be challenging to diagnose and manage. Limited knowledge about its natural history and optimal treatment further complicates matters. To shed more light on this condition, we present a case series of three patients with Zinner's syndrome, highlighting their clinical presentations, diagnostic workup, and treatment options. Our first patient was a 16-year-old male with left epididymo-orchitis and left renal agenesis. The second patient was a 25-year-old male with left epididymo-orchitis, left seminal vesicle cyst, and left renal agenesis. The third patient was a 65-year-old male with left seminal vesicle cysts and aplastic ectopic renal tissue with ectopic ureteral insertion into the seminal vesicle cyst causing acute urinary retention. The two patients who presented with epididymo-orchitis were managed conservatively while the one presenting with acute urinary retention required surgical exploration and excision. It is noted that diagnosis of Zinner's syndrome requires a high index of suspicion, and radiological imaging is crucial for confirmation. Surgical intervention is often necessary to treat symptomatic compression, and fertility counselling is necessary due to the potential for impaired semen quality. Close monitoring is needed due to the risk of renal impairment in the future.

1254 DYNAMIC FLUORODEOXYGLUCOSE -POSITRON EMISSION TOMOGRAPHY ACCURATELY IDENTIFIES AND LOCALISES ECTOPIC RENAL TISSUE IN GIRLS WITH CONSTANT URINARY DAMPNESS

You have accessJournal of UrologyPediatrics: Imaging Genital & Urinary Tract/Infections and Vesicoureteral Reflux/Andrology - Cryptorchidism & Varicoceles1 Apr 20101254 DYNAMIC FLUORODEOXYGLUCOSE -POSITRON EMISSION TOMOGRAPHY ACCURATELY IDENTIFIES AND LOCALISES ECTOPIC RENAL TISSUE IN GIRLS WITH CONSTANT URINARY DAMPNESS Chris Kimber, Rod Hicks, Neil McMullin, Yves Heloury, and Wei Cheng Chris KimberChris Kimber Hawthorn, Australia More articles by this author , Rod HicksRod Hicks Melbourne, Australia More articles by this author , Neil McMullinNeil McMullin Melbourne, Australia More articles by this author , Yves HelouryYves Heloury Melbourne, Australia More articles by this author , and Wei ChengWei Cheng Melbourne, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.799AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ectopic ureters in girls can cause constant urinary dampness (CUD) and be difficult to detect and localise. Standard investigations (nuclear medicine, ultrasound, magnetic resonance urography) are usually negative. Laparoscopy may often identify and enable correction of the anatomical abnormality. We describe a novel imaging technique that enables accurate pre-operative diagnosis and localisation of the ectopic renal tissue, ureter and site of opening. METHODS 17 girls (aged 5-17) presented with CUD over a 12 year period (1997-2009) and all were ultimately found to have ectopic ureters. There were 3 clinical scenarios: 1) Solitary kidney (n= 9); 2) Previous multicystic kidney (n=3); 3) Unilateral duplex renal system (n = 5). Prior to 2007, 13 girls had undergone exploratory laparoscopy (n = 12) or open surgery (pelvic dissection n =1 or renal bed exploration n=1). All standard investigations including cystoscopies had failed to identify the abnormal ectopic ureters. Since 2007 we developed a dynamic fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan to identify these difficult renal abnormalities for girls with CUD. RESULTS The next 4 girls with CUD underwent dynamic FDG PET after all investigations including cystoscopy were negative. In all cases the scan SUCCESSFULLY identified the site, side and drainage route of the ectopic system. Vaginal filling was demonstrated in all 4 girls. Appropriate surgery (pelvic laparoscopy n=2, laparoscopic heminephrectomy n=1 and laparoscopic uretero-ureterostomy n=1) results in complete resolution of symptoms in all four cases. CONCLUSIONS Dynamic FDG PET allows accurate localisation and diagnosis of all cases. This investigation facilitates accurate surgical planning and avoids blind exploratory surgery. Further advanced isotopes are currently being introduced to improve the anatomical resolution. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e485 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Chris Kimber Hawthorn, Australia More articles by this author Rod Hicks Melbourne, Australia More articles by this author Neil McMullin Melbourne, Australia More articles by this author Yves Heloury Melbourne, Australia More articles by this author Wei Cheng Melbourne, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Ectopic immature tenal tissue: Report of two cases

We present two cases of ectopic renal tissue. The first case had a small retroperitoneal nodule near the lower pole of the left kidney, in which the tissue was associated with nervous tissue and differentiating skeletal muscle fibers. The other case presented with a yuxtaepididimal nodule and also contained small groups of ovary hilius like cells. The possibility is raised that ectopic rests like these might be the source of extrarenal Wilms' tumours associated or not with teratomas.