Phallus Preservation for Locally Advanced Proximal Primary Urethral Carcinoma: Technique and Outcomes.

Introduction: To describe a novel method of penile sparing perineal urethrectomy for locally advanced proximal primary urethral cancers (PUC).

Technical Considerations: In mid-2021, 2 cases underwent pelvic exenterative surgery for pT3 and pT4 PUC. The procedure comprised of a complete urethrectomy, proximal penectomy, en bloc pubectomy and excision of pelvic diaphragm in both cases.

An approach to evaluating scrotal skin-based lesions: A case report of Basal Cell Carcinoma of the Scrotum in patient with multiple risk factors.

Basal cell carcinoma (BCC) is rare on non-sun exposed skin such as the scrotum and thus diagnosis is often delayed. This case highlights an approach to scrotal skin lesions, risk factors and diagnostic features of BCC. Importantly, scrotal BCCs are more likely to metastasise than non-scrotal BCCs.

Epithelioid sarcoma of the penis: A penile sparing approach, and long-term implications.

A 33-year-old male presented with a one-centimetre lesion at the penoscrotal junction which was excised and revealed to be an epithelioid sarcoma (ES). A wide local excision of the lesion and subsequent neoadjuvant radiotherapy followed, with transposition of the patient's testicles laterally to protect fertility. At 3-year follow-up, the patient has no local or distant recurrence but does have a low sperm count.

Don't be fooled by the fat: A rare case of renal cell carcinoma with intratumoural fat.

Angiomyolipoma (AML) is a benign renal tumour composed of fat, smooth muscle and blood vessels. Radiologic evidence of macroscopic fat within a solid renal lesion on computed tomography was historically thought to be pathognomonic for this condition. Herein, we report a case of an incidental solid renal cell mass with multiple foci of intra-tumoral fat, which was shown to be a clear cell renal cell carcinoma (RCC) at nephrectomy.

Tumour innervation and neurosignalling in prostate cancer.

Prostate cancer progression has been shown to be dependent on the development of autonomic nerves into the tumour microenvironment. Sympathetic nerves activate adrenergic neurosignalling that is necessary in early stages of tumour progression and for initiating an angiogenic switch, whereas parasympathetic nerves activate cholinergic neurosignalling resulting in tumour dissemination and metastasis. The innervation of prostate cancer seems to be initiated by neurotrophic growth factors, such as the precursor to nerve growth factor secreted by tumour cells, and the contribution of brain-derived neural progenitor cells has also been reported.

Tumor Neurobiology and the War of Nerves in Cancer.

Nerves are emerging regulators of cancer progression. Cancer cells induce the outgrowth of nerves in the tumor microenvironment through the release of neurotrophic factors, and in return nerves liberate neurotransmitters that activate cancer growth and dissemination. Although sympathetic nerves drive tumor angiogenesis via the liberation of noradrenaline, sensory and parasympathetic nerves stimulate cancer stem cells.

Can CRP velocity in right iliac fossa pain identify patients for intervention? A prospective observational cohort study.

Introduction: Previous studies have shown single CRP measurements at time of presentation to have limited predictive benefit for appendicitis. Our objective was to determine the diagnostic utility of serial CRP measurements (to determine CRP velocity [CRPv]) in patients with right iliac fossa (RIF) pain.

Methods: A single-centre prospective observational study was conducted on adult patients admitted with RIF pain.

Management and outcomes of Gleason six prostate cancer detected on needle biopsy: A single-surgeon experience over 6 years.

Objective: To assess the management and oncological outcomes in men diagnosed with Gleason score (GS) 6 prostate cancer on needle biopsy in a regional centre, as compared with published international data.

Materials And Methods: A retrospective analysis was conducted of patients who were diagnosed with GS 6 prostate cancer via transrectal ultrasound-guided or transperineal biopsy between June 2009 and September 2015 under the care of a single surgeon. Data were obtained from a prospectively collected database.

Ureteric Obstruction From Malignant Melanoma in Both Right Double Moiety and Left Single Moiety Ureters.

We report the first documented case of malignant melanoma obstructing ureters of both moieties of a duplex kidney and contralateral single moiety ureter in a 51-year-old male. The patient presented with fever, coryzal symptoms, and liver function test derangement several years after 2 superficial spreading melanomas were excised with clear margins. Ultrasonography demonstrated hydronephroureter in both moieties of a complete right-sided duplex kidney.

Single-stage laparoscopic cholecystectomy and intraoperative endoscopic retrograde cholangiopancreatography: is this strategy feasible in Australia?

Currently in Australasia, concomitant cholecystolithiasis and choledocholithiasis are usually managed with two procedures: laparoscopic cholecystectomy (LC) and pre or postoperative endoscopic retrograde cholangiopancreatography (ERCP). This approach exposes the patient to the risk of complications from the common bile duct stone(s) while awaiting ERCP, the risks of the ERCP itself (particularly pancreatitis) and the need for a second anaesthetic. This article explores the evidence for a newer hybrid approach, single stage LC and intraoperative ERCP (SSLCE) and compares this approach with the commonly used alternatives.

Epidemiology of enteroviral meningoencephalitis in neonates and young infants.

Aim: To describe the epidemiology of enteroviral meningoencephalitis in northern New South Wales, Australia, with a specific focus on neonatal and young infant cases.

Methods: A retrospective review of PCR-confirmed enteroviral meningoencephalitis cases in the Hunter New England Local Health District of northern NSW was conducted for the period 2008-2012.

Results: One hundred nine patients met the case definition.