A decision tree to guide long term venous access placement in children and adolescents undergoing surgery for renal tumors.

Background/purpose: While many children with renal tumors require long term venous access (VA) for adjuvant chemotherapy, certainly not all do. This study develops and tests a VA decision tree (DT) to direct the placement of VA in patients with renal tumors.

Methods: Utilizing data readily available at surgery a VADT was developed.

Reliability of intraoperative frozen section for the diagnosis of renal tumors suspicious for malignancy in children and adolescents.

Background: The ability of intraoperative frozen section (IFS) to reliably diagnose renal tumors in children and adolescents is largely unknown. The objective of our study is to evaluate the ability of IFS to establish a histologic diagnosis for renal tumors in this population.

Methods: We reviewed our experience with patients who underwent IFS at the time of surgery for a renal tumor suspicious for malignancy from 2005 to 2015.

Large Cystic Metanephric Adenoma in a 15-Year-Old Girl.

Metanephric adenoma is a rare pediatric renal tumor, generally considered to be benign. It can be difficult to distinguish from Wilms tumor and renal cell carcinoma based on imaging alone, and even may be difficult on histopathologic analysis. We present a case of a large cystic metanephric adenoma managed with surgical resection.

Long-term urological outcomes in cloacal anomalies.

Cloacal anomalies are the most complex and severe form of congenital anorectal malformations (ARM) and urogenital malformations, and it has been well documented that increased severity of ARM leads to worse outcomes. While short-term data on persistent cloaca are available, a paucity of data on long-term outcomes exists, largely because of a lack of uniform terminology, inclusion with other ARM and evolution of the operative technique. On comprehensive review of the published literature on long-term urological outcomes in patients with cloacal anomalies, we found a significant risk of chronic kidney disease and incontinence, however, with improvements in surgical technique, outcomes have improved.

Do Referral Patterns in Adolescents and Young Adults with Testicular Cancer Impact Oncologic Outcomes?

Purpose: Oncologic outcomes in advanced testicular cancer (TC) depend on appropriate and timely care. Often this care is referred to tertiary academic medical centers (AMCs). The aim of this study was to compare oncologic outcomes of adolescent and young adult (AYA) patients with TC treated from the outset at an AMC to those whose care was initiated elsewhere with subsequent referral.

Current urologic care for testicular germ cell tumors in pediatric and adolescent patients.

Testicular germ cell tumors make up 0.5% of pediatric malignancies, and 14% of adolescent malignancies. Young boys have primarily pure teratoma and pure yolk sac histologies; however, adolescent histology is mostly mixed nonseminomatous germ cell tumor.