An unusual location for metastasis - Breast cancer in the bladder.

Metastatic breast cancer is the second most common cancer related death amongst women in the United States. The common locations for metastases-lymph nodes, bone, lung, liver, brain - are well reported. Rarely, breast cancer metastasizes to the bladder.

Do commonly used prostate medications alter prostate MRI and fusion biopsy performance?

Aims: To determine whether phosphodiesterase inhibitors (PDEi) or α-antagonists (AA) were associated with differences in region of interest (ROI) characteristics or prostate cancer detection on fusion biopsy (FB).

Materials And Methods: Records from 847 consecutive patients undergoing FB at three separate institutions over a period of 2 years were retrospectively reviewed. Associations between medication use, Prostate Imaging Reporting & Data System (PIRADS) scores, and ROI locations were assessed with ordinal logistic regression.

Initial Experience of Magnetic Resonance Imaging Fusion Biopsy in the Community Setting.

Introduction: Magnetic resonance imaging fusion biopsy is diagnostically superior to transrectal ultrasound guided biopsy for detecting clinically significant prostate cancer. Fusion biopsy has an expanding role at major academic centers. However, the reproducibility of outcomes in the community setting is unknown.

Primary myxoid and epithelioid mesenchymal tumor of the kidney with a novel GLI1-FOXO4 fusion.

To our knowledge, we describe the first mesenchymal tumor with a novel GLI1-FOXO4 fusion gene. This well-circumscribed kidney tumor displayed variably myxoid and epithelioid histologic features with a focally nodular growth pattern. The tumor cells showed bland, round to ovoid nuclei, with no overt high-grade features.

Mischievous malakoplakia: A potential pitfall of mpMRI of the prostate?

Interpretation of multiparametric magnetic resonance imaging (mpMRI) for prostate cancer diagnosis and staging can be challenging and, in some cases, benign prostate disease can mimic locally advanced malignancy. We present the case of a 57 year-old male with biopsy-proven Gleason 3 + 4 prostate cancer and a preoperative mpMRI showing extraprostatic extension who was later found to have infiltrating malakoplakia on final surgical pathology. This case highlights the importance of recognizing that malakoplakia of the prostate can present as a PI-RADS 5 lesion with extracapsular extension on mpMRI.

A case of contralateral superficial inguinal recurrence of testicular embryonal carcinoma.

Metastatic embyronal carcinoma to the subcutaneous tissues is rare. Prior cases have occurred in the setting of undiagnosed widely metastatic disease. Here we present the first case of metastatic embyronal cancer to the contralateral subcutaneous inguinal region in the absence of any other sites of metastatic disease.

'Dr Google': trends in online interest in prostate cancer screening, diagnosis and treatment.

Objectives: To examine trends in online search behaviours related to prostate cancer on a national and regional scale using a dominant major search engine.

Materials And Methods: Google Trends was queried using the terms 'prostate cancer', 'prostate-specific antigen' (PSA), and 'prostate biopsy' between January 2004 and January 2019. Search volume index (SVI), a measure of relative search volume on Google, was obtained for all terms and examined by region and time period: pre-US Preventive Services Task Force (USPSTF) Grade D draft recommendation on PSA screening; during the active Grade D recommendation; and after publication of the recent Grade C draft recommendation.

Brief report: Impact of healthcare quality on prostate specific antigen screening for the early detection of prostate cancer.

With recent guidelines emphasizing patient values, patient preferences and shared decision-making in regards to prostate specific antigen (PSA) screening it is important for primary care providers and urologists to identify factors that influence men's decisions to undergo PSA screening. We sought to evaluate the impact of men's perceptions of healthcare quality on obtaining a screening PSA for the early detection of prostate cancer. A retrospective secondary data analysis was conducted of men ages 55-69 without a history of prostate cancer using 2015 Medical Expenditure Panel Survey (MEPS) data.

Acquired Hemophilia presenting as Gross Hematuria following Kidney Stone - A Case Report and Review of the Literature.

A rare condition in itself, acquired hemophilia A, seldom presents as isolated gross hematuria. It is a serious condition with a high mortality rate and thus clinical suspicion followed by prompt diagnosis is imperative (1). In fact, only 8 cases of such presentation of this condition have been reported thus far in the literature.

Primary renal lymphoma: an unusual finding following radical nephrectomy.

Secondary kidney involvement by disseminated non-Hodgkin's lymphoma (NHL) is quite common and is estimated to approach 30 - 60% in NHL patients. However, primary renal lymphoma is exceedingly rare and estimated to make up less than 1% of all kidney masses. We report a case of primary renal NHL presenting with profound hypercalcemia and renal failure recalcitrant to medical management, ultimately treated with urgent radical nephrectomy.

Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy.

Purpose: To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy.

Materials And Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics.

Clinical Outcomes After Neoadjuvant Chemotherapy and Radical Cystectomy in the Presence of Urothelial Carcinoma of the Bladder With Squamous or Glandular Differentiation.

Unlabelled: We assessed 126 patients with cT1-4, N0-2 urothelial carcinoma of the bladder who were treated with neoadjuvant chemotherapy followed by radical cystectomy. Twenty patients (16%) had squamous or glandular histological variation (HV). Significant pathologic downstaging (pT<2, N0) was seen in the HV patients (60% vs.

Minimally invasive post-chemotherapy retroperitoneal lymph node dissection for nonseminoma.

Introduction: We present our experience with minimally-invasive retroperitoneal lymph node dissection (MI-RPLND) in the post-chemotherapy (PC) setting for residual masses in patients with nonseminoma.

Materials And Methods: Nineteen men who underwent PC MI-RPLND (14--laparoscopic, 5--robotic) for low-volume residual disease (no more than 5 clinically enlarged retroperitoneal masses, size < 5 cm, no adjacent organ or vascular invasion) between 2006 and 2011 were identified. Clinicodemographic information and pathological outcomes were reported.

Oncological and functional outcomes of salvage renal surgery following failed primary intervention for renal cell carcinoma.

Purpose: To assess the oncologic and functional outcomes of salvage renal surgery following failed primary intervention for RCC.

Materials And Methods: We performed a retrospective review of patients who underwent surgery for suspected RCC during 2004-2012. We identified 839 patients, 13 of whom required salvage renal surgery.

Using percentage of sarcomatoid differentiation as a prognostic factor in renal cell carcinoma.

Background: The objective of this study was to determine if the percentage of sarcomatoid differentiation (%Sarc) in renal cell carcinoma (RCC) can be used for prognostic risk stratification, because sarcomatoid RCC (sRCC) is an aggressive variant of kidney cancer.

Patients And Methods: We performed a retrospective analysis of patients who underwent surgery for RCC at our institution between 1999 and 2012. Pathology slides for all sRCC cases were reexamined by a single pathologist and %Sarc was calculated.

Clinicopathological correlates of Gli1 expression in a population-based cohort of patients with newly diagnosed bladder cancer.

Introduction: Dysregulation of the hedgehog signaling pathway has been linked to the development and progression of a variety of different human tumors including cancers of the skin, brain, colon, prostate, blood, and pancreas. We assessed the clinicopathological factors that are potentially related to expression of Gli1, the transcription factor that is thought to be the most reliable marker of hedgehog pathway activation in bladder cancer.

Methods: Bladder cancer cases were identified from the New Hampshire State Cancer Registry as histologically confirmed primary bladder cancer diagnosed between January 1, 2002, and July 31, 2004.

Effect of tumor size on recurrence-free survival of upper tract urothelial carcinoma following surgical resection.

Objective: To identify predictors of recurrence-free survival (RFS) based on the clinicopathological features of patients with upper tract urothelial carcinoma (UTUC) who have undergone radical nephroureterectomy (RNU) with bladder cuff resection.

Materials And Methods: We retrospectively reviewed the records of patients from October 1998 to July 2012 at our tertiary institution and identified 120 patients with sufficient data who underwent RNU for UTUC. We recorded various clinical and histopathological parameters as potential predictors of outcome.

New therapeutic targets in the management of urothelial carcinoma of the bladder.

Urothelial carcinoma of the bladder, despite the myriad of treatment approaches and our progressively increasing knowledge into its disease processes, remains one of the most clinically challenging problems in modern urological clinical practice. New therapies target biomolecular pathways and cellular mediators responsible for regulating cell growth and metabolism, both of which are frequently overexpressed in malignant urothelial cells, with the intent of inducing cell death by limiting cellular metabolism and growth, creating an immune response, or selectively delivering or activating a cytotoxic agent. These new and novel therapies may offer a potential for reduced toxicity and an encouraging hope for better treatment outcomes, particularly for a disease often refractory or not amenable to the current therapeutic approaches.

[Cryosurgery for prostate cancer: a comprehensive review].

Objectives: Cryosurgery for prostate cancer has evolved to become a reasonable treatment alternative for localized prostate cancer. The advent of third-generation machines and smaller cryoprobes together with better imaging modalities allows for precise treatment of the prostate in the primary, salvage and focal setting.

Methods: A comprehensive review of the literature was performed from 1980 to January 2013 searching the Medline database.

Urinary tract infections in children: recommendations for antibiotic prophylaxis and evaluation. An evidence-based approach.

Urinary tract infections (UTIs) are common in children, but the routine work-up and treatment recommendations are still controversial. Long-term complications, including renal scarring, hypertension, and renal failure, have been the main concern and the reason for use of antibiotic prophylaxis and invasive imaging techniques. In the past several years, numerous studies have been published comparing different imaging protocols and questioning the use of antibiotic prophylaxis.