Ewing's sarcoma of the male external genitalia: a case report and review of the literature.

Background: Ewing's sarcoma (ES) within the genitourinary tract are relatively unheard of and those within the external male genitalia are even rarer. To our knowledge, this is the first known case of primary ES within the paratesticular region in an adult.

Case Presentation: We present a case of a 24-year-old man with a right sided testicular mass on examination that was initially characterized as an adenomatoid tumor on ultrasound.

Comparing Survival Outcomes and Costs Associated With Radical Cystectomy and Trimodal Therapy for Older Adults With Muscle-Invasive Bladder Cancer.

Importance: Radical cystectomy is the guidelines-recommended treatment of muscle-invasive bladder cancer, but a resurgence of trimodal therapy has occurred. Limited comparative data are available on outcomes and costs attributable to these 2 treatments.

Objective: To compare the survival outcomes and costs between trimodal therapy and radical cystectomy in older adults with muscle-invasive bladder cancer.

Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass.

Supernumerary testis, also known as polyorchidism, is a condition characterized by the presence of more than two testes. Another condition of the testes is seminoma, a common cause of testicular germ cell tumor. A 35-year-old male was transferred to our hospital with a diagnosis of abdominal mass causing abdominal pain.

Atypical small acinar proliferation at index prostate biopsy: rethinking the re-biopsy paradigm.

Purpose: Guidelines for atypical small acinar proliferation (ASAP) diagnosed on prostate biopsy recommend repeat biopsy within 3-6 months after diagnosis. We sought to discern the rate of detecting clinically significant prostate cancer on repeat biopsy and predictors associated with progression.

Materials And Methods: We performed a retrospective chart review of patients who underwent prostate biopsy at our institution from January 1, 2008, to December 31, 2015.

Cancer and All-cause Mortality in Bladder Cancer Patients Undergoing Radical Cystectomy: Development and Validation of a Nomogram for Treatment Decision-making.

Objective: To develop and validate a nomogram assessing cancer and all-cause mortality following radical cystectomy. Given concerns regarding the morbidity associated with surgery, there is a need for incorporation of cancer-specific and competing risks into patient counseling and recommendations.

Materials And Methods: A total of 5325 and 1257 diagnosed with clinical stage T2-T4a muscle-invasive bladder cancer from January 1, 2006 to December 31, 2011 from Surveillance, Epidemiology, and End Results-Medicare and Texas Cancer Registry-Medicare linked data, respectively.

Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer.

Background: The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer.

Materials And Methods: A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI-IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis.

Survival differences among patients with bladder cancer according to sex: Critical evaluation of radical cystectomy use and delay to treatment.

Objective: Sex differences in bladder cancer survival are well known. However, the effect of type of treatment, timing to surgery when rendered, and survival outcomes according to sex have not been extensively examined. Given the relatively low incidence of bladder cancer in females, large multicenter and population-based studies are required to elucidate sex differences in survival.

Novel intronic germline FLCN gene mutation in a patient with multiple ipsilateral renal neoplasms.

Multiple renal tumors of diverse morphology are rare and typically seen in Birt-Hogg-Dubé syndrome. Birt-Hogg-Dubé syndrome is a rare inherited cancer syndrome caused by a germline mutation in the folliculin (FLCN) gene, but the genetic causes for histologic diversity of renal tumors in Birt-Hogg-Dubé syndrome have not been elucidated. We describe here a 64-year-old man with a novel germline mutation in the FLCN gene who presented with 3 phenotypically distinct renal tumors in the same kidney, which were histologically classified as oncocytoma (1.

Ductal prostate cancer: contemporary management and outcomes.

Objectives: To evaluate contemporary management and outcomes of ductal prostate cancer (PCA).

Materials And Methods: We reviewed all patients with ductal PCA and at least 6 months of follow-up seen at UTMB from 1990 to 2005, which comprised 17 patients (mean age: 67.7 years, range 55-87).

Characteristics of urologists predict the use of androgen deprivation therapy for prostate cancer.

Purpose: We previously have reported wide variations among urologists in the use of androgen deprivation for prostate cancer. Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we examined how individual urologist characteristics influenced the use of androgen deprivation therapy.

Methods: Participants included 82,375 men with prostate cancer who were diagnosed from January 1, 1992, through December 31, 2002, and the 2,080 urologists who provided care to them.

Retroperitoneal mucinous cystadenocarcinoma in a man: case report and review of the literature.

In the English medical literature, 27 cases of primary retroperitoneal mucinous cystadenocarcinoma have been published. We report the second case of a primary retroperitoneal mucinous cystadenocarcinoma in a man. The patient was an 83-year-old man, with a large 26 x 20 x 16-cm retroperitoneal cystic mass causing abdominal discomfort and cachexia, who underwent excision of the mass.

Isolated recurrence of ductal prostate cancer to anterior urethra.

We report the case of a 74-year-old man with ductal prostate cancer who had originally undergone radiotherapy but developed metastases to the anterior urethral mucosa. This is the fourth such case ever reported in English publications. We suspect the metastases developed from implantation after instrumentation, a common finding in the previously reported cases.

Increasing use of gonadotropin-releasing hormone agonists for the treatment of localized prostate carcinoma.

Background: The role of androgen deprivation therapy in prostate carcinoma is controversial in earlier stages of disease. The authors examined the time trends and patterns of use for androgen deprivation in the form of gonadotropin-releasing hormone (GnRH) agonists or orchiectomy, in population-based tumor registries.

Methods: Data were obtained from the linked Surveillance, Epidemiology and End Results-Medicare database.

Arterialization of deep dorsal vein of penis for penile ischemia.

Penile ischemia, a rare complication of diabetic end-stage renal disease, is usually treated by penectomy once conservative measures fail. We present a patient with diabetes mellitus and end-stage renal disease with penile ischemia that was successfully treated with an arteriovenous interposition bypass graft between the common femoral artery and the deep dorsal vein of the penis. Retrograde flow into the corpus spongiosum resulted in immediate pain relief and healing of the ischemic lesions.

Renal and perirenal abscesses in patients with otherwise anatomically normal urinary tracts.

Purpose: We characterized evaluation, management and outcomes in a group of patients diagnosed with renal and perirenal abscesses who had otherwise anatomically normal urinary tracts.

Materials And Methods: We reviewed our experience with renal/perirenal abscesses at University of Texas Medical Branch from 1991 to 2002. Treatment was determined by physician preference in each individual.

Testicular involvement in disseminated fungal infection by Pseudallescheria boydii.

We present an immunocompromised patient with a painless testicular mass. Usually, this mass is suspicious for testicular cancer; however, a fungal abscess from Pseudallescheria boydii was found. The patient eventually died from disseminating infection.

Renal and peri-renal abscesses in children: proposed physio-pathologic mechanisms and treatment algorithm.

Renal and perinephric abscess in children are uncommon. Three basic pathophysiologic mechanisms are involved, namely, hematogenous spread, ascending infection and contamination by proximity to an infected area. Six pediatric patients diagnosed with renal abscess were treated at our institution from 1990-2000.

Genital and perineal burns in children: 10 years of experience at a major burn center.

Purpose: The aim of this report is to review a decade of experience in the management of perineal and genital burns at a major burn center.

Methods: Seventy-eight children who sustained perineal or genital burns admitted to the Shriners Hospitals for Children in Galveston are discussed.

Results: Genital and perineal burns occurred in the context of major burns and were rarely isolated.

Acute renal failure due to rhabdomyolysis associated with radical perineal prostatectomy.

We report a case of acute renal failure due rhabdomyolysis as a result of the exaggerated lithotomy position during radical perineal prostatectomy. The pathogenesis, diagnosis, management, and preventive measures of acute renal failure associated with rhabdomyolysis are also reviewed.

Spontaneous rupture of adrenal myelolipoma: spiral CT appearance.

We report the helical computed tomographic findings of a symptomatic giant (11 cm) adrenal myelolipoma with spontaneous extracapsular hemorrhage. Narrow collimation (3 mm) imaging and three-dimensional reconstructions were useful to fully characterize the components and location of the lesion. A literature search showed a striking male and right-sided predominance for spontaneously hemorrhagic myelolipomas.

Laser ablation of urethral hair.

Background And Objective: Two separate cases involving laser ablation of hair follicles in the neourethra are described.

Study Design/materials And Methods: Urethral hair developed secondarily to free-flap urethroplasty for congenital urethral defects. In both cases, cystoscopic depilation with electrocautery fulguration was attempted on multiple occasions.

Delta-aminolevulinic acid-mediated photosensitization of prostate cell lines: implication for photodynamic therapy of prostate cancer.

Background: Delta-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) is currently being investigated for the treatment of prostate diseases. In this study, we evaluate 1) the in vitro production of protoporphyrin IX (PPIX) (the active photosensitizing agent of ALA-mediated PDT) by two different prostate cancer cell lines (LNCaP and PC-3) and a benign, modified, prostatic cell line (TP-2), and 2) the extent of PDT-induced cell injury, as determined by electron microscopy (EM) and cell survival.

Methods: The cell lines were assigned into four treatment groups: group 1, control, no ALA and no light irradiation; group 2, dark control, ALA only; group 3, light control, radiation only; and group 4, PDT, ALA followed by irradiation (630 nm, 3 joules/cm2).