An unusual complication of ureteral double-J stent placement: ureteral perforation

Ureteral double-J stent implantation has become a routine procedure in the management of a variety of urinary tract pathologies. Although this is a safe and simple procedure, there can be unexpected severe complications such as malpositioning, encrustation, ureteral erosion, intravascular migration, hematoma and ureterovascular fistula. Intraoperative fluoroscopic examination and postoperative imaging modalities are useful in early diagnosis and prevention of these complications. We present a case of right ureteral perforation during retrograde double-J stent implantation. To our knowledge ureteral perforation due to double-J stent placement has not been previously described

The clinicopathologic observation, c-KIT gene mutation and clonal status of gastrointestinal stromal tumor in the sacrum

<p>Abstract</p> <p>Background</p> <p>It is very rare that gastrointestinal stromal tumor (GIST) occurs in the sacrum. Only one case of GIST occuring in the sacral region, with intracranial metastasis, has been reported in the literature. Moreover, only few cases have been published in literature about its clonal origin.</p> <p>Case presentation</p> <p>In this report, we present a rare case of GIST occuring in the sacrum and describe its clinicopathologic features, c-KIT gene mutation and clonal status. Microscopically, the lesion was composed of spindle cells arranged in cords, knitted and whirlpool patterns. Trabecula of bone were found in the lesion. The cytoplasm of tumor cells were abundant, and the nuclei were fusiform. Mitotic figures were rare. Immunohistochemically, the tumor cells showed positive reactivity for CD117 and CD34. On mutation analysis, a c-KIT gene mutation was found in exon 11. The result of clonal analysis demonstrated that the GIST was monoclonal.</p> <p>Conclusion</p> <p>In summary, we showed that tumor material, phenotypically identical with GISTs was found in the sacrum. It is difficult to differentiate GISTs from other spindle cell tumors, hence the need for immunohistochemistry, the examination of c-KIT gene amplification and sequencing.</p