Primary Renal Synovial Sarcoma Presenting as Haemorrhagic Shock: A Rare Presentation

Primary synovial sarcoma (PSS) of the kidney is considered the rarest type of all renal sarcomas with specific chromosomal translocation t (X; 18) (p11.2; q11.2). We report the case of a 65-year-old man with no medical conditions who presented to the emergency department with sudden severe right flank pain associated with haemodynamic instability and haemorrhagic shock. Computed tomography (CT) of the abdomen and pelvis revealed a right renal mass. A right open radical nephrectomy was performed. Histopathology revealed a monophasic synovial sarcoma. The patient received six cycles of docetaxel and gemcitabine as adjuvant chemotherapy. No sign of recurrence was seen on a follow-up CT urogram. This rare tumour often presents atypically, and clear guidelines regarding appropriate treatment are lacking. Our case showed that treatment with docetaxel/gemcitabine after an open radical nephrectomy is promising

Partial Nephrectomy A Comparison between Different Modalities

Kidney cancer, with 4% of all malignancies, is one of the most common malignancies occurring among in adults. In Saudi Arabia, kidney cancer comprises 2.3% of all cancers, and its incidence has increased by 33%. Partial nephrectomy (PN) is considered as the gold standard for T1 renal masses. In this retrospective study, we did a chart review for all patients who underwent PNs between April 2013 and February 2019. Data comprised pre-sentation, tumor size, type of procedure (open vs. laparoscopic vs. robotic), and intra- and post-operative complications. Chi-square, ANOVA, and cross-tabulation were done using SPSS software. P > 0.05 was considered significant. Approval was obtained from the institutional review board of King Abdullah International Medical Research Center. In all, 69 patients were identified: 26 (37.7%) males and 43 (62.3%) females, with mean age = 54.53 ± 13.21 years; mean body mass index = 32.36 ± 7.03, and mean tumor size = 3.7 ± 1.72 cm. In terms of presentation, most patients (50, 72.4%) presented incidentally as opposed to symptomatic presentation. Of these patients, 18 (26.1%) underwent open partial nephrectomy (OPN), 29 (42%) laparoscopic partial nephrec-tomy (LPN), and 22 (31.9%) robotic partial nephrectomy (RPN). On comparing minimally invasive surgery (MIS) PN with OPN, we found that OPN had more blood loss and a longer hospital stay but a shorter operating room (OR) time. Results of PN irrespective of the procedure type, whether it was OPN, LPN, or RPN, were similar if performed by experienced surgeons. However, open procedures involved a higher blood loss, more operative time, and longer hospital stay when compared with minimally invasive techniques

Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer

Summary. To lower the morbidity of retroperitoneal lymphadenectomy, the procedure was modified over the past 35 years from extended suprahilar to bilateral infrahilar, and subsequently a modified laparoscopic unilateral approach then a nerve-sparing technique was introduced. There was no increase in relapse rates associated with the introduction of these operative refinements; significant factors for relapse were pathological stage (P < 0.001) and adjuvant chemotherapy in stage II disease (P < 0.001

A case report of a xanthogranulomatous pyelonephritis case mimicking the recurrence of renal cell carcinoma after partial nephrectomy

A 44-year-old female presented to the urology clinic with flank pain and tenderness. After full assessment, the patient was booked for surgery for partial nephrectomy and the patient was diagnosed with renal cell carcinoma (RCC) chromophob type. Six months later, the patient came back for follow-up; a mass was detected on the same kidney. Radical nephrectomy was performed to excise what is thought to be a recurrence of RCC and the tissues were sent to pathology. The postoperative pathology report confirmed the presence of xanthogranulomatous pyelonephritis rather than RCC recurrence