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Section: Genitourinary Radiology

 




Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Duplex collecting system in a pelvic kidney - an unusual combination by Francesca Giorlando et al.

Published: 2017 Dec
Issue: 11(12) :: Pages: 8-15


Free full text article: Duplex collecting system in a pelvic kidney  - an unusual combination

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Abstract: Pelvic kidney is a relatively common renal malformation as well as duplex kidney; however, the unilateral coexistence of these abnormalities is not frequently found. We present a case of a young woman with a history of hypertension in whom a pelvic and dysmorphic left kidney was discovered during ultrasound examination performed for the study of the renal arteries. Magnetic resonance imaging and computed tomography imaging revealed a duplex pelvic kidney. This combination is very rare; we have not found a similar case reported in the literature.


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Ultrasound, Computed Tomography, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Adult Acute Scrotal Edema - When Radiologists Can Help to Avoid Unnecessary Surgical Treatment by Romeu Duarte Mesquita et al.

Published: 2017 Aug
Issue: 11(8) :: Pages: 24-30


Free full text article: Adult Acute Scrotal Edema - When Radiologists Can Help to Avoid Unnecessary Surgical Treatment

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Abstract: Acute idiopathic scrotal edema is a commonly painless self-limiting condition causing scrotal swelling, and is usually seen in children. In some cases, this condition is difficult to differentiate it from other causes of acute scrotum. In the right clinical scenario, ultrasonography has been used to confirm the diagnosis. We describe the ultrasound and CT findings of acute idiopathic scrotal edema in a 72-year-old male with coexistent involvement of the inferior abdominal wall.


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Ultrasound, Computed Tomography, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Mature cystic teratoma with high proportion of solid thyroid tissue: a controversial case with unusual imaging findings by Rui Gil et al.

Published: 2017 Jul
Issue: 11(7) :: Pages: 20-30


Free full text article: Mature cystic teratoma with high proportion of solid thyroid tissue: a controversial case with unusual imaging findings

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Abstract: We describe a case of a mature cystic teratoma of the ovary with high proportion of solid thyroid tissue (< 50% of the entire tumor) in a childbearing woman. The patient presented with non-specific abdominal bloating. Pelvic ultrasound and magnetic resonance imaging revealed a complex cystic-solid tumor confined to the left ovary with an anterior fat-containing locus compatible with mature cystic teratoma and a posterior predominantly solid component with low signal intensity on T2-weighted images that was histopatologically diagnosed as benign thyroid tissue. Thyroglobulin levels were in normal range. Although thyroid tissue is present in up to 20% of mature cystic teratomas, with exception of struma ovarii, it is not usually macroscopically nor radiologically identified. The differential diagnosis should include T2-hypointense adnexal lesions associated with mature cystic teratoma, malignant transformation of mature teratoma, and immature teratoma.


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Ultrasound, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Oncocytoma: A Differential Consideration for an Incidentally Detected FDG-Avid Renal Mass on PET/CT by Christopher J Smith et al.

Published: 2017 May
Issue: 11(5) :: Pages: 27-33


Free full text article: Oncocytoma: A Differential Consideration for an Incidentally Detected FDG-Avid Renal Mass on PET/CT

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Abstract: Renal oncocytoma is a benign renal neoplasm that is often discovered incidentally and closely mimics renal cell carcinoma on common imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Due to the inability to reliably distinguish between these benign and malignant lesions with imaging, both are typically treated as if they are malignant. Hypermetabolic activity of renal oncocytomas is not frequently encountered because positron emission tomography (PET) is not a standard modality for imaging primary renal tumors. We present a case of a 65 year-old female with a history of thyroid cancer who had an incidentally discovered hypermetabolic renal mass on surveillance PET-CT imaging. Due to the concern for a primary renal malignancy or metastatic disease, the mass was resected and proven to be an oncocytoma on pathologic review.


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Nuclear Medicine, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Isolated Spongy Urethral Rupture from Abrupt Coital Distractive Force by Brian J McArdle et al.

Published: 2017 Feb
Issue: 11(2) :: Pages: 23-27


Free full text article: Isolated Spongy Urethral Rupture  from Abrupt Coital Distractive Force

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Abstract: The classic presentation of penile fracture is a cracking or snap sound, with sharp pain, immediate detumescence, swelling, deformation and ecchymosis. A penile fracture involves rupture of the tunica albuginea of one or both corpora cavernosa. Concomitant urethral rupture is reported to occur in 10% to 20% of penile fracture cases. Isolated urethral injury without penile fracture is extremely rare. We report the first case of isolated pendulous urethral rupture from an abrupt coital distractive force. We include a literature review and discussion of isolated urethral trauma secondary to sexual intercourse. Retrograde urethrography rendered a stunning clinical image which was integral to the diagnosis and management of this patient`s injury.


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Clinical image, Conventional Radiography, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Hydrocele in the Canal of Nuck - CT appearance of a developmental groin anomaly. by Varun Sethi et al.

Published: 2016 Nov
Issue: 10(11) :: Pages: 29-33


Free full text article: Hydrocele in the Canal of Nuck -  CT appearance of a developmental groin anomaly.

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Abstract: Hydrocele in the Canal of Nuck is a condition of female fetal development. The Canal of Nuck is a patent tubular peritoneal fold that travels with the round ligament to its attachment on the labia major. Failure of complete obliteration of the Canal of Nuck during fetal development predisposes females to development of a hydrocele or an inguinal hernia during post-pubertal or adult stages. We present a case of a 21 year old female with a tender reducible labial mass diagnosed as a Hydrocele in the Canal of Nuck.


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Computed Tomography, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Factitious Disorder Presenting with Attempted Simulation of Fournier`s Gangrene by Joseph Tseng et al.

Published: 2016 Sep
Issue: 10(9) :: Pages: 26-34


Free full text article: Factitious Disorder Presenting with  Attempted Simulation of Fournier`s Gangrene

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Abstract: Fournier`s gangrene is a severe polymicrobial necrotizing fasciitis of the perineal, genital, or perianal regions. The classic presentation is severe pain and swelling with systemic signs. Crepitus and cutaneous necrosis are often seen. Characteristic CT findings include subcutaneous gas and inflammatory stranding. Unless treated aggressively, patients can rapidly become septic and die. Factitious Disorder is the falsification of one`s own of medical or psychological signs and symptoms. Many deceptive methods have been described, from falsely reporting physical or psychological symptoms, to manipulating lab tests, or even injecting or ingesting foreign substances in order to induce illness. We present a case of a 35-year-old man with factitious disorder who attempted to simulate Fournier`s gangrene by injecting his scrotum with air and fluid. We will review the clinical presentation and diagnosis of Factitious Disorder, as well as Fournier`s gangrene.


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Ultrasound, Computed Tomography, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Rare Case of Retroperitoneal Lipomatosis in an Indian Woman by Saurabh S Patil et al.

Published: 2016 Apr
Issue: 10(4) :: Pages: 23-30


Free full text article: Rare Case of  Retroperitoneal Lipomatosis in an Indian Woman

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Abstract: Retroperitoneal lipomatosis is a rare but distinct clinicopathological entity characterized by non encapsulated lipoma development in the retroperitoneum. Presenting complaints in the early stages are vague, and patients with retroperitoneal lipomatosis are often misdiagnosed because considerable abnormality is not detected by abdomino-pelvic sonography. However, because of the progressive nature of this lesion, most patients eventually present with varying degrees of urinary outflow obstruction and end stage renal disease, or bladder malignancies in few cases. Here we report a case of a 35-year-old Indian woman presenting with complaints of diffuse lumps in the abdomen and constipation. Based on the findings of the imaging [sonography and computed tomography (CT) scan] studies, benign retroperitoneal lipomatosis was preopreratively diagnosed and a confirmatory exploratory laprotomy was performed. Furthermore, we discuss the imaging findings obtained using various radiological modalities such as plain radiographs, intravenous urography, barium enema, sonography, CT and magnetic resonance imaging (MRI). We also discuss the etiopathogenesis, demographics, and various differential diagnoses of retroperitoneal lipomatosis.


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Ultrasound, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Prostate Brachytherapy seed migration to the Bladder presenting with Gross Hematuria by Reham R Haroun et al.

Published: 2016 Jan
Issue: 10(1) :: Pages: 22-26


Free full text article: Prostate Brachytherapy seed migration to the Bladder presenting with Gross Hematuria

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Abstract: We present the radiologic findings in a case of prostate brachytherapy seed migration to the bladder presenting as gross hematuria. While prostate brachytherapy seed implantation is considered a relatively safe procedure, migration is not uncommon; however, it is usually clinically silent and the seeds most commonly migrate to the lungs through the venous circulation via the periprostatic venous plexus. Our case illustrates that local erosion is possible, can be symptomatic, and therefore must be considered when evaluating select patients.


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Computed Tomography, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen by Oliver James Nickalls et al.

Published: 2015 Dec
Issue: 9(12) :: Pages: 21-28


Free full text article: A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen

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Abstract: The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author`s knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.


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Computed Tomography, Macroscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Contrast-enhanced ultrasound findings of post-transplant lymphoproliferative disorder in a transplanted kidney: A case report and literature review by Alyssa Lampe et al.

Published: 2015 Oct
Issue: 9(10) :: Pages: 26-34


Free full text article: Contrast-enhanced ultrasound findings of post-transplant lymphoproliferative disorder in a transplanted kidney:  A case report and literature review

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Abstract: Post-transplant lymphoproliferative disorder occurs in approximately one percent of kidney transplant recipients. We evaluated a seventy-seven year-old man with a solid mass in his transplant kidney. On contrast enhanced ultrasound, the mass enhanced but remained persistently hypovascular throughout exam. The enhancement pattern of the mass differed from that typical of clear cell renal cell carcinoma, the main differential diagnosis. Final pathology after partial nephrectomy confirmed post-transplant lymphoproliferative disorder. This is the first report of contrast enhanced ultrasound findings in a renal mass diagnosed as post-transplant lymphoproliferative disorder. Contrast enhanced ultrasound has a promising role in imaging of renal masses, particularly relevant in transplant patients due to the lack of nephrotoxicity.


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Computed Tomography, Ultrasound, Microscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Solitary Neurofibroma Of The Spermatic Cord: A Case Report by José Boto et al.

Published: 2015 Jun
Issue: 9(6) :: Pages: 19-28


Free full text article: Solitary Neurofibroma Of The Spermatic Cord:  A Case Report

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Abstract: We report the ultrasound, computerized tomography, positron emission tomography and magnetic resonance imaging findings of a 38-year-old man with a biopsy proven solitary neurofibroma of the spermatic cord. Solitary neurofibromas of the male genital tract are exceedingly rare benign peripheral nerve sheath neoplasms composed of Schwann cells and fibroblasts. In contrast to schwannomas they are not bound by a capsule thus allowing infiltration between the nerve fascicles. Although they are benign lesions whose potential for malignant degeneration is very low, especially in the absence of neurofibromatosis type 1, accurate diagnosis is important as neurofibromas in this location can cause significant morbidity and psychological distress. Despite the extensive differential diagnosis of masses in the male inguinal canal, including both benign and malignant entities, a diagnosis of benign peripheral nerve sheath tumor can be potentially suggested based on imaging, particularly if MRI is performed. Surgical resection is the treatment of choice and the final diagnosis should be provided by histopathology, as was the case with this patient.


Available image modalities: (click on modality to browse for other articles)
Ultrasound, Nuclear Medicine, Magnetic Resonance Imaging, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Inflammatory Pseudotumor of the Urinary Bladder by Elsa Rosado et al.

Published: 2015 Jan
Issue: 9(1) :: Pages: 36-42


Free full text article: Inflammatory Pseudotumor of the Urinary Bladder

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Abstract: We report a case of an inflammatory pseudotumor of the urinary bladder in a 31 year-old woman. She presented at the emergency room with low abdominal pain and urinary symptoms. Abdominal ultrasound, computed tomography and magnetic resonance imaging were performed and revealed asymmetric thickening of the urinary bladder wall. Cystoscopy with urinary cytology revealed a benign nature of the process. The patient underwent partial cystectomy and the pathologic examination of the specimen revealed an inflammatory pseudotumor. We reviewed the clinical, imaging and pathological features of the inflammatory pseudotumor of the urinary bladder and discussed its differential diagnosis.


Available image modalities: (click on modality to browse for other articles)
Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia by Jeffrey Dee Olpin¹*, Benjamin Witt² et al.

Published: 2014 Feb
Issue: 8(2) :: Pages: 46-53


Free full text article: Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia

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Abstract: Congenital adrenal hyperplasia refers to a group of autosomal recessive disorders caused by a deficiency of an enzyme involved in the synthesis of glucocorticoids. The enzyme deficiency generally leads to a deficiency of cortisol and/or aldosterone production within the adrenal cortex. The lack of glucocorticoids generally leads to elevated levels of plasma corticotropin (ACTH), which often results in adrenal hyperplasia. Testicular adrenal rest tumors may develop in males with congenital adrenal hyperplasia due to overstimulation of aberrant adrenal cells within the testes. Recognition of this disease entity is essential when evaluating young males with testicular masses.


Available image modalities: (click on modality to browse for other articles)
Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy by Deepak Batura et al.

Published: 2014 Jan
Issue: 8(1) :: Pages: 34-40


Free full text article: Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy

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Abstract: A 64 year-old male with metastatic prostate adenocarcinoma presented with bilateral hydronephrosis and renal impairment. Bilateral percutaneous nephrostomy drainage followed by ante-grade stenting was done. Shortly afterwards, the patient developed an extensive left-sided pleural effusion. His serum creatinine rose and he became anuric. Emergency pleural aspiration and later, pleural drainage were performed. Pleural aspirate was diagnostic of urinothorax and non contrast CT scan demonstrated a left reno-pleural fistula. The right stent was removed cystoscopically. The left stent could not be removed cystoscopically and was replaced in an ante grade manner through a fresh percutaneous renal approach. This led to cessation of pleural fluid accumulation. The patient was discharged with bilateral ureteric stents and normal renal function. A month later, he had normal renal function, no hydronephrosis and normal chest x-rays.


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Ultrasound, Fluoroscopy, Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Prostate gland development and adrenal tumor in a female with congenital adrenal hyperplasia: A case report and review from radiology perspective by Benjamin Fang et al.

Published: 2013 Dec
Issue: 7(12) :: Pages: 26-34


Free full text article: Prostate gland development and adrenal tumor  in a female with congenital adrenal hyperplasia:  A case report and review from radiology perspective

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Abstract: We describe a case of a female with simple virilizing congenital adrenal hyperplasia (CAH) reared as a male diagnosed at the late age of 64. Computed Tomography (CT) demonstrated a large adrenal mass, bilateral diffuse adrenal enlargement, female pelvic organs as well as a clearly visualized prostate gland. This is to the best of our knowledge the first case of such a sizable prostate gland in a female CAH patient documented on CT. We review the literature regarding aspects where radiologists may encounter CAH and the finding of presence of a prostate gland in female CAH patients.


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Ultrasound, Computed Tomography, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Papillary carcinoma arising in struma ovarii versus ovarian metastasis from primary thyroid carcinoma: a case report and review of the literature by Inês Leite et al.

Published: 2013 Oct
Issue: 7(10) :: Pages: 24-33


Free full text article: Papillary carcinoma arising in struma ovarii versus ovarian metastasis from primary thyroid carcinoma:  a case report and review of the literature

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Abstract: We present a case of a postmenopausal woman diagnosed with an ovarian mass containing thyroid follicles and foci of papillary thyroid carcinoma during pathological examination. This patient referred having had a metachronous thyroid malignancy 10 years before. The differential diagnosis between a thyroid malignancy arising from a struma ovarii and a metastatic ovarian tumor originating from thyroid-cancer is challenging. Struma ovarii should be considered when thyroid components are the predominant element or when thyroid malignant tissue is identified within an ovarian lesion. Thyroid carcinoma arising from a struma ovarii is reported to occur in a minority of cases. Of these, papillary carcinoma is the most frequent subtype encountered. Regarding primary thyroid carcinomas, papillary carcinomas have a lower metastatic potential when compared to follicular carcinomas, and most of the metastases occur in the cervical lymph nodes. Ovarian metastases are exceedingly rare and generally associated with widespread disease. However, they must be considered in the presence of previous history of malignant thyroid carcinoma. The authors review the main clinical, imaging and therapeutic aspects of both these entities and present the most likely diagnosis.


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Ultrasound, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Primary Renal Lymphoma Mimicking a Subcapsular Hematoma: A Case Report by Erik Dedekam et al.

Published: 2013 Aug
Issue: 7(8) :: Pages: 18-26


Free full text article: Primary Renal Lymphoma Mimicking a Subcapsular Hematoma: A Case Report

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Abstract: Primary renal lymphoma (PRL) is a rare entity with a history of controversy regarding its existence. Lymphomatous involvement of the kidney is more commonly seen secondarily to spread from an adjacent lymphomatous mass, rather than arising primarily from the kidney. PRL can mimic other renal lesions such as renal cell carcinoma, renal abscess, and metastasis; therefore, an early diagnosis is crucial to guide treatment and properly assess prognosis. We present a rare case of a 77 year-old male who presented with hematuria and PRL mimicking a subcapsular hematoma.


Available image modalities: (click on modality to browse for other articles)
Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Nuclear Medicine, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Stromal prostatic sarcoma: a rare tumor with rare clinical and imaging presentation by Anamaría Rojas-Jiménez et al.

Published: 2013 Jul
Issue: 7(7) :: Pages: 24-31


Free full text article: Stromal prostatic sarcoma: a rare tumor with rare clinical and imaging presentation

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Abstract: Adult prostatic stromal sarcoma is a rare malignant tumor. The main presenting symptom is urinary retention secondary to bladder outlet obstruction. Prostatic Specific Antigen level can be normal. Imaging features show a prostate mass with or without pelvic organ invasion depending on the aggressiveness of the tumor. We present a patient with prostatic stromal sarcoma who debuted with urinary obstruction, leukocytosis and neutrophilia, prostate enlargement, and hypodense prostate areas on CT images, simulating prostatitis with abscess formation.


Available image modalities: (click on modality to browse for other articles)
Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Sarcoidosis Manifesting as a Pseudotumorous Renal Mass by cott Goldsmith et al.

Published: 2013 May
Issue: 7(5) :: Pages: 23-34


Free full text article: Sarcoidosis Manifesting as a  Pseudotumorous Renal Mass

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Abstract: A 53 year-old African American woman with a three-year history of pulmonary sarcoidosis had a follow-up computed tomographic scan to evaluate the status of her disease and response to treatment. On the scan, an abnormal, hypodense mass on the left renal superior pole, which was not present on previous scans, was incidentally discovered. The initial concern was of carcinoma, despite her lack of any urinary symptoms. She underwent further evaluation with magnetic resonance, and the enhancement pattern and the shape of the mass were more suggestive of lymphoma or infarction than a carcinoma. A review of literature revealed sparse case reports demonstrating sarcoidosis presenting as infiltrative granulomatous masses resembling tumors with nonspecific imaging qualities. This diagnosis was entertained and then proven by biopsy. Pseudotumorous renal sarcoid should be in the differential of renal masses, especially in patients with a history of sarcoidosis, as it alters clinical management.


Available image modalities: (click on modality to browse for other articles)
Magnetic Resonance Imaging, Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Don`t get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus by Jonathan Carl Luis Rodrigues et al.

Published: 2013 Mar
Issue: 7(3) :: Pages: 34-38


Free full text article: Don`t get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus

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Abstract: Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification.


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Computed Tomography, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Rare case of urinary bladder agenesis - Multislice CT abdomen imaging by Venkatraman Indiran et al.

Published: 2013 Feb
Issue: 7(2) :: Pages: 44-49


Free full text article: Rare case of urinary bladder agenesis -  Multislice CT abdomen imaging

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Abstract: Complete agenesis of urinary bladder is an extremely rare anomaly with only a few live cases reported so far. In most of the instances death occurs early as it may be incompatible with life. Here we report a case of adolescent female with urinary bladder and unilateral renal agenesis, who presented with a rather unusual presentation of incontinence, for a computed tomography (CT) examination. Other congenital abnormalities visualised in the CT abdomen are also discussed.


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Computed Tomography, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Ureteral rupture from aberrant Foley catheter placement: A case report by Kevin S Baker et al.

Published: 2013 Jan
Issue: 7(1) :: Pages: 33-40


Free full text article: Ureteral rupture from aberrant Foley catheter placement: A case report

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Abstract: We present the case of a 59 year old female with history of severe neurologic dysfunction from advanced multiple sclerosis who presented with lethargy and oliguria several hours after urethral Foley catheterization. A contrast-enhanced CT scan of the abdomen/pelvis showed an aberrantly placed Foley catheter with its balloon inflated in the proximal left ureter, a rare complication of Foley catheterization with only 5 other cases reported. Incomplete ureteral rupture was demonstrated and confirmed by a followup CT scan in the urographic phase. One of our institution`s Interventional Radiologists then placed a nephroureteral stent across the injured ureter to facilitate healing. The patient expired 9 days after the procedure from unrelated sepsis from a chronic stage IV decubitus ulcer, so long term monitoring could not be performed. Following description of our case, we conduct a literature review of presentations, imaging characteristics, and treatment of ureteral Foley catheter placement.


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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Bladder Schwannoma - A Case Presentation by Andrew D. Mosier et al.

Published: 2012 Dec
Issue: 6(12) :: Pages: 26-31


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Abstract: Bladder schwannomas are exceedingly rare, benign or malignant, nerve sheath tumors that are most often discovered in patients with a known diagnosis of Neurofibromatosis type 1 (NF1). A few sporadic case reports of bladder schwannoma have been published in urologic, obstetric/gynecologic, and pathologic journals. However, this is the first case report in the radiologic literature where computed tomography imaging and radiology-specific descriptions are discussed. Furthermore, the patient presented in this case is only the fifth published patient without NF1 to be diagnosed with a bladder schwannoma, to the best of our knowledge.


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Computed Tomography, Clinical image, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

"BCGitis": A rare case of tuberculous epididymo-orchitis following intravesical Bacillus Calmette-Guérin therapy by Virginie Demers et al.

Published: 2012 Nov
Issue: 6(11) :: Pages: 16-21


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Abstract: Tuberculous epididymo-orchitis is a rare complication of intravesical Bacillus Calmette-Guérin (BCG) therapy for urothelial cancer of the bladder. We present such a case, describe its sonographic appearance and review the literature. The difficulties in diagnosing this condition based on imaging alone, given the extensive overlap with the appearance of bacterial epididymo-orchitis, malignant testicular disease and testicular torsion, are discussed. Adequate knowledge of tuberculous epididymo-orchitis is of capital importance in order to ensure a proper diagnosis and treatment.


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Ultrasound, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Calyceal Diverticulum - a Mimic of Different Pathologies on Multiple Imaging Modalities by Rebecca Mullett et al.

Published: 2012 Sep
Issue: 6(9) :: Pages: 10-17


Free full text article: Calyceal Diverticulum - a Mimic of Different Pathologies on Multiple Imaging Modalities

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Abstract: Calyceal diverticula are outpouchings of a renal calyx. Often found incidentally on radiological imaging, they are generally benign and usually asymptomatic, although complications include infection and stone formation. More importantly, calyceal diverticula may mimic other potentially more serious pathology on imaging, such as renal tumour or abscess on ultrasound or computed tomography and even rib metastasis on bone scintigraphy. We present a case of a patient with a calyceal diverticulum found incidentally on imaging, in which the diverticulum is demonstrated on ultrasound, computed tomography, intravenous urogram and bone scintigraphy, and discuss the potential differential diagnoses that need to be excluded in this condition.


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Nuclear Medicine, Ultrasound, Computed Tomography, Fluoroscopy, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Paraperitoneal Inguinal Hernia of Ureter by Albert Lu et al.

Published: 2012 Aug
Issue: 6(8) :: Pages: 22-26


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Abstract: Inguinal herniation of ureter is an uncommon finding that can potentially lead to obstructive uropathy. We report a case of inguinal herniation of ureter discovered incidentally during workup for acute renal failure and ultrasound finding of hydronephrosis.


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Ureteral fibroepithelial polyp causing urinary obstruction by Melissa L. Shive et al.

Published: 2012 Jul
Issue: 6(7) :: Pages: 23-28


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Abstract: Ureteral polyps are rare causes of ureteropelvic junction (UPJ) obstruction, particularly in children. We report a nine year-old boy with UPJ obstruction initially suggestive of an obstructive urinary stone. CT showed intraureteral calcification at the UPJ and hydronephrosis. A retrograde pyelogram showed narrowing at the UPJ and partial obstruction that was found to be a ureteral polyp. This case illustrates a rare cause of UPJ obstruction that should be considered when the imaging findings and presentation are atypical for more common etiologies of ureteral obstruction.


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Computed Tomography, Ultrasound, Nuclear Medicine, Fluoroscopy, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Hydrocele of the Canal of Nuck: Value of Radiological Diagnosis by Ranjeet Jagdale et al.

Published: 2012 Jun
Issue: 6(6) :: Pages: 18-22


Free full text article: Hydrocele of the Canal of Nuck: Value of Radiological Diagnosis

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Abstract: Hydrocele of the canal of Nuck (cyst of the canal of Nuck) is the female homologue of hydrocele of the spermatic cord in males and is a rarely encountered entity, mostly diagnosed on the operating table at the time of suspected inguinal hernia surgery, as the clinical presentation usually is subtle and inconclusive. Diagnosis is mainly by ultrasound and has shown varied presentation of the same over the years. We discuss the sonographic findings of a case of hydrocele of the canal of Nuck.


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Ultrasound, Macroscopic pathology, Table





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Sarcomatoid renal cell carcinoma: A case report and literature review by Michael Reiter et al.

Published: 2012 Apr
Issue: 6(4) :: Pages: 11-16


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Abstract: Renal cell carcinoma (RCC) is the most common malignancy of the kidney and consists of multiple subtypes. The sarcomatoid variety, while previously considered a distinct histologic subtype, is now categorized as a form of dedifferentiated carcinoma. When present, it is associated with a significant decrease in patient survival due to its rapid growth and intrusive behavior. Preoperative knowledge of this diagnosis may be beneficial to clinicians in order to modify treatment options and follow-up protocols. This report describes a case of sarcomatoid renal cell carcinoma in which the patient initially presented with flank pain. We then discuss the clinical features of sarcomatoid renal cell carcinoma and its imaging appearance on computed tomography (CT), and succinctly review the subtypes of renal cell carcinoma and their imaging characteristics.


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Computed Tomography, Microscopic pathology, Table

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Co-existing Sarcoidosis Confounds the Staging of Bilateral Renal Cell Carcinoma by Heather Willis et al.

Published: 2011 Jan
Issue: 5(1) :: Pages: 18-27


Free full text article: Co-existing Sarcoidosis Confounds the Staging of Bilateral Renal Cell Carcinoma

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Abstract: We present a case in which the undiagnosed condition of sarcoidosis complicated the staging of bilateral, subtype-discordant renal cell carcinoma. Initially thought to have metastatic renal cell carcinoma based on computed tomography imaging and referred for immunotherapy, a positron emission tomography/computed tomography scan demonstrated different levels of radiotracer activity in the primary site and the presumed pulmonary metastatic sites. The patient underwent bilateral partial nephrectomies and was ultimately diagnosed with stage T1 bilateral renal cell carcinoma and sarcoidosis. This case highlights the need to consider concurrent medical conditions that can lead to false positive results when evaluating for metastatic disease with imaging studies as well as the importance of evaluating the levels of radiotracer activity between different sites.


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Computed Tomography, Nuclear Medicine, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Malignant transformation of an endometriotic cyst: MDCT and MR findings by Athina C. Tsili et al.

Published: 2011 Jan
Issue: 5(1) :: Pages: 9-17


Free full text article: Malignant transformation of an endometriotic cyst: MDCT and MR findings

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Abstract: Malignant transformation is a rare complication of endometriosis. MR criteria for diagnosis include the presence of soft-tissue components, enhancement after contrast material administration in an endometriotic cyst. We present the multidetector CT and MR imaging findings in a case of an incidentally found endometrioid adenocarcinoma in a left-sided ovarian endometrioma, occurring in a 30-year old woman. MR imaging enabled the correct preoperative characterization of the lesion, by depicting a soft-tissue element, with strong and early enhancement after gadolinium administration. The same area had high signal intensity on diffusion-weighted images and low apparent diffusion coefficient values due to restricted diffusion, findings also strongly suggestive of malignancy.


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Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Case report of a testicular epidermoid cyst and review of its typical sonographic features by Ryan James Hernandez et al.

Published: 2010 Sep
Issue: 4(9) :: Pages: 18-23


Free full text article: Case report of a testicular epidermoid cyst and review of its typical sonographic features

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Abstract: A case of testicular epidermoid cyst, demonstrating multiple characteristic sonographic patterns in a single lesion, is presented with a brief review of the distinctive ultrasound features. It is important to remember that the sonographic patterns describing testicular epidermoids represent the varied amounts and arrangements of keratin of a particular lesion. A given lesion may demonstrate subtle variability or more than one characteristic pattern at any given time. With this in mind, preoperative characterization of testicular epidermoids should allow for increasing utilization of testicular sparring surgery in the management of this benign lesion.


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Ultrasound, Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

MRI Findings in Chronic Lithium Nephropathy: A Case Report by Aubrey Slaughter et al.

Published: 2010 Aug
Issue: 4(8) :: Pages: 15-21


Free full text article: MRI Findings in Chronic Lithium Nephropathy: A Case Report

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Abstract: Patients on long term lithium therapy for affective disorders may develop renal toxicity. It may manifest as nephrogenic diabetes insipidus with renal biopsy showing interstitial fibrosis, sclerotic glomeruli and cyst formation. Magnetic resonance imaging demonstrates the presence of microcysts in patients on long-term lithium therapy, suggesting a possible cause for their nephrotoxicity. We describe the typical magnetic resonance imaging appearance of renal microcysts in a 53 year old woman on chronic lithium therapy.


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Magnetic Resonance Imaging, Ultrasound, Table

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Renal neuroectodermal tumour presenting with hematuria by Rafel Tappouni et al.

Published: 2010 Jul
Issue: 4(7) :: Pages: 12-20


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Abstract: Peripheral primary neuroectodermal tumors (PNET) are uncommon tumors, with an overall incidence of 1% of all sarcomas. Renal PNET is extremely rare. It is an aggressive tumor, with a high incidence of local recurrence and early metastases. Radiological diagnosis can be challenging as it is often difficult to differentiate it from other primary renal neoplasms. Imaging features include a large heterogeneous mass with central low density areas due to necrosis. Intra tumor hemorrhage and calcification are rare. We present a rare case of a large PNET mimicking renal cell carcinoma in a 51 year old female that required arterial embolization and nephrectomy.


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Ultrasound, Computed Tomography, Angiography, Interventional, Macroscopic pathology, Microscopic pathology, Table

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Giant aneurysm formation in sporadic renal angiomyolipoma by Aruna R Patil et al.

Published: 2010 Jun
Issue: 4(6) :: Pages: 21-27


Free full text article: Giant aneurysm formation in sporadic renal angiomyolipoma

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Abstract: Angiomyolipomas are the most common mesenchymal renal neoplasms. Two types have been described: (i) sporadic angiomyolipoma and (ii) angiomyolipoma associated with tuberous sclerosis. Giant aneurysm formation is usually noted in angiomyolipomas associated with tuberous sclerosis and is rare in sporadic variety. Tumor diameter and aneurysm diameter have been used as predictors of rupture. We report a rare case of aneurysm formation in a sporadic angiomyolipoma.


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Ultrasound, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table

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Metastatic Breast Cancer to the Bladder – case report and review of literature by Elzbieta Luczynska et al.

Published: 2010 May
Issue: 4(5) :: Pages: 19-26


Free full text article: Metastatic Breast Cancer to the Bladder – case report and review of literature

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Abstract: The main cause of mortality among patients with breast cancer is the metastatic spread of the primary tumour. The urinary bladder is considered as an unusual site for breast cancer metastasis. A patient has presented with right breast tumour and qualified for surgical treatment. After removal of the mass, an intra-operative and final pathology evaluation indicated breast invasive lobular carcinoma. Adjuvant chemotherapy was given. Years later, an increase of serum CA15-3 tumour marker level was noted and physical examination revealed a lump at the mastectomy scar. A follow-up abdominal ultrasound scan demonstrated thickening of the urinary bladder wall segment, confirmed later by CT scan. A transurethral resection of bladder was performed, reaffirming a neoplastic mass, with histological assessment revealing invasive breast carcinoma. Palliative chemotherapy was given and another follow-up ultrasound scans were unremarkable. The patient is alive today.


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Conventional Radiography, Ultrasound, Computed Tomography, Microscopic pathology, Table

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Case Report: Gastric Adenocarcinoma Metastatic to the Prostate Gland by Ping Zhang et al.

Published: 2010 Mar
Issue: 4(3) :: Pages: 35-38


Free full text article: Case Report: Gastric Adenocarcinoma Metastatic to the Prostate Gland

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Abstract: Metastasis to the prostate gland from gastric cancer is exceedingly rare. We have presented a rare case of gastric malignancy metastasizing to the prostate diagnosed by transrectal ultrasound guided prostate biopsy.


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Ultrasound, Microscopic pathology

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Vicarious urinary excretion of iodinated contrast in a Crohn`s patient by Hooman Yarmohammadi et al.

Published: 2010 Feb
Issue: 4(2) :: Pages: 5-8


Free full text article: Vicarious urinary excretion of iodinated contrast in a Crohn`s patient

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Abstract: Vicarious renal excretion of iodinated contrast introduced into the bowel is a known phenomenon that has rarely been reported. In clinical settings like Crohn`s disease in which evaluation for recto-vesical fistula is frequently requested, vicarious excretion can cause misapprehension and error in diagnosis. We present a case of Crohn`s disease in which gastrografin enema was performed to evaluate for fistula and initial interpretation was mistakenly positive, however, simple methods of elucidation were utilized to prevent error in diagnosis.


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Fluoroscopy

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Giant urethral stone presenting as a scrotal mass: Case report by Adib R. Karam et al.

Published: 2010 Feb
Issue: 4(2) :: Pages: 1-4


Free full text article: Giant urethral stone presenting as a scrotal mass: Case report

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Abstract: Primary urethral stones are a rare form of urolithiasis accounting for less than 0.3% of urinary stones. We are reporting a case of a giant primary urethral stone that developed in the penile urethra resulting from a post-surgical complication of urethral stricture. The patient presented with difficulty urinating, ejaculatory dysfunction, and a hard palpable scrotal mass.


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Ultrasound, Fluoroscopy





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Supernumerary Testis by Jaiger Chintamani et al.

Published: 2009 Nov
Issue: 3(11) :: Pages: 29-32


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Abstract: Polyorchidism is a rare congenital anomaly of the genital tract in which more than two testes are present, usually within the scrotum. Less than 100 cases of polyorchidism have been reported in medical literature till date. The most common form is the presence of three testis referred as triorchidism or tritestis. There are characteristic sonographic features of polyorchidism, and the diagnosis is often made on the basis of ultrasonography. Magnetic resonance imaging can be used for confirmation. We present a case of polyorchidism in a 13 yrs old adolescent.


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Ultrasound, Magnetic Resonance Imaging

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Renal lymphangiectasia presented by pleural effusion and ascites by Saif Ahmed Ali Al-Dofri

Published: 2009 Oct
Issue: 3(10) :: Pages: 5-10


Free full text article: Renal lymphangiectasia presented by pleural effusion and ascites

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Abstract: A young male patient complaining of vague abdominal pain, dyspnea, generalized weakness and abdominal distension for 6 months was referred for abdominal ultrasound. Ultrasound showed enlarged echogenic kidneys, perinephric and renal sinus cystic fluid collections bilaterally with ascites and right pleural effusion. The ultrasound findings were confirmed by abdomen CT scan. Renal function test was within normal. Laboratory analysis of aspirated perinephric fluid revealed abundant lymphocytes. The radiological findings and perinephric fluid aspiration analysis are consistent with renal lymphangiectasia. Pleural effusion, in addition to ascites and perinephric fluid collections, is a new presentation of the disease. Ascites and pleural effusion were improved by diuretics.


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CT and 111In-pentetreotide SPECT of hilar ACTH-producing neuroendocrine tumor associated with Cushing`s syndrome and massive bilateral adrenal gland hyperplasia by Wichana Chamroonrat et al.

Published: 2009 Aug
Issue: 3(8) :: Pages: 1-4


Free full text article: CT and 111In-pentetreotide SPECT of hilar ACTH-producing neuroendocrine tumor associated with Cushing`s syndrome and massive bilateral adrenal gland hyperplasia

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Abstract: We present the clinical, laboratory, computed tomography (CT), single photon emission computed tomography (SPECT), and histopathological findings of a patient with adrenocorticotropic hormone (ACTH) dependent Cushing`s syndrome with massive bilateral adrenal gland hyperplasia due to a hilar ACTH-producing well-differentiated neuroendocrine carcinoma.


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Computed Tomography, Microscopic pathology

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Significance of Reversal of Diastolic Blood Flow in the Evolution of Testicular Infarction as a Complication of Epididymo-Orchitis by Robert Marks et al.

Published: 2009 Jun
Issue: 3(6) :: Pages: 21-25


Free full text article: Significance of Reversal of Diastolic Blood Flow in the Evolution of Testicular Infarction as a Complication of Epididymo-Orchitis

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Abstract: We report a case of a 50-year-old male who presented to the Emergency Department and was diagnosed with epididymo-orchitis. Sonographic evaluation of the testicle initially showed a normal, low resistance color Doppler waveform. The patient was admitted to the hospital. A follow up sonogram two days later demonstrated reversal of diastolic arterial flow on Pulse-Wave color Doppler imaging. Reversal of diastolic blood flow in testicular color Doppler sonography is a sign of impending infarction. On hospital day 6, the patient had a follow up ultrasound which demonstrated infarction of the testicle. Pathology confirmed the diagnosis and the tissue culture grew E. coli and Candida Albicans. This case documents the rapid progression of epididymo-orchitis with a normal spectral waveform to testicular infarction with reversal of diastolic blood flow on color Doppler imaging as a sign of impending infarction.


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Ultrasound, Macroscopic pathology

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A giant heterogeneous abdominoscrotal mass: haemorrhagic hydrocele by Antonio Amodeo et al.

Published: 2009 Jun
Issue: 3(6) :: Pages: 16-20


Free full text article: A giant heterogeneous abdominoscrotal mass: haemorrhagic hydrocele

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Abstract: A hydrocele is a collection of fluid in the space surrounding the testicle between the layers of the tunica vaginalis. Occasionally the scrotal hydrocele may extend through the inguinal canal, deep inguinal ring, and into the abdomen as an abdominoscrotal hydrocele. Traditionally, abdominoscrotal hydrocele have been evaluated and diagnosed with US. However if a relationship between the abdominal mass and the hydrocele is not clearly defined by sonography, the traditional modality for imaging the abdomen and the scrotum such as CT or MRI, should be considered because it can be difficult to clearly delineate the anatomy and the full extent of the abnormality. We present a rare case of a giant hemorrhagic abdominoscrotal hydrocele in a 24 year old man that required an elective operative laparotomy for complete excision of the abdominolscrotal mass.


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Magnetic Resonance Imaging, Macroscopic pathology

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Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Imaging Features of Renal Hydatid Cyst Presenting with Hydatiduria by Muhammad Umar Amin et al.

Published: 2009 Mar
Issue: 3(3) :: Pages: 6-11


Free full text article: Imaging Features of Renal Hydatid Cyst Presenting with Hydatiduria

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Abstract: We report a case of renal hydatid cyst in a 25-year-old male who presented with hydatiduria. Intravenous pyelography revealed presence of a space-occupying lesion in the lower pole of right kidney with curvilinear calcifications. Ultrasound, computed tomography and MRI were suggestive of hydatid cyst in the right kidney. Patient underwent right-sided nephrectomy. Passage of hydatid cysts in urine is an exceedingly rare occurrence. Urinary tract involvement develops in 2-4% of all cases of hydatid cyst. Hydatiduria is an extremely rare manifestation of renal hydatid cyst. We report such a case with emphasis on IVU, sonographic, CT and MRI findings.


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Macroscopic pathology, Ultrasound, Conventional Radiography, Computed Tomography, Magnetic Resonance Imaging

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An Unusual Vesical Calculus by Umar Amin et al.

Published: 2009 Feb
Issue: 3(2) :: Pages: 10-13


Free full text article: An Unusual Vesical Calculus

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Abstract: We report a 52 year old patient presenting with a bladder stone formed over a migrated intrauterine device (Copper–T). Her history was pertinent for intrauterine contraceptive (IUCD) device placement 10 years back. Investigations included plain ultrasound of abdomen, X-ray of abdomen, urinalysis, and urine culture. Ultrasound and plain X-ray of the pelvis confirmed a bladder stone formed over a migrated copper-T intrauterine device. The device was removed through suprapubic cystolithotomy. Of all the reported cases of vesical stone formation over a migrated IUCD, this case is unique as the patient was an elderly - 52 year old - female. All previously reported cases are of younger age.


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Ultrasound, Conventional Radiography, Macroscopic pathology





Other Radiology articles from the Genitourinary Radiology section Genitourinary Radiology

Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia by Basant Mahadevappa et al.

Published: 2009 Feb
Issue: 3(2) :: Pages: 7-9


Free full text article: Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia

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Abstract: Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera. Case reports and series have been published with various organs and rare organs being part of the hernia. Urinary bladder is a known content of sliding hernias. This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.


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Clinical image, Conventional Radiography, Macroscopic pathology





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