Despite the significant advancements in prostate-specific antigen (PSA) screening and the diverse array of available treatments, prostate cancer (PCa) still significantly contributes to cancer-related illness. The most prevalent sites for metastases are bones, distant lymph nodes, and abdominal organs. Nevertheless, metastasis to the renal and retroperitoneal regions originating from prostate cancer constitutes an exceptionally uncommon clinical occurrence. Metastatic PCa commonly presents with elevated serum PSA levels, a hallmark of its diagnostic profile. However, there are instances where patients exhibit atypical metastatic patterns or maintain normal PSA levels. In the case under consideration, the patient exhibited a periureteral tumor with an indeterminate primary origin, subsequently confirmed to be metastatic prostate cancer. This case underscores the importance of recognizing the varied and sometimes elusive presentations of metastatic PCa. Despite its rarity, the occurrence of renal and retroperitoneal metastasis emphasizes the need for vigilance and a comprehensive understanding of the diverse manifestations of advanced PCa for timely and accurate diagnosis, which is paramount in optimizing patient care and outcomes.

Primary pulmonary malignant melanoma (also called primary malignant melanoma of the lung, or PMML) is an exceedingly rare non-epithelial neoplasm, accounting for 0.01% of all primary lung cancers. We report a case of a 63--year--old male with no comorbidities who was found to have a large right lung upper lobe mass and was diagnosed with metastatic primary malignant melanoma of the lung. The outcome for primary pulmonary malignant melanoma is grim, with 5-year survival less than 20%, but many patients have rapid progression and a short life span, even with intervention.

暂无摘要。

Spontaneous rupture of the renal pelvis due to metastatic disease is a rare complication. Renal pelvis rupture often goes undiagnosed in cases of non-traumatic origin due to its vague abdominal and flank symptoms. We present a case of an 81-year-old male with primary non-small cell lung cancer who had renal pelvis rupture due to extrinsic compression of the ureter by retroperitoneal lymphadenopathy secondary to metastatic disease.

UNASSIGNED: Nondilated obstructive uropathy (NDOU) is a rare cause of acute renal failure reported in less than 5% of cases of obstructive uropathy. It is typically associated with intrapelvic malignancies and diseases causing retroperitoneal lymphadenopathy and retroperitoneal fibrosis. As these conditions may prevent radiographic dilation of the collecting system, the diagnosis of NDOU may be missed by usual diagnostic testing.
UNASSIGNED: We present a case of acute anuric renal failure in a middle-aged woman with metastatic breast cancer associated with abdominal and retroperitoneal lymphadenopathy. Acute kidney injury was initially deemed secondary to drug-induced acute tubular necrosis (ATN) from bisphosphonate; however, there remained a high clinical suspicion of NDOU due to the presence of enlarged retroperitoneal lymph nodes on CT abdomen and pelvis with concerns for encasement of bilateral renal pelvic regions and ureters.
UNASSIGNED: The patient underwent a retrograde pyelogram which demonstrated questionable narrowing bilaterally at the level of the renal pelvices. This led to an even stronger clinical suspicion of NDOU and urology service was consulted for evaluation.
UNASSIGNED: Bilateral ureteral stents were placed by urology which led to robust urine output and rapid reversal of renal failure over the next 24 to 48 hours.
UNASSIGNED: Despite 2 weeks of anuria and hemodialysis, this patient\'s creatinine came back to her baseline. She was able to discontinue hemodialysis and her creatinine stabilized at 88.4 μmol/L (1 mg/dL).
UNASSIGNED: Nondilated obstructive uropathy is rare but important diagnosis that requires a high clinical suspicion in the appropriate clinical scenario. The lack of dilatation is believed to be related to encasement of the collecting system by tumor, fibrosis, or as in our case metastatic retroperitoneal lymphadenopathy. As this diagnosis cannot be overlooked, aggressive direct visualization or even intervention with internal or external stenting may be required to both diagnose and treat this condition.
UNASSIGNED: L’uropathie obstructive sans dilatation (UOSD) est une cause rare d’insuffisance rénale aiguë (IRA) rapportée dans moins de 5 % des cas d’uropathie obstructive. Elle est généralement associée à des tumeurs malignes intrapelviennes et de maladies entraînant une lymphadénopathie rétropéritonéale et une fibrose rétropéritonéale. Ces conditions pouvant empêcher la dilatation radiographique du système collecteur, il arrive que le diagnostic de l’UOSD soit manqué lors des tests de diagnostic habituels.
UNASSIGNED: Nous présentons un cas d’IRA anurique chez une femme d’âge moyen atteinte d’un cancer du sein métastatique associé à une lymphadénopathie abdominale et rétropéritonéale (LAR). L’IRA avait initialement été considérée comme secondaire à une nécrose tubulaire aiguë induite par le bisphosphonate. La présence de ganglions lymphatiques rétropéritonéaux hypertrophiés sur la tomographie de l’abdomen et du bassin a toutefois soulevé un doute clinique d’UOSD; une obstruction des régions bilatérales du bassinet rénal et des uretères a été soupçonné.
UNASSIGNED: La patiente a subi un pyélogramme rétrograde qui a montré un rétrécissement bilatéral suspect au niveau des bassinets rénaux, ce qui a soulevé un doute clinique encore plus important quant à la présence d’une UOSD. Le service d’urologie a été consulté pour évaluation.
UNASSIGNED: Des endoprothèses urétérales ont été insérées bilatéralement par urologie. L’intervention a entraîné une forte production d’urine et la disparition de l’insuffisance rénale dans les 24 à 48 heures suivantes.
UNASSIGNED: Malgré deux semaines d’anurie et d’hémodialyse, le taux de créatinine de la patiente est retourné à sa valeur initiale. La patiente a pu interrompre l’hémodialyse et son taux de créatinine s’est stabilisé à 88,4 micromoles/L (1 mg/dl).
UNASSIGNED: Le diagnostic de l’UOSD est rare, mais important, car il requiert un doute clinique élevé dans le scénario clinique approprié. On pense que l’absence de dilatation pourrait être liée à l’obstruction du système collecteur rénal par une tumeur ou en raison d’une fibrose ou, comme ici, d’une lymphadénopathie rétropéritonéale métastatique. Puisque le diagnostic de l’UOSD ne doit pas être négligé, une visualisation directe plus poussée et l’insertion d’une endoprothèse interne ou externe pourraient s’avérer nécessaires pour diagnostiquer et traiter cette affection.

Background: Nontuberculous mycobacterium is a recognized cause of hypercalcemia, particularly in patients with acquired immunodeficiency syndrome (AIDS). Here we describe a case of severe hypercalcemia secondary to Mycobacterium abscessus (M. abscessus) in a patient with AIDS. To the best of our knowledge this is the first case report describing a case of M. abscessus presenting as retroperitoneal lymphadenopathy and severe hypercalcemia. Case description: A 56-year-old man with AIDS presented with altered mental status and somnolence for four days. Laboratory investigations were significant for calcium 16.49 mg/dL (RI 8.9-10.3 mg/dL), 1,25 dihydroxyvitamin D level 44.1 pg/ml (RI 19.9-79.3 pg/ml) and parathyroid hormone (PTH) 4 pg/mL (RI 15-65 pg/mL). CT scan of Abdomen and Pelvis showed hepatosplenomegaly with large retroperitoneal, retrocrural, and mesenteric lymphadenopathy which had an intense focal uptake on Gallium scan. Bone marrow biopsy revealed mild plasmacytosis (5%) with no evidence of myelodysplasia, acute leukemia or lymphoma. A subsequent lymph node biopsy showed fragments of fibrous tissue with lymphohistiocytic infiltrate and many acid-fast bacilli. Pre-antibiotic blood cultures grew Mycobacterium which was identified later as M. abscessus at four weeks. Conclusion: hypercalcemia in HIV-infected patients may suggest malignancy or infectious etiology, among other causes. Clinicians should be aware of the risk of hypercalcemia with nontuberculous mycobacterium (NTM) infection, whether as first manifestation or a late presenter in the disease course after initiating antiretroviral therapy (ART). We suggest careful monitoring of serum calcium level upon diagnosis of NTM infection and after initiation of ART, NTM therapy or vitamin D supplementation.

To investigate the impact of retroperitoneal lymphadenopathy (RPLP) on pre-operative CT scan on overall survival (OS) and disease-free survival (DFS) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for peritoneal metastases (PM) of colorectal cancer.
In patients with PM enlarged retroperitoneal lymph nodes (RPLP) are usually considered extra-regional lymph node metastases and therefore these patients may be excluded from CRS-HIPEC. This is a clinical dilemma since it is often hard to obtain histology from these nodes.
In this multicenter, retrospective study all consecutive patients with colorectal PM treated with CRS-HIPEC between 2004 and 2013 were included. The preoperative CT-scan was re-analyzed for the presence of RPLP based on the radiological appearance of enlarged lymph nodes. Outcomes were OS and DFS. Kaplan-Meier methods and Cox regression modeling were used to analyze the impact of RPLP on OS and DFS.
In 25 of 401 patients (6.1%) RPLP was observed on the preoperative CT-scan. Patient, tumor and surgical characteristics did not statistically significantly differ between groups with and without RPLP. After a median follow-up of 46 months, the one-, three- and five-year survival was 80%, 59%, 38% and 90%, 50%, 36% in the group with and without RPLP respectively. Median OS (47 vs. 35 months, logrank: p = 0.70) and median DFS (14 vs. 15 months, logrank: p = 0.81) did not statistically significantly differ between groups. In multivariable analysis, RPLP did not significantly influence survival.
Enlarged retroperitoneal lymph nodes on a pre-operative CT-scan should not automatically exclude patients from CRS-HIPEC.

We present a case of a 63-year-old female who initially presented with complaints of vulvar swelling and was subsequently found to have isolated retroperitoneal lymphadenopathy on imaging. Biopsy was performed and was indicative of weakly polarizable material that raised the consideration of joint prosthesis wear debris. Due to the patient\'s concern for an underlying malignancy of gynecologic origin, a laparoscopic lymphadenectomy was ultimately performed and final pathology was consistent with reactive changes due to joint wear and debris from the patient\'s bilateral total knee arthroplasties placed approximately 16 years prior. While this is a rare presentation, it is important to consider this in the differential of retroperitoneal lymphadenopathy as these patients are often referred to a gynecologic oncologist for further workup.

Hairy cell leukemia (HCL) is uncommonly associated with lymphadenopathy, while retroperitoneal lymphadenopathy is extremely uncommon. We report on a patient with a 12-year history of HCL who developed painless jaundice and ascites, accompanied by positional discomfort with persistent nausea. Computed tomography examination revealed 2 large retroperitoneal masses, which at autopsy consisted of HCL with focally intermixed pancreatic and peripancreatic tissue. Lymphadenopathy was not identified above the diaphragm or below the aortic bifurcation. No vasculitis or an unusual HCL histology was identified. As previous reports, our findings suggest that HCL with massive lymphadenopathy has a specific site predilection, but it is not necessarily accompanied by vasculitis or an unusual histology.