When the length of the dissected ureter was shorter than the surgeon expected, the location of the ureterostoma could be easily moved to any place that was ideal for managing postoperative stoma care. To relieve an advanced pelvic cancer patient’s severe urinary-related pain, retroperitoneoscopic right cutaneous ureterostomy

followed by embolization of the left renal artery to eliminate left kidney function was performed. The patient was free from the painful urinary-related symptoms until he died of progressive disease. This treatment strategy is feasible for selected patients to avoid decreasing the quality of their remaining life. None of the authors have any potential conflicts of interest Neratinib molecular weight to declare. “
“Angiomyolipoma (AML) is a benign renal mesenchymal tumor affecting more than 10 million people worldwide, predominantly in women aged 40-50 Cell Cycle inhibitor years. It might be sporadic or occurs in association with tuberous sclerosis complex or lymphangioleiomyomatosis (LAM).1 There are 2 variants of AML: classic (triphasic) and epithelioid. Although AML is classically benign, the epithelioid variant can closely mimic renal cell carcinoma radiographically. Epithelioid AML has been reported to exhibit aggressive clinical course

with metastases, recurrences, and high rate of mortality.2, 3 and 4 Rarely, AML might invade the major renal vein and/or lymph nodes. However, involvement of regional lymph nodes is interpreted as multifocality of growth rather than true metastases or malignant

behavior. Herein, we report a case of lipomatous AML that demonstrates an unusual aggressive behavior with inferior vena cava (IVC) tumor thrombus. The patient is a 42-year-old asymptomatic woman with no past medical history referred to us on account of a hyperechoic right kidney mass and IVC thrombus found on routine abdominal ultrasound. Physical examination was unremarkable, and laboratory values were within normal limits, with hemoglobin of 13.2 g/dL and creatinine of 0.85 mg/dL. Computed tomographic (CT) scan of the abdomen confirmed a 3-cm right upper Florfenicol pole renal mass with central fat attenuation and a 5-cm level II IVC thrombus (extension into the right renal vein and IVC below the level of the hepatic veins; Fig. 1A and B). Shortly after imaging diagnosis, she presented with a 1-week history of pleuritic chest pain and shortness of breath in the recumbent position. Urgent chest CT angiogram showed a pulmonary tumor embolus (−65 HU) in the right anterior segmental branch of the pulmonary artery, with a corresponding infarct in the medial segment of the right lower lung lobe. The CT also revealed multiple bilateral lung cysts, suggesting a diagnosis of LAM. She underwent a right radical nephrectomy and IVC thrombectomy through a modified Chevron incision.