Atypical granular cell tumor of the urinary bladder:A case report

BACKGROUND Granular cell tumor(GCT)is a neurogenic tumor mainly occurring in the head and neck.GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported.Most urinary bladder GCT cases are benign and only two malignant cases have been reported.Due to its rarity,no consensus criteria for the treatment of urinary bladder GCT are available at present.CASE SUMMARY A 62-year-old Chinese woman was found to have a urinary bladder tumor without any clinical manifestations on physical examination.Cystoscopy revealed a semispherical shaped lesion measuring approximately 4.0 cm in diameter at the junction of the left wall and roof of the bladder,which was covered with normal bladder mucosa.Computed tomography scan demonstrated a high-density lesion on the left wall of the bladder,measuring approximately 2.9 cm×2.4 cm with clear boundaries.Contrast-enhanced pelvic magnetic resonance imaging revealed a space-occupying lesion on the left wall of the bladder(non-mucosal origin/external pressure),which was preliminarily suspected to be a desmoplastic fibroma or leiomyoma.In the context of the above findings,a pre-operative diagnosis of bladder leiomyoma was made.The patient consequently underwent a laparoscopic partial cystectomy.The resected bladder mass looked yellowish and well-demarcated,measuring 4.0 cm×3.5 cm and infiltrated the muscular layer.The diagnosis of urinary bladder GCT was finally made by postoperative pathology,with positive immunohistochemical S-100 staining and negative pancytokeratin.The patient has been followed for 6 mo so far,with no tumor recurrence detected.CONCLUSION This case highlights the biological feature and differential diagnosis of urinary bladder GCT at the pathological and molecular levels.Transurethral resection of the bladder tumor and partial cystectomy are recommended in most urinary bladder GCT cases,while radical cystectomy is recommended in malignant cases.

Bilateral hematoma after tubeless percutaneous nephrolithotomy for unilateral horseshoe kidney stones:A case report

BACKGROUND Bilateral perirenal hematoma is rarely reported in endoscopic management of horseshoe kidney stones,and there are few studies reporting the formation of bilateral hematoma following tubeless percutaneous nephrolithotomy(PCNL)for unilateral horseshoe kidney calculi.CASE SUMMARY A 32-year-old man was admitted to our hospital because of repeated intermittent hematuria for 10 years.Plain abdominal computed tomography(CT)scan revealed calculi in the horseshoe kidney;the largest being 2 cm in diameter.Tubeless PCNL was performed to remove the stones.Three days after the operation,the patient was discharged in a stable situation.Three days after discharge,the patient presented to our emergency department because of right low back pain and vomiting.Emergent CT scan revealed subcapsular and perirenal hematocele and exudates in both kidneys.Ultrasound-guided puncture and drainage of perirenal effusion were performed.After the temperature stabilized,the patient received low-pressure injection of urokinase 100000 U for 3 d.His routine blood indexes and the renal function returned to normal in 3 wk.CT re-examination 3 mo after lithotripsy showed that the subcapsular and perirenal hematoma and exudates in both kidneys were significantly absorbed as compared with those before.The patient was followed up for 1 year,during which no flank pain or hematuria recurred.CONCLUSION This is the first case report on the formation of bilateral hematoma following tubeless PCNL for unilateral horseshoe kidney calculi.

Ultrasensitive and accurate diagnosis of urothelial cancer by plasmonic AuNRs-enhanced fluorescence of near-infrared Ag_(2)S quantum dots

Urothelial carcinoma(UC)is a common malignant tumor in the urinary system with high recurrence rate and low survival rate 5 years after surgery.At present,imaging examination and other diagnostic methods have some shortcomings such as invasiveness and non-specificity.Therefore,it is urgent to develop a simple,rapid,noninvasive,highly sensitive and highly specific strategy to diagnose UC.Herein,a high-performance fluorescence sensor was constructed by the plasmonic gold nanorods(AuNRs)-enhanced near-infrared(NIR)fluorescence of silver sulfide quantum dots(Ag_(2)S QDs).The designed sensor can be used for the fast and accurate detection of small molecule single-transmembrane protein(FXYD3),which is overexpressed in 90%of ureteral cancers and 84%of high-grade bladder cancers.Due to its high specificity,the NIR fluorescence sensor achieves the detection of FXYD3 in the range of 0.25-150 ng·ml^(-1)with a detection limit of 0.2 ng·ml^(-1).Importantly,it also can be used for accurate diagnosis of FXYD3 in the urine of patients with relevant cancers,and the results are consistent with clinical cystoscopy and pathological analysis.The proposed fluorescence sensor provides a simple,ultrasensitive,reliable method for UC screening,tumor-grade classification and postoperative monitoring and will have great potential for clinical applications.