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Androgen-secreting adrenal neoplasms have a low incidence, usually secrete multiple hormones, and may present with hirsutism, acne, and alopecia. We report an exceedingly rare case of a purely dehydroepiandrosterone-sulfate (DHEA-S) secreting adrenal neoplasm found incidentally on cross sectional imaging. The clinical, biochemical, and pathologic findings of this neoplasm are described. © 2020 The Author(s).Our main objective is to report the feasibility of performing simultaneous robotic-assisted laparoscopic (RAL) right partial nephrectomy with contralateral radical nephrectomy in children with bilateral Wilms' tumor. The RAL right partial nephrectomy and contralateral radical nephrectomy were performed via trans-peritoneal with a four-port approach (five ports in one patient), and the patients were repositioned and draped when moving to the other side. The operative time was 90 min, estimated blood loss was 50 cc. Postoperative length of stay was 2 days. No significant intraoperative or postoperative complications occurred. © 2020 Published by Elsevier Inc.Usual location of metastasis are in renal cell carcinoma (RCC) the lung, liver, bone, adrenal and brain. Here we report on an unusual case of a 76-year-old male with a solitary sternal metastasis as an initial presentation of clear-cell RCC. The management of metastatic kidney cancer has been disrupted over the last decade by the emergence of new treatments and the progress of surgery and ablative techniques. the Carmena study suggests that sunitinib alone is not inferior to the NCR followed by sunitinib, the patient has therefore been transferred to oncology for medical treatment (targeted therapy). © 2020 The Authors.Emphysematous cystitis is an unusual urological emergency in clinical practice. The disease characteristics are still underreported. It is characterized by the presence of gas in the urinary bladder wall secondary to gas forming organism. We report an incidental finding of emphysematous cystitis in a 35-year-old secondary to a huge liver abscess in a poorly controlled blood sugar. The infection spread hematogenously to the urinary bladder wall that was managed conservatively by urethral catheter drainage and hepatic abscess drainage in adjunct with antimicrobial therapy. The patient had no urinary symptoms. The bladder wall gas disappeared during follow-up in 2 weeks. © 2020 The Authors.Hemangiopericytoma (HPC) is rare in the urogenital system, most frequently occurs in the pelvis, head and neck, and meninges, it is extremely rare in the kidney. US, CT, or MRI do not show any specific sign of renal HPC that might aid in the differential diagnosis with other renal tumors, that's why almost all cases are diagnosed after pathological results. The majority of cases are identified in patients with an unspecific clinical manifestations associated with hematuria or hypertension, hypoglycemia or additional paraneoplastic syndromes. Here we present a rare case of hemangiopericytoma in 15 year old female, with drug refractory hypertension. © 2020 The Author(s).Nitrous oxide (N2O) is widely used as an anesthetic or an analgesic. N2O prolonged and recurrent administration is known to affect vitamin B12 metabolism with subsequent clinical consequences. We report herein the case of a 13-year-old girl with sickle cell disease exhibiting severe neurological and biochemical signs of functional vitamin B12 deficiency due to prolonged and repeated exposure to N2O. This was an incentive to prospectively investigate functional vitamin B12 deficiency in patients affected by sickle cell disease regularly exposed to N2O. We measured plasma concentrations of vitamin B12, total homocysteine, methionine and methylmalonic acid in 39 patients with sickle cell disease between 2015 and 2016. No patients developed neurological symptoms related to N2O administration but 19 patients (49%) had biochemical abnormalities suggesting mildly disturbed vitamin B12 metabolism e.g. decreased B12 vitamin, hypomethioninemia, or slightly increased methylmalonic acid or homocysteine. The clinical case highlight the potential severe deleterious effects of N2O over exposure on B12 vitamin metabolism in particular in patients affected with sickle cell disease. Conversely, when used without excess even repeatedly, there seem to be no overt clinically relevant abnormalities in vitamin B12 metabolism as observed on the cohort of 39 sickle cell disease affected patients. © 2020 Published by Elsevier Inc.Over the past years there has been a considerable increase in the use of aortic bioprostheses for treating aortic valve disease. With the increasing use of implanted medical devices, the incidence of prosthetic valve endocarditis has also increased. This is accompanied by a shift in the microbiology of infectious endocarditis. Micrococcus species are usually regarded as contaminants from skin and mucous membranes that rarely cause infectious diseases, however, they have the capacity to create biofilms from prosthetic materials and hence, to cause disease. We report the case of a 54-year-old woman who developed native valve infective endocarditis due to Micrococcus luteus. To our knowledge, only 18 cases of M. luteus prosthetic valve endocarditis have been described, none in the English literature. © 2020 The Authors.Mycobacterium chubuense is a scotochromogenic rapidly growing mycobacterium (RGM), a nontuberculous mycobacterium (NTM)that was first characterized in 1981. This case report describes a rare case of M. chubuense infection in the right hand of a 53-year-old man who lived in the coastal areas of Zhejiang province, China. selleck kinase inhibitor To the best of our knowledge, this is only the second reported case of a M. chubuense infection worldwide, the first in a hand. Culture of lesion were positive for Mycobacterium chubuense, which was confirmed by PCR and sequencing. This case report complementsthe literature regarding M. chubuense infection. © 2020 The Authors.A documented side-effect of artemisinin therapy is post-artemisinin delayed hemolysis (PADH), primarily occurring after parenteral treatment for severe P. falciparum infections. PADH has been infrequently reported after oral therapy and is rarely severe enough to require hospitalization and blood transfusions. A 24 year old man was diagnosed with P. falciparum, prompting initiation of oral artemether-lumefantrine (AL). Further work-up demonstrated that he met WHO criteria for severe malaria infection on the basis of high parasitemia and his regimen was switched to intravenous quinidine and oral doxycycline. He was transitioned back to AL after 4 days and was discharged on hospital day six. Five days later, he was readmitted for hemolytic anemia. His peripheral blood was absent of malaria parasites and he was diagnosed with PADH, ultimately requiring multiple blood transfusions. Severe hemolytic anemia requiring blood transfusions after oral artemisinin therapy is rare and may be associated with higher parasite loads.
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