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[74] Giant retroperitoneal lipoma: A case report and review of the literature
Abstracts / Arab Journal of Urology 16 (2018) S25–S39
Methods: An observational prospective study was conducted at the Medical Oncology Department of the Academic Hospital of Oran between January 2012 and May 2015. Patients enrolled were aged >18 years, with untreated ccRCC with a Karnofsky performance status (KPS) >70%. Sunitinib was administered with schedule of 50 mg/day, 4-weeks on/2-weeks off. Dose adjustment and changing schedule to 2-weeks on/1-week off, were possible in cases of persistent severe toxicity. Results: In all, 43 patients with advanced or metastatic ccRCC were enrolled in the study. The sex ratio was 1.8, with a mean (SD) age of 58.4 (3.5) years. The KPS was 100%, 80–90% and 60–70% in 11%, 77% and 12% of the patients, respectively. In all, 339 cycles were administered, with a mean (SD; range) of 11.6 (2.8; 1–42) cycles. The median PFS by intention-totreat (ITT) was 10.5 months (95% confidence interval [CI] 6.1–14.9) with a PFS rate at 12 months of 34.8%. The ORR in ITT was 45% (95% CI 30–60). The median OS was 21.3 months (95% CI 11.5–31.07) with an OS rate at 2-years of 30.2%. The main grade 3–4 toxicities were represented by asthenia (56%), anorexia (32%), hand-foot syndrome (33%), stomatitis (28%), diarrhoea (23%), hypertension (21%), and thrombocytopaenia (14%). Conclusions: The effectiveness results of sunitinib in our present study are similar to those in the literature, with a manageable and acceptable toxicity profile. doi:10.1016/j.aju.2018.10.026
[74] Giant retroperitoneal lipoma: A case report and review of the literature Soumeya Lekouaghet, Boulatrous Abdelkrim, Abdelhalim Chouakria, Toui Karim, Nour Islem Kadem, Amir Atik, Sina Haiahem, Malik Atoui, Mourad Nouacer, A. Khenniche, Abdelkrim Kadi, Kheireddine Chettibi Department of Urology, Annaba University Hospital, Annaba, Algeria Objective: To report on a very rare case of giant retroperitoneal lipoma and a literature review. Retroperitoneal lipomas are an extremely rare condition with only 17 cases described in the literature since 1980. They can reach enormous size and cause significant abdominal symptoms. The most important differential diagnosis is the well-differentiated liposarcoma, which preoperatively often may not definitely be ruled out. Methods: We present the case of a 72-year-old woman with a giant retroperitoneal lipoma. The patient presented with abdominal pain and the appearance of a gradually increasing abdominal mass. The radiological explorations found a voluminous mass of retroperitoneal fatty density having a relationship with the psoas
S35
muscle of 17 21 cm causing deviation of the intestinal structures. Results: Exploratory laparotomy was indicated with the aim of en bloc total tumour resection for potential malignancy. Intraoperatively demarcated, there were two well-limited and encapsulated masses, the first mass weighed 665 g and measured 18 cm, the second weighed 1750 g and measured 24 cm. The operative follow-up was without incident. Conclusion: Retroperitoneal lipomas are not clearly distinguishable from well-differentiated liposarcomas on imaging and even biopsies may be misleading. Moreover, abdominal symptoms, e.g. pain, constipation and dysphagia, may occur due to mechanical displacement. Therefore, surgical exploration with complete oncological resection is the therapy of choice if malignancy cannot be ruled out. doi:10.1016/j.aju.2018.10.027
[75] Renal metastasis of a primary ovarian carcinoma: A historical case report Boulatrous Abdelkrim, Samir Atik, Abdelhalim Chouakria, Karim Atoui, Nour Islem Kadem, Sina Haiahem, Malik Atoui, Mourad Nouacer, A. Khenniche, Abdelkrim Kadi, Kheireddine Chettibi Urology Department, University Hospital Annaba Algeria, Annaba, Algeria Objective: To report on a rare case of renal recurrence of ovarian malignancy. The frequency of secondary tumours of the kidney is underestimated, especially as their diagnosis is often delayed, after nephrectomy or autopsy. Unusual sites for recurrent ovarian metastases include extrahepatic solid organs (except the spleen), bone and the abdominal wall. Methods: Our case represents only the fifth reported case of metastatic ovarian carcinoma presenting as a solitary renal metastatic recurrence in the literature in 30 years. Results: A 47-year-old woman presented with vague abdominal pain. An initial ultrasonography (US) revealed a right ovarian mass, with no other mass in other organs including the kidneys. She underwent right adnexectomy. Histology confirmed an ovarian carcinoma. The patient had adjuvant chemotherapy. A computed tomography scan after surgery revealed a mass in the left kidney. US-guided percutaneous biopsy of the left renal mass confirmed metastatic carcinoma of ovarian origin. The patient underwent left nephrectomy. Histology of the renal mass confirmed the initial findings of the biopsy. Follow-up after 12 months showed complete remission, with no recurrence. Conclusion: Although unusual, awareness of the possibility of rare and atypical sites of ovarian metastatic
Methods: An observational prospective study was conducted at the Medical Oncology Department of the Academic Hospital of Oran between January 2012 and May 2015. Patients enrolled were aged >18 years, with untreated ccRCC with a Karnofsky performance status (KPS) >70%. Sunitinib was administered with schedule of 50 mg/day, 4-weeks on/2-weeks off. Dose adjustment and changing schedule to 2-weeks on/1-week off, were possible in cases of persistent severe toxicity. Results: In all, 43 patients with advanced or metastatic ccRCC were enrolled in the study. The sex ratio was 1.8, with a mean (SD) age of 58.4 (3.5) years. The KPS was 100%, 80–90% and 60–70% in 11%, 77% and 12% of the patients, respectively. In all, 339 cycles were administered, with a mean (SD; range) of 11.6 (2.8; 1–42) cycles. The median PFS by intention-totreat (ITT) was 10.5 months (95% confidence interval [CI] 6.1–14.9) with a PFS rate at 12 months of 34.8%. The ORR in ITT was 45% (95% CI 30–60). The median OS was 21.3 months (95% CI 11.5–31.07) with an OS rate at 2-years of 30.2%. The main grade 3–4 toxicities were represented by asthenia (56%), anorexia (32%), hand-foot syndrome (33%), stomatitis (28%), diarrhoea (23%), hypertension (21%), and thrombocytopaenia (14%). Conclusions: The effectiveness results of sunitinib in our present study are similar to those in the literature, with a manageable and acceptable toxicity profile. doi:10.1016/j.aju.2018.10.026
[74] Giant retroperitoneal lipoma: A case report and review of the literature Soumeya Lekouaghet, Boulatrous Abdelkrim, Abdelhalim Chouakria, Toui Karim, Nour Islem Kadem, Amir Atik, Sina Haiahem, Malik Atoui, Mourad Nouacer, A. Khenniche, Abdelkrim Kadi, Kheireddine Chettibi Department of Urology, Annaba University Hospital, Annaba, Algeria Objective: To report on a very rare case of giant retroperitoneal lipoma and a literature review. Retroperitoneal lipomas are an extremely rare condition with only 17 cases described in the literature since 1980. They can reach enormous size and cause significant abdominal symptoms. The most important differential diagnosis is the well-differentiated liposarcoma, which preoperatively often may not definitely be ruled out. Methods: We present the case of a 72-year-old woman with a giant retroperitoneal lipoma. The patient presented with abdominal pain and the appearance of a gradually increasing abdominal mass. The radiological explorations found a voluminous mass of retroperitoneal fatty density having a relationship with the psoas
S35
muscle of 17 21 cm causing deviation of the intestinal structures. Results: Exploratory laparotomy was indicated with the aim of en bloc total tumour resection for potential malignancy. Intraoperatively demarcated, there were two well-limited and encapsulated masses, the first mass weighed 665 g and measured 18 cm, the second weighed 1750 g and measured 24 cm. The operative follow-up was without incident. Conclusion: Retroperitoneal lipomas are not clearly distinguishable from well-differentiated liposarcomas on imaging and even biopsies may be misleading. Moreover, abdominal symptoms, e.g. pain, constipation and dysphagia, may occur due to mechanical displacement. Therefore, surgical exploration with complete oncological resection is the therapy of choice if malignancy cannot be ruled out. doi:10.1016/j.aju.2018.10.027
[75] Renal metastasis of a primary ovarian carcinoma: A historical case report Boulatrous Abdelkrim, Samir Atik, Abdelhalim Chouakria, Karim Atoui, Nour Islem Kadem, Sina Haiahem, Malik Atoui, Mourad Nouacer, A. Khenniche, Abdelkrim Kadi, Kheireddine Chettibi Urology Department, University Hospital Annaba Algeria, Annaba, Algeria Objective: To report on a rare case of renal recurrence of ovarian malignancy. The frequency of secondary tumours of the kidney is underestimated, especially as their diagnosis is often delayed, after nephrectomy or autopsy. Unusual sites for recurrent ovarian metastases include extrahepatic solid organs (except the spleen), bone and the abdominal wall. Methods: Our case represents only the fifth reported case of metastatic ovarian carcinoma presenting as a solitary renal metastatic recurrence in the literature in 30 years. Results: A 47-year-old woman presented with vague abdominal pain. An initial ultrasonography (US) revealed a right ovarian mass, with no other mass in other organs including the kidneys. She underwent right adnexectomy. Histology confirmed an ovarian carcinoma. The patient had adjuvant chemotherapy. A computed tomography scan after surgery revealed a mass in the left kidney. US-guided percutaneous biopsy of the left renal mass confirmed metastatic carcinoma of ovarian origin. The patient underwent left nephrectomy. Histology of the renal mass confirmed the initial findings of the biopsy. Follow-up after 12 months showed complete remission, with no recurrence. Conclusion: Although unusual, awareness of the possibility of rare and atypical sites of ovarian metastatic