The presence of signet ring cells in samples obtained from routine pretreatment endoscopic biopsies accurately predicts SRC histology and poor prognosis. The specific therapeutic strategy can consequently be considered from the initial diagnosis.
We report two clinical cases of primary granulocytic sarcoma of the pancreas that were diagnosed on the surgical specimen. Atypical clinical and morphological presentations may have lead to pretherapeutic biopsies of the pancreatic mass in order to indicate primary chemotherapy. Literature review of this rare clinical presentation may help physicians to anticipate diagnostic and therapeutic strategies.
Background
Uro-digestive fistulae are uncommon. They frequently manifest themselves with mild symptoms but can, in some cases, be life-threatening leading to septic shock and death. The diagnosis is facilitated by radiological explorations and their management remains mainly surgical.
Case presentation
We report the case of a diabetic 62-year-old patient who developed a renocolic fistula revealed by a digestive symptomatology, following a partial nephrectomy that was surgically treated with positive overall outcome.
Conclusion
The development of a fistula between the colon and the kidney is very rare. Although the outcome was positive at the price of total nephrectomy and partial colectomy, the diagnosis and management of the fistula were challenging. Urologists should keep in mind the possibility of a fistula developing in the aftermath of a partial nephrectomy.
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