Background: Kidney cancer is one of the most prevalent cancers in urology. The higher prevalence of risk factors, as well as better diagnostic modalities, has led to a reported increase worldwide. The study aims to describe the profile and management pattern of kidney cancer patients at a tertiary referral center over seven years.Methods: A descriptive study was conducted to assess the profile and management of kidney patients in the national cancer center (NCC) - Dharmais Hospital Jakarta between January 2013 and December 2020. The variables collected included age, gender, stage (AJCC staging), histopathological result, and management, using the total sampling method.Results: A total of 53 kidney cancer cases were documented in NCC - Dharmais Hospital Jakarta from 2013 to 2020. Overall, males are more prevalent than females, with a sex ratio of 2.3:1. The most frequent age group was 51–65 years. The most common histological subtype was a clear cell in the renal cell carcinoma (RCC) subtype and sarcoma in the non-RCC subtype. Noticeably, end-stage (stage IV) was found in more than half of patients (65.6%), with no patient found in stage I. Radical nephrectomy was preferable to cytoreductive nephrectomy. Conclusions: : An increasing trend of kidney cancer incidence was found between 2013 and 2020 with most patients diagnosed with stage IV.

Introduction: Radical orchidectomy is considered both a therapy and a part of the staging procedure. Stage I seminoma may be treated with orchiectomy alone while the remaining 15% to 20% may have a relapse if they receive no additional treatment during the five-year surveillance. Most recurrences occur within the first 2 years after diagnosis, and the location of the recurrence is typically in the retroperitoneum. This article aims to share the experience in the management of testicular seminoma recurrence in a multidisciplinary approach.Case Presentation: We are reporting a case of a 26-year-old male with a growing mass at the right scrotum just two months after right radical orchidectomy. This patient was previously treated with a stage I seminoma and underwent surveillance. Tumor debulking and right inguinoscrotal reconstruction using a pedicled anterolateral thigh (ALT) flap were done through collaborative surgery between urology and plastic surgery. However, according to National Comprehensive Cancer Network (NCCN), with the relapsed mass, this patient can be classified as having a stage III seminoma and considered as having a good-risk disease due to no evidence of non-pulmonary visceral metastasis. With the risk of bleomycin causing lung fibrosis, four cycles of etoposide and cisplatin can be considered the chemotherapy regimens for this patient. Evaluation after chemotherapy should be done by checking tumor markers and imaging studies.Conclusions: The reappearance of testicular seminoma in this patient unexpectedly occurred quite in a short period, that is in two months after surgery. Immediate multidisciplinary intervention by a urologist and plastic surgeon was done through tumor debulking with a wide incision margin and ALT flap reconstruction. Unfortunately, however, after the second month of follow-up, there was a bulging mass growing beneath the flap which needed further evaluation with ultrasonography to confirm the possibility of tumor recurrence or seroma. If tumor recurrence is confirmed, chemotherapy should be scheduled as soon as possible.

Wilms tumor (nephroblastoma) is rare in adults. We present a case of 28-year old female with Wilms tumor diagnosed with pre-operative abdominal magnetic resonance imaging, histopathological analysis and immunohistochemistry. She had relapse tumor two years after primary open radical nephrectomy. She was managed with chemotherapy with the ICE regimen (ifosfamide, carboplatin, and etoposide) for six cycles with partial response and excellent functional status. Keywords: ABSTRAKTumor Wilms (nefroblastoma) adalah kasus yang jarang ditemukan pada orang dewasa. Kami melaporkan satu kasus, pasien perempuan, 28 tahun dengan tumor Wilms yang didiagnosis dengan pemeriksaan magnetic resonance imaging pre-operasi, histopatologi, dan imunohistokimia. Pasien tersebut mengalami relaps dua tahun pasca-radikal nefrektomi. Pasien kemudian menjalani kemoterapi dengan regimen ICE (ifosfamid, karboplatin, dan etoposid) selama enam siklus dengan repons parsial dan status fungsional baik.

Fanconi syndrome is a group of clinical manifestations including aminoaciduria, proteinuria, glycosuria, hypophosphatemia, and metabolic acidosis. It may occur after exposure to certain drugs. The most common causes are antiepileptic, antiviral, antibiotic, and antineoplastic drugs.1 The two most common causes in the antineoplastic regimen are cisplatin and ifosfamide. Ifosfamide, a derivative of cyclophosphamide, has been used to treat pediatric solid tumors.2 Its high efficacy in numerous studies has led to its long-term administration for pediatric malignancies, including Wilms tumor. Along with other treatment modalities, ifosfamide considerably improved the survival rate (90%) of Wilms tumor while only a few cases resulted in Fanconi syndrome.1,3,4 Here we illustrate a case of presumed drug induced Fanconi syndrome in a Wilms tumor patient who previously achieved remission for 10 months.

Background: Urethral adenocarcinoma is a very uncommon problem in women, with a prevalence of 0.02%. Due to the disease's rarity, there is very little information available about it. Treatment for cancer can have a significant negative influence on a patient's condition. Mucinous adenocarcinomas are a very uncommon type of cancer that is poorly studied. These cancers almost invariably have a worse outcome compared to conventional adenocarcinomas. Case Presentation: A 67 year old woman presented with hematuria and stranguria. A computerised tomography (CT) scan of this patient revealed an urethral tumor. In her histopathologic report we found the tumor cells were arranged in small clusters and single cells were scattered among extracellular mucin and signet ring cell picture, which is consistent with mucionous adenocarcinoma. We then performed partial urethrectomy with negative surgical resection, but the tumor reappeared 18 months later with no symptoms. The patient then decided to undergo radiotherapy for 33 sessions. From a recent MRI follow up the patient remains recurrence free. Conclusions: Early surgical treatment with or without adjuvant radiotherapy appears to be the best option in cases of small, organ-confined disease of urethral mucinous adenocarcinoma. Partial urethrectomy can be performed in this type of cases, which can prevent the use of permanent urinary catheters and further improve the patient's quality of life.