BackgroundLeiomyomas are benign tumors observed mainly in adult women. The retroperitoneum is a rare location for leiomyomas; almost 100 cases have been reported. Because retroperitoneal leiomyomas are paucisymptomatic and the tumor size at diagnosis is relatively large, surgical management is challenging. Regular follow-up is required because recurrence and malignant sarcomatous transformation have been described in a few cases.Case presentationWe report a case of a 52-year-old North African woman with a 22-cm retroperitoneal leiomyoma. A preoperative embolization was performed 2 days before surgery. The clinical, therapeutic, and evolutive aspects of this rare entity are discussed.ConclusionsDespite its benignity, retroperitoneal leiomyoma is a challenging diagnostic, therapeutic, and evolutive condition. Surgeons must consider mainly the tumor’s vascularization. Regular follow-up is mandatory because malignant transformation cannot be excluded.

Pleomorphic rhabdomyosarcoma (RMS) is a rare tumor with an aggressive behavior, described mainly in adulthood. Herein we present two cases of paratesticular pleomorphic RMS in 71- and 16-year-old patients with metastases at initial diagnosis. Histological, immunohistochemical, and ultrastructural findings were essential to confirm diagnosis. Few months after radical orchiectomy, both patients died before or just after starting adjuvant chemotherapy.

The purpose of the present study is to assess the outcome of ureterolysis in the management of ureteral entrapment secondary to retroperitoneal fibrosis (RPF). A literature search of online database PubMed for studies about ureterolysis was performed. The keywords used for this literature review were: “Retroperitoneal fibrosis” and “Ureterolysis.” Articles in English published between 1980 and 2019 were included. Articles published in non-English language, without full text or lacking of relevant data, were excluded. Clinical perioperative and outcome data were collected, analyzed, and compared between open, laparoscopic, and robotic ureterolysis subgroups. Postoperative complications were recorded according to the Clavien classification. One hundred and six articles were initially collected. After analysis, 37 articles were finally selected for the review. The number of patients was 402. The number of renal units was 554. The median age of our population was 54.55 years (36.5–71). The male/female ratio was 1.71. RPF was idiopathic in 312 patients (77.61%). Ureterolysis was bilateral in 131 cases. The mean success rate in open ureterolysis was 90.45% (77%–100%), the mean success rate in laparoscopic ureterolysis was 93.72% (77.8%–100%), and the success rate in robot-assisted ureterolysis was 100%. Most complications were Clavien I and II. Clavien V was noted in four patients. Ureterolysis is an effective treatment in the management of ureteral entrapment in RPF. It is a safe procedure with possible but manageable complications. It can be proposed in cases of medical therapy failure.

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Urachal anomalies are rare affections due to incomplete closure of urachus during foetal period. Colo-urachal-cutaneous fistula is an uncommon complication of urachal anomalies. Only three cases have been reported so far in the literature. Herein, we report a new case in a 51-year-old patient presenting with umbilical feculent discharge lasting for 4 weeks. Diagnosis was made by computed tomography. After en bloc total surgical excision followup was uneventful.