Combined broad-spectrum antibacterial therapy and percutaneous renal drainage is a safe and effective treatment for EPN, especially in high-risk patients for whom nephrectomy under general anesthesia is not feasible.
Genitourinary tuberculosis, the second most common extrapulmonary tuberculosis (TB), is very difficult to diagnose unless one maintains a high index of suspicion. Isolated tuberculous epididymitis (ITE), defined as tuberculous epididymitis without clinical evidence of either renal or prostate involvement, is a rare entity among genitourinary tuberculosis. When diagnosed correctly, ITE can be cured with anti-TB medications. However, patients with poor response to medical treatment may require surgery. Here, we report a 20-year-old man who presented with a slow-growing painless scrotal tumor for 2 months, with the initial workup suspicious for a right paratesticular tumor. Surgical resection of the tumor was therefore scheduled. However, severe pain and redness over the patient's right hemi-scrotum were noted on the day of surgery. A repeat scrotal ultrasound was performed that revealed findings suggesting a chronic inflammatory process rather than a malignancy. Frozen section of the lesion confirmed the ultrasonographic findings, and the pathology established the diagnosis of ITE. The patient remained on anti-TB therapy postoperatively for 6 months and had an excellent outcome.
Benign fibroepithelial polyps of the renal pelvis are extremely rare, and are frequently mistaken for transitional cell carcinoma. Diagnosis is usually made following nephrectomy or nephroureterectomy for an assumed malignancy of the renal pelvis. We report a 56-year-old female with a right renal pelvic fibroepithelial polyp successfully treated by percutaneous nephroscopic resection.
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