Distinguishing infiltrative renal masses (IRMs) from intrarenal urothelial cancers (IUCs) is critically important, but may be challenging for any radiologist or urologist. The present study aimed to summarize the clinical, imaging and pathological characteristics of IRM, which were postoperatively confirmed as IUC. The analysis was performed using the records of 22 patients who were preoperatively diagnosed with IRM but the results of percutaneous biopsies or postoperative pathological analyses led to diagnoses of urothelial cancers (UCs) from January 2011 to December 2017. The demographic data, computed tomography (CT) imaging features and pathological characteristics were evaluated. The present study also reviewed the literature concerning the IRM and IUC. The mean age of patients was 62 years and 86.4% of them were >55 years. The sex and tumor side distributions were equal. Hematuria and/or flank pain were observed in 86.4% of patients. All patients exhibited endophytic solid renal masses with unclear tumor boundaries on CT images. The kidneys of 81.8% of patients maintained their normal shape while mild alternations were observed in 18.2% of cases. A total of 81.8% of patients maintained the reniform shape and 18.2% exhibited mild contour change. Of all patients, all tumors exhibited less or equal attenuation on unenhanced CT images and they were mildlyimproved on enhanced CT. A total of 6 cases were confirmed by biopsy, when patients underwent laparoscopic nephroureterectomy instead of radical nephrectomy. The remaining 16 patients underwent laparoscopic nephrectomy but the postoperative pathological diagnoses revealed the presence of UCs. All postoperatively confirmed cancers were stages T3 and T4 (62.5 and 37.5%, respectively). UCs should be suspected in middle aged or elderly middle-elderly patients presenting renal masses with endophytic solid unclear tumor boundary on unenhanced and slightly enhanced CT images, accompanied with hematuria and/or flank pain. Preoperative biopsy is preferred for complicated cases.

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Background: To determine independent predictors of inguinal lymph node(ILN) metastasis in patients with penile-cancer.Patients and methods: We retrospectively analyzed all patients with penile-cancer undergoing surgery at our medical center in ten years(N=157). Using univariate and multivariate logistic-regression models, we assessed associations between the following factors: age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs, pathological T stage, degree of tumor differentiation and/or corni cation, lymphatic vascular in ltration(LVI), nerve in ltration, and ILN metastases. Interaction and strati ed analyses were then used to assess age, phimosis, onset-time, number of ILNs, corni cation, and nerve in ltration.Results: Ultimately, 110 patients were included. Multiple logistic-regression analysis showed that the following factors were signi cantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter of ≥1.5 cm, 50%(19/38) had LNM(HR=2.3, 95%CI: 1.0-5.1), whereas only 30.6%(22/72) of patients with a maximum ILN diameter <1.5 cm showed LNM. Among 44 patients with stage Ta/T1, 10(22.7%) showed ILN metastases, while 31 of 66(47.0%) patients with stage T2 showed ILN metastases(HR=3.0, 95%CI: 1.3-7.1). Among 40 patients with highly differentiated penile-cancer, eight(20%) showed ILN metastasis, while 33 of 70(47.1%) patients with low-to-middle differentiation showed ILN metastases(HR=3.6, 95%CI: 1.4-8.8). In the LVI-free group, the rate of LNM was 33.3%(32/96), whereas it was 64.3%(9/14) in the LVI group(HR=3.6, 95%CI: 1.1-11.6).Conclusion: Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.

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