Primary apocrine carcinoma of an unusual site

Gupta, Archit; Gupta, Mrinal; Mardi, Kavita; Gupta, Jayesh K.

doi:10.1136/bcr-2017-222558

Cited by 1 publication

(1 citation statement)

References 8 publications

(8 reference statements)

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“…A renal hydatid cyst is typically solitary in the upper or lower poles of the kidney and cortical in location. Although often asymptomatic, patients with particularly large renal cysts (> 10 cm) can manifest a spectrum of signs and symptoms that range from flank discomfort, palpable mass, and hematuria to acute renal colic, hypertension, and even renal failure [ 8 – 10 ]. Hydatiduria, or the passage of daughter cysts in urine, is an uncommon (10–20% of cases) yet pathognomonic feature that follows cyst rupture into the pelvicalyceal system (Fig.…”

Section: Discussionmentioning

confidence: 99%

Challenges in treatment of renal echinococcosis with gross hydatiduria and unsalvageable kidney: a case report

et al. 2021

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Introduction Renal echinococcosis is of rare occurrence, and although often asymptomatic, it can present with various mild to drastic presentations, of which hydatiduria is pathognomonic. Diagnosis can be preliminarily established by imaging, and treatment is primarily surgical. We present a patient with renal echinococcosis treated successfully with exclusive antiparasitic pharmacotherapy after refusing surgery despite extensive renal involvement. We hope through this report to help establish future solid guidelines regarding this uncommon therapeutic approach. Case presentation This is a case of a 49-year-old Syrian shepherd presenting with flank pain and passage of grape-skin-like structures in urine. A diagnosis of renal echinococcosis with hydatiduria and significant parenchymal destruction was established based on exposure history, positive serology, imaging findings, and renal scintigraphy. After proper counseling, the patient refused nephrectomy and was therefore started on dual pharmacotherapy (albendazole and praziquantel) and is having an uneventful follow-up and a satisfactory response to treatment. Conclusion This case embodies the daily challenges physicians navigate as they uphold the ethical principles of their practice and support their patients’ autonomy while delivering the best standards of care and consulting the scientific evidence. Although surgery is the cornerstone of renal echinococcosis treatment, treating physicians should be prepared to tackle situations where surgery cannot be done and offer the best next available option for patients who refuse surgery. As data on exclusive pharmacotherapy are limited, future research should thoroughly investigate the efficacy of this uncommon approach and outline reliable recommendations, facilitating future clinical decision-making in this avenue.

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Section: Discussionmentioning

confidence: 99%