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Demanding cases or nightmares in uro-oncology? May/Jun 2021

It’s not in the bag until it’s out of the abdomen: abdominal wall recurrence after ruptured retrieval bag during robot-assisted partial nephrectomy We present a case of failure of a specimen retrieval bag during a robot-assisted partial nephrectomy resulting in...

Localised renal cancer

Case 1 A 56-year-old lady is referred to the urology clinic after the GP conducted an ultrasound abdomen for deranged liver function tests and found a renal lesion. She is otherwise fit and well. Figure 1. What is the sensitivity...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....

Urinary biomarkers for surveillance of non-muscle invasive bladder cancer

Bladder cancer (BC) is the ninth most common cancer worldwide with a yearly incidence of approximately 430,000 cases. There is a male predominance and it is the seventh most common cancer in men worldwide [1]. Non-muscle invasive bladder cancer (NMIBC)...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study

Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

Urine leak post partial nephrectomy: a case for lower tract before upper tract

Partial nephrectomy has become the standard of care in the management of small renal masses. It is a vital tool in maximising nephron preservation and oncological control for patients. It has been shown to produce equivalent oncological outcomes to radical...

New drug hope for prostate cancer patients

• Hormone therapy is used to slow the progression of advanced prostate cancer, but cancers often develop resistance and continue to grow.• Research reveals that patients with higher levels of heat shock proteins have worse outcomes.• Targeting these proteins with...