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Wilms tumors are the most common renal malignancy of childhood, often presenting as asymptomatic abdominal masses. These tumors can occur either in a unilateral or bilateral fashion, with bilateral tumors more commonly associated with various genetic syndromes and familial inheritance with some known loci. Bilateral tumors present challenges with regards to balancing oncologic control with renal function. Here, we present an unusual case of a young female patient diagnosed with bilateral Wilms tumors on the background of a strong family history and unknown genetic loci.

Aggressive angiomyxoma (AAM) is a rare tumor with a high risk of local recurrence. Scrotal AAM mimics common pediatric pathologies including hernia or hydrocele. We present 11-year-old boy who underwent macroscopically radical excision of right scrotal AAM. The patient has been already followed up for 29 months utilizing US every 6 months and MRI every 2 years. Residual scrotal mass has been visualized in MRI 3 months after surgery however no further growth was reported. Long term follow up with reliable local imaging is mandatory.

Nephrogenic adenoma is a rare, benign lesion that can be encountered anywhere along the urinary tract. It is associated with genitourinary trauma, chronic inflammation, genitourinary surgery, renal transplant, urolithiasis, and radiation. In children, these lesions are almost exclusively found in the bladder. However, we report an unusual case of a 15-year-old boy with no prior urologic history who presented with an obstructing right ureteral nephrogenic adenoma that required an ileal ureter interposition and right ureterectomy.

We present an unusual case of isolated urethral tuberculosis. The patient had a history of urethral strictures and persistent discharge from two peno-scrotal fistulas which was confirmed on urethrogram. He was treated with anti-tubercular treatment and a two stage urethroplasty.

Renal lymphangectasia is a benign malformation of the lymphatics which can be perirenal or peripelvic in location. Diagnosis is made on imaging including ultrasound, computed tomography , or MRI. We present an unusual case of renal lymphangectasia presenting with gross hematuria and flank pain diagnosed on computed tomography.

Pheochromocytomas have been described to be associated with renal infarction in a few sporadic cases. The underlying pathophysiologic mechanisms are catecholamine-induced vasospasm and direct compression or invasion of the tumor on renal artery or its branches. However, renal infarction caused by extra-adrenal pheochromocytoma is rarely reported. We describe an unusual case of benign extra-adrenal pheochromocytoma complicated with left renal infarction by severe vasospasm.

Phenazopyridine is a common, well-tolerated medication with minimal side effects. Severe side effects are rare and include methemoglobinemia in setting of overdose, elderly patients, renal insufficiency, and chronic use. Here, we report a case of methemoglobinemia-induced perioperative hypoxia in an adolescent patient without renal insufficiency or overdose which has not been reported previously. This case underscores the importance of judicious use of this medication in all patients but notably in pediatric patients and those with chronic lung disease.

Polyorchidism is a rare congenital anomaly with less than 200 case reports in literature. Triorchidism, the condition of having 3 testicles, is the most common presentation. We present an unusual case of a patient who was diagnosed with 5 testicles by magnetic resonance imaging. To the best of our knowledge, this rare presentation has not previously been reported in the medical literature.

Retrorectal cystic hamartoma (tailgut cyst) is a rare congenital lesion. This study is one of the few reports of this rare clinical entity causing irritative voiding symptoms and constipation in a male patient. Although most cases are asymptomatic, patients may present with symptoms resulting from local mass effect or complication.

We present an unusual case of basal cell carcinoma (BCC) arising from a non-sun-exposed area. The patient was 69-year-old male with an enlarging giant fungating mass protruding from his scrotum for which he did not seek medical treatment until recently. The mass did not involve the scrotum or epididymis and was confirmed on ultrasound. The patient underwent wide surgical excision and was diagnosed with BCC of the scrotum. Scrotal BCC appears to be more aggressive and more likely to metastasize compared with lesions arising from other areas of the body.

An unusual case report to stress the complexity of development of identity and intimacy in people with bladder exstrophy. The psychosocial support seems to play a fundamental role to promote self-esteem of abdominal scarring and altered genital appearance.

Ureteropelvic junction obstruction may present with a variety of urologic and gastrointestinal complaints. The constellation of symptoms is most often attributed to shared visceral pathways. In cases of giant hydronephrosis, mechanical obstruction of the gastric outlet or duodenal sweep may play an additional role in presentation. We present an unusual case of duodenal obstruction caused by ureteropelvic junction stenosis. The anatomic and autonomic renoalimentary relationships are reviewed.

Cavernous hemangiomas are unusual tumors with a propensity for skin and liver involvement and rarely involving genitourinary organs. We report an unusual case of adrenal hemangioma which was successfully treated surgically. In addition, we review the salient clinical, radiographic, and pathologic features of this disease.

We present an unusual case of a fragmented, long forgotten double-J stent with incontinence as a result of partial extrusion of the lower fragment across the urinary sphincters. After reviewing the published data, incontinence as a presenting complaint, to the best of our knowledge, has not been reported for this condition previously.

Animal bites to human external genitalia are rare. Only a few cases of scrotal dog bite in children have been reported. We present an additional specific case of a scrotal dog bite in a child because the lesion and its repair have not been previously reported in published pediatric studies. A traumatic resection of the right testicular vas deferens was repaired by microsurgical vasoepididymal anastomosis. A review of the published data was also performed to analyze the management of scrotal dog bite lesions.

An unusual case is reported of a fifteen-year-old adolescent boy, who was born with two independent phalli, Both organs featured separate, completely developed urethras, including an extra urethral remnant in the right penis. A third hypospadic perineal urethral duct equipped with a mechanical sphincter also could be identified histologically. Bilateral simultaneous erections could be achieved easily. A review of published cases suggests that this may be the first example of a complete diphallia eoexistina with a third urethra.

Duplication of the bladder is an unusual congenital anomaly. Complete and incomplete forms are well defined in published reports. We present an unusual case of a 3-year-old boy with two separate-walled bladders, one lying in front of the other, communicating through a tiny septum, at the neck of the primary bladder that drained to a normal single urethra. This type of isolated bladder anomaly was not defined in the classification of the duplication of the bladder. In patients with a lower abdominal cystic mass, complete bladder duplication must be included in the differential diagnosis of pelvic cystic masses.

Intrascrotal and testicular masses in the pediatric population do not usually present as treatment dilemmas. Herein, we report an unusual case of an enlarging, intrascrotal capillary hemangioendothelioma in a 3-month-old male infant. Conservative management including watchful waiting in the case of purely cutaneous scrotal hemangiomas is the treatment of choice. However, scrotal lesions with a palpable testicular or scrotal mass do not lend themselves to conservative treatment and, as in this case, exploration with intraoperative evaluation and excision is warranted.

We report an unusual case of ureteral duplication with lower-pole ectopia and ureterolithiasis, which violates the Weigert-Meyer law. The duplicated ureter arose from a lower-pole calyx and drained inferiorly into the ipsilateral vas. A presentation of the case is followed by a comparison to the only known similar one, reported in 1988. A possible embryologic hypothesis for this anomaly is discussed.

We report an unusual case of recurrent primary focal segmental glomerulosclerosis in an apparent low-risk cadaveric renal allograft recipient only 2 days after transplantation, who did not respond to repeated courses of plasmapheresis.

Metastatic renal cell carcinoma (RCC) presenting with peritoneal involvement or ascites is rare and has been previously described clinically in the setting of large renal mass or other distant metastases. We report an unusual case of RCC presenting with ascites without large mass or other distant metastases. Advances in cytologic diagnosis of metastatic RCC in serous ascitic fluid is discussed, while a potential mechanism of tumor spread is presented.

Crossed ectopia is a rare congenital anomaly. S-shaped (sigmoid) kidney is one of the varieties of crossed ectopia that is associated with absence of any renal tissue in the contralateral renal fossa. S-shaped malformation of an ipsilateral kidney with presence of the contralateral kidney is an extremely rare condition and, to our knowledge, has been described only once before in the literature. We present the case and discuss the hypothesis for this rare malformation.

Nephrolithiasis and nephrocalcinosis in low-birth-weight, preterm neonates are well-documented complications of furosemide administration. Perinephric urinomas and urinary ascites have been previously reported as complications of obstruction due to posterior urethral valves or ureteropelvic junction obstruction. We present an unusual case of furosemide-induced nephrolithiasis causing ureteral obstruction, urinoma, and acute renal failure in a preterm neonate.

We present an unusual case of primary malignant mesothelioma of the penis in an adult male. The clinical features and microscopic, immunohistochemical, and ultrastructural characteristics that help to identify this entity are described. A discussion of the behavior of malignant mesothelioma follows, as well as a possible explanation for its origin in the penis. To date, no cases of primary malignant mesothelioma of the penis have been reported.

The incidence of tuberculosis in the United States is on the rise, in part, because of its association with acquired immunodeficiency syndrome. Genitourinary tuberculosis remains one of the most common forms of secondary or extrapulmonary disease. We present an unusual case of tuberculous epididymitis with extensive retroperitoneal and mediastinal spread. The possible routes of dissemination, as well as the efficacy of antimycobacterial therapy in the management of tuberculous epididymitis, are discussed and the relevant literature is reviewed.

Mucosa-associated lymphoid tissue-type lymphomas have recently been recognized as a distinctive form of B-cell malignant lymphoma. In contrast to other types of low-grade lymphomas, these tumors have a tendency to be localized at diagnosis and to be curable with local therapy. We report an unusual case of primary localized low-grade lymphoma of mucosa-associated lymphoid tissue arising in the kidney. The patient underwent radical nephrectomy and was free of disease at 28 months of follow-up without additional treatment. Once properly staged and classified, lymphoma of mucosa-associated lymphoid tissue involving the kidney can be managed by radical nephrectomy and follow-up.

Fracture of the penis is a relatively uncommon form of urologic trauma. Wereport an unusual case of rupture of both corpora cavernosa associated with partial disruption of the urethra. The patient underwent surgical repair using a Foley catheter as a urethral stent. The patient experienced excellent results with preservation of all functions.

Renal fungus balls are rare in the adult population. A case of asymptomatic renal pelvic fungus balls is presented, and several approaches to treatment are discussed.

Immunotherapy with bacille Calmette-Guérin (BCG) is widely used for treatment of superficial urothelial cancer. Complications associated with BCG treatment are common. The most common are minor reactions as cystitis, hematuria, fever, malaise. We report an unusual case of granulomatous balanoposthitis as a complication of intravesical BCG instillation therapy. To our knowledge, only a few reports of BCG-related penile or urethral granulomatous infection have been previously published in the literature.

An unusual case of renal medullary fibroma accompanied by gross hematuria is reported. This is the eleventh reported case of this disease producing clinical symptoms.

We describe a patient with an unusual case of unicentric Castleman’s disease, which bore a malignant appearance and was located in the pararenal space. She initially presented with hydronephrosis. Two years after surgical removal of the tumor, no recurrence was evident. To our knowledge, only 2 additional cases of this uncommon disease entity associated with hydronephrosis have been reported. Furthermore, our patient was the first to receive conservative surgery. On the basis of our experience, owing to the benign clinical course of this tumor and its excellent response to limited resection, radical surgery may be avoided.

True hermaphroditism, the rarest form of intersex, is usually diagnosed during the newborn period in the course of evaluating ambiguous genitalia. As an exception, we present an unusual case of a 15-year-old boy with phenotypically normal male genitalia and bilaterally descended ovotestes, who was seen for evaluation of intermittent scrotal swelling and pain. Although rare, true hermaphroditism should be included in the differential diagnosis of apparently normal males presenting with similar complaints.

Primary signet ring cell adenocarcinoma of the prostate is a rare malignancy with a total of 13 cases reported to date in the English literature. We report a very unusual case of signet ring adenocarcinoma of the prostate occurring in a patient who presented initially with irritative voiding symptoms and a bladder mass. Results of immunohistochemical, flow cytometric, and cytogenetic analyses of the tumor are presented.

We report an unusual case of ischemic cecal perforation after extracorporeal shock wave lithotripsy for an impacted stone at the distal end of the right ureter of a ureterosigmoidostomy in a 78-year-old female patient.

An unusual case of xanthogranulomatous pyelonephritis (XGP) in an infant is presented,Findings on magnetic resonance imaging, computerized tomography, ultrasound, and intravenous urography in our patient are contrasted with others reported in the literature. Absent were such commonly seen findings as nonfunctioning kidney, hydronephrosis, urinary calculi, and calcifications.

An unusual case of a recurrent ovarian theca granulosa cell tumor presenting as a bladder neoplasm is described.

Metastatic malignancy of the testes is unusual. Reports of testicular metastasis of neurogenic tumor are extremely rare. Only 28 cases with testicular metastasis of neurogenic tumor have been reported in the world literature. Cases of primary malignant schwannoma with testicular metastasis have not been reported previously. We present an unusual case of a thirty-seven-year-old man who had a malignant schwannoma of the chest wall with testicular metastasis.

We report an unusual case of primary extrarenal nephroblastomatosis present along the tunica albuginea of a testis found incidentally during routine inguinal orchiopexy. The worldwide published data and embryologic implications of extrarenal nephroblastomatosis and Wilms tumor are discussed.

Intracavernous self-injection of pharmacologic agents is an effective method of treatment of erectile dysfunction. Intracorporeal needle breakage is a rare complication of intracavernosal self-injection. We report an unusual case of multiple retained needles in a 44-year-old man who presented with penile edema after intracavernous self-injection complicated by needle breakage. The patient was treated with nonoperative therapy and observed on a course of antibiotics to which he responded favorably. He continued to have good erectile function. We also present a review of the reported data and recommend a treatment strategy for the management of retained intracorporeal needles.

Prostatic abscess has occasionally been known to present with urinary retention. We report an unusual case of a Staphylococcus aureus periprostatic abscess causing acute urinary retention. Diagnosis was made by transrectal sonogram and computed tomography scan, and the patient was treated successfully with intravenous antibiotics, perineal exploration, and drainage.

Different techniques for penile augmentation have been published. We report a 45-year-old man who had undergone a subcutaneous penile stone implantation for enlargement, which is the first published report to our knowledge.

An unusual case of complete duplication of bladder and urethra is reported. The pertinent literature is reviewed and treatment discussed.

An unusual case of bladder injury due to ingestion of alcohol and LSD is described. The signs and symptoms, and radiologic findings are discussed.

Herein is presented an unusual case of uriniferous perirenal pseudocyst secondary to ureteropelvic junction obstruction which was accurately diagnosed preoperatively with an intravenous pyelogram and supportive findings on ultrasound and computerized axial tomography. A review of the literature and discussion of pertinent clinical aspects are presented.

Adenocarcinoma of the kidney in children and adolescents is believed to be a rare disease. Although only 57 cases 1,2 have been described in the world literature, many others, no doubt, have occurred and have not been reported. Herein reported is an unusual case of a very small neoplasm in which urinary cytologic study aided in the diagnosis.

A case is presented of pigmented epidermoid carcinoma of the urethra in a black man after a staged urethroplasty. Histology of the tumor suggests an origin from skin incorporated into the urethral repair. Response of the tumor to chemotherapeutic agents, proved effective in epidermoid carcinoma of the penis, is discussed.

We report an unusual case of testicular tumor presenting as thrombosis of the inferior vena cava. However, in contrast to a previous report, thrombosis in this patient was not caused by compression of the vena cava by neoplasm metastases. In our patient, we postulate that tumor invaded the vena cava and that thrombosis was exacerbated by a hypercoagulable state induced by the tumor.

Approximately 1 to 3 per cent of patients presenting with metastatic renal cell carcinoma will have a solitary metastatic lesion. An unusual case of solitary metastasis is described. Treatment consisted of nephrectomy and radiation therapy to the pericardium.