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Goran Stimac

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Professional experience in research, urologic oncology and surgery, endourology, minimally invasive procedures and male incontinence surgery. Lecturer in postgraduate courses and sudies, domestic and international congresses. My special interests are moutaineering, nature and landscape photography.

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Université de Genève

Jahangirnagar University

Maja Vasiljevic

University of Belgrade

Md. Monwar Hossain

Jahangirnagar University

Joseph Shalhoub

Imperial College London

Viacheslav Kuleshov

Stockholm University

Timothy P. Newfield

Georgetown University

Sungsit Sungvornyothin

Mahidol University

Jagannath University

Peter Delobelle

University of Cape Town

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Papers by Goran Stimac

Detekcija karcinoma prostate u ponovljenoj biopsiji na osnovi pojavnosti proliferativne upalne atrofije u inicijalnoj biopsiji prostate [Detection of prostate carcinoma on repeat biopsy by the presence of proliferative inflammatory atrophy on initial biopsy]

The effect of asymptomatic prostate inflammation on PSA - a false alarm?

Uloga biomaterijala kod uroloških infekcija

Surgical Treatment of Patients with Penile Carcinoma from 1995 to 2004 in the Clinical Department of Urology, Universty Hospital “Sestre Milosrdnice”, Zagreb, Croatia

Penile carcinoma is a rare malignant disease with a low rate of occurrence. Approximately 20 pati... more Penile carcinoma is a rare malignant disease with a low rate of occurrence. Approximately 20 patients are diagnosed in Croatia each year and an average of 3 patients are diagnosed and treated in our clinic. Many clinical issues regarding the treatment of penile cancer have not been studied systematically, and therefore many questions remain unanswered. Essentially, all reports in the recent literature are retrospective reviews of treatment outcomes, often with patients treated over several decades. There are still many controversies regarding the management of penile carcinoma. The purpose of this report is to present our experience in surgical treatment of patients with penile carcinoma during the period from 1995 to 2004. DISCUSSION:Experiences in the treatment of penile carcinoma in Croatia are not consistent and therefore a penectomy is usually the option of treatment. The presence of regional metastases significantly influences a patient's chance of survival. However, lymph...

Uloga upale u patogenezi i ranoj dijagnostici raka prostate

Učinak Asimptomatske Upale Prostate Na Psa – Lažna Uzbuna?

Prostatični specifični antigen (PSA) i njegove frakcije (slobodni PSA) trenutno su najvažniji ser... more Prostatični specifični antigen (PSA) i njegove frakcije (slobodni PSA) trenutno su najvažniji serumski tumorski markeri za ranu detekciju karcinoma prostate. Osjetljivost i specifičnost PSA ograničeni su jer dosadašnja saznanja sugeriraju da porast ukupnog PSA i promjena udjela slobodnog PSA nije samo karakteristika karcinoma prostate. Zbog nedovoljne specifičnosti PSA,velik broj bolesnika podvrgava se nepotrebnim ponavljanim biopsijama, što naravno rezultira niskom stopom pozitivnih nalaza. Histološki, asimptomatski prostatitis učestali je patološki nalaz u biopsijama prostate učinjenima u bolesnika bez dokazanog karcinoma i bez kliničkih znakova akutnog prostatitisa. Dosadašnje studije pokazuju čitav spektar različitih relacija subkliničke upale i vrijednosti ukupnog i slobodnog PSA. Većina studija potvrdila je porast PSA u bolesnika s akutnim prostatitisom. Drugi pak negiraju učinak subkliničke upale prostate na PSA, no najveća razmimoilaženja u recentnoj literaturi nalazimo u od...

Proliferative inflammatory atrophy (PIA): New precusor lesion for prostate cancer

In recent publications there is emerging evidence that inflamma¬tion may contribute to prostatic ... more In recent publications there is emerging evidence that inflamma¬tion may contribute to prostatic carcinogenesis. It is hypothesised that oxydative stress triggers the appearance of proliferative inflammatory atrophy (PIA) lesions which can degenerate into carcinoma. The results from recent studies connecting PIA with cancer have been contraversial. The aim of the study was to assess the risk of detecting prostate carcinoma on repeat biopsy based on the pre-biopsy PSA levels, presence and morphological characteristics of inflammation and PIA lesions on initial biopsy. This retrospective study included 208 patients with PSA level ≤ 10 ng/mL, submitted to repeat biopsy for detection of prostate carcinoma during the 2003-2008 period. The presence and number of PIA lesions were determined on initial biopsy, while a modified system of inflammation type grading, developed by Irani et al, was used for pathomorphological analysis. Factor analysis was used to assign specific inflammatory fact...

Diagnosis and treatment of chronic prostatitis

Prostatitis is a prevalent, confusing and frustrating presentation for both patients and clinicia... more Prostatitis is a prevalent, confusing and frustrating presentation for both patients and clinicians. It is an inflammatory condition of the prostate that presents with urethral symptoms, prostatic symptoms and sexual dysfunction. It is diagnosed by clinical symptoms and signs, the microscopy of expressed prostatic secretion (EPS) and culture of EPS and segmented urine samples. Prostatitis is chronic when symptoms have been present for at least 3 months. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome, defined primarily on the basis of urologic symptoms and/or pain or discomfort in the pelvic region. It is a common condition among men of a wide age range, with detrimental effects on quality of life. The etiology, pathogenesis, and optimal treatment of CP/CPPS still remain relativelly unknown, although significant progress has been made in the last few years in the understanding and management of this disorder. A wide variety of pharmacologic and nonp...

The role of partial nephrectomy in T1B RCC

Prostatitis u patogenezi i ranoj dijagnostici raka prostate

Erectile Dysfunction

Medicus

Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an ... more Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an erection suf-ficient to permit satisfactory sexual performance. Although ED is a benign disorder, it affects physical and psychosocial health and has a significant impact on the quality of life of sufferers and their partners. Recent epidemiological data have shown a high prevalence and incidence of ED worldwide and it is as-sumed that ED is bothering more than half of men aged 40-70 years. Today, ED is not considered a disease but one of the very early symptoms of cardiovascular disease, and it is in most cas-es caused by organic changes. New oral therapies have com-pletely changed the diagnostic and therapeutic approach to ED. Phosphodiesterase-5 inhibitors are considered to be the first line treatment for all types of ED, regardless of its cause. The article presents the etiology, pathogenesis, diagnosis, and current recommendations for ED treatment.

Prostatitis i rana detekcija raka prostate

Medicus

Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up o... more Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up of patients with prostate cancer. However, PSA is not a cancer-specific marker and elevated PSA levels due to benign conditions most directly underscore the difficulty in making a decision about the need for prostate biopsy. Today, an important question re-mains as to the nature of the relationship between PSA and chronic prostatic inflammation. Inflammation is a frequent pathological finding in prostate biopsies, performed on men without prostatic malignancy. Although it is known that acute inflammation can contribute to the lack of PSA specificity, there is still a disagreement about the effect of chronic and asympto-matic inflammation on total and free PSA values. Recent stud-ies suggest that subclinical inflammation seems to have signif-icant influence on free PSA in patients with total PSA levels up to 10 ng/ml. It is not characterized by elevated total PSA con-centrations alone but ...

Smjernice liječenja prostatitisa

Ministarstvo zdravlja Republike Hrvatske imenovalo je članove Radne grupe za izradu smjernica za ... more Ministarstvo zdravlja Republike Hrvatske imenovalo je članove Radne grupe za izradu smjernica za liječenje prostatitisa. Smjernice su prvenstveno namijenjene liječnicima opće prakse te specijalistima koji rade u primarnoj zdravstvenoj zaštiti i bolnicama, a odnose se na klasifikaciju, dijagnozu i liječenje sindroma prostatitisa. Cilj je smjernica standardizacija, izjednačavanje i optimalizacija dijagnostike, liječenja i praćenja bolesnika s prostatitisom koja će dovesti do poboljšanja kvalitete zdravstvene zaštite ovih bolesnika te promovirati racionalnu potrošnju antibiotika. Smjernice se temelje na dokazima iz sistematski pregledane literature, na lokalnim podacima o osjetljivosti bakterija na antibiotike, na postojećim kliničkim protokolima za dijagnozu i liječenje prostatisa, kao i prijedlozima i komentarima kolega liječnika. U smjernicama su predstavljene kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze i liječenja bolesnika s prostatitisom u...

Prostatitis and early detection of prostate cancer

Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up o... more Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up of patients with prostate cancer. However, PSA is not a cancer-specific marker and elevated PSA levels due to benign conditions most directly underscore the difficulty in making a decision about the need for prostate biopsy. Today, an important question remains as to the nature of the relationship between PSA and chronic prostatic inflammation. Inflammation is a frequent pathological finding in prostate biopsies, performed on men without prostatic malignancy. Although it is known that acute inflammation can contribute on lack of PSA specificity, there is still a disagreement in the effect of chronic and asymptomatic inflammation on total anf free PSA values. Recent studies suggest that subclinical inflammation seems to have significant influence on free PSA in patients with total PSA levels up to 10 ng/ml. It is not characterized by elevated total PSA concentrations alone but also by a de...

Treatment of prostatitis: Implications for prostate cancer early detection and prevention

Prostate-specific antigen (PSA) is the most useful serum marker for the early detection of prosta... more Prostate-specific antigen (PSA) is the most useful serum marker for the early detection of prostate cancer (PC), but it is not cancer-specific and various processes, such as benign prostatic hyperplasia or prostatitis, also effect PSA levels. Particularly acute prostatitis shows elevated PSA levels. In practice, we are often confronted with the association of abnormal PSA and prostate biopsies that reveal no cancer but only inflammation. Subclinical prostatitis is a very frequent finding in prostate biopsy reports. These patients pose a special problem in PC detection and often undergo unnecessary repeat biopsies. Should then the abnormal PSA be interpreted as a sign for missed PC or can a subclinical inflammation explain the elevation of PSA? Although acute inflammation is known to contribute to the lack of PSA specificity, there is still disagreement concerning the effect of subclinical prostatitis on PSA and its fractions. However, recent body of evidence is suggesting that subcl...

A case of cystic, nultilocular metanpehric adenoma of the kidney: clical, radiological and pathological features

Introduction & Objectives: A case of cystic metanephric adenoma (MA) is presented to increase awa... more Introduction & Objectives: A case of cystic metanephric adenoma (MA) is presented to increase awareness among urologists of this rare entity. MA is extremely rare and its diagnosis should be considered in a patient with well circumscribed multilocular mass. A little more than 80 cases were reported in the literature, but only few illustrated radiological features resembling our case. Material & Methods: A 34-year-old male patient was referred for the evaluation of incidentally detected mass in the right kidney. Ultrasonography (USG) disclosed a multilocular renal mass. To establish nature of the tumor intravenous pyelography (IVP) and magnetic resonance imaging (MRI) were employed. Results: Radiologically tumor was showing calcifications of multilocular cyst walls. Findings suggested a diagnosis of cystic renal cell carcinoma (RCC). Due to preoperative findings radical nephrectomy was performed. There was no lymph node involvement. The resected tumor measured 10x10x9 cm. Pathologica...

Clinical Results and Complications of Trapezoidal Keratotomy

Journal of Refractive Surgery, 1988

Collecting duct carcinoma of the kidney: A report of three cases and review of the literature

Pathology, 1997

Collecting duct carcinoma (CDC) of the kidney is a rare neoplasm arising from the medullary colle... more Collecting duct carcinoma (CDC) of the kidney is a rare neoplasm arising from the medullary collecting ducts. The clinicopathological features of three cases are here presented to add to the 42 cases reported so far in the English language literature. Hematuria is the most common presenting symptom, although 10% of patients present with metastatic disease, often in neck lymph nodes. The tumor mass is typically centred on the medulla of the kidney and extends into the cortex. Radiological diagnosis may be difficult because the radiological features of CDC are poorly described. The histological appearances have been described as tubulo-papillary, tubular, solid and sarcomatoid. Intracytoplasmic mucin may be present. The typical immunohistochemical profile is positive staining with antibodies for low and high molecular weight keratin and epithelial membrane antigen (EMA) and positive staining with the lectin Ulex europaeus agglutinin. Literature reports of cytogenetic characterisation show loss of chromosomes resulting in monosomies. Prognosis is poor as more than half of the reported cases have developed metastases or died within two years of presentation.

Seminal vesicle cyst with ectopic ureteral insertion and ipsilateral renal dysplasia--an unexpected diagnosis

Acta Clinica Croatica, Jul 1, 2008

An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ec... more An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ectopic ureter is presented. A 36-year-old patient underwent nephroureterovesiculectomy. Considering the clinical and imaging profile of the patient, a diagnosis of ureterocele with megaureter was initially suspected, but intraoperative findings and definitive pathological analysis of the specimen revealed right renal dysplasia with ectopic ureter opening into seminal vesicle cyst. The clinical and therapeutic peculiarities of this rare condition are presented and the literature on this topic is reviewed.

Karcinom bubrežnog sabirnog kanala: prikaz triju slučajeva

Acta Clinica Croatica, Mar 1, 2001

∑ Collecting duct carcinoma or Bellini duct carcinoma is a highly malignant neoplasm that arises ... more ∑ Collecting duct carcinoma or Bellini duct carcinoma is a highly malignant neoplasm that arises from the collecting duct epithelium of the kidney and accounts for approximately 1% of renal neoplasms. Collecting duct carcinoma generally pursues a more aggressive course than conventional renal cell carcinoma. Metastases to regional lymph nodes, bone, adrenal glands, lung, skin and meninges have been reported. During the 1998-2000 period, 161 patients underwent nephrectomy due to renal cell carcinoma at our hospital. The patients' age ranged from 24 to 90 (mean 59.5) years. There were 50 female and 111 male patients. Collecting duct carcinoma was diagnosed in three (1.9%) male patients aged 79, 66 and 67 (mean age 71.0) years. The patients presented with hematuria associated with fever, weight loss, pain and palpable abdominal mass. On gross examination, the tumors were located in the medulla of the kidney and extended into the cortex and adjacent adipose tissue. Histologically, the tumors showed tubulopapillary, tubular or solid areas. Immunohistochemically, positive staining with cytokeratin, EMA and Ulex Europaeus agglutinin was observed. All patients had regional lymph node metastases, and two of them died within one month from surgery. The third patient was alive and without signs of recurrence six months from presentation.

Detekcija karcinoma prostate u ponovljenoj biopsiji na osnovi pojavnosti proliferativne upalne atrofije u inicijalnoj biopsiji prostate [Detection of prostate carcinoma on repeat biopsy by the presence of proliferative inflammatory atrophy on initial biopsy]

The effect of asymptomatic prostate inflammation on PSA - a false alarm?

Uloga biomaterijala kod uroloških infekcija

Surgical Treatment of Patients with Penile Carcinoma from 1995 to 2004 in the Clinical Department of Urology, Universty Hospital “Sestre Milosrdnice”, Zagreb, Croatia

Penile carcinoma is a rare malignant disease with a low rate of occurrence. Approximately 20 pati... more Penile carcinoma is a rare malignant disease with a low rate of occurrence. Approximately 20 patients are diagnosed in Croatia each year and an average of 3 patients are diagnosed and treated in our clinic. Many clinical issues regarding the treatment of penile cancer have not been studied systematically, and therefore many questions remain unanswered. Essentially, all reports in the recent literature are retrospective reviews of treatment outcomes, often with patients treated over several decades. There are still many controversies regarding the management of penile carcinoma. The purpose of this report is to present our experience in surgical treatment of patients with penile carcinoma during the period from 1995 to 2004. DISCUSSION:Experiences in the treatment of penile carcinoma in Croatia are not consistent and therefore a penectomy is usually the option of treatment. The presence of regional metastases significantly influences a patient's chance of survival. However, lymph...

Uloga upale u patogenezi i ranoj dijagnostici raka prostate

Učinak Asimptomatske Upale Prostate Na Psa – Lažna Uzbuna?

Prostatični specifični antigen (PSA) i njegove frakcije (slobodni PSA) trenutno su najvažniji ser... more Prostatični specifični antigen (PSA) i njegove frakcije (slobodni PSA) trenutno su najvažniji serumski tumorski markeri za ranu detekciju karcinoma prostate. Osjetljivost i specifičnost PSA ograničeni su jer dosadašnja saznanja sugeriraju da porast ukupnog PSA i promjena udjela slobodnog PSA nije samo karakteristika karcinoma prostate. Zbog nedovoljne specifičnosti PSA,velik broj bolesnika podvrgava se nepotrebnim ponavljanim biopsijama, što naravno rezultira niskom stopom pozitivnih nalaza. Histološki, asimptomatski prostatitis učestali je patološki nalaz u biopsijama prostate učinjenima u bolesnika bez dokazanog karcinoma i bez kliničkih znakova akutnog prostatitisa. Dosadašnje studije pokazuju čitav spektar različitih relacija subkliničke upale i vrijednosti ukupnog i slobodnog PSA. Većina studija potvrdila je porast PSA u bolesnika s akutnim prostatitisom. Drugi pak negiraju učinak subkliničke upale prostate na PSA, no najveća razmimoilaženja u recentnoj literaturi nalazimo u od...

Proliferative inflammatory atrophy (PIA): New precusor lesion for prostate cancer

In recent publications there is emerging evidence that inflamma¬tion may contribute to prostatic ... more In recent publications there is emerging evidence that inflamma¬tion may contribute to prostatic carcinogenesis. It is hypothesised that oxydative stress triggers the appearance of proliferative inflammatory atrophy (PIA) lesions which can degenerate into carcinoma. The results from recent studies connecting PIA with cancer have been contraversial. The aim of the study was to assess the risk of detecting prostate carcinoma on repeat biopsy based on the pre-biopsy PSA levels, presence and morphological characteristics of inflammation and PIA lesions on initial biopsy. This retrospective study included 208 patients with PSA level ≤ 10 ng/mL, submitted to repeat biopsy for detection of prostate carcinoma during the 2003-2008 period. The presence and number of PIA lesions were determined on initial biopsy, while a modified system of inflammation type grading, developed by Irani et al, was used for pathomorphological analysis. Factor analysis was used to assign specific inflammatory fact...

Diagnosis and treatment of chronic prostatitis

Prostatitis is a prevalent, confusing and frustrating presentation for both patients and clinicia... more Prostatitis is a prevalent, confusing and frustrating presentation for both patients and clinicians. It is an inflammatory condition of the prostate that presents with urethral symptoms, prostatic symptoms and sexual dysfunction. It is diagnosed by clinical symptoms and signs, the microscopy of expressed prostatic secretion (EPS) and culture of EPS and segmented urine samples. Prostatitis is chronic when symptoms have been present for at least 3 months. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome, defined primarily on the basis of urologic symptoms and/or pain or discomfort in the pelvic region. It is a common condition among men of a wide age range, with detrimental effects on quality of life. The etiology, pathogenesis, and optimal treatment of CP/CPPS still remain relativelly unknown, although significant progress has been made in the last few years in the understanding and management of this disorder. A wide variety of pharmacologic and nonp...

The role of partial nephrectomy in T1B RCC

Prostatitis u patogenezi i ranoj dijagnostici raka prostate

Erectile Dysfunction

Medicus

Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an ... more Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an erection suf-ficient to permit satisfactory sexual performance. Although ED is a benign disorder, it affects physical and psychosocial health and has a significant impact on the quality of life of sufferers and their partners. Recent epidemiological data have shown a high prevalence and incidence of ED worldwide and it is as-sumed that ED is bothering more than half of men aged 40-70 years. Today, ED is not considered a disease but one of the very early symptoms of cardiovascular disease, and it is in most cas-es caused by organic changes. New oral therapies have com-pletely changed the diagnostic and therapeutic approach to ED. Phosphodiesterase-5 inhibitors are considered to be the first line treatment for all types of ED, regardless of its cause. The article presents the etiology, pathogenesis, diagnosis, and current recommendations for ED treatment.

Prostatitis i rana detekcija raka prostate

Medicus

Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up o... more Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up of patients with prostate cancer. However, PSA is not a cancer-specific marker and elevated PSA levels due to benign conditions most directly underscore the difficulty in making a decision about the need for prostate biopsy. Today, an important question re-mains as to the nature of the relationship between PSA and chronic prostatic inflammation. Inflammation is a frequent pathological finding in prostate biopsies, performed on men without prostatic malignancy. Although it is known that acute inflammation can contribute to the lack of PSA specificity, there is still a disagreement about the effect of chronic and asympto-matic inflammation on total and free PSA values. Recent stud-ies suggest that subclinical inflammation seems to have signif-icant influence on free PSA in patients with total PSA levels up to 10 ng/ml. It is not characterized by elevated total PSA con-centrations alone but ...

Smjernice liječenja prostatitisa

Ministarstvo zdravlja Republike Hrvatske imenovalo je članove Radne grupe za izradu smjernica za ... more Ministarstvo zdravlja Republike Hrvatske imenovalo je članove Radne grupe za izradu smjernica za liječenje prostatitisa. Smjernice su prvenstveno namijenjene liječnicima opće prakse te specijalistima koji rade u primarnoj zdravstvenoj zaštiti i bolnicama, a odnose se na klasifikaciju, dijagnozu i liječenje sindroma prostatitisa. Cilj je smjernica standardizacija, izjednačavanje i optimalizacija dijagnostike, liječenja i praćenja bolesnika s prostatitisom koja će dovesti do poboljšanja kvalitete zdravstvene zaštite ovih bolesnika te promovirati racionalnu potrošnju antibiotika. Smjernice se temelje na dokazima iz sistematski pregledane literature, na lokalnim podacima o osjetljivosti bakterija na antibiotike, na postojećim kliničkim protokolima za dijagnozu i liječenje prostatisa, kao i prijedlozima i komentarima kolega liječnika. U smjernicama su predstavljene kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze i liječenja bolesnika s prostatitisom u...

Prostatitis and early detection of prostate cancer

Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up o... more Prostate-specific antigen (PSA) is the most useful marker for the early detection and follow up of patients with prostate cancer. However, PSA is not a cancer-specific marker and elevated PSA levels due to benign conditions most directly underscore the difficulty in making a decision about the need for prostate biopsy. Today, an important question remains as to the nature of the relationship between PSA and chronic prostatic inflammation. Inflammation is a frequent pathological finding in prostate biopsies, performed on men without prostatic malignancy. Although it is known that acute inflammation can contribute on lack of PSA specificity, there is still a disagreement in the effect of chronic and asymptomatic inflammation on total anf free PSA values. Recent studies suggest that subclinical inflammation seems to have significant influence on free PSA in patients with total PSA levels up to 10 ng/ml. It is not characterized by elevated total PSA concentrations alone but also by a de...

Treatment of prostatitis: Implications for prostate cancer early detection and prevention

Prostate-specific antigen (PSA) is the most useful serum marker for the early detection of prosta... more Prostate-specific antigen (PSA) is the most useful serum marker for the early detection of prostate cancer (PC), but it is not cancer-specific and various processes, such as benign prostatic hyperplasia or prostatitis, also effect PSA levels. Particularly acute prostatitis shows elevated PSA levels. In practice, we are often confronted with the association of abnormal PSA and prostate biopsies that reveal no cancer but only inflammation. Subclinical prostatitis is a very frequent finding in prostate biopsy reports. These patients pose a special problem in PC detection and often undergo unnecessary repeat biopsies. Should then the abnormal PSA be interpreted as a sign for missed PC or can a subclinical inflammation explain the elevation of PSA? Although acute inflammation is known to contribute to the lack of PSA specificity, there is still disagreement concerning the effect of subclinical prostatitis on PSA and its fractions. However, recent body of evidence is suggesting that subcl...

A case of cystic, nultilocular metanpehric adenoma of the kidney: clical, radiological and pathological features

Introduction & Objectives: A case of cystic metanephric adenoma (MA) is presented to increase awa... more Introduction & Objectives: A case of cystic metanephric adenoma (MA) is presented to increase awareness among urologists of this rare entity. MA is extremely rare and its diagnosis should be considered in a patient with well circumscribed multilocular mass. A little more than 80 cases were reported in the literature, but only few illustrated radiological features resembling our case. Material & Methods: A 34-year-old male patient was referred for the evaluation of incidentally detected mass in the right kidney. Ultrasonography (USG) disclosed a multilocular renal mass. To establish nature of the tumor intravenous pyelography (IVP) and magnetic resonance imaging (MRI) were employed. Results: Radiologically tumor was showing calcifications of multilocular cyst walls. Findings suggested a diagnosis of cystic renal cell carcinoma (RCC). Due to preoperative findings radical nephrectomy was performed. There was no lymph node involvement. The resected tumor measured 10x10x9 cm. Pathologica...

Clinical Results and Complications of Trapezoidal Keratotomy

Journal of Refractive Surgery, 1988

Collecting duct carcinoma of the kidney: A report of three cases and review of the literature

Pathology, 1997

Collecting duct carcinoma (CDC) of the kidney is a rare neoplasm arising from the medullary colle... more Collecting duct carcinoma (CDC) of the kidney is a rare neoplasm arising from the medullary collecting ducts. The clinicopathological features of three cases are here presented to add to the 42 cases reported so far in the English language literature. Hematuria is the most common presenting symptom, although 10% of patients present with metastatic disease, often in neck lymph nodes. The tumor mass is typically centred on the medulla of the kidney and extends into the cortex. Radiological diagnosis may be difficult because the radiological features of CDC are poorly described. The histological appearances have been described as tubulo-papillary, tubular, solid and sarcomatoid. Intracytoplasmic mucin may be present. The typical immunohistochemical profile is positive staining with antibodies for low and high molecular weight keratin and epithelial membrane antigen (EMA) and positive staining with the lectin Ulex europaeus agglutinin. Literature reports of cytogenetic characterisation show loss of chromosomes resulting in monosomies. Prognosis is poor as more than half of the reported cases have developed metastases or died within two years of presentation.

Seminal vesicle cyst with ectopic ureteral insertion and ipsilateral renal dysplasia--an unexpected diagnosis

Acta Clinica Croatica, Jul 1, 2008

An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ec... more An extremely rare case of seminal vesicle cyst associated with ipsilateral renal dysplasia and ectopic ureter is presented. A 36-year-old patient underwent nephroureterovesiculectomy. Considering the clinical and imaging profile of the patient, a diagnosis of ureterocele with megaureter was initially suspected, but intraoperative findings and definitive pathological analysis of the specimen revealed right renal dysplasia with ectopic ureter opening into seminal vesicle cyst. The clinical and therapeutic peculiarities of this rare condition are presented and the literature on this topic is reviewed.

Karcinom bubrežnog sabirnog kanala: prikaz triju slučajeva

Acta Clinica Croatica, Mar 1, 2001

∑ Collecting duct carcinoma or Bellini duct carcinoma is a highly malignant neoplasm that arises ... more ∑ Collecting duct carcinoma or Bellini duct carcinoma is a highly malignant neoplasm that arises from the collecting duct epithelium of the kidney and accounts for approximately 1% of renal neoplasms. Collecting duct carcinoma generally pursues a more aggressive course than conventional renal cell carcinoma. Metastases to regional lymph nodes, bone, adrenal glands, lung, skin and meninges have been reported. During the 1998-2000 period, 161 patients underwent nephrectomy due to renal cell carcinoma at our hospital. The patients' age ranged from 24 to 90 (mean 59.5) years. There were 50 female and 111 male patients. Collecting duct carcinoma was diagnosed in three (1.9%) male patients aged 79, 66 and 67 (mean age 71.0) years. The patients presented with hematuria associated with fever, weight loss, pain and palpable abdominal mass. On gross examination, the tumors were located in the medulla of the kidney and extended into the cortex and adjacent adipose tissue. Histologically, the tumors showed tubulopapillary, tubular or solid areas. Immunohistochemically, positive staining with cytokeratin, EMA and Ulex Europaeus agglutinin was observed. All patients had regional lymph node metastases, and two of them died within one month from surgery. The third patient was alive and without signs of recurrence six months from presentation.