Introduction. Metastatic renal cell carcinoma (RCC) frequently spreads not only to neighboring lymph nodes, but also to distant organs, including the lungs, liver, bones and brain. Case report. We presented three cases of RCC with colon metastasis. In the first, 63-year-old patient, after left nephrectomy followed with lyphadenectomy in paraaortic lymph node, left hemicolectomy was done due to RCC metastasis in rectosigmoid colon. In the second, 35-year-old patient, left radical nephrectomy was followed two years later with partial right nephrectomy, lung metastasectomy, small bowel and coecum resection and right orchiectomy all as separate procedures in different time intervals. The patient died from brain and bone metastases two years after the first surgery. The third, 35-year-old patient, had right nephrectomy followed by repeted lymphadenectomies after 6, 12 and 24 months. Four years later RCC spreaded to coecum and right hemicolectomy was performed. Conclusion. RCC treated with nephrectomy should be carefully followed up with imaging methods as a proper treatment of RCC metastases to distant organs could be important for a patient survival.

Background/Aim. Radical cystectomy is the method of choice in management of muscle invasive, organ-confined tumors of the bladder (Т2-Т4, N0-Nx). The most frequent continent orthotopic urinary diversion after radical cystectomy is the ileal neobladder. A modified technique consists of using a shorter segment of the terminal ileum than the standard technique, around 30 cm. The aim of this study was to determine the urodynamic characteristics of the orthotopic ileal neobladder created by a modified technique. Methods. In this prospective clinical study we analyzed the urodynamic parameters of 24 patients who had underwent radical cystectomy with orthotopic urinary diversion by ileal neobladder created using a modified technique. In all the patients we performed invasive and noninvasive urodynamic investigations 12 months after the operation. The urethral pressure profile parameters analyzed were maximal urethral pressure, maximal urethral closure pressure and the functional urethral profile length. Results. The average age of the patients was 63 (49-73) years, 90% were males and 10% were females. The median length of the shorter segment of the terminal ileum was 28 (range 22-35) cm. Prior to enterocystometry and uroflowmetry postvoid residual (PVR) urine was measured by a urethral catheter. The median PVR was 16.7 (0-140) mL. The median enterocystometric capacity was 396 (range 372-532) mL. The median end filling pouch pressure was 27.6 (range 20-70) cmH20. The median maximal flow of urine was 22.1 (range 9.7- 39.5) mL/s and the average flow of urine was 9.61 (range 3.6-17.6) mL/s. Flow time in the analyzed group was 47.5 (range 22-119) s. The median maximal urethral pressure was 54 (range 12-101) cmH2O, maximal urethral closure pressure 36.6 (range 6-91) cmH2O. Functional urethral profile length was 14.9 (range 4-37) mm. Conclusion. An ileal orthotopic pouch created by a modified technique using a shorter segment of the terminal ileum after 12 months presents with urodynamic characteristics similar to the native bladder.

Thyroid-like follicular carcinoma of the kidney (TLFC-K) is a rare primary kidney carcinoma with fewer than 60 reported cases. Current data suggest that TLFC-K has low malignant potential, with only a few reported cases of unfavorable clinical behavior. Histologically, TLFC-K is indistinguishable from kidney metastasis of well-differentiated follicular cell-derived thyroid carcinomas. Furthermore, folliculo-tubular patterns can be seen in different types of kidney lesions, making assessing follicular architecture in the kidney diagnostically challenging. We present a case of TLFC-K with a list of differential diagnoses. A hyperechoic tumor was found incidentally in the upper pole of the right kidney of a 66-year-old man. The patient underwent a radical nephrectomy. Histologically, the tumor was well-circumscribed, composed of follicular/tubular structures of different sizes filled with colloid-like material. Immunohistochemically, the absence of a positive reaction for thyroglobulin and TTF-1 excluded the secondary origin of the tumor from the thyroid. Tumor cells also showed diffuse positivity for vimentin and PAX8 and focal positivity for CK7 and CD10. The results of all other applied immunostaining tests did not align with those of different types of kidney tumors that may exhibit predominantly follicular patterns. Accordingly, TLFC-K was diagnosed. The patient shows no signs of disease relapse at the 5-month follow-up.

Background/Aim. Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a condition with recurring discomfort or pain in the urinary bladder and the surrounding pelvic region without an identifiable disease. The aim of this study was to assess hydrodistension as a diagnostic and treatment procedure in patients with BPS. Methods. This prospective study included 45 patients who underwent cystoscopy with hydrodistension. The mean values for 24-hr voiding frequency, maximal voided urine volume, average voided urine volume, and minimal voided urine volume originated from the frequency volume chart. The values were compared between the time before hydrodistension and one, three, and six months after that. Results. By comparing the initial data and data in all three follow-up periods (after one, three, and six months), the statistical significance (p < 0.046) was found, and that: for 24-hr voiding frequency, it was 19.64 ? 3.56, 9.42 ? 1.71, 9.58 ? 1.45, and 12.2 ? 2.79, respectively; then, for the minimal voided urine volume (p < 0.03), it was 59.11 ? 23.72 mL, 114.89 ? 4.09 mL, 112.44 ? 100.86 mL, and 89.00 ? 29.45 mL, respectively; for an average voided volume (p < 0.04), it was 105.33 ? 18.29 mL, 186.89 ? 23.14 mL, 186.44 ? 21.44 mL, and 155.78 ? 30.78 mL, respectively. There was no significant statistical difference (p < 0.1) regarding the maximal voided urine volume between initial and follow-up interval data: 196.89 ? 43.68 mL, 312.89 ? 54.59 mL, 316.00 ? 49.47 mL, 266.67 ? 53.17 mL, respectively. Conclusion. Our results demonstrate that hydrodistension is a reliable diagnostic and therapeutic procedure.