Multicystic nephroma in an elderly man. Case report

Multicystic nephroma is a relatively rare tumor of the kidney presenting unclear histological origin. Abdominal mass is a common onset sign in children while abdominal flank pain or abdominal discomfort, hematuria and recurrent urinary tract infections usually affect adults. Preoperative diagnosis is impossible especially in the adult variant of the tumor where clear cells carcinoma with cystic degeneration must always be suspected. We herein report a case of a 77 year old man complaining of flank abdominal pain and recurrent episodes of urinary tract infection due to a right-sided multicystic nephroma successfully treated with nephrectomy.

Squamous cell carcinoma of the renal pelvis with stones and inferior vena cava infiltration. Case report

We report a rare case of a 50 year old man with renal squamous cell carcinoma (SCC) who first came to our attention with renal colic and fever not responding to antibiotic or analgesic treatment. He had a long history of kidney stones, but had not undergone any imaging in the last 5 years. Physical examination revealed tenderness and a palpable mass in the right flank and lumbar region. A whole body CT scan was performed, revealing an 11 cm mass in the right kidney infiltrating the inferior vena cava. There were areas of calcification within the mass and multiple stones within the renal pelvis. The tumor was considered unsuitable for resection according to radiological and clinical criteria. The mass was biopsied percutaneously under CT guidance and histological examination revealed squamous cell carcinoma of the renal pelvis. The patient was treated with neoadjuvant chemotherapy and embolization of the renal artery. He died one month after diagnosis. To our knowledge this is the second reported case in the world of renal SCC infiltrating the inferior vena cava and with kidney stones.

The Southern Ischia canyon system: examples of deep sea depositional systems on the continental slope off Campania (Italy)

The Southern Ischia canyon system has been investigated in detail through Multibeam bathymetry and Sparker seismic data and has been put in the geological framework of the deep sea depositional systems off the Campania region. The geological and geomorphological characteristics of the canyon system have been also compared with the characters of the Mediterranean submarine canyons and with the deep sea depositional systems of the Tyrrhenian sea. The Southern Ischia canyon system engraves a narrow continental shelf from Punta Imperatore to Punta San Pancrazio, being limited southwestwards from the relict volcanic edifice of the Ischia Bank. It consists of twenty-two drainage axes, whose planimetric trending has been reconstructed in a sketch morphological map realized through the geological interpretation of Multibeam bathymetry. While the eastern boundary of the canyon system is controlled by extensional tectonics, being limited by a NE-SW trending (anti-Apenninic) normal fault, its western boundary is controlled by volcanism, due to the growth of the Ischia volcanic bank. Submarine gravitational instabilities also acted in relationships to the canyon system, allowing for the individuation of large-scale creeping at the sea bottom and hummocky deposits already interpreted as debris avalanche deposits. Quaternary marine seismic sequences have been reconstructed through a densely spaced seismic grid recorded through a Sparker multitip seismic source, allowing for a detailed observation of steep erosional slopes occurring on the southern flank of the island and related deep sea depositional systems. Important implications of this study will regard the coastal monitoring and beach nourishment of the southern flank of the island, being involved by a strong erosion of marine and coastal systems.

Suspecting Renal Artery Thrombosis

Renal artery thrombosis is a threatening clinical diagnosis, in which renal infarction may occur. Often misdiagnosed, for mimicking other common diseases, it should be considered in persistent flank pain to improve care and reduce morbidity. We review a case of a healthy, 57 year-old woman with renal artery thrombosis mimicking pyelonephritis and renal calculus obstruction, highlighting features of this clinical condition. An accurate diagnosis is essential for optimal management and prompts treatment, which still remains to be defined.