Transcript CASE 1

Dr George P Abraham
MS, MCh, FICS, FRCS(Glasg)
Senior Consultant Urologist & Transplant Surgeon
Lakeshore Hospital & PVS Memorial Hospital, Kochi, Kerala.
CASE 1
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42 year / male incidentally detected 42 mm right
adrenal mass.
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No H/o Hypertension.
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On evaluation - Non- functioning adrenal mass.
MRI Scan
• Well defined T1 Hypointense & T2 Heterogeneously hyperintense
lession – 4.1 x 3.2 x 3 cm in right adrenal gland.
CASE 2
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1 year old male child with antenatally detected
Hydronephrosis.
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Post natal Uss confirmed Hydronephrosis.
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Child is aymptomatic.
MR UROGRAM
CASE 3
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48/F Incidentally detected Lower pole Renal Mass.
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No H/o Hematuria, Surgeries.
CT UROGRAPHY
31 mm predominantly entophytic heterogeneously enhancing mass in the lower
pole of the right kidney.
CASE 4
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74 /F, C/o left loin pain.
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No H/o calculi disease, hematuria.
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H/o low anterior resection for CA rectum in 2010.
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USG KUB revealed left hydronephrosis with no
evidence of renal calculi.
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Right kidney – normal.
CECT KUB
 20 mm x 14 mm nodular enhancing soft tissue lesion in left mid
ureter @ level lumbo sacral junction with features suggestive of
Transitional Cell Carcinoma Ureter.
 No significant retroperitoneal adenopathy.
 7 cm long tight stricture involving lower 3rd of ureter from VUJ.
 Left kidney – parenchymal thinning with decreased cortical
perfusion and hydronephrosis .
CECT KUB
CECT KUB
CASE 5
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6 year old male child.
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H/o recurrent episodes of UTI.
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Vague abdominal pain.
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O/E abdomen soft, Ext. gen – normal.
CTIVU
CASE 6
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24 year old male with primary infertility.
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No significant past history.
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O/E – B/L testis normal.
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Left - grade 3 varicocele, Right - grade 2 varicocele.
SEMEN ANALYSIS
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Volume viscosity & liquifaction time – Normal
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Sperm count - 22 million/ml
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Active motility – 60%, Non Motile – 25%
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Morphology – Normal - 90%
SCROTAL DOPPLER
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Right Testis – 40 x 19 mm, Left Testis – 31x13 mm.
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Peritesticular vein are dilated in both sides:
Right – 3.8 mm and Left – 6.0 mm.
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Grade 2 varicocele in Right and Grade 3 in Left side.