Grand Rounds A 25-Year-old Woman With Gross Hematuria Paola Bustillos, Preston S. Kerr, Christopher D. Kosarek, Eduardo J. Eyzaguirre, and Stephen B. Williams contrast were ordered to further delineate the degree of pul- THE CASE monary and renal vein involvement, respectively. CT of 25-year-old African American woman was trans- the thorax showed signiﬁcant constriction of the right lower ferred from an outside hospital for workup of newly lung segmental bronchioles believed to be secondary to Adiagnosed adnexal and renal masses. She had ini- metastatic lymphadenopathy as well as metastatic disease tially presented with gross hematuria and a urinary tract involving the trachea and esophagus (Fig. 2). Magnetic reso- infection 6 months prior that prompted workup. This was nance imaging of the abdomen with contrast showed diffuse accompanied by progressively worsening right-sided back metastatic disease, including metastatic lymphadenopa- pain 4 months before admission. The patient had a medical thy, a malignant right pleural effusion, bilateral retroperi- history of normocytic anemia and unknown family history. toneal implants, and a left paraspinal musculature metastasis. She had no history of smoking or alcohol use. On exami- Blood work was signiﬁcant for hemoglobin of 11.1 g/ nation, she had decreased air movement in the
Urology – Elsevier
Published: Feb 1, 2018
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