ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

largest published single surgeon series and it shows
encouraging perioperative, continence and oncologic
outcomes.
140
ROBOT-ASSISTED RADICAL PROSTATECTOMY
IN PATIENTS WITH A HISTORY OF
ENDOSCOPIC TREATMENT FOR BENIGN
HYPERPLASIA OF THE PROSTATE
Bernardo Rocco, Pietro Acquati and Giancarlo Albo
Dipartimento di Scienze Chirurgiche Specialistiche Sezione
di Urologia, Università degli Studi di Milano Fondazione
IRCCS Ca’ Granda Ospedale Maggiore Policlinico
U.O. di Urologia, Milano, Italy
Aim: The purpose of this study was to determine whether
previous prostate surgery has an adverse effect on the
perioperative, histopathological and functional outcomes of
robot-assisted radical prostatectomy (RARP). Patients and
Methods: We retrospectively identified 42 patients (Group 1)
who had a history of endoscopic prostate surgery for the
treatment of benign prostate hyperplasia (BPH). We performed
one-to-one matching based upon ten variables (age, BMI,
PSA, SHIM, AUA-SS, c stage, biopsy Gleason score, median
lobe presence, pathological stage and the extent of nervesparing)
using a propensity score matching algorithm to
generate a control group (Group 2). The perioperative,
histopathological and functional outcomes were compared
between these groups. All the patients were evaluated for
continence outcomes, while only those patients who had a
preoperative SHIM score of 17 and had a nerve-sparing
surgery (unilateral, bilateral or partial) were examined for
potency outcomes. Results: The patient demographics after
matching are listed in Table I. The perioperative
histopathological and functional outcomes were evaluated.
There was no statistically significant difference at any point in
time for either continence or potency outcomes Conclusion:
RARP is a safe and effective procedure in patients who have
a history of endoscopic prostate surgery. Although the OR
time is higher in these patients, the PSM rates, complications,
histopathological and functional outcomes are comparable to
those of patients who have no prior prostate surgery.
141
RENAL LEIOMYOMA: A RARE BENIGN
TUMOR OF KIDNEY. A CASE REPORT
Cristian Vincenzo Pultrone, Eugenio Brunocilla,
Riccardo Schiavina, Christian Rocca,
Davide Diazzi and Giuseppe Martorana
1884
ANTICANCER RESEARCH 31: 1807-1956 (2011)
Clinica Urologica - Università di Bologna, Policlinico S.
Orsola Malpighi, Bologna, Italy
Aim: We present a case of renal leiomyoma in a 31-year-old
man who presented with hematuria and abdominal pain on the
left flank at the first aid unit of our institution. Case Report:
Ultrasonography and computed tomography (CT) were
performed. A conventional pathological analysis, including
immunohistochemistry, was performed after radical
nephrectomy. Ultrasonography detected enlargement of the
left kidney with a mass occupying the caudal half of the organ,
hypoechoic with irregular central fluid collection and destructuration
of the normal renal echo-structure. The power-
Doppler appearance was hypovascular without visualization
of the renal vein. At CT scan, the lesion was described as a
voluminous heterogeneous mass of 8.6×11 cm in the lower
pole of the left kidney. Before contrast medium injection, the
lesion appeared hyperdense compared with the surrounding
renal parenchyma, with signs of bleeding. It also revealed a
renal pelvis and ureter dilatation with non-flow of contrast
medium into the bladder. Radical nephrectomy was
performed. On gross examination, the mass was well
circumscribed and encapsulated, with a well-defined limit
between the thin rim of renal tissue and the lesion. The outer
surface was lobular and the cut surface showed a solid
whorled white appearance. The tumor was very hard in
consistency. No cystic change, hemorrhage, or necrosis was
evident. On microscopic examination, the lesion showed
fascicles of long spindle cells, showing a whirling pattern with
intervening areas of collagen deposition. Nuclei were regular
oval with bland chromatin. Mitoses were not evident. No
tumor cell pleomorphism, epithelial components or immature
elements were evident on multiple sections that were studied.
On immunohistochemical evaluation, tumor cells were
strongly positive for smooth muscle actin and negative for
cytokeratin and HMB 45. Discussion and Conclusion: Renal
leiomyomas are rare benign tumors of the kidney originating
from muscle cells. A few cases of leiomyoma are described in
the literature. They can be found directly at autopsy as they
are asymptomatic, or diagnosed by the appearance of
symptoms (abdominal/flank pain, hematuria, palpable mass).
Today the widespread use of ultrasonography and CT has
increased the detection of clinically asymptomatic renal
leiomyomas. Ultrasonographic evaluation detects leiomyoma
as a hypoechoic lesion that may appear solid or cystic. At CT
scan leiomyomas appear hyperdense compared to the
surrounding tissue, with density similar to that of muscles. The
differential diagnosis between leiomyoma and other malignant
lesions (above all renal cell carcinoma and leiomyosarcoma) is
still possible only by histological examination. Macroscopically,
leiomyoma is described as a white or red peripheral lesion, well
defined, with a solid aspect and elastic consistence. Color is
related to mass vascularization. Histologically, renal