ESPU Congress 2018 - Abstract Book

29 11–14 APRIL, 2018, HELSINKI, FINLAND MATERIAL AND METHODS We present a case of a 2-year-old boy who was admitted to the Pediatric Emergency Department with a large mass occupying the right hemiabdomen and flank. Imaging with ultrasound and MRI showed a renal tumor with tumor thrombus in the infradiadiaphragmatic subhepatic vena cava inferior (VCI). Further radiological features were as well typical of Wilms tumor with local lymph node involvement but without metastases. Correspondingly, no biopsy was performed, and six weeks of nephroblastoma-specific chemotherapy were applied. Follow-up imaging then showed tumor progression, combined with clinical deterioration. We decided to proceed to resection without prior biopsy. Radical tumor nephrectomy with partial VCI resection including tumor thrombus was performed, with a VCI reconstruction using a biograft interposition. RESULTS Histology of the resected tumor revealed a primary renal neuroblastoma, N-myc amplified, and bone metastases were detected. Multimodal therapy according to the SIOPEN high-risk protocol was started. CONCLUSIONS Primary renal neuroblastoma is an absolute rarity that can be misdiagnosed as Wilms tumor, especially in the case of tumor thrombus with extension into VCI. In such cases detection of vanil- lylmandelic acid and homovanillic acid in the urine can lead to the correct diagnosis. 14:26–14:28 S2-9 (CP) STAGED LAPAROSCOPIC FOWLER STEPHENS PROCEDURE FOR TRANSVERSE CROSSED TESTICULAR ECTOPIA: AN UNUSUAL APPROACH FOR A RARE CONDITION Francisca YANKOVIC, Francisco REED, Nelly LETELIER, Ricardo ZUBIETA and Pedro Jose LOPEZ Hospital exequiel Gonzalez Cortes & Universidad de Chile, Paediatric Urology, Santiago De Chile, CHILE PURPOSE Transverse testicular ectopia (TTE) is an extremely rare condition in which both testicles tend to migrate through the same inguinal canal. We describe two TTE cases with bilateral non-palpable testis. MATERIAL AND METHODS Retrospective review of two patients with TTE. Prior endocrine and genetic evaluation confirmed 46XY karyotype and normal hormones. Patients were managed with a two-stage laparoscopic Fowler Stephens procedure (FSP) and conjoined descend though a neo-inguinal canal (medial to the medial umbilical ligament) at the second stage. RESULTS Diagnostic laparoscopy identified both intra abdominal testicles with partial fusion of the vas defer- ens at the proximal end and abnormal localization (crossing the midline) of one of the gonads. A first bilateral FSP was performed at 12 and 18 months. After 34 and 44 months the second stage was performed. In both patients the gonads were vital and after preserving a single peritoneal strip from the partially fused deferens, a conjoined descend of both testicles through the neo-inguinal canal was made. Afterwards, via a trans-septal positioning, the gonads reached a tension free scrotal site. Clinical and ultrasound follow up at 6 and 18 months shows adequate testicular position and symmetrical volume.