Synovial sarcoma (SS) is a mesenchymal tumor that more rarely affects the kidneys. As of 2020, only around 100 cases of renal SS have been reported. Herein described is a 28-year-old female with a huge mass occupying almost the entire abdomen. Her history, physical examination and imaging suggested a renal cell carcinoma with metastases to the diaphragm, liver and large vessels. A radical nephrectomy was successfully performed, removing an enormous 26-kilogram, 52cm x 37cm x 14cm right renal mass and providing immediate relief. Histopathology surprised the authors with findings of extra-gastrointestinal stromal tumor. 20 months post-surgery, there was tumor recurrence, and a metastasectomy was done. Immunostaining revealed renal synovial sarcoma. To date, the patient remains asymptomatic and disease free. The rarity of renal SS, as well as its ability to mimic more common tumors, makes clinicopathological diagnosis and management difficult. Moreover, the role of chemotherapy for SS remains unclear.

Objective: To determine if intravesical protrusion of the prostate (IPP) is a predictor of acute urinary retention. Patients and Methods: In a prospective study, men (aged >50 years) with lower urinary tract symptoms were evaluated using the 1) international prostate symptoms score (IPSS), 2) prostate specific antigen (PSA), 3) prostate volume and age. The patient bladder was filled with 200 ml normal saline via foley catheter. IPP was measured using transabdominal ultrasound. The degree of protrusion was classified as Grade 1: 5 mm or less; Grade 2: 6 to 10 mm; and Grade 3: > 10 mm. Urine flow rate and post void residual urine were recorded after catheter removal. Urinary retention was established if the patient failed to establish satisfactory urination, post-void residual urine greater than 100 ml, and urine flow rate less than 10 ml/sec. Results: A total of 64 patients were enrolled in the study but only 56 patients were included in the study. Of the five parameters considered, only intravesical prostate protrusion (p = 0.01405914) and IPSS (p = 0.00578724) had a significant relationship with acute urinary retention. Conclusion: The IPP significantly predicts acute urinary retention; grade 3 IPP had more tendency to have acute urinary retention. The other contributing predictor of urinary retention is the IPSS.

Prostate-specific Antigen ; Prostate ; Urinary Retention ; Prospective Studies