[Papillary renal cell carcinoma; clinic and pathological study about 27 cases]

Background: Papillary renal cell carcinoma [PRCC] represent 10 to 15% of renal tumours in adults. They contain more than 75% of tubule-papillary structure and are divided histologically into two subtypes. The distinction between these two sub-types is essential because of different prognosis

Aim: To describe the main clinical, radiological, therapeutic and prognostic features of these tumors. A comparative analysis between the two sub histological types was performed. Methods: This is a retrospective study, from January 2000 to December 2010, concerning 27 patients operated for PRCC. Clinical data was taken from medical observations and radiological analysis was based on CT findings. A second analysis of blades was made in doubtful cases to clarify the histological subtype

Results: PRCC represented 11.3% of renal tumors operated during this period. Mean patients' age was 62 years with a male predominance [sex ratio 3.5]. All tumors were unilateral and mean tumor size was 7 cm. There was no clinical or radiological sign suggestive of this histological type. Treatment consisted of radical nephrectomy in 74% of the cases and nephron sparing surgery in 26% of the cases. We found 17 subtype 1 tumors and 10 subtype 2 tumors. The five year overall and disease-free survival rate were, respectively 86% and 90% in type 1 tumors and 57% and 54% in type tumors

Conclusion: PRCC is the second most common renal cancer in adults. They have no clinical or radiological specific signs suggesting their diagnosis. The distinction between these two sub histological types is essential as subtype 1 tumors have a better prognosis

[Vesico-sigmoid fistula secondary to diverticulitis: a case report]

Vesico-sigmoid fistula is a rare complication of colic diverticular disease. It develops when the bladder sticks to an flammatory colon making of a communication between the bladder and the digestive segment. Usually the sigmoid. Liquid usually passes from the colon to the bladder because of the existing pressure gradient. Hence, urinary symptoms are the most frequent. Surgery is the treatment of choice. The present case is about a 72-year-O1d man who had a total hematuria for 3 months. The diagnosis of a fistula secondary to colic diverticulitis was established by cystoscopy, colonoscopy and cystography Surgery was undertaken and the postoperative outcome was excellent. Through this case the clinical features, special investigations and treatment of vesico-sigmoid fistula, are reported