Esquistossomose de vesícula seminal: vesiculectomia seminal videolaparoscópica / Schistosomiasis of the seminal vesicle: laparoscopic seminal vesiculectomia

Objetivo: Relatar um caso de esquistossomose mansonide vesícula seminal, com cirurgia de vesiculectomiavideolaparoscópica transperitoneal. Relato de caso: Paciente66 anos, masculino, natural de Teófilo Otoni (nortede Minas Gerais), com queixa inicial de hemospermia.Sem outras queixas. PSA: 4,2 ng/dl. História de ressecçãotransuretral de próstata em 2004, com anátomo--patológico descrevendo hiperplasia prostática benigna.Alterações em ultrasson transretal e em ressonância nuclearmagnética de pelve: U.S.T.R.: massa de localizaçãoextraprostática, com volume de 96cm3 . Próstata de 19g e com sinais sugestivos de prostatite crônica. R.N.M.pelve: Imagem medindo 8,4 x 8,5 x 7,7 cm, localizada natopografia das vesículas seminais, sugerindo neoplasia.Submetido Vesiculectomia Seminal por videolaparoscopiatransperitoneal. Anátomo-patológico (AP) e imuno--histoquímica: Hiperplasia fibromuscular associada àesquistossomose mansoni (ovos com espícula lateral),sem evidências de malignidade. Considerações finais:O achado de esquistossomose de próstata e vesículaseminal no Brasil é raro. Em nossa revisão, não encontramosnenhum relato de esquistossomose mansoniisolada de vesícula seminal, com tratamento através decirurgia videolaparoscópica.

Objective: Report a case of seminal vesicle of schistosomiasiswith laparoscopic surgery transperitoneal vesiculecomia.Case report: pacient 66 years old, male, he wasborn in Teófilo Otoni (northen Minas Gerais), with initialcomplaint of hemospermia. PSA: 4,2ng/dl. History of transurethralresection of the prostate in 2004, the pathologicalexamination is describing benign prostatic hyperplasia.Alteration in pelvis transrectal ultrasound and resonancemagnetic imaging (MRI): hypoechoic heterogeneous mass,extraprostatic location, with a volume of 96 cm3. Prostate19g and signs suggestive of chronic prostatitis. MRI pelvis:image with signal intensity and heterogeneous uptakeof contrast, measuring 8,4 x 8,5 x 7,7 cm, located in thetopography of the seminal vesicles, image is suggestingmalignancy. Submitted by video laparoscopic transperitonealvesiculectomia seminal. Pathological and immunohistochemistry:fibromuscular hyperplasia associated withschistosomiasis mansoni (eggs with lateral spike), withoutevidence of malignancy. Conclusion: The find of schistosomiasisof the prostate and seminal vesicles in Brazil is rare.In our review, we found no report of schistosoma mansoniisolated from seminal vesicle treated by video laparoscopicsurgery. After surgical treatment, use of praziquantelwas prescribed 50mg/kg in two divided doses.

Retroperitoneal bilateral laparoscopic adrenalectomy for metastasis of transitional cell carcinoma of the bladder

We report a rare case of transitional cell carcinoma of the bladder metastasizing to bilateral adrenal glands without other metastasis. A 73-year-old male underwent radical cystoprostatectomy due to bladder cancer in 2006. Two years later, a CT scan showed a bilateral solitary adrenal tumor. Bilateral retroperitoneal laparoscopic adrenalectomy revealed metastatic transitional cell carcinoma. The patient has been doing well without evidence of recurrence, being supported by adrenocortical steroids. Although laparoscopic resection for malignant adrenal tumors is still controversial, we consider that retroperitoneal laparoscopic adrenalectomy may be an optional treatment for metastatic adrenal tumors, provided no other sites of metastasis exist.

Lesäo de ducto hepático lobar tratada por ligadura / Hepatic duct injury managed with duct ligation

We present a case of left hepatic duct injury due to gunshot projectile treated by duct ligature. After a five-year follow-up no changes in the hepatic function tests were noted. The lobar duct ligature in the complex biliary tract injury seems to be a good alternative in selected cases. A discussion of the subject is herein presented