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1.
Rev. cuba. pediatr ; 91(1): e441, ene.-mar. 2019. tab, graf
Artigo em Espanhol | LILACS (Américas) | ID: biblio-985592

RESUMO

Introducción: Existen pocas investigaciones sobre factores de riesgo de tumores renales pediátricos. Objetivo: Caracterizar en detalle regiones geográficas de alta incidencia de tumores renales pediátricos en el centro de Argentina y su posible vinculación con factores de riesgo genéticos. Métodos: El área de estudio comprendió la provincia de Córdoba (Argentina). Se generó una base de datos de incidencia del cáncer renal infantil con información del Registro Provincial de Tumores. Se realizaron análisis de conglomerados espaciotemporales. En localidades dentro de los conglomerados, se llevaron a cabo entrevistas en profundidad a informantes claves. Resultados: Se registraron 56 casos de tumores renales pediátricos en el Registro en el periodo 2004-2013. Se detectó un conglomerado espacial significativo que abarca siete departamentos de la provincia. En esa región se concretaron seis entrevistas en profundidad a informantes claves. Los entrevistados resaltaron la mayor frecuencia de enfermedad genética de Sandhoff y las prácticas de endogamia (corroboradas en numerosos resultados científicos). A partir de estos datos se determinaron zonas de superposición de tumores renales y de la enfermedad de Sandhoff. Conclusiones: Se detectó una región particular de la provincia con alta frecuencia de tumores renales pediátricos y de la enfermedad de Sandhoff. Numerosos estudios científicos determinan que la endogamia es el factor de riesgo que aumenta la frecuencia de esta enfermedad en esta región. En futuras investigaciones se deberá corroborar si la endogamia también actúa aumentando la incidencia de tumores renales infantiles(AU)


Introduction: There is little research on risk factors of pediatric renal tumors. Objective: To characterize in detail the geographic regions of greatest incidence of pediatric renal tumors in central Argentina and exploring their possible link to genetic risk factors. Methods: The study area comprised the province of Córdoba (Argentina), and a database of pediatric renal tumors incidence was generated with information from the Provincial Tumor Registry. Analyses of spatio-temporal clusters were performed. In-depth interviews with key informants were carried out at localities within the conglomerates. Results: 56 cases of pediatric renal tumors were registered in the Provincial Registry of Tumors between 2004 and 2013. A significant spatial conglomerate was detected, covering seven districts of the province. In that region, six in-depth interviews were conducted with key informants. Interviewees highlighted the increased frequency of Sandhoff genetic disease and endogamous practices (corroborated in numerous scientific results). From these data, zones of overlap of renal tumors and of Sandhoff disease were determined. Conclusions: A particular region of the province was detected with high frequency of pediatric renal tumors and Sandhoff disease. Numerous scientific studies have determined that endogamy is the risk factor that increases the frequency of Sandhoff disease in this region. In future research, it should be confirmed whether it also acts by increasing the incidence of renal tumors in children(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Consanguinidade , Predisposição Genética para Doença/etiologia , Neoplasias Renais/complicações , Neoplasias Renais/epidemiologia , Argentina , Conglomerados Espaço-Temporais , Neoplasias Renais/genética
3.
Int. braz. j. urol ; 41(1): 172-176, jan-feb/2015. graf
Artigo em Inglês | LILACS (Américas) | ID: lil-742882

RESUMO

Main findings A 25-year-old hypertensive female patient was referred to our institution. Initial workup exams demonstrated a 2.8 cm cortical lower pole tumor in the right kidney. She underwent laparoscopic partial nephrectomy without complications. Histopathologic examination revealed a rare juxtaglomerular cell tumor known as reninoma. After surgery, she recovered uneventfully and all medications were withdrawn. Case hypothesis Secondary arterial hypertension is a matter of great interest to urologists and nephrologists. Renovascular hypertension, primary hyperadosteronism and pheocromocytoma are potential diagnosis that must not be forgotten and should be excluded. Although rare, chronic pyelonephritis and renal tumors as rennin-producing tumors, nephroblastoma, hypernephroma, and renal cell carcinoma might also induce hypertension and should be in the diagnostic list of clinicians. Promising future implications Approximately 5% of patients with high blood pressure have specific causes and medical investigation may usually identify such patients. Furthermore, these patients can be successfully treated and cured, most times by minimally invasive techniques. This interesting case might expand knowledge of physicians and aid better diagnostic care in future medical practice. .


Assuntos
Adulto , Feminino , Humanos , Hipertensão/etiologia , Sistema Justaglomerular , Neoplasias Renais , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Renina/biossíntese , Hipertensão/cirurgia , Sistema Justaglomerular/patologia , Neoplasias Renais/complicações , Neoplasias Renais/patologia , Laparoscopia/métodos , Tratamentos com Preservação do Órgão , Resultado do Tratamento
4.
Rev. bras. ginecol. obstet ; 36(8): 377-380, 08/2014. graf
Artigo em Inglês | LILACS (Américas) | ID: lil-720498

RESUMO

Renal angiomyolipoma is a benign tumor, composed of adipocytes, smooth muscle cells and blood vessels. The association with pregnancy is rare and related with an increased risk of complications, including rupture with massive retroperitoneal hemorrhage. The follow-up is controversial because of the lack of known cases, but the priorities are: timely diagnosis in urgent cases and a conservative treatment when possible. The mode of delivery is not consensual and should be individualized to each case. We report a case of a pregnant woman with 18 weeks of gestation admitted in the emergency room with an acute right low back pain with no other symptoms. The diagnosis of rupture of renal angiomyolipoma was established by ultrasound and, due to hemodinamically stability, conservative treatment with imaging and clinical monitoring was chosen. At 35 weeks of gestation, it was performed elective cesarean section without complications for both mother and fetus.


O angiomiolipoma é um tumor benigno, constituído por adipócitos, células de músculo liso e vasos sanguíneos. Sua associação com a gravidez é rara e está relacionada com um aumento de complicações, nomeadamente rotura com hemorragia retroperitoneal maciça. O follow-up é controverso em razão do escasso número de casos descritos, no entanto as prioridades são: diagnóstico atempado nas situações urgentes e, sempre que possível, tratamento conservador. O tipo de parto não é consensual e deve ser individualizado caso a caso. Relatamos um caso de uma grávida com 18 semanas de gestação que recorreu ao serviço de urgência por lombalgia direita aguda, sem outros sintomas relevantes. Diagnosticou-se ecograficamente rotura de angiomiolipoma renal e, em decorrência da estabilidade hemodinâmica do quadro, procedeu-se ao tratamento conservador com monitorização imagiológica e clínica. Às 35 semanas de gestação, realizou-se uma cesariana eletiva que decorreu sem complicações maternas ou fetais.


Assuntos
Adulto , Feminino , Humanos , Gravidez , Angiomiolipoma/complicações , Neoplasias Renais/complicações , Complicações Neoplásicas na Gravidez , Ruptura Espontânea
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-224084

RESUMO

BACKGROUND/AIMS: Sunitinib is an oral multitargeted tyrosine kinase inhibitor used mainly for the treatment of metastatic renal cell carcinoma. The renal adverse effects (RAEs) of sunitinib have not been investigated. The aim of this study was to determine the incidence and risk factors of RAEs (proteinuria [PU] and renal insufficiency [RI]) and to investigate the relationship between PU and antitumor efficacy. METHODS: We performed a retrospective review of medical records of patients who had received sunitinib for more than 3 months. RESULTS: One hundred and fifty-five patients (mean age, 58.7 +/- 12.6 years) were enrolled, and the mean baseline creatinine level was 1.24 mg/dL. PU developed in 15 of 111 patients, and preexisting PU was aggravated in six of 111 patients. Only one patient developed typical nephrotic syndrome. Following discontinuation of sunitinib, PU was improved in 12 of 17 patients but persisted in five of 17 patients. RI occurred in 12 of 155 patients, and the maximum creatinine level was 3.31 mg/dL. RI improved in two of 12 patients but persisted in 10 of 12 patients. Risk factors for PU were hypertension, dyslipidemia, and chronic kidney disease. Older age was a risk factor for RI. The median progression-free survival was significantly better for patients who showed PU. CONCLUSIONS: The incidence of RAEs associated with sunitinib was lower than those of previous reports. The severity of RAEs was mild to moderate, and partially reversible after cessation of sunitinib. We suggest that blood pressure, urinalysis, and renal function in patients receiving sunitinib should be monitored closely.


Assuntos
Idoso , Antineoplásicos/efeitos adversos , Carcinoma de Células Renais/complicações , Feminino , Humanos , Incidência , Indóis/efeitos adversos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Proteinúria/induzido quimicamente , Pirróis/efeitos adversos , Insuficiência Renal/induzido quimicamente , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
7.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-106794

RESUMO

Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.


Assuntos
Carcinoma Hepatocelular/complicações , Carcinoma de Células Renais/complicações , Ablação por Cateter , Humanos , Neoplasias Renais/complicações , Cirrose Hepática/complicações , Neoplasias Hepáticas/complicações , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
8.
Rev. chil. urol ; 78(4): 71-73, ago. 2013.
Artigo em Espanhol | LILACS (Américas) | ID: lil-774923

RESUMO

El Cáncer Renal se presenta habitualmente como un hallazgo de las imágenes abdominales y cuando se manifiesta clínicamente lo hace a través de los efectos que produce una gran masa abdominal o las metástasis a distancia. En este trabajo se presenta un caso de cáncer renal cuyas manifestaciones clínicas fueron secundarias a la obstrucción de las venas supra hepáticas, es decir un síndrome de Budd-Chiari florido por la presencia de un trombo tumoral en la cava retro hepática. El diagnóstico oportuno y una evaluación adecuada con imágenes permitieron la ejecución de un plan de tratamiento que incluyó un abordaje combinado abdominal y torácico que permitió un tratamiento no solo sintomático sino que potencialmente curativo de un cáncer renal con esta rara presentación.


Renal Cancer usually occurs as a finding of abdominal imaging and when it clinically manifests itself it does so through a large abdominal mass or distant metastases. In this paper we present a case of renal cancer whose clinical manifestations were secondary to obstruction of hepatic veins, a Budd-Chiari syndrome because of the presence of a tumor thrombus in the retro hepatic vena cava. Early diagnosis and appropriate imaging evaluation allowed the implementation of a treatment plan that included a combined abdominal and thoracic approach allowing not only a symptomatic treatment but potentially curative treatment of renal cancer with this rare presentation.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Renais/cirurgia , Neoplasias Renais/complicações , Síndrome de Budd-Chiari/cirurgia , Síndrome de Budd-Chiari/etiologia , Nefrectomia , Trombectomia
9.
Rev. cuba. oftalmol ; 26(1): 180-188, ene.-abr. 2013.
Artigo em Espanhol | LILACS (Américas) | ID: lil-683105

RESUMO

La endoftalmitis endógena puede ocurrir en aquellos casos de inflamación de los tejidos oculares internos secundaria a infección intraocular, resultado de la diseminación hematógena de los microorganismos desde un foco distal al ojo. Es el grupo menos frecuente de todas las endoftalmitis (5 por ciento), es preferentemente unilateral, y en la mayoría de los pacientes se aprecia al menos un foco extraocular infeccioso. Aunque puede darse en pacientes sanos inmunocompetentes, esta enfoftalmitis afecta fundamentalmente a pacientes con uno o más factores de riesgo, entre ellos, enfermedades crónicas, procedimientos quirúrgicos, neoplasias, usuarios de drogas administradas por vía parenteral, inmunodeficiencias, catéteres intravenosos. Se presenta un caso de una paciente diabética con una endoftalmitis endógena secundaria a un tumor renal, cuyo cuadro inicial apuntaba hacia un coma diabético y en la medida que evolucionó y a través del estudio oftalmológico se logró un completo diagnóstico y tratamiento de su problema de salud


The endogenous endophthalmitis may occur in cases of internal tissue inflammation secondary to intraocular infection, as a result of the hematogenous dissemination of microorganisms from a distal focus to the eye. It is the less frequent group of all types of endophthalmitis (5 percent), preferably unilateral, and most of the cases present with an extraocular infectious focus. Although it may appear in healthy immuno competent patients, this endophthalmitis mainly affects patients with one or more risk factors such as chronic illnesses, surgical procedures, neoplasias, parenterally administered drug users, immunodeficiencies and intravenous catheters. A case of a diabetic female patient with endogenous endophthalmitis secondary to a renal tumor was presented. Her initial clinical picture pointed to diabetic coma, but as the disease evolved and based on the ophthalmological study, it was possible to reach a complete diagnosis and to apply a treatment for her health problem


Assuntos
Humanos , Feminino , Idoso , Endoftalmite/diagnóstico , Endoftalmite/etiologia , Endoftalmite/terapia , Neoplasias Renais/complicações , Neoplasias Renais/terapia , Nefrectomia
10.
Rev. méd. Chile ; 140(5): 629-632, mayo 2012. ilus
Artigo em Espanhol | LILACS (Américas) | ID: lil-648590

RESUMO

Background: We report a 21-year-old male, presenting with erythromelalgia and polycythe-mia. A solid renal mass of the lower pole of the right kidney was discovered. The patient was subjected to a right open partial nephrectomy. The pathological study of the surgical specimen showed a metanephric adenoma of the kidney. The patient had an uneventful postoperative evolution. Currently the patient is in good health without evidence of recurrence of the tumor and normal hematological parameters.


Assuntos
Humanos , Masculino , Adulto Jovem , Adenoma/complicações , Carcinoma de Células Renais/complicações , Eritromelalgia/complicações , Neoplasias Renais/complicações , Policitemia/complicações , Adenoma/patologia , Neoplasias Renais/patologia
11.
Rev. AMRIGS ; 56(1): 67-70, jan.-mar. 2012. ilus
Artigo em Inglês | LILACS (Américas) | ID: lil-647294

RESUMO

A hemocromatose caracteriza-se pelo acúmulo excessivo de ferro no organismo, que é depositado redominantemente no fígado, e resulta ou de um defeito genético determinando uma absorção excessiva de ferro ou da administração parenteral deste íon. O ferro em excesso determina alterações celulares através da peroxidação lipídica, estímulo da deposição de colágeno e interação com o oxigênio reativo e DNA. Os autores relatam um caso de hemocromatose em paciente portador de cirrose hepática associada ao desenvolvimento de hepatocarcinoma, hemangioma hepático, adenocarcinoma prostático e carcinoma renal, e apresentam uma discussão geral deste processo, frequentemente associado ao desenvolvimento de neoplasias.


Hemochromatosis is characterized by excessive accumulation of iron in the body, which is deposited primarily in the liver. It results either from a genetic defect determining an excessive absorption of iron or from parenteral administration of this ion. The excess iron determines cellular changes through lipid peroxidation, stimulation of collagen deposition, and interaction with reactive oxygen and DNA. The authors report a case of hemochromatosis in a patient with liver cirrhosis associated with development of hepatocellular carcinoma, hepatic hemangioma, prostate adenocarcinoma and renal cell carcinoma, and provide a general discussion of this process often associated with the development of neoplasias.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hemocromatose/genética , Hemocromatose/tratamento farmacológico , Neoplasias Hepáticas/complicações , Neoplasias Renais/complicações , Adenocarcinoma/complicações , Carcinoma Hepatocelular/complicações , Carcinoma de Células Renais/complicações , Cirrose Hepática/complicações
13.
Mediciego ; 17(1)mar. 2011. ilus
Artigo em Espanhol | LILACS (Américas) | ID: lil-616706

RESUMO

La presencia de carcinoma de células renales durante la evolución de una enfermedad poliquística renal autosómica dominante es muy rara y poco reportada en la literatura internacional. El carcinoma renal suele manifestarse clínicamente de forma tardía, por lo que aproximadamente un tercio de los pacientes presentan metástasis a distancia en el momento del diagnóstico. Se reporta un caso de enfermedad poliquística renal asociado con carcinoma de células renales operado hace 3 años con tratamiento clínico conservador, además de diagnosticado con una enfermedad renal crónica avanzada el cual ha mantenido una evolución estable.


The presence of renal cell carcinoma during the evolution of an autosomal dominant polycystic kidney disease is very rare and little reported in international literature. Clinical manifestations of renal cell carcinoma are often late, so that approximately one-third of patients have metastatic disease at the time of diagnosis. It is reported a case of polycystic renal disease associated with renal cell carcinoma operated three years ago with conservative clinical treatment, besides he had been diagnosticated with an advanced chronic kidney disease who had mantained an stable evolution.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Rim Policístico Autossômico Recessivo/complicações
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-64134

RESUMO

Radical nephrectomy with inferior vena cava (IVC) thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. Cephalic extension of the thrombus is closely related to perioperative morbidity. We purposed to design a safe and successful surgical strategy through a review of our surgical experience and treatment results in 35 patients (male:female=28:7, mean age=56 yr [32-77]) who underwent IVC thrombectomy with radical nephrectomy between January 1997 and December 2006. The limit of tumor extension was level I in 10 patients (28.6%), level II in 17 (48.6%), and level III and IV in 4 patients each (11.4%). Liver mobilization with hepatic vascular exclusion was performed in 12 patients and cardiopulmonary bypass in 7. Thirty-two primary closures, 2 patch closures, and 1 graft interposition were performed. One patient underwent simultaneous pulmonary embolectomy because of an operative pulmonary embolism. There was no operative mortality, and the overall survival at 5-yr was 50.8%. Complete thrombus removal without tumor fragmentation under long venotomy on fully exposed involved IVC is recommended for successful result in a bloodless operative field. The applicability of liver mobilization, hepatic vascular exclusion, and cardiopulmonary bypass, can be determined by the level of thrombus.


Assuntos
Adulto , Idoso , Carcinoma de Células Renais/mortalidade , Feminino , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nefrectomia , Embolia Pulmonar/complicações , Índice de Gravidade de Doença , Taxa de Sobrevida , Tomografia Computadorizada por Raios X , Veia Cava Inferior/cirurgia , Trombose Venosa/etiologia
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-157567

RESUMO

Multicystic dysplastic kidney (MCDK) is a relatively common developmental anomaly in infants and children and has a good prognosis. In contrast, a malignant rhabdoid tumor of the kidney (MRTK) is one of the most lethal neoplasms of early life. However, the presentation of such a lethal tumor combined with multicystic dysplasia has not been reported to date. In this report, we describe a case of MRTK in a 5-yr-old girl who also had multicystic dysplasia. She was previously diagnosed with MCDK at birth due to a huge palpable mass on the right side of the abdomen. The right kidney was extensively replaced by numerous grossly dilated, variable-sized cysts. Microscopically, the tumor cells show a diffusely infiltrative growth pattern, which revealed large non-cohesive, round-to-polygonal tumor cells with vesicular nuclei. Some tumor cells had eccentric nuclei and large, round, eosinophilic cytoplasmic inclusions. There were metanephrons present, with the central ureteric bud and peripheral branches surrounded by condensing mesenchyma, immature glomeruli, and metaplastic cartilage in the adjacent parenchyma. To our knowledge, this is the first combined case of the two aforementioned diseases and this case may, in fact, suggest a new disease entity.


Assuntos
Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Renais/complicações , Rim Displásico Multicístico/complicações , Prognóstico , Tumor Rabdoide/complicações
16.
Int. braz. j. urol ; 35(6): 652-657, Nov.-Dec. 2009. tab, ilus
Artigo em Inglês | LILACS (Américas) | ID: lil-536797

RESUMO

PURPOSE: Renal cell carcinoma (RCC) has a propensity to propagate into the renal vein and inferior vena cava (IVC). Due to inherent differences in the venous anatomy of the right and left kidneys, tumor thrombus involvement of IVC may vary. The aim of this study is to compare clinical presentation and outcome of right vs. left RCC with IVC thrombus. MATERIALS AND METHODS: Patients who underwent radical nephrectomy and IVC thrombectomy between 1997 and 2008 were identified. All relevant data were collected and analyzed. Results: Eight-seven patients were included. Sixty patients (69 percent) had a right sided tumor. Mean tumor size was 10.2 (± 4) cm and was not significantly different on either side. Fifty-six percent of right sided tumors had level-III (intra-hepatic) or higher tumor thrombus, while 22 percent of left sided tumors had similar level thrombus extension (p < 0.0001). Nearly 50 percent of left sided tumors showed level-I thrombus compared to 10 percent of right side tumors. A comparison of age, estimated blood loss and transfusion rate was not significantly different. The recurrence free (p = 0.9) and disease specific survival (p = 0.4) were not significantly different between the right and left side tumors with IVC thrombus. Conclusion: A level-III IVC tumor thrombus is more frequently seen with a right side tumor. However, clinical and operative characteristics among the left and right sided tumors with IVC thrombus were not different. More significantly, recurrence rate and survival did not differ with the laterality of the tumor.


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Renais/complicações , Veia Cava Inferior , Trombose Venosa/etiologia , Intervalo Livre de Doença , Seguimentos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Invasividade Neoplásica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Nefrectomia , Estudos Retrospectivos , Trombectomia , Trombose Venosa/patologia , Trombose Venosa/cirurgia
17.
West Indian med. j ; 58(6): 556-560, Dec. 2009. ilus
Artigo em Inglês | LILACS (Américas) | ID: lil-672540

RESUMO

OBJECTIVE: Angiomyolipoma (AML) of the kidney is an uncommon tumour that, until recently, was often misdiagnosed preoperatively as renal cell carcinoma (RCC). Newer radiological techniques have allowed more accurate preoperative diagnosis which can facilitate preoperative counselling and planning for conservative therapy. This study reviews the experience with these uncommon tumours at the University Hospital of the West Indies. METHODS: All cases of AML diagnosed during the period 1980 to 2007 were retrospectively identified from the files of the Department of Pathology. From these records, selected data were retrieved and analysed. These included patient demographics, clinical history, clinical diagnosis and pathologic characteristics of the specimen submitted. The total number of primary renal tumours diagnosed in adults during the same period was also determined for comparison. RESULTS: Eleven cases of AML were identified among 149 primary renal tumours in adults. Ten of these cases occurred in women. Amongst these, a single case of tuberous sclerosis was confirmed in a patient with bilateral lesions. Excluding this patient, who was 24 years old, ages ranged from 24 to 86 years with a mean of 44 years (median 40.5 years) and an equal number of lesions was present on each side. Abdominal or flank pain were the most common clinical symptoms, present in six cases but in three cases, the tumours were discovered incidentally. The correct clinical diagnosis was made pre-operatively in a single case. By contrast, a diagnosis of RCC or other malignant tumour was proffered in eight cases. Pathologically, the maximum dimension of the seven excised tumours, in whom such information was recorded, ranged from 3.5 cm to 12 cm with a median of 7 cm. Spontaneous haemorrhage in the tumour was noted in three cases, all greater than 4.5 cm in maximum dimension. CONCLUSIONS: These data confirm that AML is uncommon at the University Hospital of the West Indies. There was an overwhelming female preponderance and patients presented, most commonly, in the 3rd to 4th decades. Tuberous sclerosis was identified in a solitary case. In this series, symptomatic lesions were > 4.5 cm in maximum dimension and haemorrhage complicated three cases. Most cases were incorrectly diagnosed preoperatively.


OBJETIVO: El angiomiolipoma (AML) del riñón es un tumor poco común que hasta hace poco era a menudo mal diagnosticado preoperatoriamente como carcinoma celular renal (RCC). Técnicas radiológicas más nuevas han permitido realizar un diagnóstico preoperatorio más exacto, que puede facilitar aconsejamiento preoperatorio y planificar una terapia conservadora. El presente estudio examina la experiencia con estos tumores poco comunes en el Hospital Universitario de West Indies. MÉTODOS: Todos los casos de AML diagnosticados durante el periodo de 1980 a 2007 fueron identificados retrospectivamente a partir de los archivos del Departamento de Patologías. De estos archivos, se seleccionaron datos que fueron recuperados y analizados. Estos abarcaron: la demografía de los pacientes, las historias clínicas, el diagnóstico clínico y las características patológicas del espécimen presentado. El número total de tumores renales primarios diagnosticados en adultos durante el mismo período, se determinó también por comparación. RESULTADOS: Se identificaron once casos de AML entre 149 tumores renales primarios en adultos. Diez de estos casos ocurrieron en mujeres. Entre éstas, se confirmó sólo un caso de esclerosis tuberosa, en un paciente con lesiones bilaterales. Excluyendo a este paciente, que tenía 24 años de edad, las edades fluctuaron de 24 a 86 años para una media de 44 años (mediana 40.5) y un número igual de lesiones estuvieron presentes en cada lado. El dolor abdominal o el lateral, constituyeron los síntomas clínicos más comunes, presentes en seis casos, pero en tres casos, los tumores fueron descubiertos incidentalmente. El diagnóstico clínico correcto se realizó preoperatoriamente en un solo caso. En contraste con ello, un diagnóstico de RCC u otro tumor maligno se presentó en ocho casos. Patológicamente, la máxima dimensión de los siete tumores extirpados, en los cuales se registró tal información fue registrada, fluctuó de 3.5 a 12 cm con una mediana de 7 cm. La hemorragia espontánea en el tumor fue observada en tres casos, todos mayores de 4.5 cm. de tamaño máximo. CONCLUSIONES: Estos datos confiman que la AML es poco común en el Hospital Universitario de West Indies. Hubo una abrumadora preponderancia de casos femeninos, y los pacientes se presentaron con mayor frecuencia en las décadas 3era y 4ta. La esclerosis tuberosa se identificó sólo en un caso. En esta serie, las lesiones sintomáticas tuvieron > 4.5 cm. de dimensión máxima, y la hemorragia complicó tres casos. La mayoría de los casos fueron diagnosticados incorrectamente en la etapa preoperatorio.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Angiomiolipoma/diagnóstico , Neoplasias Renais/diagnóstico , Angiomiolipoma/complicações , Angiomiolipoma/patologia , Carcinoma de Células Renais/diagnóstico , Diagnóstico Diferencial , Hospitais Universitários , Jamaica , Neoplasias Renais/complicações , Neoplasias Renais/patologia , Estudos Retrospectivos , Fatores Sexuais , Esclerose Tuberosa/complicações
18.
Rev. chil. urol ; 74(3): 240-242, 2009. ilus
Artigo em Espanhol | LILACS (Américas) | ID: lil-551922

RESUMO

Son infrecuentes los casos de linfoma renal primario, ya que la afectación renal por un proceso linfoproliferativo es, por lo general, secundaria a una enfermedad sistémica. Presentamos el caso de una paciente mujer de 48 años que acude por dolor lumbar y masa abdominal. Después de realizar estudios (TC), se práctica nefrectomía cuyo resultado anatomopatológico fue de linfoma no-hodking B primario renal. Asimismo el paciente presentaba una gammapatía monoclonal IgM asociada, por lo que precisó tratamiento quimioterápico sistémico. Realizamos una revisión bibliográfica centrándonos en los criterios diagnósticos y terapéuticos actuales.


Reports on primary renal lymphoma are scarce in the urological literature, the most part f them are secondary on a lymphomatous infiltration of the kidneys. We report the case of a 48 year old women with lumbar pain and adominal mass. After radiological studies (CT), we practise nephrectomy with a pathological result of a non-hodking B primary lymphoma. The patient present a IgM monoclonal gammapathy who need complementary treatment with chemotherapy. A literature review on currently recommended diagnostic and treatment practices in presented.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Imunoglobulina M/sangue , Linfoma não Hodgkin/complicações , Neoplasias Renais/complicações , Paraproteinemias/complicações , Clorambucila/uso terapêutico , Linfoma não Hodgkin/cirurgia , Linfoma não Hodgkin/tratamento farmacológico , Nefrectomia , Neoplasias Renais/cirurgia , Neoplasias Renais/tratamento farmacológico , Paraproteinemias/tratamento farmacológico
19.
Rev. méd. Chile ; 136(8): 1031-1033, ago. 2008. ilus
Artigo em Espanhol | LILACS (Américas) | ID: lil-495803

RESUMO

Renal angiomyolipoma is a benign tumor formed by smooth muscle, adipose tissue and blood vessels. It is commonly found incidentally and its clinical manifestations are pain and abdominal mass or spontaneous tumor rupture with retroperitoneal bleeding. The clinical presentation of a hemorrhagic shock secondary to a retroperítoneal hematoma is uncommon. We report a 40 year-old male who presented to the emergency room with lumbar pain and deteríoration of hemodynamic parameters. The CT sean showed a left renal injury associated to an expansive retroperítoneal process. The abdominal exploration, vascular control of the renal pedicle and nephrectomy allowed a successful outcome.


Assuntos
Adulto , Humanos , Masculino , Angiomiolipoma/complicações , Neoplasias Renais/complicações , Dor Lombar/etiologia , Angiomiolipoma/diagnóstico , Hematoma/etiologia , Neoplasias Renais/diagnóstico , Espaço Retroperitoneal , Ruptura Espontânea , Tomografia Computadorizada por Raios X
20.
Indian J Pathol Microbiol ; 2008 Jul-Sep; 51(3): 409-10
Artigo em Inglês | IMSEAR (Sudeste Asiático), GHL | ID: sea-73041

RESUMO

Primary renal fibrosarcoma is a rare tumor. We describe a case of primary renal fibrosarcoma in a 54-year-old male who presented with abdominal lump and intermittent hematuria.


Assuntos
Abdome/patologia , Fibrossarcoma/complicações , Hematúria/etiologia , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade
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