Neumonía lipoidea aguda tras inhalación de queroseno. A propósito de tres casos / Acute lipoid pneumonia after kerosene inhalation. Report of three cases

La neumonía lipoidea es una enfermedad causada por la inhalación o la aspiración de materiales grasos. El origen del material inhalado puede ser muy diverso (alimentos, fármacos, productos cosméticos o sustancias empleadas en el lavado o mantenimiento de maquinaria). Los síntomas acompañantes son muy variables, pudiendo presentarse cuadros de distrés respiratorio, o formas asintomáticas. Presentamos tres casos de neumonía lipoidea aguda tras la inhalación masiva de sustancias oleicas (parafina y queroseno) por parte de tres varones jóvenes que han acudido al Servicio de Urgencias de nuestro hospital en el último año y entre cuyas ocupaciones está la de "tragafuegos" (AU)

Lipoid pneumonia is a condition caused by the inhalation or aspiration of fatty materials. The origin and nature of the inhaled material may be quite varied (foodstuffs, drugs, cosmetics or substances used in machinery cleaning or maintenance). The associated symptoms are quite variable, ranging from full-blown respiratory distress to asymptomatic forms. We report three cases of acute lipoid pneumonia after massive inhalation of oily substances (kerosene and paraffin) in three young males seen at the Emergency Outpatient Ward of our hospital over the last year; all three reported, among other occupations, that of "fire-eater" (AU)

[Prepuce simulating an igloo]. / Prepucio semejante a un "iglú".

OBJECTIVE: To report what could be the first reference of a prepucial congenital abnormality which has been termed an "igloo-like prepuce". The presence of a prepuce completely covering the glans and presenting the outer opening on the ventral side, resembles the ice constructions used as temporary dwelling by certain groups of eskimos. METHODS: Two cases with this unusual abnormality seen in two young brothers are described. RESULTS AND CONCLUSIONS: The "igloo-like prepuce" is a prepucial congenial abnormality with rare incidence which carries no other genitourinary condition but which translates in a merely aesthetic alteration.

[Malignant fibrohistiocytoma of the renal capsule. Report of a case and review of the literature]. / Fibrohistiocitoma maligno de cápsula renal. Aportación de un caso y revisión de la literatura.

Presentation of one case of malignant fibrohistiocytoma derived from the renal capsule. While conducting a bibliographic review the low incidence of this tumoration of renal origin was noted. The difficulties in differentiating this entity from a secondary renal invasion by a malignant fibrohistiocytoma derived from other retroperitoneal structures is commented. Brief review of current diagnosis and therapeutical management for this tumoral entity.

[Leiomyosarcoma of the urinary bladder. A little frequent neoformation]. / Leiomiosarcoma de vejiga urinaria. Una neoformación muy poco frecuente.

Presentation of one case of vesical wall leiomyosarcoma found during exploratory laparotomy due to abdominal pain, where partial cystectomy and lymphadenectomy were performed. Due to the singularity of this tumour, drafting of this clinical communication was undertaken including a brief review of the existing literature relative to the diagnosis and treatment of this neoformation.

[Congenital prepubic sinus]. / Sinus prepúbico congénito.

Presentation of one case of Urethral Duplicity of the Blind Epispadias variant, also known as Congenital Prepubic Sinus. This form of accessory urethra is a congenital malformation which consists in a pseudofistular passage which starts at the proximity of the bladder's anterior side-though uncommunicated with it-and spreads to the skin of the pubic area where it ends. No other malformative condition was found in the comprehensive study conducted, and only the existence of repeat episodes of mucopurulent drainage material advised its removal. This manoeuvre was followed by a complete cure and, after more than two years follow-up, the patient remains asymptomatic.

[Intermittent testicular torsion]. / Torsión testicular intermitente.

OBJECTIVES: The present study focuses attention on intermittent testicular torsion, a well-differentiated but underdiagnosed entity. METHODS: Four cases of intermittent testicular torsion are described. The presence of recurrent acute testicular pain that remits spontaneously or following self-manipulation and the horizontal of the testis (bell clapper) are sufficient to make the diagnosis. RESULTS: All four cases underwent bilateral orchipexy with excellent results. At years' follow-up all patients remain asymptomatic. CONCLUSIONS: Intermittent testicular torsion must be considered appropriately since these patients comprise the largest group at high risk for developing acute testicular torsion. Bilateral orchidopexy will ensure the viability of the testis with 100% good results.

[A case of leiomyosarcoma of the spermatic cord]. / Un caso de leiomiosarcoma del cordón espermático.

We report a case of leiomyosarcoma of the spermatic cord that we consider singular because of the excellent outcome. The patient is alive and tumor-free 8 years following the initial diagnosis. We discuss the management of these patients, a controversial subject since there are no definitive therapeutic guidelines because of the very limited series of patients.

[First results of our experience with the Fabian's prosthesis]. / Primeros resultados de nuestra experiencia con la prótesis de Fabián.

Report on our experience with Fabian's prothesis as alternative therapy to benign prostate hyperplasia (B.P.H.) surgery. Throughout 1990 ten patients with various surgical contraindications were implanted the above device. In spite of the series small size (10 patients) and short follow-up (4 to 11 months), we believe the 70% good results obtained is very encouraging and can either be of help to banish the ominous indwelling vesical catheter, a permanent evidence of Urologists' failure in the prostate obstructive disease, or it will allow us to relief patients with B.P.H. non-secondary to other more aggressive therapies.

[Verrucous carcinoma of the penis or Buschke-Löwenstein tumor. A rare tumor. Apropos of a case]. / "Carcinoma verrucoso de pene o tumor de Buschke-Löwenstein". Una tumoración poco frecuente. A propósito de un caso.

An additional case of verrucous carcinoma of the penis is described. This tumor type accounts for approximately 5% of squamous carcinomas of the penis. Today penile verrucous carcinoma is widely considered to be the same tumor as that described by Buschke and Löwenstein in 1925. The histological and clinical features as well as the therapeutical aspects of this tumor type are briefly reviewed herein.

[Fibroepithelial polyp with atypical stromal cells in the trigone of the bladder as a cause of lower obstructive uropathy]. / Pólipo fibroepitelial con células estromales atípicas en el trígono vesical como causa de uropatía obstructiva baja.

Fibroepithelial polyp of the trigone of bladder conditioning an occlusive syndrome at the bladder cervix level causing secondary multidiverticular bladder with ureterohydro-nephrosis and chronic bilateral pyelonephritis. Besides the rare vesical location for the fibroepithelial polyps, the case also presents some atypical stromal cells.

[Bladder adenocarcinoma. Presentation of 3 new cases]. / Adenocarcinoma vesical. Presentación de tres nuevos casos.

Three additional cases of primary adenocarcinoma of the bladder, an uncommon tumor type, seen at our department during the past years are described. These may arise from urachal remnants or metaplastic changes occurring in bladders with cystitis cystica or glandularis. Clinically, their behaviour is not unlike the rest of the infiltrating urothelial tumors. Treatment is by partial cystectomy for urachal adenocarcinoma and radical cystectomy for those arising from other sites of the bladder. Radio- and chemotherapy have a very limited efficacy in this tumor type.

[Rupture of the excretory tract to renal cyst, its sequestration and later infection, as a complication of ureteral lithiasis]. / Rotura de la vía excretora a quiste renal, secuestro del mismo y posterior infección, como complicación de litiasis ureteral.

We report on a case of infected solitary renal cyst following rupture and communication of the excretory tract from a ureteral calculus. The etiopathogenic mechanisms, the diagnostic difficulties encountered in this uncommon disease process, and the usefulness of radiologic and ultrasound assessment are discussed.

[Eosinophilic cystitis: a new cause of diagnostic error]. / Cistitis eosinofílica: de nuevo causa de error diagnóstico.

Presentation of a new case of tumoral-like eosinophilic cystitis mistaken for a vesical carcinoma until completion of anatomopathological study.

[Papillary necrosis and formation of fungal balls in a patient with AIDS: a clinical case and brief review]. / Necrosis papilar y formación de pelotones de hongos en paciente afecto de SIDA: caso clínico y breve revisión.

An AIDS case, with a Candida urinary infection causing papillary necrosis and accompanied by occurrence of fungal lumps is reported. The paper remarks on the incidence and peculiarities of urinary affectation in these patients, emphasizing the usefulness of percutaneous nephrostomy as a diagnostic, and above all as a therapeutic procedure, in cases of expanded urinary tract.

[Eosinophilic cystitis]. / Cistitis eosinofílica.

Another case of eosinophilic cystitis is reported. Special interest is placed in the incorrectly assigned nature of this disease entity. Most of the authors tend to subdivide eosinophilic cystitis into two subtypes with its own clinical, histological, and evolutive aspects: allergic eosinophilic cystitis (AEC) and eosinophilic cystitis (EC). Several hypotheses have been put forward to explain its origin which, however, remains unclear. There is no specific treatment and its course tends to develop towards chronicity, with periods of remission and unpredictable exacerbation that warrant continuous monitoring. Diagnosis is by anatomopathological findings and differential diagnosis is warranted to distinguish it from bladder neoplasm (with which it is invariable confused), tuberculosis, etc.

[Inverted papilloma or inverted urothelial carcinoma. A problem not yet resolved in its totality. Contribution of two new cases to the literature]. / Papillome inversé ou carcinome urothélial inversé. Un problème qui encore aujourd'hui n'a pas été résolu dans sa totalité. Apport de deux nouveaux cas à la littérature.

We present two case of inverted vesical papillomas, one of a trabecular histology and the other glandular, which--in view of the appearance in the last few years of inverted papillomas coexisting alongside other urothelium tumorous states, recurring and even malignant inverted papillomas--raise the possibility of them being considered as superficial urothelium carcinomas. We propose the use of post-surgical endo-vesical chemotherapy, above all in the patients affected by the trabecular variety of inverted papillomas, due to their high indices of recurrence and high possibilities of malignancy.

[A new case of multilocular cyst]. / Un nuevo caso de quiste multilocular.

We report another case of multilocular cyst of the kidney. We underscore the current theory on the neoplastic and not cystic origin of this disease entity. Attention is drawn to the confusion arising from a wide variety of terms (17) used to refer to this disease entity. Its clinical features, diagnosis, and treatment are briefly discussed. We highlight the need to follow currently available diagnostic criteria in diagnosing multilocular cyst of the kidney.

[Multilocular cyst of the kidney: clinico-pathologic considerations]. / Quiste multilocular renal: consideraciones clínico-patológicas.

Multilocular Renal Cyst is a variety contained within the Spectrum of Renal Embryonic Tumors, presenting much confusion relating to its terminology, histology, clinical aspects, etc. We have carried out a review of this subject through bibliographical compilation of the cases published between 1976-86, and close analysis of the series thus far published. The diagnostic criteria described by Boggs and Kimmeslstiels in 1956, which classify this entity separate from other varieties of R.E.T. and similar ones. This pathological state can be seen in both children and adults, and it is characterized by its unusual appearance, clinical silent in the adults and in the child it appears as an abdominal mass. This pathology lacks specific diagnostic tests as well as the assistance rendered by clinical, radiological or ultrasound studies, it will depend on a correct preoperative diagnosis, an extremely difficult task to achieve, or on a diagnostic approximation geared to avoid in the child population the implementation of coadjuvant measures to surgery that will no doubt give rise to unwanted situations in the long run. The treatment of this pathology is strictly surgical and must be preceded by an extremely conservative approach. Tumorectomy or Partial Nephrectomy is curative and sufficient. From the anatomopathological study of the surgical sample, the correct diagnosis may be inferred.