The effect of composition, microfluidization and process parameters on formation of oleogels for ice cream applications.

The use of oleogels is an innovative and economical option for the technological development of some food products, among them ice creams. The aim of this study was to establish the best processing conditions to obtain an emulsion which form oleogels with the lowest ζ-potential and average droplet size (ADS) for use as ice cream base. Using surface response methodology (SRM), the effects of three numerical factors (microfluidization pressure, oil and whey protein concentration, WP) and four categorical factors (oil type, temperature, surfactant, and type of WP) on formation of emulsions were assessed. The response variables were ζ, ADS, polydispersity index (PDI), viscosity (η), hardness, cohesiveness and springiness. Additionally, a numerical optimization was performed. Two ice creams containing milk cream and oleogel, respectively were compared under the optimization conditions. Results suggest oleogels obtained from the microfluidization of whey and high oleic palm oil are viable for the replacement of cream in the production of ice cream.

[Hand-assisted laparoscopic nephrectomy in challenging cases]. / Nefrectomía laparoscópica asistida por la mano en casos difíciles.

OBJECTIVE: To assess the outcome of hand-assisted laparoscopic nephrectomy in patients with significant complicating clinical factors. METHODS: A retrospective assessment was made of 100 laparoscopic nephrectomies performed at a single hospital from 2001 to 2005. Patients with a history of prior abdominal surgery, prior procedures on the involved kidney, evidence of perirenal inflammation, renal lesions 10 cm or more in diameter, or level I renal vein thrombosis were enrolled. RESULTS: Twelve patients were enrolled. Of these, 5 had a lesion at least 10 cm in diameter, 2 had renal vein thrombosis, and 5 reported major abdominal surgery. Most patients had more than one of these findings. Three patients showed inflammatory conditions (staghorn calculi) and a T4 renal tumor was successfully treated without conversion to open surgery. Mean operating time and blood loss were 210 minutes and 310 ml respectively, while mean length of hospital stay was 3 days. No patient required conversion to open surgery. CONCLUSIONS: Hand-assisted laparoscopic nephrectomy is an attractive minimally invasive option for technically challenging tumors and has reasonable operating times, blood losses, and complication rates.

Nefrectomía laparoscópica asistida por la mano en casos difíciles / Hand-assisted laparoscopic nephrectomy in challenging cases

Objetivo: evaluar los resultados de nefrectomía laparoscópica asistida por la mano en pacientes con masas renales técnicamente complejas. Métodos: se ha realizado una evaluación retrospectiva de 100 nefrectomías laparoscópicas realizadas en un solo hospital entre 2001 y 2005. Se ha seleccionado a los pacientes con antecedentes de cirugía abdominal previa, procedimientos previos en el riñón afectado, evidencia de inflamación perirrenal, lesiones renales de más de 10 cm de diámetro o trombosis venosa renal tipo I. Resultados: se ha incluido un total de 12 pacientes; 5 de ellos presentaban una lesión de al menos 10 cm de diámetro, dos trombosis venosa renal y 5 referían cirugía abdominal mayor. La mayoría de los pacientes tenía más de uno de estos hallazgos. Tres pacientes presentaban procesos inflamatorios (cálculos coraliformes) y un tumor renal T4 fue tratado con éxito, sin necesidad de reconversión. El tiempo operatorio y la pérdida sanguínea medias fueron de 210 minutos y 310 ml, respectivamente, con una estancia media de tres días. Ningún paciente requirió reconversión a cirugía abierta. Conclusiones: la nefrectomía laparoscópica asistida por la mano es una opción mínimamente invasiva, atractiva en el contexto de masas técnicamente complejas, con un tiempo operatorio, una pérdida sanguínea y una tasa de complicaciones razonables (AU)

Objective: To assess the outcome of hand-assisted laparoscopic nephrectomy in patients with significant complicating clinical factors. Methods: A retrospective assessment was made of 100 laparoscopic nephrectomies performed at a single hospital from 2001 to 2005. Patients with a history of prior abdominal surgery, prior procedures on the involved kidney, evidence of perirenal inflammation, renal lesions 10 cm or more in diameter, or level I renal vein thrombosis were enrolled. Results: Twelve patients were enrolled. Of these, 5 had a lesion at least 10 cm in diameter, 2 had renal vein thrombosis, and 5 reported major abdominal surgery. Most patients had more than one of these findings. Three patients showed inflammatory conditions (staghorn calculi) and a T4 renal tumor was successfully treated without conversion to open surgery. Mean operating time and blood loss were 210 minutes and 310 ml respectively, while mean length of hospital stay was 3 days. No patient required conversion to open surgery. Conclusions: Hand-assisted laparoscopic nephrectomy is an attractive minimally invasive option for technically challenging tumors and has reasonable operating times, blood losses, and complication rates (AU)

[Clinical efficacy of prostatic biopsy. Experience in our center from 1990 to 2002]. / Eficacia clínica de la biopsia prostática. Experiencia en nuestro centro 1990-2002.

INTRODUCTION: The prostate biopsy is the only valid tool to diagnose the existence of cancer of prostate. The indications of the biopsy, according with EAU, are the existence of high PSA, increased velocity PSA and a rectal suspicious tact. OBJECTIVES: validation of the utility of the prostate biopsy, to know the value of the PSA as a marker of prostate cancer in our way and to value the indication and efficiency of repeated biopsies. MATERIAL AND METHODS: we practice a manual review of the biopsies in our hospital, between the years 1990 and 2002. We study the level of PSA before the biopsy, number of prostatic cores and histologic information of the biopsy. A statistical descriptive and inferencial study has been performed by SPSS 12.0 package. RESULTS: The total number of biopsies registered was a 1202, with 36.96% of biopsy positive. The PSA before the biopsy (available in the biopsies realized between the year 1999 and 2002: 578 biopsies, 48.08% of the whole) was > 10 ng/ml in 55,88% of these patients, 4-10 ng/ml in 39.27% and 0-4 ng/ml in 4.84%. The average and PSA's median is of 19.09 (standard error: 1.87) and 10.6, respectively. The positividad of the biopsy increases with PSA's level: 48,61% with PSA > 10; 25.11% with PSA 4-10 and 21,4% in patients with PSA < 4. There was realized prostate rebiopsy (2 or more biopsies) in 132 patients (21.97% positive) 88,36% of the cancers was diagnosed in the first biopsy, and 6.62% in the second one (94,98% of the diagnoses of cancer of prostate carried out with the first 2 biopsies). CONCLUSIONS: The information obtained in the study by means of the descriptive analysis of our series meets in conformity the published in other studies and publications. There exists a need to increase the diagnostic profitability of the biopsy of prostate, for which we have introduced a protocol of biopsy under local anesthesia in order to be able to increase the number of obtained cylinders.

Eficacia clínica de la biopsia prostática. Experiencia en nuestro centro 1990-2002 / Clinical efficacy of prostatic biopsy. Experience in our center from 1990 to 2002

Introducción: La biopsia prostática es la única herramienta válida para diagnosticar la existencia de cáncer de próstata. Las indicaciones para su realización según la Asociación Europea de Urología son la existencia de PSA elevado, velocidad aumentada y la evidencia de un tacto rectal sospechoso. Objetivos: Valoración tanto de la utilidad clínica de la biopsia prostática, como del PSA como marcador de cáncer de próstata en nuestro medio y la indicación y eficacia de sucesivas biopsias. Material y Métodos: Efectuamos una revisión manual de las biopsias realizadas en nuestro servicio entre los años 1990 y 2002, valorando nivel de PSA previo a la biopsia, número de cilindros obtenidos y datos de la biopsia. Se llevó a cabo un estudio estadístico descriptivo mediante el programa estadístico SPSS 12.0. Resultados: Se han realizado 1202 biopsias en este periodo, con un porcentaje de positividad global del 36.96%. El PSA previo a la biopsia (disponible en las biopsias realizadas entre los años 1999 y 2002: 578 biopsias, 48.08% del total) era >10 ng/ml en el 55,88% de estos pacientes, 4-10 ng/ml en el 39.27% y 0-4ng/ml en el 4,84%. La media y mediana de PSA es de 19,09 (error típico: 1,87) y 10,6, respectivamente. La positividad de la biopsia aumenta con el nivel de PSA: 21,4% en pacientes con PSA<4; 25,11% con PSA 4-10 y 48,61% con PSA >10. Fue realizada rebiopsia prostática en 132 pacientes (21,97% positivas) El 88,36%de los cánceres fueron diagnosticados en la primera biopsia, y un 6,62% en la segunda (94,98% de los diagnósticos de cáncer de próstata se realizaron con las 2 primeras biopsias). Conclusiones: Los datos obtenidos en el estudio mediante el análisis descriptivo de nuestra serie se encuentran en concordancia con lo publicado en otros estudios y publicaciones. Existe una necesidad de aumentar la rentabilidad diagnóstica de la biopsia de próstata, para lo cual hemos introducido un protocolo de biopsia bajo anestesia local con el fin de poder aumentar el número de cilindros obtenidos (AU)

Introduction: The prostate biopsy is the only valid tool to diagnose the existence of cancer of prostate. The indications of the biopsy, according with EAU, are the existence of high PSA, increased velocity PSA and a rectal suspicious tact. Objectives: validation of the utility of the prostate biopsy, to know the value of the PSA as a marker of prostate cancer in our way and to value the indication and efficiency of repeated biopsies. Material and methods: we practice a manual review of the biopsies in our hospital, between the years 1990 and 2002. We study the level of PSA before the biopsy, number of prostatic cores and histologic information of the biopsy. A statistical descriptive and inferencial study has been performed by SPSS 12.0 package. Results: The total number of biopsies registered was a 1202, with 36.96 % of biopsy positive. The PSA before the biopsy (available in the biopsies realized between the year 1999 and 2002: 578 biopsies, 48.08 % of the whole) was> 10 ng/ml in 55,88 % of these patients, 4-10 ng/ml in 39.27 % and 0-4ng/ml in 4.84 %. The average and PSA’s median is of 19.09 (standard error: 1.87) and 10.6, respectively. The positividad of the biopsy increases with PSA’s level: 48,61 % with PSA> 10; 25.11 % with PSA 4-10and 21,4 % in patients with PSA <4. There was realized prostate rebiopsy (2 ó more biopsies) in 132 patients (21,97 % positive) 88,36 % of the cancers was diagnosed in the first biopsy, and 6.62 % in the second one (94,98% of the diagnoses of cancer of prostate carried out with the first 2 biopsies).Conclusions: The information obtained in the study by means of the descriptive analysis of our series meets in conformity the published in other studies and publications. There exists a need to increase the diagnostic profitability of the biopsy of prostate, for which we have introduced a protocol of biopsy under local anesthesia in order to be able to increase the number of obtained cylinders (AU)

Second record of Tityus bahiensis (Scorpiones, Buthidae) from Venezuela: epidemiological implications

This work reports the second record of the scorpion Tityus bahiensis Perty from Venezuela. The specimen was found alive in a wardrobe at a hotel resort in Margarita Island, northeastern Venezuela. Morphological characterization allowed its assignment to the Tityus bahiensis population inhabiting the southernmost area of the species' geographic range, e.g. the state of São Paulo in Brazil, northern Argentina and Paraguay. The fact that the only available Venezuelan antiscorpion (anti-Tityus discrepans) serum does not neutralize the effects of alpha- and beta-toxin from Tityus serrulatus venom (which resembles in composition that of T. bahiensis) constitutes a warning to local clinicians confronted with envenomations by noxious species transported to Venezuela from Brazil by human agency.

[Schistosomiasis: not an uncommon parasitosis in Europe]. / Esquistosomiasis: una parasitosis urinaria cada vez más frecuente.

UNLABELLED: Despite the fact that urinary parasitosis are very unusual diseases in our place, their frequency is growing up because of migration movements. CLINICAL CASE: A 28 years old subsaharian patient presented with haematuria and low urinary symptoms. The cystoscopic shows small white round granulate in bladder mucosa and anatomopathologic study informed about eggs an adult parasites on bladder biopsy. Despite of the infrequency of schistosomiasis in our country and because of migration movements we must include this disorder in monosimptomatic haematuria differential diagnosis.

Esquistosomiasis: una parasitosis urinaria cada vez más frecuente / Schistosomiasis: not an uncommon parasitosis in Europe

Las parasitosis urinarias, muy infrecuentes hasta la fecha en nuestro medio, están siendo diagnosticadas cada vez con mayor frecuencia debido a los fenómenos migratorios. Presentamos un nuevo caso de esquistosomiasis urinaria y realizamos una revisión de la literatura en relación a su diagnóstico y tratamiento. Paciente subsahariano de 28 años que consulta por hematuria y síndrome miccional de 1 año de evolución. La cistoscopia muestra características granulaciones blanquecinas pequeñas en la mucosa vesical y el estudio anatomopatológico de la biopsia fría de la mucosa vesical confirma la existencia de huevos y parásitos adultos. A pesar de la infrecuencia de la esquistosomiasis en nuestro medio y en relación al aumento de los fenómenos migatrorios poblacionales, debemos incluir esta afectación urinaria en el diagnostico diferencial de la hematuria monosintomática

Despite the fact that urinary parasitosis are very unusual diseases in our place, their frequency is growing up because of migration movements. Clinical case: A 28 years old subsaharian patient presented with haematuria and low urinary symptoms. The cystoscopic shows small white round granulate in bladder mucosa and anatomopathologic study informed about eggs an adult parasites on bladder biopsy. Despite of the infrequency of schistosomiasis in our country and because of migration movements we must include this disorder in monosimptomatic haematuria differential diagnosis

[Kidney lipomatosis in a transplantation donor]. / Lipomatosis renal en donante cadáver.

OBJECTIVES: The aim of this clinical note is to report one case of incidental superficial renal mass during an organ explantation. METHODS: The renal donor was a 56-years-old male patient death for subaracnoidea haemorrhage without urological history. RESULTS: The anatomopathologic intraoperative study of the renal masses informed about the fatty nature of the tissue, and the renal implantation was performed. CONCLUSIONS: The find of a superficial renal mass during an organ explantatiation determine the necessity of a preoperative biopsy.

Lipomatosis renal en donante cadáver / Kidney lipomatosis in a transplantation donor

Objetivo: Valorar la actitud a seguir ante el hallazgo de una o varias masas en la superficie renal durante la extracción de órganos de un donante cadáver. Material y métodos: Donante cadáver varón de 56 años fallecido por hemorragia subaracnoidea y sin antecedentes urológicos de interés. Resultados: El estudio anatomopatológico intraoperatorio de las masas renales informó de la naturaleza lipomatosa de las mismas, procediéndose al implante renal según la técnica habitual. Conclusiones: El hallazgo de una masa en la superficie renal durante la extracción de órganos para trasplante constituye una indicación absoluta de biopsia previa al implante

Objectives: The aim of this clinical note is to report one case of incidental superficial renal mass during an organ explantation. Methods: The renal donor was a 56-years-old male patient death for subaracnoidea haemorrhage without urological history. Results: The anatomopathologic intraoperative study of the renal masses informed about the fatty nature of the tissue, and the renal implantation was performed. Conclusions: The find of a superficial renal mass during an organ explantatiation determine the necessity of a preoperative biopsy

[Nephrolithiasis and topiramate]. / Nefrolitiasis y topiramato.

INTRODUCTION: Topiramate (TPM) is a new antiepileptic drug whose multiple mechanisms of action justify both its broad therapeutic spectrum and its increasingly widespread use in childhood epilepsy. TPM acts as a carbonic anhydrase inhibitor and, although this does not affect its effectiveness as an antiepileptic, it does account for certain side effects such as nephrolithiasis. The frequency of nephrolithiasis secondary to TPM in childhood is unknown and we have only found reports of five cases in children. CASE REPORTS: We describe two cases of medication-resistant infantile epilepsy--a 3-year-old female with Dravet's syndrome and a male aged 4.5 years with Lennox-Gastaut syndrome. In both cases the decision was made to introduce TPM as add-on therapy after a prolonged therapeutic programme; a high degree of effectiveness was achieved in both patients. Nevertheless, the two patients developed nephrolithiasis secondary to TPM, which in the second case was related to the simultaneous treatment with adrenocorticotropic hormone (ACTH), while no known favouring factor was found in the first patient. CONCLUSIONS: We outline the physiopathogenic mechanism explaining nephrolithiasis secondary to TPM, the risk factors involved and the therapeutic and preventive options available in dealing with this side effect, which occurs in a low percentage of cases but which usually means stopping administration of this therapy. We therefore believe it necessary to analyse the risk factors for nephrolithiasis before prescribing the drug and we suggest that generalised preventive measures should be implemented, especially in children who are carriers of encephalopathies or conditions that reduce mobility.

Nefrolitiasis y topiramato / Nephrolithiasis and topiramate

Introducción. El topiramato (TPM) es un nuevo antiepiléptico cuyo mecanismo de acción múltiple justifica tanto su amplio espectro terapéutico como su empleo cada vez mayor en la epilepsia infantil. Aunque no influye en su eficacia antiepiléptica, el TPM inhibe la anhidrasa carbónica, efecto que es el responsable de reacciones adversas como la nefrolitiasis. La frecuencia de la nefrolitiasis secundaria al TPM en la infancia es desconocida y únicamente hemos encontrado cinco casos comunicados en niños. Casos clínicos. Se presentan dos casos de epilepsia infantil refractaria al tratamiento farmacológico, una niña de 3 años con síndrome de Dravet y un niño de 4,5 años con síndrome de Lennox-Gastaut, en los que después de un prolongado programa terapéutico se decide introducir TPM en terapia añadida, obteniendo en ambos pacientes un elevado grado de eficacia. No obstante, los dos desarrollan nefrolitiasis secundaria al TPM, que en el segundo caso relacionamos con el tratamiento simultáneo con hormona corticotropa (ACTH) no existiendo un factor favorecedor conocido en el primero. Conclusiones. Se hace una exposición del mecanismo fisiopatogénico de la nefrolitiasis secundaria al TPM, de los factores de riesgo implicados y de las opciones terapéuticas y preventivas de este efecto adverso, que representa un porcentaje muy bajo, pero que obliga usualmente a prescindir de esta alternativa terapéutica, por lo que creemos que se deben analizar los factores de riesgo de nefrolitiasis antes de prescribir este fármaco y que se deben generalizar las medidas preventivas, especialmente en los niños portadores de encefalopatías o de patologías que reduzcan la movilidad (AU)

Introduction. Topiramate (TPM) is a new antiepileptic drug whose multiple mechanisms of action justify both its broad therapeutic spectrum and its increasingly widespread use in childhood epilepsy. TPM acts as a carbonic anhydrase inhibitor and, although this does not affect its effectiveness as an antiepileptic, it does account for certain side effects such as nephrolithiasis. The frequency of nephrolithiasis secondary to TPM in childhood is unknown and we have only found reports of five cases in children. Case reports. We describe two cases of medication-resistant infantile epilepsy – a 3-year-old female with Dravet’s syndrome and a male aged 4.5 years with Lennox-Gastaut syndrome. In both cases the decision was made to introduce TPM as add-on therapy after a prolonged therapeutic programme; a high degree of effectiveness was achieved in both patients. Nevertheless, the two patients developed nephrolithiasis secondary to TPM, which in the second case was related to the simultaneous treatment with adrenocorticotropic hormone (ACTH), while no known favouring factor was found in the first patient. Conclusions. We outline the physiopathogenic mechanism explaining nephrolithiasis secondary to TPM,the risk factors involved and the therapeutic and preventive options available in dealing with this side effect, which occurs ina low percentage of cases but which usually means stopping administration of this therapy. We therefore believe it necessaryto analyse the risk factors for nephrolithiasis before prescribing the drug and we suggest that generalised preventivemeasures should be implemented, especially in children who are carriers of encephalopathies or conditions that reduce mobility (AU)

[Testicular and paratesticular prepuberal tumors: our experience and update on the topic]. / Tumores testiculares y paratesticulares prepuberales. Experiencia en nuestro centro y revisión de la literatura.

OBJECTIVES: To evaluate the importance of testicular and paratesticular prepubertal tumors in our center and to make an update on the topic. METHODS AND PATIENTS: Data from all patients diagnosed of testicular and paratesticular prepubertal tumors and treated in our pediatric oncology unit from January 1st 1998 to December 31st 2003 have been revised. RESULTS: Seven cases are reported among one hundred and ninety patients (represents 3,68 percent of all treated tumors): five tumors affecting the testis and two cases of paratesticular tumors. Pathology classification was as follows: one yolk sack tumor, one mature teratoma, two nongerminomatous testicular tumors (one Sertoli cell tumor and one unclassifiable), one Burkitt's lymphoma and two paratesticular rhabdomyosarcomas. Primary approach was inguinal radical orchiectomy in all cases except neoadjuvant chemotherapy in the case of lymphoma and partial escrotectomy in one patient previously managed with transcrotal orchiectomy. Rhabdomyosarcoma cases received adjuvant chemotherapy. All patients are alive and well after a follow-up period ranging from 17 to 74 months. CONCLUSIONS: Testicular and paratesticular prepubertal tumors are rare. Except for one patient affected of lymphoma, surgical primary approach have been essential for treatment. The prognoses in this series has been excellent.

Tumores testiculares y paratesticulares prepuberales. Experiencia en nuestro centro y revisión de la literatura / Testicular and paratesticular prepuberal tumors: our experience and update on the topic

Objetivos: evaluar la importancia de los tumores testiculares y paratesticulares en nuestro medio, así como realizar una puesta al día sobre el tema. Métodos y pacientes: se ha revisado la base de datos de la Unidad de Oncología del hospital Universitario “Virgen de la Arrixaca” desde el 1 de Enero de 1998 hasta el 31 de diciembre del 2003, extrayendo los casos referidos a neoplasias en esta localización. Resultados: se han detectado 7 neoplasias entre los 190 pacientes tratados (representa el 3,68% del total de tumores): 5 testiculares y 2 paratesticulares. Las estirpes testiculares fueron: un tumor del seno endodérmico, un teratoma maduro, un tumor de células de Sertoli, uno de tipo estromal mixto o indiferenciado y un caso delinfoma de Burkitt. Los dos tumores paratesticulares fueron rabdomiosarcomas. La actitud inicial fue orquiectomía radical en todos los casos, salvo una escrotectomía parcial en un caso de rabdomiosarcoma debido a cirugía transescrotal previa y quimioterapia aislada en el caso del linfoma. Los rabdomiosarcomas requirieron quimioterapia adyuvante. Todos los pacientes están vivos y libres de recidiva con un seguimiento entre 17 y 74 meses.Conclusiones: los tumores testiculares y paratesticulares son infrecuentes en nuestra práctica habitual. Salvo en un caso de linfoma, el tratamiento quirúrgico inicial ha sido esencial en su manejo. En nuestra serie tienen un excelente pronóstico (AU)

Objetives: to evaluate the importance of testicular and paratesticular prepubertal tumors in our center and to make an update on the topic. Methods and patients: data from all patients diagnosed of testicular and paratesticular prepubertal tumors and treated in our pediatric oncology unit from January 1st 1998 to December 31st 2003 have been revised. Results: seven cases are reported among one hundred and ninety patients (represents 3,68 percent of all treated tumors): five tumors affecting the testis and two cases of paratesticular tumors. Pathology classification was as follows: one yolk salk tumor, one mature teratoma, two nongerminomatous testicular tumors (one Sertoli cell tumor and one unclassifiable), one Burkitt’s lymphoma and two paratesticular rhabdomyosarcomas. Primary approach was inguinal radical orchiectomy in all cases except neoadjuvant chemotherapy in the case of lymphoma and partial escrotectomy in one patient previously managed with transcrotal orchiectomy. Rhabdomyosarcoma cases received adjuvant chemotherapy. All patients are alive and well after a follow-up period ranging from 17 to 74 months. Conclusions: testicular and paratesticular prepubertal tumors are rare. Except for one patient affected of lymphoma, surgical primary approach have been essential for treatment. The prognoses in this series has been excellent (AU)

[Non obstructive retrocaval ureter]. / Uréter circumcavo no obstructivo.

We report a case on circumcavum ureter without obstruction or type two, according the Batenson and Atkinson's classification, in a forty-nine year old man. It was diagnosticated for a gross haematuria and renoureteral pain, because of a simultaneous urinary tract infection. We emphasize its absence of the typical morphology and obstruction signs. After twelve months the patient is still asymptomatic, without any medical or surgical treatment.

Uréter circumcavo no obstructivo / Non obstructive retrocaval ureter

Se presenta un caso de uréter circumcavo derecho no obstructivo o tipo dos de Batenson y Atkinson en un hombre de 49 años. Se diagnostico tras consulta por hematuria y dolor ureteral, atribuíble a infección urinaria concomitante. Destacamos la ausencia de retardo funcional, dilatación y morfología típica del mismo. Se decidió actitud expectante, estando asintomático tras 12 meses de seguimiento

We report a case on circumcavum ureter without obstruction or type two, according the Batenson and Atkinson´s classification, in a forty-nine years old man. It was diagnosticated for a gross haematuria and renoureteral pain, because of a simultaneous urinary tract infection. We emphasize its absence of the tipical morphology and obstruction signs. After twelve months the patient is still asintomatic, without any medical or surgical treatment