ABSTRACT
OBJECTIVES: To report two cases of bladder and prostate oat cell tumors with bad outcome, in accordance to the bibliographic review. METHODS: The case in the bladder was associated with squamous differentiation and adenocarcinoma. Radical treatment followed by adjuvant chemotherapy did not stop the fatal outcome which ended 13 months later in acute septicemia having developed multiple metastases. The case in the prostate presented as oliguria-anuria and bilateral hydronephrosis which required the placement of a nephrostomy tube in an emergency basis. Once diagnosis was achieved the extemal urinary diversion was converted to intemal to improve patient's comfort. There was no response to systemic chemotherapy and the patient died 4 months after diagnosis. CONCLUSIONS: These cases add to the rare presence of this pathology in the bibliography. In our country, 15 cases have been confirmed in the bladder and 5 in the prostate; around the world, 150 and 59 respectively. Although there is a certain tendency to think that radical treatment and chemotherapy is the least bad of the options, some consequences of conservative attitudes offer similar results, mainly when preserving the bladder.
Subject(s)
Carcinoma, Small Cell , Prostatic Neoplasms , Urinary Bladder Neoplasms , Carcinoma, Small Cell/diagnosis , Carcinoma, Small Cell/therapy , Fatal Outcome , Humans , Male , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapyABSTRACT
OBJETIVO: Presentar dos casos: vesical yprostático de oat-cell que siguieron una mala evolucióncomo es habitual ver en las publicaciones que se han revisadocon ese motivo.MÉTODO/RESULTADOS: El caso de localización vesicalse presentó asociado a diferenciación escamosa y adenocarcinoma.El tratamiento radical seguido de quimioterapiaadyuvante no detuvo la fatal evolución que culminóa los 13 meses con un cuadro agudo séptico enmarcadopor múltiples metástasis. El caso localizado en próstatadebutó con una oligoanuria e hidronefrosis bilateral quefue preciso derivar de urgencia (nefrostomía) Una vezdiagnosticado se transformó la derivación externa en internapara mejorar algo la confortabilidad del paciente. Laquimioterapia sistémica no obtuvo respuesta alguna y seprodujo el exitus a los 4 meses del diagnóstico.CONCLUSIÓN:Los casos presentados se suman a laescasa presencia que, sobre esta patología, es posibleencontrar en la revisión bibliográfica. Quince casos devejiga y cinco de próstata han sido confirmados en nuestroPaís y, a nivel mundial, 150 y 59 respectivamente.Aunque existe una cierta tendencia a opinar que el tratamientoradical y la quimioterapia es la menos mala de lasopciones, algunas consecuencias de actitudes conservadorasofrecen parecidos resultados, especialmente en vejigacon conservación de la misma
OBJECTIVES: To report two cases ofbladder and prostate oat cell tumors with bad outcome,in accordance to the bibliographic review.METHODS: The case in the bladder was associatedwith squamous differentiation and adenocarcinoma.Radical treatment followed by adjuvant chemotherapydid not stop the fatal outcome which ended 13 monthslater in acute septicemia having developed multiplemetastases. The case in the prostate presented asoliguria-anuria and bilateral hydronephrosis whichrequired the placement of a nephrostomy tube in anemergency basis. Once diagnosis was achieved theexternal urinary diversion was converted to internal toimprove patients comfort. There was no response tosystemic chemotherapy and the patient died 4 monthsafter diagnosis.CONCLUSIONS: These cases add to the rare presenceof this pathology in the bibliography. In our country,15cases have been confirmed in the bladder and 5 in theprostate; around the world, 150 and 59 respectively.Although there is a certain tendency to think that radicaltreatment and chemotherapy is the least bad of theoptions, some consequences of conservative attitudesoffer similar results, mainly when preserving the bladde
Subject(s)
Male , Humans , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapy , Carcinoma, Small Cell/diagnosis , Carcinoma, Small Cell/therapy , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Fatal OutcomeABSTRACT
OBJECTIVES: To report a solitary kidney ureterosigmoidostomy (US) secondary to urinary tuberculosis which we believe has the longest follow-up in the world literature. With this purpose we performed an analysis of the experience with such a urinary diversion published in our country, which maybe has been exaggeratedly excluded during the last decades. METHODS: Male patient who was diagnosed of urinary tuberculosis at the age of 17 in 1950 and underwent left nephrectomy. Due to bladder retraction he underwent cystectomy and urinary diversion to the sigmoid colon following the technique by Coffeyone year later. Follow-up for half a century has demonstrated an excellent outcome with almost no effect on renal function and urinary tract morphology, and very low incidence of infectious complications. DISCUSSION: We review cases of US with longest follow-up in the literature, finding a remarkable number of cases followed for more than 30 years. It is true they were performed almost exclusively for benign diseases. There is only one published citation in which US was indicated for bladder carcinoma and after 31 years of follow-up patient died from a nonrelated disease at the age of 85. We also review the scarce number of papers published in our country, focusing on the "Ponencia al Congreso Nacional de Urología 1983" which presented a thorough review of "urinary diversions" with the cooperation of 27 Spanish centers.
