[Paratesticular fibrosarcoma. A rare malign neoplasm]. / Fibrosarcoma paratesticular: una neoplasia maligna muy infrecuente.

Hereby we wish to present the clinical and pathological results of a rare paratesticular sarcome of the spermatic cord. This tumor was a fibrosarcoma in a 55 year old male that started in a most unusual way and developed very quickly. We practised a radical orquitectomy with inguinal ligation of the pedicule without post-operatory therapy. After a 5 year follow up, there is no trace of clinical or radiological recurrence in the region or metastasis. We consider radical surgery to be the only therapeutic alternative, even for cases of fast developing, being in our case a good pronostic.

Fibrosarcoma paratesticular: una neoplasia maligna muy infrecuente / Paratesticular fibrosarcoma. A rare malign neoplasm

Presentamos los hallazgos clínicos y patológicos de un sarcoma paratesticular de cordón espermático muy infrecuente. El tumor fue un fibrosarcoma en un varón de 55 años de edad que debutó de forma atípica con un crecimiento rápido. Se practicó orquiectomía radical con ligadura inguinal de pedículo sin terapia postoperatoria. Tras 5 años de seguimiento no hay signos clínicos ni radiológicos de recidiva locorregional ni a distancia. Concluimos que la cirugía radical es la única alternativa terapéutica, aún cuando presente crecimiento rápido, siendo en nuestro caso el pronóstico favorable

Hereby we wish to present the clinical and pathological results of a rare paratesticular sarcome of the spermatic cord. This tumor was a fibrosarcoma in a 55 year old male that started in a most unusual way and developed very quickly. We practised a radical orquitectomy with inguinal ligation of the pedicule without post-operatory therapy. After a 5 year follow up, there is no trace of clinical or radiological recurrence in the region or metastasis. We consider radical surgery to be the only therapeutic alternative, even for cases of fast developing, being in our case a good pronostic

[Selective arterial embolization in a case of renal cell carcinoma as therapeutic choice]. / Embolización arterial selectiva en un caso de carcinoma de células renales como alternativa terapéutica.

We show a big renal cell carcinoma case in an aged woman with many pathology associated. In view of the family refuse to make the radical surgery and the high surgical risk we decided to apply transarterial embolization treatment with polivinil alcohol particles (PVA). 28 months later the patient becames with no symptoms and with high quality life. We come to the conclusion that embolization is an effective therapeutic for the symptoms control in selectionated cases.

Embolización arterial selectiva en un caso de carcinoma de células renales como alternativa terapéutica / Selective arterial embolization in a case of renal cell carcinoma like therapeutic choice

Presentamos un caso de carcinoma de células renales muy voluminoso en una paciente de avanzada edad y con pluripatología asociada. Dada la negativa familiar a realizar cirugía radical y el elevado riesgo quirúrgico se optó por practicar embolización tumoral arterial selectiva con partículas depolivinil alcohol (PVA). Tras 28 meses de seguimiento la paciente resulta asintomática y con excelente calidad de vida. Concluimos que la embolización es una alternativa terapéutica eficaz en el control de la sintomatología para casos seleccionados (AU)

We show a big renal cell carcinoma case in an aged woman with many pathology associated. Inview of the family refuse to make the radical surgery and the high surgical risk we decided to apply transarterial embolization treatment with polivinil alcohol particles (PVA). 28 months later the patient becames with no symptoms and with high quality life. We come to the conclusion that embolization is an effective therapeutic for the symptoms control in selectionated cases (AU)

[Adrenal gland myelolipoma: review of the bibliography regarding a case]. / Mielolipoma suprarrenal: revisión bibliográfica a propósito de un caso.

OBJECTIVE: To describe an additional case of this rare disease entity, with special reference to its diagnosis and treatment, and to briefly review the literature. METHODS: We report on an 82-year-old male with adrenal myelolipoma that had been incidentally discovered during evaluation for another condition. A left adrenalectomy was performed due to the large size of the tumor and in order to determine its benign or malignant nature. RESULTS: The histopathological findings disclosed an andrenal myelolipoma. CONCLUSIONS: Adrenal myelolipoma is an uncommon tumor type. CT is the most effective diagnostic method. Surgery is advocated in symptomatic cases and in asymptomatic cases with a large tumor mass.

[Urologic impact of Crohn disease]. / Sobre las repercusiones urológicas de la enfermedad de Crohn (EC).

Presentation of two cases of Crohn's disease seen in our Service in which the urological symptoms were of special relevance. One patient presented clinically with a picture of anaemic gross haematuria. The other one, was a patient already diagnosed with Crohn's disease who developed an enterovesical fistula in spite of receiving medical treatment. Both cases were resolved surgically. The clinical aspects, natural history and treatment of this uncommon form of urinary tract involvement are discussed.

[Pheochromocytoma: a review of our own cases]. / Feocromocitoma: revisión de nuestra casuística.

Presentation of 6 cases of pheochromocytoma, diagnosed and treated in our Unit over the last 5 years. Five were adrenal pheochromocytomas and 1 an abdominal paraganglioma in a 42 year-old woman. Distribution by gender was 4 male and 2 female, and mean age at presentation was 45.2 years ranging from 35 to 55 years. Clinically, all patients were hypertensive. Two of the 5 cases with adrenal location presented with catecholaminic crisis with BP > 240/140 mmHg. The paraganglioma was diagnosed while studying a case of sustained HBP in a 42 year-old female referred from another unit. With regard to diagnosis, the sensitivity of urinary tests was 100%, and gammagraphy with meta-iodine-benzyl-guanidine (MIBG) was particularly useful in the extra-adrenal location case. In all our patients, computerized tomography (CT) was the choice procedure to locate the tumour. Treatment was surgical in all cases, access being transperitoneal in 3 cases, thoracoabdominal in 2 and classic lumbotomy in 1. All our patients received prior treatment with alpha-blocking agents, and intraoperative complications were 1 arrythmic crisis, 1 hypotensive picture and 1 hypertensive crisis, all of which resolved successfully. Currently, 5 patients remain disease free. Mild HBP controlled with low dose captopril still persists in one patient.

[A glandular-type inverted papilloma of the bladder: apropos a case with an evident chronic irritative factor]. / Papiloma invertido de vejiga tipo glandular: a propósito de un caso con claro factor irritativo crónico.

OBJECTIVES: Inverted papilloma of the bladder is a rare condition that presents in the middle-aged. Its histological features and prognosis are unique and its diagnosis is always by anatomopathology. To date, its histogenesis has not been elucidated. The present study reports an additional case of this uncommon disease entity, which is even more so due to its glandular anatomopathological morphology. METHODS: A case of inverted papilloma of the bladder in a 52-year-old man with a permanent bladder catheter is described. The tumor was located in the posterosuperior bladder wall and had been successfully resected. RESULTS: The histological diagnosis was that of glandular inverted papilloma of the bladder. The patient is asymptomatic at two years follow up. CONCLUSIONS: In our view, inverted papilloma of the bladder results from a previous metaplasia in which the chronic irritative factor plays an important role.

[Endoscopic electrofulguration of intraurethral condylomata acuminata]. / Electrofulguración endoscópica de los condilomas acuminados intrauretrales.

Cluster condyloma is currently one of the sexually transmitted diseases of higher incidence. The most common sites for condyloma in males are the balanopreputial sulcus, frenulum and the glans' mucosa. Associated to penis condyloma there can be urethral lesions in 5% of patients which in 80% of cases develop less than 3 cm from the meatus. This paper presents a series of 14 cases of cluster intraurethral condyloma managed by transurethral electrofulguration. The technique consists in the introduction of a coagulation probe through the urethrotome and the application of electrofulguration to the condyloma base. Results have been satisfactory although relapse has occurred in 2 cases (14%), and in one of them the procedure had to be repeated up to 3 times. There has been no complications such as stenosis in the loop resections. The authors conclude that due to the difficulties in the medical management of these lesions, the use of invasive techniques, of which transurethral electrofulguration of the condyloma base with endoscopic urethrotome is the choice because of its simplicity and effectiveness, is justified.

[Endoscopic trigono-cervico-prostatotomy: our experience]. / Trigonocervicoprostatotomía endoscópica: nuestra experiencia.

Presentation of our experience in treating the disease of the vesical neck through longitudinal endoscopic transurethral incisions in 24 patients following the Orandi procedure. Of the 24 patients seen in our service, 21 showed a clear clinical and urodynamic improvement. Complications were 2 cases of epididimorchitis and 1 iatrogenic stenosis of the anterior urethra. There were no major haemorrhages, urinary incontinence, or retrograde ejaculation except for an obvious decrease of ejaculate volume in 2 cases.

[Supernumerary kidney with ectopic ureteral opening to the vagina associated with horseshoe kidney]. / Riñón supernumerario con abocamiento de uréter ectópico a vagina asociado a riñón en herradura.

Contribution of one case of supernumerary kidney with ureter ectopically opened to vagina associated to horseshoe kidney. Supernumerary kidneys are extremely unusual entities, there being only about 70 cases described in the international literature. This is the first case where it is found associated to horseshoe kidney.