[Angiomyolipoma of the kidneys].

59 angiomyolipomas were studied: immunohistochemistry (IHC) was used in 24 cases, electron microscopy (EM) in 6 cases. 57 tumors had a typical structure, 2 did not contain fat component. Premelanosomes were found by EM in one tumor. Smooth muscle actin was found in all tumor cells. Involvement of lymph nodes was observed in 2 patients. Histogenesis of this tumor is discussed.

[Regional metastases of penile cancer: optimal treatment policy]. / Regionarnye metastazy raka polovogo chlena - optimal'naia taktika lecheniia.

Emergence of regional penile cancer (PC) metastases reduces late survival of PC patients from 94.4 to 83.9%. PC stage can hardly be diagnosed by clinical data significantly. Bilateral inguinal lymphadenectomy is indicated for all PC patients with enlarged and clinically negative regional lymph nodes in poorly differentiated primary tumor (G3) and stages T2-3. Follow-up can be recommended for patients with stage Tis-T1, low and moderate anaplasia (G1-2) of the primary tumor. Metastases to the iliac lymph nodes are an indication to pelvic lymphadenectomy. Preventive removal of the iliac lymph nodes in intact inguinal ones is not justified. Unremovable fixed regional lymph nodes should be exposed to radiotherapy.

[Organ-saving treatment of penile cancer]. / Organosokhraniaiushchee lechenie raka polovogo chlena.

Conservative penis-salvage treatment provides a complete local effect in 55% cases, preservation of the penis in 51.4% patients without a fall in long-term specific and recurrence-free survival compared to penectomy and can be recommended as an alternative to penis amputation in patients with stages Tis-T2. Removal of a penile tumor raises efficacy of salvage treatment and insignificantly increases survival. Application of surgical treatment only is associated with a high rate of local recurrences. Chemoradiotherapy in penile cancer is significantly more effective vs each method alone. Radiation in a total focal dose more than 60 Gy improves local control over the tumor. Most effective are schemes of chemotherapy based on bleomycin. Polychemotherapy has no advantages over monochemotherapy with bleomycine.

[Paratesticular rhabdomyosarcoma]. / Paratestikuliarnaia rabdomiosarkoma.

Paratesticular rabdomyosarcoma (PR), the most frequently occurring paratesticular tumor, is encountered mostly in young and middle-aged men. PR metastasizes early and is characterized by lymphogenic dissemination of the tumor with affection of the retroperitoneal lymph nodes. Orchofuniculectomy is the first-line treatment in all the patients. If the patient is metastases-free it is followed by preventive retroperitoneal lymphadenectomy with subsequent adjuvant chemoradiotherapy. In disseminated PR, combined treatment is indicated including surgical removal of metastatic foci and adjuvant chemo- or chemoradiotherapy. If surgical removal of all the tumor foci is infeasible, patients with disseminated PR undergo chemotherapy. Radiation of metastatic retroperitoneal lymph nodes is uneffective. Prognosis of PR depends on the age, stage of the disease and treatment.

[Testicular sertolioma]. / Sertolioma iaichka.

Sertolioma accounts for 4.5% of all non-herminogenic testicular tumors. Sertolioma presents clinically with local symptoms (enlarged testis) which may be associated with dyshormonal symptoms. Most sertoliomas are benign, only 16.7% of them are malignant. Metastatic process is primarily lymphogenic and involves first retroperitoneal lymph nodes. Accurate histological criteria of malignancy for sertolioma have not been determined yet. The treatment should be started with orchofuniculectomy. Organ-saving operations may be performed in metastases-free children with bilateral sertoliomas. Surgical treatment is the only treatment effective in malignant sertolioma. Retroperitoneal and (or) solitary distant metastases should be removed surgically. Sertolioma is resistant to chemotherapy and is low sensitive to radiotherapy. Contrary to benign sertolioma, malignant one has poor prognosis.

[Surgical treatment of late metastases of kidney cancer]. / Operativnoe lechenie pozdnikh metastazov raka pochki.

Whereas 25-57% of patients diagnosed with renal cell carcinoma (RCC) present with metastatic disease, about 50% of (RCC) patients develop metastases after potentially curative radical nephrectomy. Five-year survival at following surgical removal of solitary metastases is approximately 35-50%. Our experience demonstrate that a small cohort of patients benefit from aggressive surgical therapy for consequtively arising solitary distant metastases with long-term palliation.

[Leydig-cell tumors of the testis]. / Leidigo-kletochnye opukholi iaichka.

The authors review case histories of 23 patients with leydigomas selected from records on 134 patients with nongerminogenic testicular tumors. Malignancy occurred in 6 cases. Two cases with uni- and bilateral testicular involvement are reported. The course of leydigoma in children is described.

[Malignant epithelioid schwannoma of the kidney]. / Zlokachestvennaia épitelioidnaia shvannoma pochki.

Malignant epithelioid renal schwannoma was recorded in a 16-year-old youth. Examined light-optically and electron-microscopically, it showed signs of multiprofile differentiation involving elements of a malignant schwannoma, neurofibroma, undifferentiated epithelioid component, photoreceptors, cells with neuroendocrine granules, Vater-Pacini corpuscles.