Giant cavernous hemangioma in renal graft: a case report.

BACKGROUND: We present a case of giant cavernous hemangioma in renal graft tumor; we have not found any cases described in literature. CLINICAL CASE: Patient transplanted from a deceased donor, 8 years previous to her admission due to deterioration in renal function, observing a 12-cm renal mass in the front face of the renal graft, which displaces it, provoking obstructive uropathy. On ultrasonography and computed tomography, it is seen as a complicated, cystic lesion. Tumorectomy with a good functional recovery of the graft was carried out. A histopathologic study showed a mass with extensive adherences to the perirenal adipose tissue and a cross section showed a spongy appearance with blood clots in the centre, microscopically formed by vascular channels, lined by a layer of endothelial cells, and filled with blood. CONCLUSIONS: Giant cavernous hemangioma in renal graft tumor has not been previously described. Given its benign condition, nephron-sparing surgery should be carried out if possible.

Determinants of resistive index shortly after transplantation: independent relationship with delayed graft function.

Measurement of the vascular resistive index (RI) by Doppler ultrasonography has been proposed as a non-invasive method to evaluate renal allograft dysfunction, but there are conflicting reports about its clinical utility. The aim of our study was to analyse the donor and recipient characteristics related to RI measured at days 2 and 3 after renal transplantation and the relationship between RI and allograft outcome. RI was measured by Doppler ultrasonography in 333 patients at days 2 or 3 post-transplantation. Donor and recipient variables and allograft outcome were collected from a prospectively maintained institutional database. In patients with RI higher than 0.7, donor age, recipient age, duration of renal replacement therapy, incidence of diabetes, hypertension and atherosclerosis in the recipient, pulse pressure, initial creatinine and the incidence of delayed graft function (DGF) were higher. After multivariate analysis, the only variables that remained significant for an increased risk of higher RI were recipient age over 55 years, presence of diabetes in the recipient and DGF. Recipient age, previous diabetes mellitus and DGF are the most important determinants of transplant kidney RI in the first days after transplantation. So both the graft recipient and the graft itself, but not the donor, determine intra-renal Doppler indices.

[Abscess colon diverticular disease produced for Actinomyces israelii in a renal transplant recipient]. / Diverticulitis abscesificante por Actinomyces israelii en un trasplante renal.

We present the case of a 53 years old man with a cadaveric kidney transplant under cyclosporin A and prednisolone therapy. Clinical transplant course was uneventful until 15 years after transplant, when he was admitted in our hospital with fever and a perirenal mass of unknown origin. Cyclosporin A was removed and a left sided colon was carried out and a abscess colon diverticular disease produced for Actinomyces israelii was diagnosed. The development was satisfactory after medical and surgical treatment.

Diverticulitis abscesificante por Actinomyces israelii en un trasplante renal / Abscess colon diverticular disease produced for actinomyces israelii in a renal transplant recipient

Paciente de 53 años, trasplantado renal en tratamiento con Ciclosporina A y esteroides, con buena función renal, que ingresa 15 años después del trasplante por fiebre y una masa perirrenal a estudio. Al ingreso, se retiró la Ciclosporina A y, tras realizar diversas pruebas de imagen, se hizo una hemicolectomía izquierda detectándose una diverticulitis abscesificante por Actinomyces israelii con evolución favorable

We present the case of a 53 years old man with a cadaveric kidney transplant under cyclosporin A and prednisolone therapy. Clinical transplant course was uneventful until 15 years after transplant, when he was admitted in our hospital with fever and a perirenal mass of unknown origin. Cyclosporin A was removed and a left sided colon was carried out and a abscess colon diverticular disease produced for Actinomyces israelii was diagnosed. The development was satisfactory after medical and surgical treatment

Dolor abdominal en paciente tratado con acenocumarol. Un caso de hematoma intramural espontáneo de intestino delgado / Abdominal ain in a patient using acenocoumarol. A case of spontaneous intramural samll-bowel hematoma

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[Testicular epidermoid cyst: uncommon lesion of difficult preoperative diagnosis]. / Quiste epidermoide testicular: una rara entidad de dificil diagnostico preoperatorio.

Intratesticular epidermoid cysts are rare tumours that constitute one percent of all testicular masses. They are bening lesions that make differential diagnosis from malignant testicular tumours difficult. The absence of serum markers elevation and ultrasound imaging could support these lesions being bening epidermoid cysts, and in that case, conservative surgery is adequate. We present the case of a 22 years old patient who complains of a left testicular mass. In this case ultrasound diagnosis was non-specific and a left radical inguinal orchiectomy was performed.

Quiste epidermoide testicular: una rara entidad de difícil diagnostico preoperatorio / Testicular epidermoid cyst: uncommon lesion of difficult preoperative diagnosis

Los quistes epidermoides intratesticulares son tumores raros, constituyendo el 1% de todos los tumores testiculares. Se trata de tumoraciones benignas que plantean un difícil diagnóstico diferencial preoperatorio frente a los tumores malignos testiculares. La ausencia de elevación de los marcadores tumorales y la apariencia ecográfica, pueden orientar hacia su diagnóstico preoperatorio y en este caso la cirugía conservadora del testículo. Se presenta el caso de un paciente de 22 años que consulta por una masa en el testículo izquierdo. En este caso, el diagnóstico ecográfico preoperatorio no descartaba otras patologías por lo que se procedió a la realización de orquiectomía inguinal izquierda (AU)

Intratesticular epidermoid cysts are rare tumours that constitute one percent of all testicular masses. They are bening lesions that make differential diagnosis from malignant testicular tumours difficult. The absence of serum markers elevation and ultrasound imaging could support these lesions being bening epidermoid cysts, and in that case, conservative surgery is adequate. We present the case of a 22 years old patient who complains of a left testicular mass. In this case ultrasound diagnosis was non-specific and a left radical inguinal orchiectomy was performed (AU)

[Considerations about angiolymphoid hyperplasia with eosinophilia (ALHE) with regard to a case localized in the penis]. / Consideraciones en torno a la Hiperplasia Angiolinfoide con Eosinofilia (ALHE). A propósito de un caso localizado en el pene.

We report the case of a 27 year old man who presented a nodule in the ventral face of the penis, which increased in volume and turned painful during erection so a vascular lesion was suspected, later confirmed with a Doppler study. A complete excision of the lesion was carried out with local anaesthesia. The pathological specimen was informed as "angiolimphoid hyperplasia with eosinophilia" in its intravascular form. This is the third communication of this kind of lesion in the penis but no other adopted the intravascular variant like the present case. We discuss about this exceptional entity and make review of the most relevant literature.

Consideraciones en torno a la Hiperplasia Angiolinfoide con Eosinofilia (ALHE). A propósito de un caso localizado en el pene / Considerations about angiolymphoid hyperplasia with eosinophilia (ALHE) with regard to a case localized in the penis

Presentamos el caso de un paciente varón de 27 años de edad que presentaba un nódulo en la cara ventral del pene que aumentaba de tamaño y se volvía doloroso durante la erección por lo que se sospechó que se trataba de una lesión vascular, confirmado posteriormente mediante estudio Doppler. Se realizó la extirpación del nódulo con anestesia local. El informe anatomopatológico fue de “hiperplasia angiolinfoide con eosinofilia” en su variante intravascular. Este caso representa la tercera comunicación de esta lesión en el pene, pero ninguna otra adoptaba la variante intravascular como la aquí presentada. Se discute acerca de esta excepcional entidad y se revisa la literatura

We report the case of a 27 years old man who presented a nodule in the ventral face of the penis, which increased in volume an turned painful during erection so a vascular lesion was suspected, later confirmed with a Doppler study. A complete excision of the lesion was carried out with local anaesthesia. The pathological specimen was informed as “angiolimphoid hyperplasia with eosinophilia” in its intravascular form. This is the third communication of this kind of lesion in the penis but no other adopted the intravascular variant like the present case. We discuss about this exceptional entity and make review of the most relevant literature

[Diverticuli of the female urethra. Diagnosis with transrectal ultrasonography]. / Divertículos de uretra femenina. Diagnóstico por ecografía transrectal.

OBJECTIVE: To analyze the role of transrectal ultrasound in the diagnosis of diverticula of the female urethra. METHODS/RESULTS: Transrectal ultrasound assessment was performed with a biplanar 5 MHz probe and translabial ultrasound was performed with a 7 MHz linear or 3.5 MHz sectorial transducer in 9 women suspected to have urethral diverticula. Cystourethrography was also performed in three patients. Eleven diverticula were found in these 9 patients. CONCLUSIONS: The incidence of diverticula of the female urethra has been reported to range from 0.5-6%. Diagnosis is confirmed by urethroscopy or imaging methods. Transrectal ultrasound is the method of choice in the assessment of urethral diverticulum.

[Genital wound caused by low-speed fire arm]. / Herida genital por arma de fuego de baja velocidad.

OBJECTIVE: To report a case of genital gunshot injuries and review the literature. METHODS: A case of low velocity multiple gunshot penile injuries is described. Surgical exploration was performed, gunshot removed and the albuginea repaired. A broad spectrum antibiotic was administered prophylactically for infection. RESULTS: Good cosmetic and functional results, including sexual potency and voiding, were achieved. CONCLUSIONS: Surgical exploration is mandatory in genital gunshot injuries. The best approach to the albuginea is by a crown incision and denudation of the penile skin, which permits surgical repair with excellent cosmetic results.

Symptomatic solitary right renal vein aneurysm: a case report.

Renal vein aneurysms are very uncommon. Those located in the right side are exceptional. A symptomatic, solitary, voluminous aneurysm of the right renal vein in a 33-year-old man is reported. The lesion was diagnosed preoperatively as a renal tumor. The pathologic study of the nephrectomy specimen disclosed a thrombosed saccular aneurysm measuring 5.5 cm with marked medial atrophy of its wall. Recognition that a mass like this reported is of vascular origin is very important to avoid percutaneous biopsy which could be potentially hazardous; and for undertaking conservative prophylactic surgery. Renal venography is indicated for the diagnosis of these lesions.

[The association of pelvic injuries with urethral ruptures]. / Asociación de los traumatismos pélvicos con las roturas de uretra.

INTRODUCTION: Pelvic trauma is associated in a high rate of patients with posterior urethral injuries. Blood at the urethral meatus or the inability to void are suspicious of urethral damage, but their absence do not exclude it. The attempt to pass a urethral catheter can worse a previous injury. METHOD: Retrospective study of 565 pelvic trauma along the last 5 years in the Hospital Valdecilla of Santander. We asses the urethral injury according Colapinto and McCallum classification and their relationship with the pelvic trauma, their outcome and diagnosis methodology. RESULTS: There was 60 urethral injuries among 565 pelvic trauma (10.61%); 15 (25%) grade I were associated with trauma of the posterior ring of the pelvis; 17 (28.3%) grade II were associated in 12 cases with fractures of the anterior ring and in 5 cases with severe fractures of the posterior ring; 28 (46.66%) grade III were associated in 26 cases with fractures of the anterior ring and 2 fracture-luxation of the posterior one. Against the suggest of avoiding the attempt of passing a urethral catheter, nearly all patients had suffered and attempt before the urologist were asked for. The deferred combined urethrography was the best method of urethral evaluation.

[Intrascrotal lithiasis: an infrequent finding?]. / Litiasis intraescrotal: un hallazgo infrecuente?

OBJECTIVE: To report on 10 additional cases of intrascrotal calculi and briefly review the literature and pathogenesis of this benign lesion. METHODS: 10 patients that had consulted for diverse testicular conditions were evaluated by ultrasound using the 7.5 MHz probe. RESULTS: All patients were found to have a hydrocele of a larger or smaller volume with a mobile hyperechoic focus that produced acoustic shadows. CONCLUSIONS: The ultrasound finding of intrascrotal calculi is becoming increasingly more frequent. In our view, this is due to the fact that more sonographic studies are currently performed. The possibility to diagnose this condition obviates the need for subsequent explorations or surgery.

[Primary testicular tumor]. / Tumor testicular fundido.

OBJECTIVE: To report a case of primary germ cell testicular tumor that spontaneously remitted after metastasizing to the retroperitoneum, leaving histologically characteristic lesions of a fused tumor. The characteristic testicular ultrasound findings that permitted the diagnosis are described. METHODS/RESULTS: A 21-year-old male consulted for a retroperitoneal mass. The testes were normal on palpation. The testicular ultrasound showed a hyperechoic area with an acoustic shadow suspected as being a tumoral cicatrix. The histological analysis after orchidectomy revealed a mixed non-seminomatous germ cell tumor. CONCLUSIONS: Testicular ultrasound evaluation should be performed on all patients with retrosperitoneal germ cell tumor and normal testes on palpation. In the case described, there was good correlation between the ultrasound and the histological findings.

Transrectal sonography in the assessment of vaginal pathology: a preliminary study.

PURPOSE: We assessed the value of transrectal sonography (TRUS) in the diagnosis of vaginal abnormalities. METHODS: Six women between 16 and 77 years old underwent TRUS with a biplanar probe equipped with 5-MHz axial sector and longitudinal linear transducers. Sagittal and axial images of the bladder, vagina, and urethra were obtained. Sonographic findings were compared with those from surgery. RESULTS: TRUS showed hematocolpos in 3 patients and cysts in 3 patients. Surgery confirmed the findings. Pathologic examination revealed 2 Gartner's cysts and 1 vaginal inclusion cyst. CONCLUSIONS: TRUS represents a valid diagnostic tool for the assessment of vaginal abnormalities because it accurately visualizes lesions and clearly shows anatomic relationships.