[Nonspecific sexual cord testicular tumor. Case report]. / Tumor testicular de los cordones sexuales no específico. Presentación de un caso.

OBJECTIVE: We report one case of gonadal stromal testicular tumor and perform a bibliographic review. METHODS/RESULTS: We present the case of a 42 year-old male patient consulting for a painless right testicular mass. Orchiectomy was performed and the patient underwent follow-up. CONCLUSIONS: Nonspecific sexual cord tumors are extremely rare, with slow growing and benign behaviour, presenting positive staining for various markers.

Tumor testicular de los cordones sexuales no específico. Presentación de un caso / Nonspecific sexual cord testicular tumor. Case report

Objetivos: Presentamos el caso de un tumor testicular del estroma gonadal y revisamos la literatura al respecto. Métodos/Resultados: Presentamos el caso de un varón de 42 años que consulta por bultoma indoloro en testículo derecho, practicándose orquiectomía y seguimiento. Conclusiones: Los tumores de los cordones sexuales no específicos son una entidad extremadamente rara, con un crecimiento lento y comportamiento benigno, que presentan positividad para distintos marcadores (AU)

Objective: We report one case of gonadal stromal testicular tumor and perform a bibliographic review. Methods/Results: We present the case of a 42-year-old male patient consulting for a painless right testicular mass. Orchiectomy was performed and the patient underwent follow-up. Conclusions: Nonspecific sexual cord tumors are extremely rare, with slow growing and benign behaviour, presenting positive staining for various markers (AU)

Litiasis renal multiple en riñón en herradura / Multiple renal lithiasis in a horseshoe kidney

No disponible

[Renal cell carcinoma: prognostic factors and staging]. / Adenocarcinoma de celulas renales: factores pronosticos y estadificacion.

OBJECTIVES: To evaluate the prognostic significance of the 2002 TNM tumor classification for renal cell carcinoma, as well as other factors intervening in its survival. METHODS: Retrospective chart review of 316 renal carcinomas operated between 1970 and 2003. Twenty-five prognostic variables were analyzed. RESULTS: The histological type was renal cell carcinoma in 90.5% of the patients. Most tumors were T1b or T2, with a Fuhrman nuclear grade I or II. Mean tumor size was 7.17 +/- 3.4 cm. Most cases had a solitary tumor. 8.2% of the patients had lymph node involvement at the time of diagnosis, and 8.6% metastases. The most frequent clinical presentations were hematuria and/or pain. Mean follow-up was 57.8 months. 24.1% of the cases had recurrence, more than 50% of them during the first year. Advanced tumors (T3, T4) had the tendency to have a nuclear grade III-IV, bigger size, necrosis, vascular involvement, lymph node involvement, and metastases. At the end of follow-up, most patients were alive and disease free. The number of months free of disease, the presence of metastatic lymph nodes, the treatment of the first recurrence and the presence of anemia were independent factors for cancer specific mortality. CONCLUSIONS: The modification of the current classification of renal tumors pT3 and pT4 would help to a better decision-making in the therapy of tumors with vascular, perirenal fat or adrenal involvement. Anemia and treatment of the first recurrence are important factors for cancer specific survival.

[Intravesical therapy: Influence on superficial bladder cancer recurrence]. / Terapia endovesical: influencia sobre la recidiva en el cáncer vesical superficial.

OBJECTIVES: To review the influence of various intravesical treatments on superficial bladder cancer recurrence. METHODS: We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different adjuvant treatment and follow-up schemes. RESULTS: The following factors were independent risk factors for a longer recurrence-free time: intravesical instillations, high dose BCG, and maintenance therapy in comparison to induction. CONCLUSIONS: The use of intravesical instillations independently increases the time to recurrence. It was demonstrated that recurrence was significantly later when high dose BCG and maintenance therapy were employed.

Adenocarcinoma de células renales: factores pronósticos y estatificación / Renal cell carcinoma: prognostic factor and staging

Objetivo: Valorar el significado pronóstico de la clasificación tumoral TNM de 2002 para el carcinoma de células renales (CCR), así como otros factores implicados en la supervivencia. Métodos: Estudio retrospectivo de historias clínicas de 316 carcinomas renales intervenidos entre los años 1970 y 2003. Se analizaron 25 variables implicadas en el pronóstico de pacientes con CCR. Resultados: En un 90,5% de pacientes el tipo histológico fue de células renales. La mayoría de los tumores fueron T1b o T2, con un grado nuclear de Fuhrman I o II. La media del tamaño tumoral fue de 7,17 +/- 3,4 cm. En la mayoría de casos existió tumor único. En un 8,2% hubo afectación ganglionar en el momento del diagnóstico y en un 8,6% existían metástasis a distancia. La clínica más frecuente fue hematuria y/o dolor. El seguimiento medio fue de 57,8 meses. Recidivaron un 24,1% de los cuales más del 50% ocurrió en el primer año. Los tumores avanzados (T3, T4) tendieron a presentar un grado nuclear III-IV, mayor tamaño, necrosis, afectación vascular, afectación ganglionar y metástasis a distancia. Al finalizar el seguimiento la mayor parte de pacientes estaba vivo libre de tumor. Los factores que influyeron de forma independiente en la mortalidad cáncer específica fueron los meses libres de enfermedad, la presencia de adenopatías metastásicas, el tratamiento de la primera recidiva y la presencia de anemia. Conclusión: La modificación de la actual clasificación de los tumores renales pT3 y pT4, ayudaría a la mejor toma de decisiones en cuanto a la actitud terapéutica de tumores con afectación vascular, de grasa perirrenal y de glándulas adrenales. La anemia y el tratamiento de la primera recidiva son factores importantes implicados en la supervivencia cáncer específica (AU)

Objectives: To evaluate the prognostic significance of the 2002 TNM tumor classification for renal cell carcinoma, as well as other factors intervening in its survival. Methods: Retrospective chart review of 316 renal carcinomas operated between 1970 and 2003. Twenty- five prognostic variables were analyzed. Results: The histological type was renal cell carcinoma in 90.5% of the patients. Most tumors were T1b or T2, with a Fuhrman nuclear grade I or II. Mean tumor size was 7.17 ± 3.4 cm. Most cases had a solitary tumor. 8.2% of the patients had lymph node involvement at the time of diagnosis, and 8.6% metastases. The most frequent clinical presentations were hematuria and/or pain. Mean follow-up was 57.8 months. 24.1% of the cases had recurrence, more than 50% of them during the first year. Advanced tumors (T3, T4) had the tendency to have a nuclear grade III-IV, bigger size, necrosis, vascular involvement, lymph node involvement, and metastases. At the end of follow-up, most patients were alive and disease free. The number of months free of disease, the presence of metastatic lymph nodes, the treatment of the first recurrence and the presence of anemia were independent factors for cancer specific mortality. Conclusions: The modification of the current classification of renal tumors pT3 and pT4 would help to a better decision-making in the therapy of tumors with vascular, perirenal fat or adrenal involvement. Anemia and treatment of the first recurrence are important factors for cancer specific survival (AU)

Terapia endovesical: influencia sobre la recidiva en el cáncer vesical superficial / Intravesical therapy: influence on superficial bladder cancer recurrence

OBJETIVOS: Revisar la influencia de distintos tratamientos endovesicales sobre la recurrencia del cáncer vesical superficial. METODOS: Se revisaron retrospectivamente un total de 473 neoplasias vesicales superficiales. A partir del diagnóstico y la RTU vesical, y en función del resultado anatomopatológico, se plantearon distintos esquemas de seguimiento y tratamiento complementario. RESULTADOS: Resultaron independientes para explicar mayor tiempo libre hasta la recurrencia superficial los siguientes factores: empleo de lavados endovesicales, tratamiento con dosis altas de BCG y terapia de mantenimiento frente a inducción. CONCLUSIONES: El empleo de instilaciones vesicales incrementaron de forma independiente el tiempo hasta la recidiva. Se demostró que la recurrencia se produjo significativamente más tarde cuando se habían empleado dosis altas de BCG y terapia de mantenimiento (AU)

OBJECTIVES: To review the influence of various intravesical treatments on superficial bladder cancer recurrence. METHODS: We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different adjuvant treatment and follow-up schemes. RESULTS: The following factors were independent risk factors for a longer recurrence-free time: intravesical instillations, high dose BCG, and maintenance therapy in comparison to induction. CONCLUSIONS: The use of intravesical instillations independently increases the time to recurrence. It was demonstrated that recurrence was significantly later when high dose BCG and maintenance therapy were employed

A new form of presentation of renal actinomycosis: renal tumor with retroperitoneal bleeding.

OBJECTIVE: The aim of this case report is to add to the literature a new case of renal actinomycosis, but with a form of presentation that has never been reported: renal tumor with retroperitoneal bleeding. METHODS/RESULTS: We present the case of a 27-year-old woman, with a 5-month history of general syndrome and right flank pain. Radiological findings showed a right renal tumor with suspicious of retroperitoneal bleeding. Right radical nephrectomy was performed and the pathological examination of the specimen found actinomyces colonies. The patient received 8 weeks of Penicillin after surgery and had none sequelae. easily diagnosed because of non-specific clinical and radiological findings. Early diagnosis of renal actinomycosis is important to avoid surgery since actinomyces respond well to high doses of Penicillin.

A new form of presentation of renal actinomycosis: renal tumor with retroperitoneal bleeding

OBJETIVO: El objetivo de este artículo es añadir que en una forma de presentación nunca antes sido publicada: tumor renal con sangrado retroperitoneal. MÉTODOS: Presentamos el caso de una mujer de 27 años con síndrome constitucional y dolor en flanco derecho de cinco meses de evolución. Las pruebas radiológicas mostraron un tumor renal derecho con sospecha de sangrado retroperitoneal. Se realizó nefrectomía radical derecha y el estudio patológico encontró colonias de actinomices. El paciente recibió penicilina durante ocho semanas después de la cirugía y no tuvo secuelas. CONCLUSIONES: La actinomicosis renal es una infección crónica poco frecuente producida por actinomices, generalmente actinomices israelii, una bacteria gram positiva anaerobia de difícil diagnóstico debido a los hallazgos clínicos y radiológicos inespecíficos. Es importante diagnóstico precoz de la actinomicosis renal para evitar la cirugía, puesto que el actinomices responde bien a altas dosis de penicilina

OBJECTIVE: The aim of this case report is to add to the literature a new case of renal actinomycosis, but with a form of presentation that has never been reported: renal tumor with retroperitoneal bleeding. METHODS/RESULTS: We present the case of a 27 year old woman, with a 5-month history of general syndrome and right flank pain. Radiological findings showed a right renal tumor with suspicious of retroperitoneal bleeding. Right radical nephrectomy was performed and the pathological examination of the specimen found actinomyces colonies. The patient received 8 weeks of Penicillin after surgery and had none sequelae. CONCLUSIONS: Renal actinomycosis is an uncommon chronic infection caused by a gram-positive anaerobic actinomyces bacteria, usually actinomyces israelii, not easily diagnosed because of non-specific clinical and radiological findings. Early diagnosis of renal actinomycosis is important to avoid surgery since actinomyces respond well to high doses of Penicillin

[Spontaneous regression of venous thrombus in a case of renal carcinoma]. / Regresión espontánea de trombosis venosa en un caso de carcinoma renal.

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1 % of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava.

Regresión espontánea de trombosis venosa en un caso de carcinoma renal / Spontaneous regression of venous thrombus in a case of renal carcinoma

OBJETIVO: Describir el primer caso deregresión espontánea de trombosis de vena renal y cavainferior en un paciente con carcinoma de células renales.MÉTODO/RESULTADO: Se describe el caso de una mujerdiagnosticada de masa renal con trombosis de venasrenal y cava. En los estudios de extensión previos a lanefrectomía radical se constata la regresión de dicho tromboque se confirma posteriormente tras la nefrectomía.CONCLUSIÓN: La regresión espontánea de metástasisde carcinoma de células renales se estima menor al 1%.Este es el primer caso descrito en la literatura que afectaa una trombosis tumoral de venas renal y cava inferior

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1% of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava

[Treatment of a cavernous hemangioma of the bladder by endoscopical resection]. / Resección endoscópica como tratamiento del hemangioma cavernoso de vejiga.

OBJECTIVES: We report three cases of bladder hemangioma. METHODS: Three cases of cavernous hemangioma of the bladder with pathologic confirmation treated by endoscopical resection. RESULTS: There is no evidence of recurrence in either patient after resection. CONCLUSIONS: The endoscopical treatment of small bladder hemangiomas is an effective treatment.

[Renal cell carcinoma with late lung and ocular metastases]. / Carcinoma de células renales con metástasis pulmonar y ocular tardías.

OBJECTIVES: We report one case of ocular and lung metastases seven years after radical nephrectomy for renal cell carcinoma. METHODS: The case of a 45-year-old male patient who underwent radical nephrectomy for a localized renal cell carcinoma (T2N0M0) in 1995 was found in a review of malignant renal neoplastic pathology. RESULTS: Seven years later he presented with a lung metastasis requiring neumonectomy, and an ocular metastasis requiring enucleation. He is currently receiving systemic treatment with interferon and interleukin. CONCLUSIONS: Clinical presentation and evolution of metastasic renal carcinoma is very variable, a difference with other neoplasias. Ocular localization is exceptional and may appear long time after primary tumor; clinically, it may be asymptomatic or present with sudden sight loss. MRI, CT scan and retinal examination are the diagnostic methods employed, and treatment may be surgery, brachytherapy or radiotherapy depending on location and size of the lesion.

[Cystic hamartoma of the renal pelvis: unfrequent finding]. / Hamartoma quístico de pelvis renal, un hallazgo infrecuente.

OBJECTIVES: This cystic hamartoma of the renal pelvis is a very unfrequent benign tumor. We report one case emphasizing its histology and performed a bibliographic review. METHODS: Mid age female patient with the incidental diagnosis of a renal mass taking up the pelvis. RESULTS: A radical nephrectomy was performed with the pathologic report of cystic hamartoma of the renal pelvis. CONCLUSIONS: It is a cystic renal tumor with well-defined histologic and immunohistochemical criteria, and it probably does not involve any danger for the patient's live.

[A new case of bladder endometriosis in a patient with a history of Cesarean section]. / Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea.

OBJECTIVES: To report one new case of endometriosis in a patient with history of caesarean section. METHODS: It is the case of a female patient presenting with voiding symptoms and hematuria, with a bladder tumor on ultrasound. RESULTS: After TUR of a retro trigonal tumor pathology report showed bladder endometriosis. Treatment was completed with hormone therapy, being the patient relapse free at one year follow-up. CONCLUSIONS: History of caesarean section is one of the possible etiologies of bladder endometriosis.

Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea / New case of bladder endometriosis in a patient with history of caesarean section

OBJETIVO: Presentar un nuevo caso de endometriosis en una paciente con antecedentes de cesárea. MÉTODO: Se trata de una paciente que consulta por síndrome miccional y hematuria, con hallazgo ecográfico de neoformación vesical. RESULTADOS: Se practica RTU de neoformación retrotrigonal con el resultado anatomopatológico de endometriosis vesical, se completa el tratamiento con terapia hormonal, estando la paciente libre de recidivas al año de control. CONCLUSIONES: Entre las posibles etiologías de la endometriosis vesical se encuentra el antecedente de cesárea (AU)

No disponible

[Clinical course of epidermoid carcinoma of the penis in our series]. / Análisis de la evolución del carcinoma epidermoide de pene en nuestra serie.

OBJECTIVES: To study the evolution of 49 patients with squamous cell carcinoma of the penis. METHODS: 49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases. RESULTS: There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis. CONCLUSIONS: Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.

Análisis de la evolución del carcinoma epidermoide de pene en nuestra serie / Analysis of the evolution of squamous cell carcinoma of the penis in our series

OBJETIVOS: Se estudia la evolución de 49 pacientes con carcinoma epidermoide de pene. MÉTODOS: Se trata de 49 pacientes sometidos a cirugía por carcinoma epidermoide de pene (30 penectomías parciales, 11 totales y 7 circuncisiones).Se practicaron 27 linfadenectomías inguinales, superficial, profunda y en dos casos ilio-obturatriz, por persistencia de ganglios tras penectomía, a pesar de tratamientos antibióticos de 4 semanas o por alto estadio del tumor primario. Se objetivan metástasis ganglionares en 13 de los pacientes tratados, recibiendo posteriormente tratamiento adyuvante con QT, RT o combinación de ambos. Se realiza un seguimiento de los pacientes en función del estadio, Grado de diferenciación celular y existencia o no de ganglios positivos y metástasis a distancia. RESULTADOS: Se encuentran 5 tumores en estadio Ta y 26 T1 (63,2 per cent), 16 T2 (32,6 per cent) y 2 T3 (4,08 per cent). En cuanto al grado 81 per cent fueron GI, 16 per cent GII y 2 per cent GIII. Tras linfadenectomía se objetivan metástasis ganglionares en 13 de los pacientes (26,53 per cent). En 6 de los pacientes se produjo fallecimiento por diseminación del tumor, dos de ellos T2G2, un T2G1, tres T1G2; además dos pacientes T1G1 fallecieron por causas ajenas al proceso tumoral, siendo todos N+ clínicamente en el momento del diagnóstico. CONCLUSIONES: Por lo tanto se trata de un tumor agresivo cuya evolución dependerá sobretodo del estadio locorregional en el momento del diagnóstico y del grado de diferenciación celular que alcance, en función de los cuales se planteará la posibilidad de linfadenectomía versus vigilancia (AU)