[Mucinous carcinoma of the prostate: critical review of Elbadawi's criteria]. / Carcinoma mucinoso de la próstata: revisión crítica de los criterios de Elbadawi.

OBJECTIVES: We present our experience on prostatic mucinous adenocarcinoma and at once we practice an actualization and a critical review of Elbadawi's criteria. METHODS: After reviewing 206 prostatic carcinomas diagnosed in our hospital, we describe one case that fulfill criteria for being considered a prostatic mucinous adenocarcinoma. We also carry out a wide literature review trying to define anew the including criteria of this tumour by the light of modern knowledge and technology. CONCLUSIONS: We think that for accepting a tumour as a prostatic mucinous adenocarcinoma, this have to fulfill the following criteria: 1. "More than 25% of a significative tumoral sample is mucinous pattern and present, single or clustered, tumour cells floating in immunohistochemically probed, acidic and neutral, mucin lakes". 2. "Tumour is Gleason 3-4 cribiform pattern with direct transition to colloid areas and usually coexist with classic adenocarcinoma but papillary growth patterns should be excluded. Tumour may contain a moderate proportion of signet-ring cells". 3. "Immunohistochemical staining for PSA have to be strongly positive in both, cribiform and mucinous, areas". 4. "Those PSA nonreactive, or only focally positive, mucinous adenocarcinomas, could be labeled as prostatic only when local or distant mucinous carcinomas are ruled out".

Carcinoma mucinoso de la próstata:revisión crítica de los criterios de Elbadawi / Prostatic mucinous carcinoma: critical review of Elbadawi's criteria

OBJETIVOS: Presentar nuestra experiencia sobre el adenocarcinoma mucinoso de la próstata (AMP) a la vez que se realiza una actualización y una revisión crítica de los criterios de Elbadawi. MÉTODOS: Tras revisar 206 carcinomas prostáticos diagnosticados en nuestro servicio, describimos un caso que cumple los criterios para ser considerado un AMP. Realizamos además una amplia revisión de la literatura intentando redefinir dichos criterios de inclusión a la luz de los conocimientos y tecnologías actuales. CONCLUSIONES: Pensamos que para aceptar que un tumor es un AMP, este debería cumplir los siguientes criterios: 1. "Más del 25 por ciento de una muestra tumoral significativa es de tipo mucinoso y presenta células tumorales, sueltas o en racimos, dentro de lagos de mucinas ácidas y neutras demostradas por inmunohistoquímica".2. "El tumor tiene un patrón cribiforme Gleason 3-4 con transición más o menos directa hacia áreas coloides y usualmente coexiste con adenocarcinoma clásico pero descartándose los patrones de crecimiento papilar. El tumor puede contener células en anillo de sello en proporción moderada".3. "Ambas áreas, cribiforme y mucinosa, deben teñirse intensamente con PSA y/o PSAP".4. "Aquellos adenocarcinomas mucinosos que no se tiñen con el PSA, o sólo son focalmente positivos, podrán eti-quetarse como prostáticos sólo si se excluye de forma inequívoca la presencia de tumores mucinosos locales o distantes" (AU)

[Use of the urologic resectoscope in the treatment of rectal pathology. Analysis of our experience and review of the literature]. / Utilización del resector urológico en el tratamiento de patología rectal. Análisis de nuestra experiencia y revisión de la literatura.

Treatment of rectal polypoid disease, particularly villous adenoma, by electrocoagulation has proven its efficacy in a large number of cases. However, it does not permit adequate control or analysis of the specimen because the morbid excrescence is destroyed. Transsphincteric or transanal surgery, anterior resection or abdominoperineal amputation are generally too aggressive for a recurrent but benign condition. The enhanced efficacy of other therapeutic modalities such as chemo-, immuno- or radiotherapy will undoubtedly be beneficial to conservative surgical management of a malignant rectal pathology. Our initial experience in 15 patients with different rectal tumors is reported. These patients were treated by endoscopic transanal resection (ETAR) utilizing the urologic resectoscope. Local control of the disease process was achieved in 66.6% of the cases with scant morbidity and a mortality rate of 7.3% (1 case). The foregoing results and those reported in the literature indicate that ETAR is a valid alternative surgical procedure for definitive treatment of sessile, villous, or mixed adenomatous polyps and certain cases of rectal adenocarcinoma. Moreover, this procedure has proved effective as palliative treatment in advanced rectal adenocarcinoma and obviates the need for stomas.

[Symptomatic simple cyst of the kidney. Treatment using puncture-aspiration and sclerosis with 95% ethanol]. / Quistes renales simples sintomáticos. Tratamiento mediante punción-aspiración y esclerosis con etanol 95 por 100.

Puncture of cystic renal masses is useful in diagnosing a small number of cases when commonly used imaging techniques cannot determine the benign nature of the liquid mass with total accuracy. It can also be used as a therapeutic procedure in those cases with symptomatology arising from the presence of a renal cyst or functional alterations. In the present study, we report our experience using puncture-aspiration and sclerosis with 95% ethanol instillation in 12 renal cysts causing different symptoms. The procedure achieved good overall results with practically no complications. In 10 of the 12 cases the procedure was performed on an outpatient basis.

[Adrenal gland myelolipoma: apropos of a case]. / Mielolipoma suprarrenal: a propósito de un caso.

The myelolipoma is an uncommon benign tumour of the suprarrenal gland, composed of fat and hematopoietic tissue. We submit a case diagnosed preoperatively by means of echography and T.A.C. and treated surgically with tumoural excision. The gland was preserved to a large extent. We comment on etiopathogenic and diagnostic aspects.

[Incomplete bladder partition. Comments. A clinical case]. / Tabique vesical incompleto. Comentarios. A un caso clínico.

The authors present a rare case of incomplete vesical partition wall in a 59 years old woman, with mictional troubles and repeated cystitis which was surgically resolved by the abdominal way with excellent results. They finally review the different possibilities of vesical partition.