Solitary Fibrous Tumor of the Urinary Bladder Associated with Hypoglycemia: An Unusual Case of Doege-Potter Syndrome.

Solitary fibrous tumors (SFT) are rare mesenchymal tumors, mostly benign. Less than 30 cases have been described for the urinary bladder, 2 of them malignant. These lesions show infrequent clinical and radiological usual features, making the diagnosis difficult. Therefore, an immunohistochemical and morphological comprehensive study, which will provide the main prognostic factors, is necessary for histological diagnosis. The hypoinsulinemic hypoglycemia, as a paraneoplastic syndrome associated with SFTs - also known as the Doege-Potter Syndrome - is an infrequent finding, and quite incidental when located in the bladder. In order to obtain a fair oncological result, the recommended procedure for this type of tumors is surgical exeresis with negative margins, including non-standardized chemotherapy/radiotherapy as an alternative treatment.

[Testicular germ cell tumours: descriptive study of 13 years of experience in the health care area of Badajoz]. / Estudio descriptivo de los tumores testiculares germinales: 13 años de experiencia en el area de salud de Badajoz.

OBJECTIVES: To describe the incidence of germ cell testicular tumors in our Center, their characteristics and therapy results. METHODS: Retrospective study of 66 cases of germ cell testicular tumors diagnosed in the Health Area of Badajoz between 1993 and 2005. RESULTS: Mean age of the time of diagnosis was 32 years (range 16-80 years), presenting a younger age patients with non seminomatous germ cell tumors (NSGCT) (mean age 30 years). 86.5% of the patients did not have risk factors associated with the diagnosis of germ cell testicular tumor. Testicular mass was the most frequent symptom, and a higher proportion of tumors were located in the left testicle (51.5%). Non seminomatous germ cell tumors were the most frequent histological type (64.8%). Stage I (72%) was the most frequent stage in the group of seminomatous tumors, in comparison with 68.5% of non seminomatous tumors. Stages II-III appeared in 34.4% of the NSGCT and 28% of seminomatous, having worse prognosis. 92% of the patients received adjuvant treatment with chemotherapy and/or radiotherapy, and curative surgery was the only treatment in the remainder 8%. Residual mass surgery was undertaken in five patients (stages IIa, IIc and IIIa). Eight of the 66 cases were lost for follow-up. Fifty-three of the 58 patients with follow-up are disease-free, 18 of them with more than five years of follow-up. CONCLUSIONS: An increased incidence of germ cell testicular tumors have been verified over last years, mainly NSGCT Nevertheless, the diagnosis of advanced stages of the disease has diminished in favour of initial stages, which have a better prognosis for the patient. Oncologycal treatment protocols have high cure rates, although a long-term follow-up is needed due to the natural history of these tumors.

[Non venereal sclerosing lymphangitis of the penis. Case report]. / Linfangitis esclerosante no venerea del pene. Presentacion de caso clinico.

OBJECTIVE: We report a clinical case with a diagnosis of nonvenereal sclerosing lymphangitis of the penis and revision of the literature existing on this pathology. CLINICAL CASE: We describe the case of a 28 years old man who has presented for 10 days an induration of cartilaginous consistence next to the sulcus coronarius penis and symptomatic during the erections, compatible with the diagnosis of sclerosing lymphangitis. RESULTS: Sexual abstinence was recommended and we kept an expectating attitude so ceasing the process after 4 weeks. CONCLUSIONS: Nonveneral sclerosing lymphangitis of the penis is a process of unknown etiology, related to an increase of sexual activity, which is during the erection and it has a self-limited character, so the initial treatment is conservative.

Estudio descriptivo de los tumores testiculares germinales: 13 años de experiencia en el área de salud de Badajoz / Testicular germ cell tumours: descriptive study of 13 years of experience in the health care area of Badajoz

Objetivo: Descripción de la incidencia, las características tumorales y los resultados de la terapéutica aplicada en los tumores germinales testiculares diagnosticados en nuestro Centro. Método: Estudio retrospectivo de los 66 casos de tumores germinales diagnosticados en el Área de Salud de Badajoz en el período comprendido entre 1993 y 2005. Resultados: La edad media del diagnóstico de los tumores germinales de testículo (TGT) fue de 32 años (rango 16-80 años), presentando una edad más precoz los pacientes con tumores no seminomatosos (TGNS), media de 30 años. En un 86.5% de los paciente no se encontraron factores de riesgo relacionados con el diagnóstico de TGT. El hallazgo de una masa escrotal fue el síntoma mas frecuente y el tumor se localizó en mayor proporción en el testículo izquierdo (51.5%). Los tumores germinales no seminomatosos fueron la histopatología más común (64.8%). En el grupo de los tumores seminomatosos (TGTS), el estadio I (72%) fué el más diagnosticado frente al 68.5% de los no seminomatosos. Los estadios II-III se dieron en el 34.4% de los TGNS y 28% de los seminomas, conllevando peor pronóstico. El 92% de los pacientes recibió tratamiento adyuvante con quimioterapia y/o radioterapia, y se realizó cirugía curativa como único tratamiento en el 8% restante de los pacientes. Se practicó cirugía de masas residuales en 5 pacientes (estadios IIb, IIc y IIIa). Ocho de los 66 casos se han perdido en el seguimiento. De los 58 pacientes restantes, donde fue posible el control de la evolución, 53 pacientes están libre de enfermedad,18 de ellos con más de 5 años de seguimiento. Conclusiones: En los últimos años se verifica un aumento de la incidencia de TGT, sobre todo a expensa de los TGNS. Sin embargo, ha disminuido el diagnóstico en fase avanzada de la enfermedad en favor de estadios iniciales que confieren un mejor pronóstico para el paciente. Los protocolos de tratamiento oncológicos utilizados proporcionan una alta tasa de curabilidad, aunque debido a la historia natural de tumor, es necesario un seguimiento a largo plazo (AU)

Objectives: To describe the incidence of germ cell testicular tumors in our Center, their characteristics and therapy results. Methods: Retrospective study of 66 cases of germ cell testicular tumors diagnosed in the Health Area of Badajoz between 1993 and 2005. Results: Mean age of the time of diagnosis was 32 years (range 16-80 years), presenting a younger age patients with non seminomatous germ cell tumors (NSGCT) (mean age 30 years). 86.5% of the patients did not have risk factors associated with the diagnosis of germ cell testicular tumor. Testicular mass was the most frequent symptom, and a higher proportion of tumors were located in the left testicle (51.5%). Non seminomatous germ cell tumors were the most frequent histological type (64.8%). Stage I (72%) was the most frequent stage in the group of seminomatous tumors, in comparison with 68.5% of non seminomatous tumors. Stages II-III appeared in 34.4% of the NSGCT and 28% of seminomatous, having worse prognosis. 92% of the patients received adjuvant treatment with chemotherapy and/or radiotherapy, and curative surgery was the only treatment in the remainder 8%. Residual mass surgery was undertaken in five patients (stages IIa, IIc and IIIa). Eight of the 66 cases were lost for follow-up. Fifty-three of the 58 patients with follow-up are disease-free, 18 of them with more than five years of follow-up. Conclusions: An increased incidence of germ cell testicular tumors have been verified over last years, mainly NSGCT. Nevertheless, the diagnosis of advanced stages of the disease has diminished in favour of initial stages, which have a better prognosis for the patient. Oncologycal treatment protocols have high cure rates, although a long-term follow-up is needed due to the natural history of these tumors (AU)

Linfangitis esclerosante no venerea del pene. Presentacion de caso clinico / Non venereal sclerosing lymphangitis of the penis. Case report

Objetivo: Aportar un caso clínico con diagnóstico de linfangitis esclerosante de pene y revisión de la literatura existente sobre esta patología. Método: Describimos el caso de un varón de 28 años, que presentaba desde hacía 10 días induración próxima a nivel del surco balanoprepucial de consistencia cartilaginosa y sintomático durante las erecciones, compatible con diagnóstico de linfangitis esclerosante. Resultados: Se recomendó abstinencia sexual y se mantuvo una actitud expectante, remitiendo el proceso a las 4 semanas. Conclusiones: La linfangitis esclerosante no venérea de pene es un proceso de etiología desconocida, al cual se relaciona con aumento de la actividad sexual y que se presenta como un cordón subcutáneo indurado que causa molestias o dolor durante la erección y que suele ser de carácter autorresolutivo, por lo que no suele ser necesario el tratamiento con fármacos (AU)

Objective: We report a clinical case with a diagnosis of nonvenereal sclerosing lymphangitis of the penis and revision of the literature existing on this pathology. Clinical case: We describe the case of a 28 years old man who has presented for 10 days an induration of cartilaginous consistence next to the sulcus coronarius penis and symptomatic during the erections, compatible with the diagnosis of sclerosing lymphangitis. Results: Sexual abstinence was recommended and we kept an expectating attitude so ceasing the process after 4 weeks. Conclusions: Nonveneral sclerosing lymphangitis of the penis is a process of unknown etiology, related to an increase of sexual activity, wich is during the erection and it has a self-limited character, so the initial treatment is conservative (AU)