ABSTRACT
A Caucasian 39-year-old male patient with a poorly-differentiated infiltrating epidermoid penile carcinoma with urethral invasion was diagnosed. The patient received concomitant adjuvant chemotherapy with radiotherapy in the palliative setting, which produced painful ulceration of tumour lesions at loco-regional level (Numerical Rate Scale, NRS=9). The patient consented for treatment with direct topical sevoflurane instillations, at initial doses of 1 mL/cm2 of ulcerated area, as per unit protocol. The local use of undiluted sevoflurane achieved a marked reduction of the pain score in both nociceptive and irruptive pains (average NRS=3 immediately post-application). This improvement was corroborated by a decline in total morphine needs, any adverse events associated with major opiates. PGI-I and CGI-I scales were used before and after treatment with topical sevoflurane to assess patient and clinician perceptions of improvement in the quality of life. The pharmacy of our hospital had the responsibility to elaborate pre-loaded syringes with sevoflurane so that the patient was instilled simply and comfortably.
ABSTRACT
OBJETIVO: Presentar una serie de 4 casos de quiste de Gartner, mostrando su forma de presentación y realizando una revisión de la literatura. MÉTODO: La serie está constituida por 4 mujeres, con una edad media de 39 años, cuyo motivo de consulta fue la presencia de un aumento de volumen de pared vaginal anterior y diversa sintomatología urinaria. RESULTADOS: Se realizó la extirpación quirúrgica en todos los casos, sin complicaciones. En los cuatro casos se confirmó el diagnostico anátomo-patológico de quiste de Gartner. No hubo recidivas en el largo plazo. CONCLUSIÓN: Los quistes de la pared vaginal constituyen una entidad poco frecuente dentro de la práctica urológica habitual. Los quistes de Gartner se originan como consecuencia de la obstrucción del conducto de Gartner, remanente mesonéfrico, y se localizan en la pared anterior o lateral de la vagina. Puede asociarse a anomalías renales y ureterales. El diagnostico diferencial con otros quistes vaginales solo puede realizarse mediante el estudio histológico, siendo el tratamiento de elección la extirpación por vía vaginal
OBJECTIVES: To present a series of four cases of Gartner cysts and their clinical presentation. A bibliographic review was performed. METHODS: The series consisted of 4 women, mean age 39, who complained of a bulge at the anterior vaginal wall, associated with a variety of urinary symptoms. RESULTS: Surgical removal was performed in all cases. The pathological studies confirmed the diagnosis of Gartner cyst. There were no recurrences in the long-term follow-up. CONCLUSION: Vaginal wall cysts are rarely found in common urological practice. Gartner cysts arise as a consequence of the Gartner duct (mesonephric remainder) obstruction and they are located in the anterior or lateral wall of the vagina. They may be associated with renal and ureteral anomalies. Differential diagnosis with other vaginal cysts can only be made by histological studies. The correct treatment is the entire removal through a vaginal approach
