[Synchronous metastases of the spermatic cord from papillary renal cell carcinoma]. / Carcinoma renal papilar con metástasis sincr6nica en el cordón espermático.

Papillary renal cell carcinoma has been related with higher survival rate and lower metastatic cancer mortality rate than clear renal cell carcinoma. We present an aggressive case related to unusual features for this histological type, like a tumor size higher than ten cm, great perirrenal fat and suprarenal gland infiltration, tumoral thrombosis of the infrahepatic cava vein, retroperitoneal adenopatic tumoral infiltration, high nuclear grade and synchronous solitary distant organ metastases of the right spermatic cord, finding three previous cases in the literature with this last feature. Prognostic implication of the papillary renal cell carcinoma type is unclear in cases like this, so probably we need better molecular and cytogenetic studies to get a correct classification of this histological type.

Carcinoma renal papilar con metástasis sincrónica en el cordón espermático / Synchronous metastases of the spermatic cord from papillary renal cell carcinoma

El carcinoma de células renales papilar (CCRP) se ha relacionado con porcentajes de supervivencia superiores y tasas de mortalidad por cáncer metastático inferiores respecto al carcinoma de células renales convencional. Presentamos un caso de comportamiento agresivo de acuerdo a la suma de características infrecuentes para esta variante histológica, como el tamaño tumoral superior a 10 cm, la infiltración severa de la grasa perirrenal y de la glándula suprarrenal homolateral, la trombosis tumoral de la vena renal y de la vena cava infradiafragmática, la afectación adenopática retroperitoneal, un alto grado nuclear y la asociación en el momento del diagnóstico de una metástasis a distancia única sincrónica en el cordón espermático derecho, habiéndose comunicado esta última circunstancia en tres casos previos. La diferenciación pronóstica de la variante papilar resulta controvertida ante casos de este tipo, planteando la necesidad de obtener mejores perfiles diferenciales citogenéticos y moleculares para la clasificación de esta entidad histológica

Papillary renal cell carcinoma has been related with higher survival rate and lower metastatic cancer mortality rate than clear renal cell carcinoma. We present an aggressive case related to unusual features for this histological type, like a tumor size higher than ten cm, great perirrenal fat and suprarenal gland infiltration, tumoral thrombosis of the infrahepatic cava vein, retroperitoneal adenopatic tumoral infiltration, high nuclear grade and synchronous solitary distant organ metastases of the right spermatic cord, finding three previous cases in the literature with this last feature. Prognostic implication of the papillary renal cell carcinoma type is unclear in cases like this, so probably we need better molecular and cytogenetic studies to get a correct classification of this histological type

[Traumatic rupture of a horseshoe kidney]. / Rotura traumática de riñón en herradura.

One-third to one-half of all patients with horseshoe kidney are asymptomatic and the condition is found incidentally. This congenital renal anomaly has shown as a predisponent condition for renal injury in blunt abdominal trauma, but often the degree of injury has a nonoperative therapy. Horseshoe kidney rupture is an exceptional pathology that require a complete diagnostic study to make an adequate management when surgical therapy is indicated. We present a fifteen-year-old male with previously unsuspected horseshoe kidney that suffered an atypical right upper-pole and mesorrenal kidney rupture after low-velocity-impact blunt abdominal trauma. A correct presurgical diagnose let a deferred surgical approach with right lower pole and horseshoe renal isthmus preservation. The trauma conditions, an excesive clinic manifestation, a clinical investigation about known congenital simultaneous anomallies and typical radiological signs, can suggest this infrequent patology. Computed tomography provides the best radiological information.

Rotura traumática de riñón en herradura / Traumatic fracture of a horseshoe kidney

Entre un tercio y la mitad de los riñones en herradura son asintomáticos y se diagnostican incidentalmente. Esta anomalía congénita de fusión se ha mostrado como condición predisponente a la lesión renalante un traumatismo abdominal, aunque con frecuencia el grado de afectación renal no precise cirugía. Más excepcional es el hallazgo de fractura de riñón en herradura, requiriéndose un estudio diagnóstico completo para un manejo adecuado a sus características cuando la cirugía está indicada. Se aporta el caso de un varón de 15 años con riñón en herradura no previamente conocido, que presentó una fractura de localización atípica polar superior y mesorrenal derecha, tras un traumatismo abdominal de baja intensidad. El correcto diagnóstico prequirúrgico permitió una cirugía diferida con preservación del polo renal inferior derecho y del istmo del riñón en herradura. Las características del trauma, la desproporción de la repercusión clínica y la búsqueda de posibles anomalías congénitas asociadas y de signos radiológicos compatibles, pueden orientar esta rara posibilidad diagnóstica, confirmándose el TAC con contraste como la mejor prueba de imagen

One-third to one-half of all patients with horseshoe kidney are asymptomatic and the condition is found incidentally. This congenital renal anomaly has shown as a predisponent condition for renal injury in blunt abdominal trauma, but often the degree of injury has a non operative therapy. Horseshoe kidney rupture is an exceptional pathology that require a complete diagnostic study to make an adequate management when surgical therapy is indicated. We present a fifteen year-old-male with previously unsuspected horseshoe kidney that suffered an atipicright upper-pole and mesorrenal kidney fracture after low velocity impact blunt abdominal trauma. A correct presurgical diagnose let a deferred surgical approach with rigth lower pole and horseshoe renal isthmus preservation. The trauma conditions, an excesive clinic manifestation, a clinical investigation about known congenital simultaneous anomallies and typical radiological signs, can suggest this infrequent patology. Computed tomography provide the best radiological information

[Fibrous pseudotumor of the testis: description of a case]. / Pseudotumor fibroso de testículo: descripción de un caso.

A case of testicular fibrous pseudotumor is reported with special reference to the site of implantation, in testicular adnexa and tunica albuginea.