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1.
Arch Esp Urol ; 60(1): 81-3, 2007.
Article in Spanish | MEDLINE | ID: mdl-17408180

ABSTRACT

OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. CASE REPORT: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis.


Subject(s)
Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/surgery , Neoplasms, Second Primary/diagnosis , Testicular Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , Aged , Humans , Male , Neoplasm Invasiveness , Urinary Bladder Neoplasms/pathology
2.
Arch. esp. urol. (Ed. impr.) ; 60(1): 81-83, ene.-feb. 2007. ilus
Article in Es | IBECS | ID: ibc-054461

ABSTRACT

OBJETIVOS: Presentar un caso raro de metástasis testicular secundaria a carcinoma urotelial infiltrante años después de practicada cirugía radical. METODOS: Exposición del caso clínico: paciente de 71 años sometido a cistoprostatectomía radical con uretrectomía por tumor vesical infiltrante. A los siete años debuta con dolor y aumento del tamaño testicular derecho. Se le practicó orquiectomía por vía inguinal siendo diagnosticado de metástasis testicular de carcinoma vesical de alto grado. y revisión de la literatura publicada al respecto. RESULTADOS: Supervivencia libre de enfermedad a los 12 meses de la orquiectomía. CONCLUSIONES: El tumor testicular metastático excluyendo leucemias y linfomas es extremadamente raro. La presencia de metástasis testiculares supone una diseminación metastásica a otros niveles y por ello la Quimioterapia podría mejorar el pronóstico (AU)


OBJECTIVE: To report a rare case of testicular metastasis secondary to an infiltrative transitional cell carcinoma years after radical surgery. METHODS: Case Report: 71-year-old male patient with history of infiltrative bladder tumor, status post radical cystoprostatectomy with urethrectomy. Seven years after surgery he presents with pain and swelling in the right testicle. Inguinal orchyectomy was carried out with the pathologic diagnosis of testicular metastasis of a high-grade transitional cell carcinoma. We perform a bibliographic review. RESULTS: The patient is disease-free twelve months after orchyectomy. CONCLUSIONS: Apart from leukemia and lymphoma, testicular metastases are extremely rare. The existence of testicular metastases means a metastatic dissemination to other organs, therefore chemotherapy could improve prognosis


Subject(s)
Male , Aged , Humans , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/surgery , Neoplasms, Second Primary/diagnosis , Testicular Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , Neoplasm Invasiveness , Urinary Bladder Neoplasms/pathology
3.
Arch Esp Urol ; 59(9): 859-66, 2006 Nov.
Article in Spanish | MEDLINE | ID: mdl-17190207

ABSTRACT

OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli's technique. METHODS: We retrospectively review 8 patients undergoing dorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results. RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to end anastomosis) with good outcome. CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results.


Subject(s)
Foreskin/transplantation , Urethra/surgery , Urethral Stricture/surgery , Humans , Male , Mucous Membrane/transplantation , Retrospective Studies , Urologic Surgical Procedures, Male/methods
4.
Arch Esp Urol ; 59(8): 779-84, 2006 Oct.
Article in Spanish | MEDLINE | ID: mdl-17153496

ABSTRACT

OBJECTIVES: We report two exceptional cases of metachronous adrenal metastasis of renal cell carcinomas and perform a bibliographic review. After the evaluation of various features such as frequency, etiopathogenesis, diagnosis and follow-up of these patients we conclude that these metastases are rare, and they usually appear late in the evolution of patients with low stage renal cell carcinoma. RESULTS/CONCLUSIONS: Once reviewed the treatment and checked the absence of guidelines for the therapeutic management of these patients we propose surgery for the adrenal metastasis as well as adjuvant treatment with immunotherapy.


Subject(s)
Adrenal Gland Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Carcinoma, Renal Cell/surgery , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Nephrectomy , Aged , Female , Humans , Male , Middle Aged
5.
Arch. esp. urol. (Ed. impr.) ; 59(9): 859-866, nov. 2006. ilus, tab
Article in Es | IBECS | ID: ibc-052187

ABSTRACT

OBJETIVO: Valoramos la indicación y nuestros resultados en el tratamiento de la estenosis de uretra compleja mediante la Técnica de Barbagli.MÉTODO: Realizamos una revisión retrospectiva de 8 pacientes a los que se indica la uretroplastia dorsal con injerto de mucosa libre prepucial. Analizamos las característicaspreoperatorias de los pacientes. La longitud media de la estenosis fue de 6,25 cm, la localización bulbar en 7 casos y peneana en uno. El flujo medio obtenido en la flujometría preoperatoria fue de 8,78 ml/seg. Describimos la técnica y presentamos los resultadosobtenidos con la misma. RESULTADOS: Con un tiempo medio de seguimiento de 22 meses tenemos un 87,5% de buenos resultados, entendiendo estos como la resolución definitiva de la estenosis. Sólo 1 paciente ha precisado un nuevo tratamientoquirúrgico (anastomosis término terminal), con buen resultado evolutivo.CONCLUSIONES: Concluimos que la uretroplastia dorsalcon injerto libre de mucosa prepucial es una técnica efectiva en estenosis de uretra larga y compleja y que por los resultados obtenidos, la consideramos técnica de primera elección en este tipo de estenosis uretrales


OBJECTIVES: We evaluate the indication and results in the treatment of complex urethral stenosis by the Barbagli`s technique.METHODS: We retrospectively review 8 patients undergoingdorsal onlay urethroplasty with foreskin mucosa free graft. We analyze their preoperative characteristics. Mean stenosis length was 6.25 cm and the site was bulbar urethra in seven cases and penile in one. Mean preoperative flow was 8.78 ml/sec. We describe the technique and present our results.RESULTS: There are 87.5% of goods results (cure of the stenosis) with 22 months of mean follow-up. Only one patient required a second operation (end to endanastomosis) with good outcome.CONCLUSIONS: The dorsal onlay urethroplasty with foreskin mucosa free graft is an effective technique in long and complex urethral stenosis, and we consider it the technique of first choice in view of our results


Subject(s)
Male , Humans , Urethral Stricture/surgery , Tissue Transplantation/methods , Urologic Surgical Procedures, Male/methods , Retrospective Studies , Surgical Flaps , Plastic Surgery Procedures/methods
6.
Arch. esp. urol. (Ed. impr.) ; 59(8): 779-784, oct. 2006. ilus
Article in Spanish | IBECS | ID: ibc-135599

ABSTRACT

OBJETIVOS/MÉTODOS: Presentamos dos casos excepcionales de metástasis suprarrenales metacrónicas de carcinoma de células renales y revisamos la literatura existente. Valorados distintos aspectos como la frecuencia, etiopatogenia, diagnóstico y seguimiento de estos pacientes concluimos que estas metástasis son poco frecuentes y suelen presentarse tardías en su evolución en pacientes con CCR con bajo estadios anatomopatológicos. RESULTADOS/CONCLUSIONES: Revisado el trata- miento y constatando que no hay directrices en cuanto al manejo terapéutico de estos pacientes con metástasis proponemos la cirugía de la metástasis suprarrenal así como el tratamiento adyuvante con inmunoterapia (AU)


OBJECTIVES: We report two exceptional cases of metachronous adrenal metastasis of renal cell carcinomas and perform a bibliographic review. After the evaluation of various features such as frequency, etiopathogenesis, diagnosis and follow-up of these patients we conclude that these metastases are rare, and they usually appear late in the evolution of patients with low stage renal cell carcinoma. RESULTS/CONCLUSIONS: Once reviewed the treatment and checked the absence of guidelines for the therapeutic management of these patients we propose surgery for the adrenal metastasis as well as adjuvant treatment with immunotherapy (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Adrenal Gland Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Carcinoma, Renal Cell/surgery , Kidney Neoplasms/pathology , Kidney Neoplasms/surgery , Nephrectomy
7.
Arch Esp Urol ; 57(2): 162-5, 2004 Mar.
Article in Spanish | MEDLINE | ID: mdl-15074789

ABSTRACT

OBJECTIVES: We report one case of malakoplakia within a female urethral diverticulum. METHODS: 33-year-old patient who consulted for an asymptomatic vaginal tumor. Physical examination, blood and urine analysis and microbiology tests, as well as urethrocystoscopy and intravenous pyelogram were performed. With the diagnosis of urethral diverticulum we undertook surgical excision through a vaginal approach. RESULTS: Pathology revealed the typical characteristics of malakoplakia within the diverticular lumen. CONCLUSIONS: Malakoplakia is an infrequent inflammatory disease which involves the urinary tract in most cases. Urethra location is exceptional.


Subject(s)
Diverticulum/complications , Malacoplakia/complications , Urethral Diseases/complications , Adult , Diverticulum/surgery , Female , Humans , Urethral Diseases/surgery
8.
Arch Esp Urol ; 57(2): 179-82, 2004 Mar.
Article in English | MEDLINE | ID: mdl-15074793

ABSTRACT

OBJECTIVES: Collecting duct carcinoma (Bellini) of the kidney is a rare histological type of renal cell carcinoma (1%) with distinctive clinical and histopathological features. It is associated with aggressive behavior and a poor prognosis. METHODS AND RESULTS: We describe the clinical and immunohistochemical features of a new case of collecting duct carcinoma and discuss the radiological findings and therapeutic aspects. CONCLUSIONS: Collecting duct carcinoma is associated with aggressive behavior and a poor prognosis. The imaging features (US and CT) suggest the diagnosis. The immunohistochemical characteristics of the distal tubular epithelium aid the differential diagnosis between renal tumours. Percutaneous biopsy with a Tru-cut needle can be useful for pathological diagnosis. Management is currently restricted to radical nephrectomy, and chemotherapy or immunotherapy may offer only limited benefits.


Subject(s)
Carcinoma, Renal Cell , Kidney Neoplasms , Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/secondary , Carcinoma, Renal Cell/therapy , Fatal Outcome , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Lymphatic Metastasis , Male , Middle Aged , Retroperitoneal Space
9.
Arch. esp. urol. (Ed. impr.) ; 56(10): 1154-1157, dic. 2003.
Article in Es | IBECS | ID: ibc-26870

ABSTRACT

OBJETIVO: Aportamos un caso excepcional de mesotelioma multiquístico de túnica vaginal testicular. MÉTODO: Varón de 72 años remitido para estudio de masa escrotal. Se realiza examen físico, analítico y ecográfico previo a la extirpación quirúrgica y estudio anatomopatológico de la lesión. RESULTADO: En el estudio ecográfico se apreció una lesión quística multilobulada junto a cordón espermático. Los hallazgos anatomopatológico fueron múltiples formaciones quísticas de 3-4 mm,con papilas rudimentarias revestidas por epitelio hipercromático e inmunofenotipo vimentina (+), CD34 (+). CONCLUSIÓN: El mesotelioma multiquístico es una forma rara de mesotelioma, bien reconocido pero infrecuente. Este tumor afecta normalmente a la superficie peritoneal de la pelvis y del abdomen, aunque se han descrito otras localizaciones menos frecuentes, la localización testicular es excepcional. Presentamos el caso de un paciente afecto de un mesotelioma multiquístico de túnica vaginal testicular y revisamos el diagnóstico, la histopatología y las opciones de tratamiento de este tipo de tumor (AU)


Subject(s)
Aged , Male , Humans , Mesothelioma, Cystic , Testicular Neoplasms
10.
Arch Esp Urol ; 56(5): 485-9, 2003 Jun.
Article in Spanish | MEDLINE | ID: mdl-12918305

ABSTRACT

OBJECTIVES: To review the epidemiology, classification, prognosis, and therapeutic options of adrenal cortical carcinoma, mainly those of functional tumors. METHODS AND RESULTS: 52-year-old male presenting with wasting syndrome and a big left adrenal tumor, as well as a possible inferior vena cava thrombus. The tumor was catalogued as non functional after functional studies. Surgical intervention was carried out including adrenal tumor excision, splenectomy, and cavotomy with thrombectomy of a tumoral thrombus coming from the left adrenal and renal veins. Infrarenal iliocaval thrombosis appeared during the postoperative period, requiring intensive anticoagulant therapy and ICU admission for control. Pathological diagnosis confirmed the existence of a high grade malignant adrenal cortical carcinoma. Patient died two months after surgery due to disease progression. CONCLUSIONS: Radiological tests are fundamental in the diagnosis of adrenal masses. In the case of big tumoral masses, it is important to rule out the existence of possible tumor thrombi in the adrenal vein territory, including the inferior vena cava.


Subject(s)
Adrenal Cortex Neoplasms/pathology , Carcinoma/pathology , Thrombosis/etiology , Vena Cava, Inferior/pathology , Adrenal Cortex Neoplasms/complications , Adrenal Cortex Neoplasms/surgery , Carcinoma/complications , Carcinoma/surgery , Fatal Outcome , Humans , Male , Middle Aged , Neoplasm Invasiveness , Nephrectomy , Postoperative Complications/etiology , Spleen/pathology , Splenectomy , Venous Thrombosis/etiology
11.
Arch Esp Urol ; 56(5): 521-4, 2003 Jun.
Article in Spanish | MEDLINE | ID: mdl-12918310

ABSTRACT

OBJECTIVE: To check the possible relationship between testicular microlithiasis and testicular carcinoma in a patient in the one which previously we discovered a sonographic image of this condition. The etiopathogenesis, incidence and attitude are discussed. METHODS: A 23-year-old male with a psychomotor retardation secondary to a chromosomopathy presented with orchitis. Scrotal ultrasound discovered testicular microlithiasis, described as many hyperechoic images. Thirteen months later a testicular cancer was found in a new ultrasound. Radical orchiectomy was performed. Currently the patient is under intense follow-up. RESULTS: The histopathological study showed mature teratoma and intratubular germ cell neoplasm. CONCLUSIONS: The testicular microlithiasis has been related with benign and malignant testicular pathology. However, this presence it is not sufficiently clarified and the urologist's attitude to a patient with testicular microlithiasis but asymptomatic is not enough studied.


Subject(s)
Lithiasis/complications , Teratoma/complications , Testicular Diseases/complications , Testicular Neoplasms/complications , Adult , Cri-du-Chat Syndrome/complications , Epididymitis/etiology , Humans , Lithiasis/diagnostic imaging , Male , Orchitis/etiology , Teratoma/diagnostic imaging , Testicular Diseases/diagnostic imaging , Testicular Neoplasms/diagnostic imaging , Ultrasonography
12.
Arch Esp Urol ; 56(5): 527-9, 2003 Jun.
Article in Spanish | MEDLINE | ID: mdl-12918312

ABSTRACT

OBJECTIVES: To report a case of acute prostatitis as the first symptom of brucellosis. METHODS: 43-year-old patient who presented with a clinical picture of acute prostatitis and a febrile syndrome for seven days. Physical exam, blood and urine analysis and microbiological tests, and specific serologic studies were performed. RESULTS: Microbiological diagnosis was negative for bacteria, but Bengala pink (+), antibrucella serum agglutination (+) 1/320, and anti-Brucella Coombs test (+) 1/5120. Specific treatment was started with doxycyclin 100 mg b.i.d for 45 days and streptomycin 1 gr o.d for 15 days, with a positive outcome. CONCLUSIONS: The genitourinary tract is the second most frequent localization, being the testicle the most frequently affected organ, although it can also be localized in other areas of the urinary tract.


Subject(s)
Brucellosis/diagnosis , Prostatitis/microbiology , Acute Disease , Adult , Brucellosis/drug therapy , Coombs Test , Doxycycline/therapeutic use , Drug Therapy, Combination/therapeutic use , Humans , Male , Prostatitis/drug therapy , Staining and Labeling , Streptomycin/therapeutic use
13.
Arch. esp. urol. (Ed. impr.) ; 56(5): 527-529, jun. 2003.
Article in Es | IBECS | ID: ibc-25079

ABSTRACT

OBJETIVO: Aportamos un caso clínico de prostatitis aguda como primer síntoma de brucelosis. MÉTODO: Paciente de 43 años que presentó cuadro clínico de prostatitis aguda acompañado de síndrome febril de una semana de evolución. Se realiza examen físico, analítico y microbiológico de sangre y orina, y estudio serológico específico. RESULTADO: El diagnóstico bacteriológico fue negativo, pero presentó rosa de Bengala (+), seroaglutinación anti-brucella (+) 1/ 320 y Coombs anti-brucella (+) 1/5120. Se instauró tratamiento específico con doxiciclina 100 mg cada 12 horas durante 45 días y estreptomicina 1 gr cada 24 horas durante 15 días, con resultado satisfactorio. CONCLUSIÓN: El aparato genitourinario es el segundo en frecuencia, siendo el testículo el órgano más afectado, aunque también puede localizarse en otros tramos del tracto urinario (AU)


Subject(s)
Adult , Male , Humans , Streptomycin , Staining and Labeling , Prostatitis , Brucellosis , Doxycycline , Acute Disease , Drug Therapy, Combination , Coombs Test
14.
Arch. esp. urol. (Ed. impr.) ; 56(5): 521-524, jun. 2003.
Article in Es | IBECS | ID: ibc-25077

ABSTRACT

OBJETIVOS: Revisar la posible relación entre el carcinoma testicular y la microlitiasis testicular, presentando el caso clínico de un paciente con hallazgo casual de imagen ecográfica compatible con esta entidad, y que tras un intervalo de tiempo desarrolló una neoplasia testicular. Se comentan la etiopatogenia, incidencia y actitud a tomar ante la presencia de microlitiasis testicular. MÉTODOS: Varón de 23 años, afecto de retraso psicomotor por cromosomopatía, que consulta por orquiepididimitis. En estudio ecográfico de urgencias, aparte de describir imagen compatible con esta, se aprecian múltiples focos hiperecogénicos en ambos testículos, imagen que define la microlitiasis testicular. En ecografía de seguimiento trece meses mas tarde, con persistencia de dichos focos hiperecoicos, se descubre imagen hipoecogénica compatible con proceso tumoral testicular. Ante dicho hallazgo se decide realizar orquiectomía radical. El paciente se encuentra en programa de seguimiento en estrecha vigilancia clínica. RESULTADOS: En el estudio histopatológico se informa la presencia de teratoma maduro asociado a neoplasia intratubular de células germinales. CONCLUSIONES: Se ha intentado relacionar la presencia de microlitiasis testicular con una amplia variedad de procesos testiculares, tanto benignos como malignos. Sin embargo, el significado real de dicha presencia esta aun por establecer, así como la actitud del urólogo ante su hallazgo casual en un testículo, que por otro lado no presente otras alteraciones significativas (AU)


Subject(s)
Adult , Male , Humans , Testicular Diseases , Teratoma , Orchitis , Lithiasis , Cri-du-Chat Syndrome , Epididymitis , Testicular Neoplasms
15.
Arch. esp. urol. (Ed. impr.) ; 56(5): 485-489, jun. 2003.
Article in Es | IBECS | ID: ibc-25072

ABSTRACT

OBJETIVOS: Se revisan la epidemiología, clasificación, pronóstico y alternativas terapéuticas del carcinoma suprarrenal, fundamentalmente de las masas no funcionales. MÉTODOS Y RESULTADOS: Varón de 52 años con síndrome constitucional y gran tumoración suprarrenal izquierda, así como posible trombo en cava inferior. El estudio de funcionalidad catalogó a la masa como no funcional. Durante la intervención quirúrgica, se realizó extirpación de la masa adrenal, esplenectomía y trombectomía mediante cavotomía por trombo tumoral procedente de vena suprarrenal y renal izquierdas. En el postoperatorio sufrió cuadro de trombosis iliocava infrarrenal, que requiso tratamiento anticoagulante intensivo y control en UCI. El diagnóstico anatomopatológico confirmó la presencia de carcinoma suprarrenal de alto grado de malignidad. El paciente falleció a los dos meses de la intervención por progresión de la enfermedad. CONCLUSIONES: Las pruebas de imagen son fundamentales en el diagnóstico de las masas suprarrenales. En el caso de grandes masas es importante sospechar la posible presencia de trombos tumorales en el territorio venoso de la glándula adrenal, incluyendo la vena cava. El clampaje de la vena cava exige la instauración de tratamiento anticoagulante precoz a dosis terapéuticos. La cirugía es el único tratamiento que ha demostrado un aumento de la supervivencia (AU)


Subject(s)
Middle Aged , Male , Humans , Spleen , Splenectomy , Thrombosis , Vena Cava, Inferior , Fatal Outcome , Neoplasm Invasiveness , Nephrectomy , Postoperative Complications , Venous Thrombosis , Carcinoma , Adrenal Cortex Neoplasms
16.
Arch Esp Urol ; 56(10): 1154-7, 2003 Dec.
Article in Spanish | MEDLINE | ID: mdl-14763424

ABSTRACT

OBJECTIVES: To report an exceptional case of multicystic mesothelioma of the testicular tunica vaginalis. METHODS: A 72-year-old male was referred for study of a scrotal mass. Physical examination, blood tests, and ultrasound were performed prior to surgical excision and pathologic study of the lesion. RESULTS: The ultrasound study showed a multilobar cystic lesion near the spermatic cord. Pathology reported multiple 3-4 mm cystic formations, with rudimentary papillae covered by a hyperchromatic epithelium and vimentin (+), CD 34 (+) immunophenotype. CONCLUSIONS: Multicystic mesothelioma is a rare form of mesothelioma, easy to recognize but infrequent. This tumor generally affects the peritoneal surface of the pelvis and abdomen; although other less frequent locations have been described testicular location is exceptional. We report the case of a patient presenting with a multicystic mesothelioma of the testicular tunica vaginalis and review the diagnosis, pathology and treatment options for this type of tumor.


Subject(s)
Mesothelioma, Cystic , Testicular Neoplasms , Aged , Humans , Male , Mesothelioma, Cystic/diagnosis , Testicular Neoplasms/diagnosis
17.
Arch Esp Urol ; 55(8): 900-6, 2002 Oct.
Article in Spanish | MEDLINE | ID: mdl-12455280

ABSTRACT

OBJECTIVE: We report three cases of pelvic lipomatosis, and from them we discuss its diagnostic and therapeutic considerations. METHODS/RESULTS: Three patients, 71, 65 and 61 years old respectively, presented with irritative lower urinary tract symptoms. Intravenous pyelogram (IVP) and CT scan were performed as diagnostic procedures. After diagnosis an endoscopic evaluation including biopsies was performed to rule out tumours. All three underwent Bricker-Wallace II type urinary diversion resulting in good control of irritative symptoms. During follow-up one patient presented with an infiltrative bladder tumour. CONCLUSION: Pelvic lipomatosis is a rare disease; although traditionally has been considered benign it can result in urinary tract obstruction with severe physiopathological consequences. IVU and CT-scan are valuable to confirm the diagnosis. Lower urinary tract symptoms are controlled with urinary diversion without cystectomy but potential malignization of the bladder lesions should make us reconsider treatment.


Subject(s)
Lipomatosis/diagnostic imaging , Tomography, X-Ray Computed , Aged , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/surgery , Cystectomy , Cystoscopy , Diagnosis, Differential , Humans , Lipomatosis/complications , Lipomatosis/surgery , Male , Metaplasia , Middle Aged , Neoplasm Invasiveness , Prostatectomy , Retroperitoneal Space , Urinary Bladder/pathology , Urinary Bladder Neoplasms/complications , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/surgery , Urinary Diversion , Urinary Retention/etiology , Urination Disorders/etiology , Urography
18.
Arch. esp. urol. (Ed. impr.) ; 55(8): 900-906, oct. 2002.
Article in Es | IBECS | ID: ibc-18323

ABSTRACT

OBJETIVO: Presentamos tres casos de lipomatosis pélvica, y a partir de ellos discutimos los aspectos diagnósticos y terapéuticos. METODO/RESULTADOS: Tres varones de 71, 65 y 61 años que consultaban por sintomatología baja de tipo irritativo. Para el diagnostico se utilizó la UIV y el TAC. Tras el diagnóstico y previamente a tomar una actitud terapéutica se realiza una evaluación endoscópica con biopsia para descartar patología tumoral. A todos ellos se les realiza una derivación urinaria tipo Bricker-Wallace II con buen control de la sintomatología imitativa. A lo largo de la evolución un paciente presenta un tumor vesical infiltrante. CONCLUSIÓN: La lipomatosis pélvica es una enfermedad rara, que aunque considerada tradicionalmente benigna puede ocasionar en mayor o menor grado obstrucción urinaria con graves consecuencias fisiopatológicas. La UIV y el TAC sirven para corroborar la sospecha clínica. La derivación urinaria sin cistectomía controla la sintomatología miccional baja pero la posible malignización de las lesiones vesicales hacen que debamos replantearnos el tratamiento (AU)


Subject(s)
Middle Aged , Aged , Male , Humans , Tomography, X-Ray Computed , Urination Disorders , Urinary Diversion , Urography , Cystectomy , Urinary Retention , Metaplasia , Neoplasm Invasiveness , Prostatectomy , Retroperitoneal Space , Carcinoma, Transitional Cell , Diagnosis, Differential , Cystoscopy , Lipomatosis , Urinary Bladder , Urinary Bladder Neoplasms
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