A rare case of penile metastases from small cell prostate cancer / Un caso inusual de metástasis peneanas en el carcinoma prostático de células pequeñas

We present a case of an 83-year-old-male with painless penile nodules several months after he was diagnosed with pure prostatic small cell carcinoma. Penile doppler ultrasound and magnetic resonance imaging demonstrated solid nodules in both corpora cavernosa. Fine-needle aspiration of the nodules with immunohistochemical examination confirmed prostatic small cell carcinoma origin of metastases. Small cell carcinoma of the prostate is a rare disorder accounting for less than 1% of all prostate cancers, the penis being an uncommon site for metastasis. An extremely low number of cases of penile metastases from prostatic small cell carcinoma has been reported to date in the literature

Presentamos un caso de un varón de 83 años con nódulos peneanos indoloros, tras ser diagnosticado meses atrás de carcinoma prostático de células pequeñas puro. La eco-doppler e imagen de resonancia magnética de pene reflejaron nódulos sólidos en ambos cuerpos cavernosos. La aspiración con aguja fina de los nódulos con prueba inmunohistoquímica confirmó el origen metastásico del carcinoma de células pequeñas. El carcinoma prostático de células pequeñas es un trastorno inusual que representa menos del 1% de todos los cánceres prostáticos, siendo el pene un sitio infrecuente de metástasis. Hasta la fecha se ha reportado en la literatura un número de casos extremadamente bajo de metástasis peneanas en el carcinoma de próstata de células pequeñas

A rare case of penile metastases from small cell prostate cancer.

We present a case of an 83-year-old-male with painless penile nodules several months after he was diagnosed with pure prostatic small cell carcinoma. Penile doppler ultrasound and magnetic resonance imaging demonstrated solid nodules in both corpora cavernosa. Fine-needle aspiration of the nodules with immunohistochemical examination confirmed prostatic small cell carcinoma origin of metastases. Small cell carcinoma of the prostate is a rare disorder accounting for less than 1% of all prostate cancers, the penis being an uncommon site for metastasis. An extremely low number of cases of penile metastases from prostatic small cell carcinoma has been reported to date in the literature.

Local and distant recurrence of the chromophobe renal cell carcinoma / Recidiva local y a distancia del carcinoma renal cromófobo

INTRODUCTION: There is still limited knowledge about surveillance and optimal management for patients with recurrent chromophobe renal cell carcinoma. OBJECTIVE: Describe our experience in the diagnosis and management in recurrent chromophobe renal cell carcinoma. MATERIAL AND METHOD: Review of medical records of patients with chromophobe renal cell carcinoma, selecting those cases that developed recurrence. RESULTS: Of the 23 patients, 4 developed recurrence and were the subjects of our analysis. The mean age was 61.5 years. Surgical treatment of primary renal tumor consisted of three radical nephrectomies and one partial nephrectomy. The mean time from nephrectomy to disease recurrence was 6.7 years. One patient had recurrence in the retrovesical area, another in bone, and the two others in the retroperitoneum. The treatment for retrovesical recurrence was an incomplete metastasectomy followed by temsirolimus and subsequent removal of the residual mass, staying stable. The other three cases were unresectable surgically and received sunitinib. One patient now has a stable diseaseand the two others died. CONCLUSIONS: Chromophobe renal cell carcinoma showed a greater tendency to metastasize, so requires a surveillance protocol based on the risk of recurrence

INTRODUCCIÓN: Existe un conocimiento limitado respecto al manejo óptimo y seguimiento del carcinoma renal cromófobo recidivante. OBJETIVO: Describir nuestra experiencia en el diagnóstico y tratamiento del carcinoma renal cromófobo recidivante. MATERIAL Y MÉTODO: Revisión de las historias clínicas de 23 pacientes diagnosticados de carcinoma renal cromófobo, seleccionando aquellos casos que desarrollaron recidiva. RESULTADOS: De los 23 pacientes, 4 desarrollaron recidiva y fueron los casos de nuestro análisis. La edad media fue de 61,5 años. La cirugía del tumor renal primario consistió en tres nefrectomías radicales y una parcial. La media del tiempo desde la nefrectomía hasta la recidiva fue de6,7 años. Un paciente tuvo recidiva retrovesical, otro ósea y los otros dos en retroperitoneo. El tratamiento para la recidiva retrovesical fue una metastasectomía parcial seguida de temsirolimus y posterior exéresis de la masa residual, manteniéndose estable. Los otros tres casos fueron irresecables quirúrgicamente y recibieron sunitinib, de los cuáles, un paciente está estable y los otros dos fallecieron. CONCLUSIONES: El carcinoma renal cromófobo presentó una mayor tendencia a metastatizar, por lo que requiere un protocolo de vigilancia basado en el riesgo de recidiva

Local and distant recurrence of the chromophobe renal cell carcinoma. / Recidiva local y a distancia del carcinoma renal cromófobo.

INTRODUCTION: There is still limited knowledgeabout surveillance and optimal management for patientswith recurrent chromophobe renal cell carcinoma. OBJECTIVE: Describe our experience in the diagnosis andmanagement in recurrent chromophobe renal cell carcinoma. MATERIAL AND METHOD: Review of medical records ofpatients with chromophobe renal cell carcinoma, selectingthose cases that developed recurrence. RESULTS: Of the 23 patients, 4 developed recurrence andwere the subjects of our analysis. The mean age was 61.5years. Surgical treatment of primary renal tumor consistedof three radical nephrectomies and one partial nephrectomy.The mean time from nephrectomy to disease recurrencewas 6.7 years. One patient had recurrence in the retrovesicalarea, another in bone, and the two others in theretroperitoneum. The treatment for retrovesical recurrencewas an incomplete metastasectomy followed by temsirolimusand subsequent removal of the residual mass, stayingstable. The other three cases were unresectable surgicallyand received sunitinib. One patient now has a stable diseaseand the two others died. CONCLUSIONS: Chromophobe renal cell carcinomashowed a greater tendency to metastasize, so requires asurveillance protocol based on the risk of recurrence.

INTRODUCCIÓN: Existe un conocimientolimitado respecto al manejo óptimo y seguimiento del carcinomarenal cromófobo recidivante. OBJETIVO: Describir nuestra experiencia en el diagnósticoy tratamiento del carcinoma renal cromófobo recidivante. MATERIAL Y MÉTODO: Revisión de las historias clínicasde 23 pacientes diagnosticados de carcinoma renal cromófobo,seleccionando aquellos casos que desarrollaronrecidiva. RESULTADOS: De los 23 pacientes, 4 desarrollaron recidivay fueron los casos de nuestro análisis. La edad mediafue de 61,5 años. La cirugía del tumor renal primario consistióen tres nefrectomías radicales y una parcial. La mediadel tiempo desde la nefrectomía hasta la recidiva fue de6,7 años. Un paciente tuvo recidiva retrovesical, otro óseay los otros dos en retroperitoneo. El tratamiento para la recidivaretrovesical fue una metastasectomía parcial seguidade temsirolimus y posterior exéresis de la masa residual,manteniéndose estable. Los otros tres casos fueron irresecablesquirúrgicamente y recibieron sunitinib, de los cuáles,un paciente está estable y los otros dos fallecieron. CONCLUSIONES: El carcinoma renal cromófobo presentóuna mayor tendencia a metastatizar, por lo que requiereun protocolo de vigilancia basado en el riesgo de recidiva.

Bear Paw Sign: Xanthogranulomatous Pyelonephritis.

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis in which the involved areas of the kidneys are destroyed and replaced by foam cells. It usually occurs in immunocompromised middle-aged females with ureteral obstruction or chronic urinary tract infection induced by the formation of renal stones. We herein report the case of a 44-year-old woman, with a history of left kidney staghorn calculi and recurrent urinary tract infections. Abdominal computed tomography showed the 'bear paw' sign, typical appearance of XGP and patient underwent a nephrectomy with uneventful post-operative course.

Acral papular mucinosis: a new case of this rare entity

Abstract Acral persistent papular mucinosis (APPM) is a rare subtype of localized lichen myxedematosus. It consists of small papules localized exclusively on the back of the hands, wrists and extensor aspects of distal forearms with no other clinical or laboratory manifestations. The lesions tend to persist and may increase slowly in number. Histologically, hematoxylin-eosin and Alcian blue staining demonstrate mucin accumulation in the upper reticular dermis with separation of collagen fibers as a result of hyaluronic acid deposition. Treatment is rarely necessary due to the absence of symptoms. We present a 27-year-old healthy woman with asymptomatic papules on her upper extremities, which adequately meet clinical and pathological criteria of acral papular mucinosis.

Acral papular mucinosis: a new case of this rare entity.

Acral persistent papular mucinosis (APPM) is a rare subtype of localized lichen myxedematosus. It consists of small papules localized exclusively on the back of the hands, wrists and extensor aspects of distal forearms with no other clinical or laboratory manifestations. The lesions tend to persist and may increase slowly in number. Histologically, hematoxylin-eosin and Alcian blue staining demonstrate mucin accumulation in the upper reticular dermis with separation of collagen fibers as a result of hyaluronic acid deposition. Treatment is rarely necessary due to the absence of symptoms. We present a 27-year-old healthy woman with asymptomatic papules on her upper extremities, which adequately meet clinical and pathological criteria of acral papular mucinosis.

Obstrucción intestinal en un caso de endometriosis extragenital / Intestinal obstruction in a case of extragenital endometriosis

Presentamos un caso insospechado de obstrucción intestinal secundario a endometriosis. Analizamos los síntomas clínicos, las claves diagnósticas y el diagnóstico diferencial de esta inusual localización de endometriosis (AU)

We present an unsuspected case of acute ileal obstruction due to endometriosis. We analyze the clinical symptoms, the diagnostic clues, and the differential diagnosis of this unusual location of endometriosis (AU)

Correlación cito-histológica del tumor papilar de la glándula pineal. Presentación de un caso / Papillary pineal tumor: cyto-histological correlation. Case report

En la última revisión de la Organización Mundial de la Salud (OMS) en relación a los tumores del sistema nervioso central (SNC), se describieron nuevas entidades, como el Tumor Papilar de la Glándula Pineal. Esta lesión de rara aparición, se ha identificado en adultos jóvenes. El diagnóstico de estos tumores es complejo ya que depende de su ubicación, edad de aparición y el aspecto histológico; éste último tiene similitudes con otras lesiones como el ependimoma papilar o el papiloma/carcinoma de plexos coroides. Citológicamente presentan características claras que pueden ayudar al diagnóstico a través de la impronta en el estudio intraoperatorio; reconocer ciertos criterios con éste importante y sencillo método diagnóstico ha sido la motivación principal para el estudio de entidades poco frecuentes del SNC, además de corroborar el necesario trabajo de un equipo multidisciplinar.

In the latest revision of the central nervous system tumors (CNS) of the World Health Organization (WHO), new entities has been described, as papillary tumor of the pineal region. This rare lesion has been identified in young adults. The diagnosis of these tumors is complex, depends on the location, age of onset and histological appearance. Histological characteristics have similarities with other lesions such as papillary ependymoma, papiloma / choroid plexus carcinoma. Cytologically have clear characteristics that can aid in the diagnosis through the smears on the intraoperative study. Certain criteria for recognize this important and simple diagnostic method has been the main motivation for the study of CNS rare entities, as our case, in addition to corroborating the necessary work of a multidisciplinary team.

Leishmaniasis laríngea, modificación quirúrgica tras estudio intraoperatorio. Comunicación de un caso / Modified surgical procedure following intraoperative frozen section of laringeal leishmaniasis. A case report

La leishmaniasis es una metazoonosis crónica de distribución mundial que está producida por cualquier integrante del género Leishmania, y su infección afecta la piel, las mucosas o las vísceras. Presentamos el caso de un varón de 67 años con disfonía y disfagia, valorado por el servicio de otorrinolaringología, quienes realizaron cirugía laríngea sospechando un carcinoma y solicitaron un estudio intraoperatorio que evidenció ausencia de malignidad y la presencia de microorganismos intracelulares. Por este motivo se suspendió la cirugía. Al ser una enfermedad endémica en España, conviene tener presente la leishmaniasis entre los diagnósticos diferenciales de las lesiones excrecentes de la laringe para evitar actitudes quirúrgicas agresivas(AU)

Leishmaniasis is a chronic metazoonosis caused by any member of the genus Leishmania and occurs throughout the world. Infection affects the skin, mucous membranes and viscera. We report a case in a 67 year old man with dysphonia and dysphagia who underwent surgery for suspected laryngeal carcinoma. Intraoperative frozen section revealed no malignancy and the presence of intracellular organisms and no further surgery was performed. As leishmaniasis is endemic in Spain, it should be included in the differential diagnosis of excrescent lesions of the larynx in order to prevent unnecessary surgery(AU)