[Retroperitoneal liposarcoma in a patient with renal transplantation]. / Liposarcoma retroperitoneal en un paciente trasplantado renal.

A case of retroperitoneal sarcoma in a kidney transplanted patient is presented. We describe the presentation pattern and the aggressive outcome despite the surgical removal of 5.900 gr. retroperitoneal tumor, included native kidney. The patient died due multiple metastasis six months later. An interesting iconography shows the great volume of the tumor.

[Pelvic lipomatosis: contribution of a new case to the literature]. / Lipomatosis pelviana: aportación de un nuevo caso a la literatura.

OBJECTIVE: To describe an additional case of pelvic lipomatosis, a rare condition that can be encountered by the urologist. METHODS/RESULTS: A 66-year-old patient consulted for irritative voiding syndrome and fever. Patient evaluation by IVP and CT demonstrated pelvic lipomatosis. CONCLUSIONS: Pelvic lipomatosis is a disease with variable clinical and radiological features. Careful follow-up is warranted for prevention and treatment of possible complications.

[Socioeconomic justification of kidney transplantation]. / Justificación socioeconómica del trasplante renal.

OBJECTIVES: In recent years, the socioeconomic aspects of renal transplantation have focused the attention of the managers of the health care system and the professionals involved in transplant programs. The present study analyzed, within the context of renal transplantation, the two fundamental concepts of health care: quality of life and health costs. METHODS: A survey was conducted in 427 patients who underwent renal transplantation to evaluate the improvement in their quality of life. RESULTS: 93% referred physical improvement, 85% emotional, and 85% subjective improvement in their family relationship. Considering 9% of the kidneys were not viable, 15% of the grafts were lost in the first year and 4% thereafter, the cost of transplantation for the first year (in million pesetas) was 3,597 versus 2,961 for hemodialysis and 905 for the second year, with hemodialysis costs practically unchanged. CONCLUSIONS: Renal transplantation not only increases survival but also improves quality of life. It is less costly and the savings in health costs can be allocated to other fields of health care.

[Inverted Y ureteral duplication]. / Duplicación ureteral en Y invertida.

We report a case of inverted Y duplication of the ureter, incidentally found in a man consulting for hematuria. The diagnostic and therapeutic aspects are briefly discussed.

[Calcified renal oncocytoma]. / Oncocitoma renal calcificado.

The appearance of calcifications in a renal oncocytoma is uncommon since they appear in a scanty proportion of solid renal tumors. Nine cases of renal calcified oncocytomas have been previously reported; three of these had microscopic calcic deposits. The calcifications can be either central or peripheric. Their size or localization in the tumor mass does not alter the good prognosis of this type of renal tumor. We report on a 40-year-old man who presented a solid renal mass with central and peripheral linear calcifications. The histological analysis following nephrectomy disclosed a renal oncocytoma.

[Lipoma of the spermatic cord. Report of a case]. / Lipoma de cordón espermático. A propósito de un caso.

Thirty per cent of spermatic cord tumors are malignant and the remaining 70% are benign, lipoma being the most common benign lesion. Although it is the most common tumor of the spermatic cord, its clinical presentation is rare. It is an extratesticular intrascrotal mass that grows relatively rapidly, with no other clinical symptoms or signs. The clinical diagnosis is confirmed by US, CT and, occasionally, by exploratory scototomy. Treatment is by surgical excision.

[Cytology positive for malignant cells in hydrocele secondary to testicular seminoma]. / Citología positiva a células malignas en hidrocele secundario a seminona testicular.

Finding tumor cells in the fluid of hydrocele secondary to testicular tumor is rare and may be due to the fact that hydrocele fluid cytology has not been studied systematically. The presence of malignant cells in the hydrocele fluid may be ascribed to two mechanisms: retrograde lymphatic flow from the infiltrated retroperitoneal lymph nodes or from tumor directly invading the tunica albuginea and vaginalis testis, with cells passing into the cavity of the vaginalis. Only two cases of hydrocele secondary to testicular seminoma with vaginalis fluid cytology positive for malignant seminomatous cells have been previously reported in the literature. To our knowledge, the case reported herein is the third. These three cases are briefly discussed.

[Fraley's syndrome: a case report]. / Síndrome de Fraley: presentación de un caso.

A case of Fraley's syndrome is described. Intermittent nephralgia was the presenting symptom. The diagnosis was made on the radiologic finding of obstruction of the infundibulum arising from vascular compression. The diagnostic and therapeutic aspects of this uncommon cause of obstruction of the infundibulum are discussed.

[Multifocal renal adenocarcinoma. Considerations regarding a case]. / Multifocalidad en el adenocarcinoma renal. Consideraciones a propósito de una observación.

There is scant reference to the clinicopathological feature of multifocality in renal adenocarcinoma. Inadvertently disregarding this feature may result in local recurrence in those patients in whom partial nephrectomy is contemplated.

[Exceptional tumor: primary renal osteosarcoma. Review of 18 cases and report of a new one]. / Tumor excepcional: osteosarcoma renal primario. Revisión de 18 casos y aportación de uno nuevo.

Primary renal osteosarcoma is an uncommon tumor type. To our knowledge, only 18 such cases have been reported to date. This tumor is very aggressive and may be localized or distant, the survival rate being less than 18 months despite a radical surgical procedure. Polichemotherapy has been attempted. We report on a 47-year-old patient with primary osteosarcoma of the right kidney, 8 cm x 8 cm in diameter, which was not amenable to surgical excision due to invasion of the adjacent structures. Systemic polichemotherapy was unsuccessful, and the patient died 3 months following diagnosis with multiple pulmonary metastases.

[Fournier's gangrene. Presentation of 11 cases and review of the literature]. / Gangrena de Fournier. Presentación de 11 casos y revisión de la literatura.

Fournier's gangrene is an infectious necrotizing cellulitis of the penis and/or perineoscrotal region, which rapidly progresses and carries a high mortality. Eleven cases of Fournier's gangrene that had undergone an emergency procedure from 1985 to 1992 are described. Excellent results were achieved, with a survival rate of 91%. In our view, treatment of this disease entity is fundamentally based on early diagnosis, wide radical debridement of the affected area, frequent local treatment, debridement at the least sign of recurrence and early antibiotic therapy with three agents.

[Rectal involvement secondary to prostatic adenocarcinoma]. / Afectación rectal secundaria a adenocarcinoma prostático.

Rectal involvement secondary to adenocarcinoma of the prostate is uncommon and carries a poor prognosis. Distinguishing secondary from primary rectal tumors is mandatory, since each condition warrants a completely different treatment. There are at least five forms of clinicopathological involvement, depending on the rectal wall invasion and its consequences. We report on 6 cases, 4 had been diagnosed when rectal invasion was present, the enteric involvement appeared during the process in 1 patients and the other had prostate carcinoma coexisting with squamous cell carcinoma of the anus.

[Medico-surgical management of renal leiomyosarcoma]. / Manejo médico-quirúrgico del leiomiosarcoma renal.

Because renal leiomyosarcoma is extremely rare, the experience in the management of this tumor type is necessarily scant. Our surgical and chemotherapeutic approach in a 17-year-old male patient with renal leiomyosarcoma achieved partial remission of tumor recurrence and a survival of 31 months following diagnosis.

[2 new cases of ++urethral diverticuli in women]. / Dos nuevos casos de divertículos uretrales femeninos.

The first two cases of diverticulum of the female urethra seen in our Service are described. The secretion of purulent material from the urethra on vaginal compression prompted us to suspect this condition, which could not be confirmed radiologically in one case and a urethroscopy procedure was required. The etiopathogenesis of this disease is briefly reviewed and the therapeutic possibilities depending on the location of the urethral diverticulum are discussed.

[Bilateral renal lymphoma]. / Linfoma renal bilateral.

Lymphomas can present as a solid tumor mass in one or both kidneys or compromise renal function directly or indirectly. Lymphoma should be discarded before performing surgical excision of a rapidly growing renal mass, particularly if involvement is bilateral. Reducing the renal mass may lead to difficulty in instituting specific chemotherapy for this tumor type.

[Leydig cell tumor in a patient with type I multiple endocrine neoplasm: study of a case and review of the literature]. / Tumor de células de Leydig en paciente con neoplasia endocrina múltiple tipo I: estudio de un caso y revisión de la literatura.

Presentation of the case of a 42-year old male patient with Type I Multiple Endocrine Neoplasia, known as the Wermer Syndrome, who developed Leydig's cells tumour. No association was found between both processes and therefore a fortuitus, though worthwhile mentioning given the characteristics and hormonal implications of both pathologies, can be presumed.

[Lymphatic involvement predominating and revealing prostatic carcinoma]. / Afectación linfática predominante y reveladora en el carcinoma prostático.

The lymphatic system is the most common site of metastasis of prostatic carcinoma. However, carcinoma of the prostate presenting as lymphadenopathy is rare. It can present at any site and may sometimes mimic lymphoreticular tumors. The diagnosis is based on the histological findings. Histochemical techniques using immunoperoxidase demonstration of acid phosphatase and prostate specific antigen are fundamental in detecting the occult tumor of the prostate. Treatment is palliative and enlargement may occasionally remit with hormone therapy. The prognosis is invariably poor. Survival is less than 5 years irrespective of the response to treatment. Three cases are described herein: 2 presented as retroperitoneal mass and 1 as left lateral cervical lymphadenopathy.

[Spontaneous extravasation of urine secondary to bladder carcinoma. Non-invasive therapy]. / Extravasación espontánea de orina secundaria a carcinoma vesical. Terapéutica no invasiva.

A case of spontaneous urinary extravasation secondary to bladder carcinoma is described. The patient received systemic polychemotherapy which reduced tumor size and resolved renal ectasia and urinary extravasation. Spontaneous urinary extravasation secondary to bladder carcinoma is rare. For this reason we considered it of interest to report this case.

[Fistula between ileal conduit and small intestine after cutaneous ureteroileostomy]. / Fístula entre conducto ileal e intestino delgado tras ureteroileostomía cutánea.

We report on a case of ileal conduit-enteric fistula which appeared early after ureteroileostomy using the Bricker technique. The appearance of gastrointestinal content through the stoma was the only sign. An ileogram permitted making the diagnosis. Conservative treatment was instituted and the fistula resolved spontaneously. The different diagnostic and therapeutic aspects of this uncommon complication after ureteroileostomy are discussed.

[Genital location of a clear-cell hidradenoma]. / Hidradenoma de células claras de localización genital.

Clear cell hidradenoma of the penile prepuce progressing to malignancy transformation is rare and arises from the adnexal glands of the skin. It may present in nodular or ulcerated forms, which make it almost impossible to distinguish from spinocellular carcinoma. Treatment is by wide surgical excision. Local recurrence and distant metastasis rare.