[Inflammatory pseudotumor of the kidney]. / Pseudotumor inflamatorio de riñón.

Inflammatory pseudotumours are rare lesions that may appear in several organs, and sporadically in the bladder and the renal pelvis. Aetiology is unknown and they show a non-malignant behaviour although differential diagnosis with other neoplasia such as leiomyosarcoma and rabdomyosarcoma must be established. Electron microscopy and immunohistochemistry are commonly used techniques to achieve diagnosis. The aim of this paper is to examine the second case report of intrarenal inflammatory pseudotumour.

Pseudotumor inflamatorio de riñón / Inflammatory pseudotumor of kidney

El pseudotumor inflamatorio es una rara lesión descrita en diversos órganos y de forma esporádica en vejiga y pelvis renal. Su etiología es desconocida y el comportamiento benigno, pero se debe establecer el diagnóstico diferencial con otras neoplasias como el leiomiosarcoma y el rabdomiosarcoma, lo que suele requerir del uso de técnicas de microscopía electrónica e inmunohistoquímica. El propósito de este artículo es presentar el segundo caso de pseudotumor inflamatorio a nivel intrarrenal (AU)

Tumor de wilms del adulto. Aportación de un caso / Wilms tumor in the adult. Report of a case

OBJETIVO: El tumor de Wilms o nefroblastoma es el tumor renal más común en la infancia. Su incidencia en adultos es escasa, suponiendo acerca del 1 por ciento de los casos, con aproximadamente 200 casos descritos en la literatura. Aportamos un nuevo caso de tumor de Wilms en adulto y hacemos una breve revisión. OBSERVACIÓN CLÍNICA: Presentamos un caso de tumor de Wilms en un varón de 15 años, con alteraciones génito-urinarias asociadas, diagnosticado recientemente y tratado con nefrectomía radical y quimioterapia post-operatoria. CONCLUSIONES: La presentación del tumor de Wilms en adultos es excepcional, y su diagnóstico definitivo sólo puede realizarse tras el estudio anatomopatológico. La aplicación de los protocolos terapéuticos realizados habitualmente en pediatría con llevan unas tasas de curación meno-res y un peor pronóstico. Protocolos terapéuticos más agresivos son necesarios para elevar el pobre pronóstico aunque la escasa incidencia hace difícil el poder establecer el tratamiento más efectivo (AU)

No disponible

[Wilms tumor in adults. Report of a case]. / Tumor de Wilms del adulto. Aportación de un caso.

OBJECTIVE: Wilms' tumor or nephroblastoma is the most common renal tumor of childhood. The incidence in adults is rare, estimated at about 1% of all cases and approximately 200 cases have been described in the world literature. We report a new case of adult Wilms' tumor and realize a short review. METHODS/RESULTS: We describe a case of Wilms' tumor in a young male, aged 15 years, with associate genitourinary abnormalities. The patient underwent radical nepherctomy with postoperative chemotherapy. CONCLUSIONS: The Wilms' tumor in the adult population is exceptional, and the definitive diagnostic is based in the findings of the pathological analysis. The application of therapeutic protocolos for children to adults offers an smaller percentage of cure and poorer prognostic. Therapheutic protocolos more aggressive are necessary for increase the worse prognostic in the adult, but because of the rarity is difficult to define the most effective form of treatment.

[Cryptorchism and testicular cancer]. / Criptorquidia y cáncer testicular.

OBJECTIVE: This report insists on the higher risk of testicular cancer in cryptorchidism and indicates the more adequate management of this pathology. METHODS/RESULTS: We report a 27 years old patient with history of cryptorchidism, diagnosed of abdominal tumor in urgency. This tumor was a seminoma in intrapelvic testicle. CONCLUSIONS: The risk of developing testicular cancer in cryptorchidism is 3 to 10 times greater than in a patient with normally descended testes, and orchiopexy does not prevent the risk of malignancy. We underscore the need to follow these patients closely and recommend the orchiectomy in postpubertal patients.

Criptorquidia y cáncer testicular / Cryptorchidism and testicular cancer

OBJETIVO: Insistir en la mayor incidencia de cáncer testicular en la criptorquidia y expresar el manejo más adecuado de dicha patología. OBSERVACIÓN CLÍNICA: Presentamos un paciente de 27 años con antecedentes de criptorquidia que se diagnostica de urgencias de tumoración abdominal, que correspondió a un seminoma sobre testículo intrapélvico. DISCUSIÓN: El riesgo de padecer cáncer testicular en la criptorquidia es de 3 a 10 veces mayor que en el paciente con testes normodescendidos, y la orquidopexia no previene frente a la futura maligni-zación. Se resalta la necesidad de seguimiento en estos pacientes, y se recomienda la orquiectomía en los pacientes pospuberales (AU)

[Extragonadal germ tumor]. / Tumor germinal extragonadal.

Extragonadal primary tumors are uncommon and account for 3 to 5% of all germ cells neoplasias. Preferentially found in middle line structures, such tumors are frequently in an advanced stage when diagnosed. Differentiation between primary extragonadal tumors and metastasis of testicular primary tumors is essential, but may be difficult in many instances.

[Bilharziasis and bladder cancer. A case report]. / Bilharziasis y cáncer vesical. Aportación de un caso.

In our setting, the association between bilharziasis and bladder cancer is uncommon. However, the presence of recurrent haematuria in a patient from an endemic area of bilharziasis (east of Africa and Middle East), is highly suspicious of this disease. Lack of an adequate treatment by using anthelminthic drugs during the acute phase of disease, might lead to the onset of chronic bladder lesions and, on occasion, bladder cancer, of the epidermoid type in the majority of cases. Because of the high mortality and aggressivity of this type of cancer, an early diagnosis and appropriate treatment of acute lesions is mandatory. We report a 40-year-old black male from Senegal, presenting chronic bladder schistosomiasis and infiltrative epidermoid carcinoma of the bladder, diagnosed and treated in our department by palliative cystectomy.

[Tuberculous orchiepididymitis as clinical onset of human immunodeficiency virus (HIV) infection]. / Orquiepididimitis tuberculosa como inicio clínico de infección por el virus de inmunodeficiencia humana (VIH).

The emergence of acquired immunodeficiency syndrome has changed the natural history of tuberculosis which has now become the second most common infection associated to human immunodeficiency virus infection. It is only rarely that a tuberculous infection has an urogenital location, and extrapulmonary locations are generally related to severe immunosuppression. This paper presents one case of tuberculous orchitis that presented as the clinical onset of acquired immunodeficiency syndrome. Discussion of the clinical evolution and the therapeutic approach that consisted in orchiectomy associated to treatment with tuberculostatics.

[Retrovesical hydatic cyst]. / Quiste hidatídico retrovesical.

The hydatid disease is a common condition in endemic countries, generally involving the liver or the lungs. Genitourinary tract involvement is quite uncommon, and the organ most usually affected is the kidney. A retrovesical location is even more rare. The present paper contributes one case with no evidence of hydatidosis in any other abdominal organ and describes the diagnostic and therapeutic protocol followed.

[Urologic complications of pancreas-kidney simultaneous transplantation]. / Complicaciones urológicas en el trasplante simultáneo de pancreas-riñón.

Pancreas Transplantation (PT) is the only available therapy today for diabetes that allows an insulin-independent euglycemic state with complete normalization of glycosilated haemoglobin levels. Survival of patient, pancreatic graft and renal graft is 93%, 86% and 90% respectively at one year and 90%, 84% and 85% at three years. The most accepted method for exocrine drainage in most centres where simultaneous pancreas-kidney transplantation is being performed is vesical drainage. In spite of the improvements achieved in graft and patient survival, it is evident that a most frequent use of this type of technique involves a greater number of urological complications (repeat infections, haematuria, fistulae or leakage, reflux pancreatitis, urethral stenosis and disruption, dehydration and acidosis, previous diabetic bladder) and the familiarization of the urologist with this type of disease in immunodepressed patients. This paper reviews the current situation and illustrates the general approach regimes in our Pancreas-Kidney Transplantation Unit with regard to each complication.

[Evaluation and treatment of closed renal trauma]. / Evaluación y tratamiento del traumatismo renal cerrado.

Renal trauma accounts for more than 50% of all genitourinary trauma cases, nearly 90% of them corresponding to blunt trauma. Incidence is higher in male (3:1 ratio); is more frequent between the second and third decades; and predominantly affects the left side. Our group analyzed 89 cases of blunt renal trauma seen in our service between 1983 and 1996 with the purpose of determining the choice imaging studies, indications and type of management. Based on severity, injuries were rated in 5 grades using the classification of the Organic Injuries Survey Committee (OIS) from the American Association of Surgery in Trauma (AAST). We analyzed the etiology, clinical findings, prior renal conditions, associated injuries, radiologic studies and treatment instituted. CAT was considered the choice diagnostic technique for trauma rating since it permits greater definition of renal injury grade, as well as the associated abdominal and thoracic injuries. Most renal traumas were mild in severity, and evolved favourably with conservative treatment. In renal trauma grades IV and V, surgery is the recommended therapeutic approach, always preferring the most conservative criteria.

[Management of obstructive renal candidiasis. Report of a clinical case]. / Manejo de la candidiasis renal obstructiva a propósito de un caso clínico.

Neonatal renal candidiasis is a rare complication but serious, associated with prematurity, immunodeficiency, parenteral nutrition and other risk factors, with a mortality rate until 50%. We describe a neonate premature of 28 weeks who developed septicaemia by Candida, complicated with bilateral ureterohydronephrosis and intrapelvic fungus ball. The patient was managed by bilateral nephrostomy drainage and amphotericin B local irrigation, anyway with systemic amphotericin B together with oral fluconazol, needing subsequently bilateral open surgery and external drainage. The infection was eradicated, reaching the patient a gradual healing.