[Metachronous bilateral Wilms' tumor]. / Tumor de Wilms bilateral metacrónico.

OBJECTIVE: To report on a female patient with metachronous bilateral Wilms' tumor with a long survival. METHODS: An 11-year-old girl underwent total nephrectomy when she was 4 years old for Wilms' tumor of the right kidney. She received cobalt therapy and chemotherapy, and the evolution was good for three years, at which time a control US scan detected a tumor in the left kidney that was diagnosed as Wilms' tumor. She underwent a partial nephrectomy at the Hospital Pediátrico de Centro Habana (Cuba) and received chemotherapy. RESULTS/CONCLUSION: A recent US scan and a descending pyelogram showed completely normal findings and growth of the remaining renal parenchyma. The patient is alive and well 7 years and 8 months later.

[Long-term survival in a patient surgically treated for renal carcinoma in childhood]. / Supervivencia extensa en una paciente operada en la infancia por un carcinoma renal.

OBJECTIVE: To report on a patient who underwent surgery for renal carcinoma at the age of 12 years and who is alive and symptom-free after 22 years. METHODS: A 34-year-old female who underwent surgery for a right renal tumor when she was 12 is described. The histological analysis demonstrated renal adenocarcinoma. To date, no symptoms of metastatic spread have been observed. A recent renal scintiscan and chest film were normal. RESULTS: Renal carcinoma is relatively frequent in adults, but rare in children. Of the 250 cases reported in the world literature, only two patients have survived for more than 20 years. Our patient leads a normal life and has two children, aged 8 and 2 years. CONCLUSIONS: To our knowledge, the patient described herein is the third case with a long survival reported in the world literature.

[A simple kidney cyst in childhood]. / Quiste renal simple en la infancia.

OBJECTIVE: To report on a 6-year-old patient with an infected simple renal cyst. METHODS/RESULTS: A 6-year-old girl was admitted on three occasions for acute infectious syndrome and right lumboabdominal pain. The ultrasound scans showed a simple cyst in the right kidney which contained cellular elements. The patient was treated with antimicrobials on each occasion and the symptoms disappeared a few days later. On her third admission surgery was decided due to the recurrent clinical symptoms, a persistently high erythrocyte sedimentation rate and the presence of intracystic cellular elements, which raised the suspicion of intracystic abscess or tumor. The patient was submitted to surgery; the cyst was drained, resected and the internal wall marsupialized. The postoperative period was unremarkable and the patient is asymptomatic 10 months after surgery. CONCLUSION: The case described herein is uncommon; to our knowledge, a similar case has not been reported in the literature.

[Wilms tumor treated with partial surgery. 31-year survival]. / Tumor de Wilms tratado por cirugía parcial. 31 años de supervivencia.

OBJECTIVE: To report on a patient with Wilms' tumor treated by partial nephrectomy with 31 years survival. METHODS: Herein we describe a 33-year-old patient who had undergone surgery for a right renal tumor at age 2 years and 10 months. A partial nephrectomy was performed because the patient had left ureterohydronephrosis. Histological analysis of the surgical specimen disclosed a nephroblastoma or Wilms' tumor. RESULTS/CONCLUSIONS: The progressive deterioration of the left urinary tract, despite attempts to correct this condition, warranted its complete suppression. The patient has remained symptom-free and leads an active social and working life 31 years after the first operation, which makes this an exceptional case in the world literature.

[Congenital vaginal atresia and simultaneous vesico-vaginal fistula]. / Atresia congénita de vagina y fístula vesico-vaginal simultáneas.

OBJECTIVES: To describe an uncommon case of congenital atresia of the vagina associated with vesico-urethro-vaginal fistula caused by violent coitus. METHODS/RESULTS: We report on a patient who was unaware she had the Rokitanski-Mayer-Kuster-Hauser syndrome when she had her first sexual intercourse which caused partial destruction of the urethra and bladder neck, resulting in complete incontinence. The different surgical procedures performed to recovery urinary continence and the creation of a viable vaginal tunnel are described. CONCLUSIONS: Congenital atresia of the vagina is uncommon. To our knowledge, this is the first case with associated vesico-urethro-vaginal fistula reported in the literature.

[Simultaneous renal cell carcinoma and transitional cell carcinoma of the bladder. A case report]. / Carcinoma de célula renal y carcinoma transicional de vejiga simultáneos. Informe de un caso.

Herein we describe a case of renal cell carcinoma at the base of a giant right renal cyst coexisting with transitional cell carcinoma. The humoral, radiographic, endoscopic and CT findings are presented, as well as treatment and the results achieved at one year follow-up.

[Priapism induced by intracavernous injection]. / Priapismo provocado por inyección intracavernosa.

We report 16 cases of priapism in 13 of 404 patients who received intracavernous injection of vasoactive drugs to induce erection. In 10 patients the complication presented following injection of papaverine and phentolamine in combination. Despite reducing the dose of both agents, one patient had another episode of priapism. One patient who had been receiving papaverine alone in increasing doses with no results, developed priapism after the first injection of the combined treatment modality and again after the dose of both drugs had been reduced. Three cases presented priapism after injection with papaverine alone. One presented the complication again after injection of a reduced dose. The patients were seen after a sustained erection of 20 hours maximum on 15 occasions and one patient was seen after a sustained erection of 36 hours.

[Prolonged survival of an adult with Wilms' tumor]. / Sobrevida prolongada de un adulto con tumor de Wilms.

We report on an adult patient who underwent surgery for Wilms' tumor or nephroblastoma with a prolonged survival. At 13 years post-operatively, the patient is alive and disease-free, a father of two children, and has an active working and social life. Recent blood analyses, chest X-ray and abdominal ultrasound scan were unremarkable. We reviewed the cases of Wilms' tumor reported in the world literature highlighting the survivorship reported by some of the authors. To our knowledge, of the adult patients reported with this malignant tumor type, ours has the longest survival.

[Arterial risk factors in sexual impotence]. / Factores arteriales de riesgo en la impotencia sexual.

The present study was undertaken in 223 male patients who had consulted for erectile dysfunction. Patient failure to obtain spontaneous erection on waking was a prerequisite for inclusion in the study. The mean patient age was 50.82 years. The penile brachial pressure index (PBI) was determined by Doppler stethoscopy in all patients; 194 patients had a mean PBI of 0.79%. We evaluated 197 patients for the following arterial risk factors: smoking habit, hyperlipidemia, arterial hypertension, and diabetes mellitus. The results showed 148 were smokers; of these, 40 (28.6%) had no other arterial risk factor. Ninety-five had hyperlipidemia; of these, 19 (20%) had no other arterial risk factor. Hypertension was the only arterial risk factor in 8 (10%) of 73 hypertensives. Diabetes was the only arterial risk factor in 2 (6.4%) of the 31 with this condition. The mean age of patients with no arterial risk factors was 42.64 years. The number of risk factors increased with mean patient age. Three or more risk factors were observed in the patient group with a mean age of 57 years. The PBI dropped as the number of arterial risk factors rose. Patients with no arterial risk factors had a PBI of 0.83 whereas patients with three or more arterial risk factors had a PBI of 0.75. No statistical significance was observed when the arterial risk factors were combined.

Estenosis distal de la uretra en las ninas. Estudio de 100 casos. / Distal urethral stenosis in girls. Study of 100 cases

En el hospital infantil docente "Pedro Borras Astorga" hemos sido motivados a estudiar un numero de 100 pacientes con diagnostico de estenosis distal de la uretra, entidad de gran importancia a la luz de los conocimientos actuales debido a las manifestaciones disuricas que produce. Estas pacientes las hemos estudiado desde el punto de vista clinico, bacteriologico y radiologico, obteniendose el diagnostico mediante el examen fisico y la cistografia miccional. El tratamiento que hemos utilizado en todos los casos ha sido la dilatacion uretral asociada a tratamiento antimicrobiano. En este trabajo analizaremos el resultado obtenido de 100 pacientes que han sido dignosticados de estenosis distal de la uretra

Torsion congenita del pene. Estudio de seis casos. / Congenital torsion of the penis. Study of six cases

Se estudian seis pacientes diagnosticados de torsion congenita del pene, todos menores de diez anos, encontrandose que la rotacion era en contra de las manecillas del reloj, entre los cuales hubo uno de 180o.Las afecciones mas frecuentes asociadas fueron la criptorquidea, prepucio redundante e hipospadia. Solo un caso de la serie estudiada fue motivo de tratamiento quirurgico

Lesiones quística de las glándulas suprarrenales

Se reportan 6 casos de quistes adrenales (4 quistes linfático y 2 pseudoquistes) señalandose la incidencia de la lesión. Los quistes constituyen frecuentemente un hallazgo necrópsico u operatorio, aunque pueden tener expresión clínica y no tiene actividad endocrina. Se destaca la importancia de calcificaciones en el diagnóstico preoperatorio. Se revisan algunas clasificaciones y teorías etiopatogénicas, adoptándose la clasificación de Hodges y Ellis por razones prácticas(AU)