[The psoas bladder-hitch. An illustrative case]. / Vejiga psoica. Caso ilustrativo.

The psoas bladder hitch is an invaluable surgical procedure in the treatment of lesions of the lower ureteral third and transplantation with short ureters. We briefly review this procedure and describe an illustrative case of ureteroneocystostomy of the right lumbar ureter.

[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.

[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.

[Primary retroperitoneal hydatidosis]. / Hidatidosis retroperitoneal primaria.

The case of a primary retroperitoneal hydatidosis in a 62 year-old patient found accidentally during an haematuria study is presented. Both the possible extraperitonization mechanisms and efficacy of ultrasound scanning and percutaneous puncture in the etiological diagnosis in cases of retroperitoneal mass are evaluated.

[Bilateral renal adenocarcinoma: relationship with phakomatosis]. / Adenocarcinoma renal bilateral: relación con la facomatosis.

Von Hippel-Lindau disease is a very uncommon finding in our environment. A case of an incidental finding of that entity expressed through retinal angioma, bilateral renal cysts and bilateral renal carcinoma is described. A surgical course was followed performing a radical left nephrectomy, given the large size of the tumour, and right lower partial nephrectomy, as well as a review of the renal cysts considering the big tendency they have to degenerate in the disease.

[Leiomyosarcoma and liposarcoma: rare tumors of the kidney]. / Leiomiosarcoma y liposarcoma: tumores infrecuentes de riñón.

Sarcoma accounts for 2.8% of all renal tumours. We report a case of renal leiomyosarcoma (T2 N0 M0) and a case of renal liposarcoma (T3 N0 M0) submitted to surgery and chemo- and radiotherapy. Follow-up at nine months and 4 years, respectively, revealed the patients are tumor-free. The literature is reviewed highlighting the beneficial effect of chemo- and radiotherapy combined with surgery in the treatment of these tumors with a poor prognosis per se.

[Kidney hydatidosis]. / Hidatidosis renal.

Seven cases of hydatid renal cyst seen at our department over the past 8 years are described. The literature is reviewed and the importance of conservative surgery in the treatment of this disease is highlighted.

[Renal carcinoma presenting as a multilocular cyst]. / Carcinoma renal presentado como quiste multilocular.

Although it is not uncommon to find small foci of cystic degeneration in renal adenocarcinoma, it is uncommon to find these so extensive as to permit a preoperative diagnosis of multilocular cyst as in the present case. Several etiopathogenic mechanisms have been described. In the present case, the underlying mechanisms are likely to be tumor necrosis and intrinsic multilocular cystic growth. Arteriography is not the best diagnostic method and there are doubts as to the usefulness of punction aspiration. Prognosis remains unclear.