Colecistectomía y nefrectomía radical por puerto único umbilical en un mismo acto quirúrgico / Trans-umbilical single-port radical nephrectomy with concomitant cholecystectomy

Objetivos: La evolución de los procedimientos laparoscópicos hace que sea necesario en ocasiones, la realización de cirugías combinadas con otras especialidades. Actualmente, algunas de estas intervenciones se pueden realizar mediante cirugía por puerto único umbilical. Material y métodos: Presentamos el caso de un paciente con tumoración renal de 4,5 cm y colelitiasis al que realizamos colecistectomía y nefrectomía radical derecha por puerto único umbilical de manera concomitante. Este es el primer caso publicado en España en el que se realiza esta intervención combinada mediante cirugía de puerto único umbilical. Resultados: Se realizó la cirugía sin complicaciones intraoperatorias ni postoperatorias, con un correcto control de la patología tumoral y un excelente resultado estético. Conclusión: En las situaciones que sean necesarias realizar un abordaje multidisciplinar con otras especialidades quirúrgicas involucradas, estas se pueden realizar mediante cirugía por puerto único umbilical, con las ventajas de una menor morbilidad postoperatoria y un mejor resultado estético

Objectives: Occasionally, the development of laparoscopic procedures allows the performance of combined surgeries. Currently, some of these can be carried out by trans-umbilical single-port laparoscopy. Material and methods: We report a patient with renal tumor of 4.5 cm and cholelithiasis who undergone to trans-umbilical single port-right radical nephrectomy with concomitant cholecystectomy. This is the first case reported in Spain that this combined procedure is performed using umbilical single port surgery. Results: No complications (intra or postoperative) have been described in this case, achieving proper control of tumor pathology and an excellent cosmetic outcome. Conclusion: In those cases in which multidisciplinary approach is required, surgery can be performed by trans-umbilical single-port laparoscopy as consequence of its reduced postoperative morbidity and better cosmetic results

Trans-umbilical single-port radical nephrectomy with concomitant cholecystectomy.

OBJECTIVES: Occasionally, the development of laparoscopic procedures allows the performance of combined surgeries. Currently, some of these can be carried out by trans-umbilical single-port laparoscopy. MATERIAL AND METHODS: We report a patient with renal tumor of 4.5cm and cholelithiasis who undergone to trans-umbilical single port-right radical nephrectomy with concomitant cholecystectomy. This is the first case reported in Spain that this combined procedure is performed using umbilical single port surgery. RESULTS: No complications (intra or postoperative) have been described in this case, achieving proper control of tumor pathology and an excellent cosmetic outcome. CONCLUSION: In those cases in which multidisciplinary approach is required, surgery can be performed by trans-umbilical single-port laparoscopy as consequence of its reduced postoperative morbidity and better cosmetic results.

[Paratesticular lipoma]. / Lipoma paratesticular.

Among the neoplasias affecting the scrotum and other elements contained within, testicular tumours are the most common; paratesticular neoplasias account for about 2%. 70% of them are benign tumours, lipoma being one the most frequent types. We contribute a new case of paratesticular lipoma in a 45-year old patient, who presented with scrotal complaints. Physical examination found fibroelastic scrotal tumoration; diagnosis being aided with ultrasound and CAT that showed fat tissue radiographic patterns. Complete removal of tumoration and subsequent pathoanatomical study confirmed the diagnosis of paratesticular lipoma. A literature review on the subject is included with reflections on the clinical, diagnostic and therapeutical aspects.

Lipoma paratesticular / Paratesticular lipoma

Dentro de las neoplasias que afectan al escroto y elementos contenidos en el mismo, los tumores testiculares son los más frecuentes; las neoplasias paratesticulares representan aproximadamente el 2 por ciento del total, y de ellas el 70 por ciento son tumores benignos, siendo el lipoma uno de los tipos más frecuentes. Presentamos un nuevo caso de lipoma paratesticular en un paciente de 45 años, manifestado por molestia escrotal y detectándose una tumoración escrotal fibroelástica en la exploración física. El diagnóstico se complementó con ecografía y TAC, mostrando unos patrones radiográficos de tejido graso. La extirpación completa de la tumoración y posterior estudio anatomopatológico, confirmaron el diagnóstico de lipoma paratesticular. Asimismo hacemos una revisión bibliográfica del tema comentando aspectos clínicos, diagnósticos y del tratamiento (AU)

[Report of 2 new cases of bladder inverted papilloma, one with them complicated with acute urinary obstruction]. / Presentación de dos nuevos casos de papiloma invertido vesical, cursando uno de ellos con obstrucción urinaria aguda.

Inverted papilloma is a rare tumour (2.2% of urothelial tumours) considered to be benign. The bladder is the most frequent site and growth tends to be endophytic towards the submucosa. Haematuria and obstruction symptoms appear to be the most typical clinical manifestations. Contribution of two cases of inverted bladder papilloma; one showing very unusual clinical development with relapsing acute urinary obstruction. Strict follow-up is recommended in spite of its benign behaviour as it may become associated to transitional cell carcinoma. Literature review on this tumoral entity in terms of etiology, clinical manifestations, diagnosis and treatment.

Presentación de dos nuevos casos de papiloma invertido vesical, cursando uno de ellos con obstrucción urinaria aguda / Contribution of two new cases of inverted bladder papilloma, one evolving with acute urinary obstruction

El papiloma invertido es un tumor poco frecuente (2.2 por ciento de los tumores uroteliales), y considera-do de comportamiento benigno. La localización vesical es la más frecuente y su crecimiento suele ser endofítico hacia la submucosa. Las manifestaciones clínicas más frecuentes son hematuria y sintomatología obstructiva. Presentamos dos casos de papiloma invertido vesical, destacando en uno de ellos el curso clínico poco frecuente con obstrucción urinaria aguda recidivante. A pesar de su comportamiento benigno se recomienda seguimiento estricto ya que puede asociarse en ciertos casos con carcinoma de células transicionales. Realizamos una revisión bibliográfica de esta entidad tumoral sobre aspectos de su etiología, manifestaciones clínicas, diagnóstico y tratamiento (AU)

[Metanephric adenoma of the kidney and chronic myeloproliferative syndrome. An unusual association]. / Adenoma metanéfrico de riñón y síndrome mieloproliferativo crónico. Una rara asociación.

The metanephric adenoma is an uncommon tumour included in the class of benign renal epithelial tumours. This paper presents the case of a 64-year old female with incidentally diagnosed renal tumoration affecting the patient concomitantly to a chronic myeloproliferative syndrome with myelofibrosis. Left kidney ultrasound and CAT findings suggested a diagnosis of renal cell carcinoma. Left radical nephrectomy was performed. The pathoanatomical study confirmed the diagnosis of a renal metanephric adenoma 9 x 7.5 cm in size. Although some cases of metanephric adenoma have been described in patients with haematological conditions, polycythemia being specially frequent, no case associated to chronic myeloproliferative syndrome has been found in the literature.

[Acute pyelonephritis as presentation form of renal angiomyolipoma with large granulomatous component]. / Pielonefritis aguda como forma de presentación de un angiomiolipoma renal con gran componente granulomatoso.

Angiomyolipoma is a benign tumour of the kidney; is most cases is a finding during radiologic studies (ultrasound and CAT) and therefore asymptomatic. Due to their histologic features, these tumours show characteristic ultrasound and CAT patterns. This paper presents one case of angiomyolipoma in a 26-year old female patient who presented with a clinical picture of acute pyelonephritis. The tumour features in both ultrasound and CAT were not the typical ones for this kind of tumour. The surgical piece removed corresponded to an angiomyolipoma with a large granulomatous reaction.