Asymptomatic renocolic fistula as a complication of staghorn calculus: case report.

OBJECTIVE: To report a complication of a staghorn stone in a non-functioning right kidney. METHODS: We present a 47 year old female with right lumbar pain and history of recurrent urinary tract infection (UTI). After an acute pyelonephritis episode, a right staghorn stone was diagnosed in a non-functioning right kidney. RESULTS: During right nephrectomy, we found a renocolic fistula not observed in the imaging studies before surgery. We performed a simple closure of the colon wall after resection of the fistula. CONCLUSION: Asymptomatic renocolic fistula is a rare complication of an acute pyelonephritis secondary to a staghorn stone.

Fístula reno-cólica asintomática como complicación renal coraliforme / Asymptomatic renocolic fistula as a complication of staghorn calculus: Case report

OBJETIVO: Presentamos complicación de una litiasis coraliforme en riñón no funcionante. MÉTODOS: Paciente femenina de 47 años con dolor lumbar derecho e infecciones urinarias a repetición. Luego de una pielonefritis aguda, se diagnostica una litiasis coraliforme en un riñón no funcionante. RESULTADO: Durante la nefrectomía derecha se comprueba una fistula reno-colónica no informada en los estudios de imágenes previos a la cirugía. Luego de la resección de la misma, se realiza un cierre simple de la pared colónica involucrada. CONCLUSIONES: La fistula reno-colónica es una complicación poco frecuente de una pielonefritis aguda secundaria a litiasis coraliforme (AU)

OBJECTIVE: To report a complication of a staghorn stone in a non-functioning right kidney. METHODS: We present a 47 year old female with right lumbar pain and history of recurrent urinary tract infection (UTI). After an acute pyelonephritis episode, a right staghorn stone was diagnosed in a non-functioning right kidney. RESULTS: During right nephrectomy, we found a renocolic fistula not observed in the imaging studies before surgery. We performed a simple closure of the colon wall after resection of the fistula. CONCLUSION: Asymptomatic renocolic fistula is a rare complication of an acute pyelonephritis secondary to a staghorn stone (AU)

Tumor testicular del síndrome adrenogenital. A propósito de un caso y diagnóstico intraoperatorio / Testicular tumour of the adrenogenital syndrome. A case report and frozen section diagnosis

Presentamos el caso de un varón de 34 años con hiperplasia adrenal congénita por déficit de 21-hidroxilasa diagnosticada durante la infancia. En la actualidad presenta múltiples masas testiculares hipoecogénicas y bilaterales. Se optó por realizar biopsia intraoperatoria de una de estas lesiones, observándose un aspecto microscópico constituido por cordones y trabéculas de grandes células poligonales con abundante citoplasma y núcleo redondo con patrón cromatínico fino, similares a las células de Leydig, entre los cuales serpenteaban tractos fibrosos más o menos gruesos, los cuales nos ayudaron a emitir el diagnóstico de tumor testicular del síndrome adrenogenital. En los pacientes con síndrome adrenogenital es típica la aparición de tumoraciones testiculares bilaterales originadas como consecuencia de niveles elevados de ACTH en sangre periférica. Las teorías actuales orientan a un origen a partir de células madre totipotenciales del estroma testicular. Son tumores de gran parecido morfológico, radiológico y bioquímico con los tumores de células de Leydig, por lo que es de gran importancia realizar un diagnóstico diferencial acertado y evitar así cirugías radicales realizadas clásicamente con estas lesiones(AU)

We present a case of a 34 years old male with congenital adrenal hyperplasia caused by 21-hidroxilase deficiency, diagnosed during his childhood. Currently he presents multiple testicular hypoechogenic and bilateral masses. We chose to perform intraoperatory biopsy in one of these lesions, observing a microscopic appearance constituted by cords and trabeculae of large polygonal cells with abundant cytoplasm and round nuclei with fine chromatin pattern similar to Leydig cells, including meandering fibrous tracts of more or less thickness, which helped us delivering the diagnosis of testicular tumor of adrenogenital syndrome. In patients with adrenogenital syndrome is typical the arising of bilateral testicular tumors as a result of elevated levels of adrenocorticotropin hormone (ACTH) in peripheral blood. Current theories directed to an origin from pluripotential stem cells from testicular stroma. These tumors are morphologically, biochemically and radiologically very similar to Leydig cell tumours, so it is very important to make a correct differential diagnosis and avoid radical surgery performed classically with these lesions(AU)

Atypical primary carcinoid tumour of the skin.

We present a new case of a primary carcinoid tumour of the skin. The mitotic index (4/10 HPF) warrants classification of this case as atypical. The patient was a 58-year-old woman with a 1-year history of a mass on the scalp. Literature review showed this to be only the seventh case of primary carcinoid tumour of the skin. Importantly, the evolution has been favourable in all seven tumours, with a mean follow-up of 2.5 years for the previous six cases. Although the number of cases is too small to draw definitive conclusions, information to date suggests that this type of tumour can be expected to have a benign behaviour, despite the presence in some cases of criteria suggestive of uncertainty, such as the presence of mitosis.