[Impact of prostate cancer on the nervous system: two different cases and a review of the literature.] / Impacto del cáncer de próstata en el sistema nervioso: dos casos diferentes y revisión de la literatura.

We present two different cases of involvement of the nervous system due to prostate cancer. We know that atypical metastases can also affect supraclavicular lymphatics, adrenal gland and testicles. In these cases we present a typical places in the nervous system. We musttake into account that sometimes the shape the presentation of symptoms can be confused with other pathologies. In some cases, this type of patient has never had a urological check-up and in our sagacity as doctors we come to find the origin of the problem: the prostate.

Presentamos dos casos diferentes de afectación del sistema nervioso por cáncer de próstata. Sabemos que las metástasis atípicas también pueden afectar linfáticos supraclaviculares, glándula suprarenal y testículos. En estos dos casos presentamos lugares atípicos que afectan el sistema nervioso. Debemos tener en cuenta que a veces la forma de presentación de los síntomas pueden confundirse con otras patologías. En algunas oportunidades este tipo de pacientes jamás han hecho un chequeo urológico y en nuestra sagacidad como médicos llegamos a encontrar el origen del problema: la próstata.

Impacto del cáncer de próstata en el sistema nervioso: dos casos diferentes y revisión de la literatura / Impact of prostate cancer on the nervous system: two different cases and a review of the literature

Presentamos dos casos diferentes de afecta-ción del sistema nervioso por cáncer de próstata. Sabemosque las metástasis atípicas también pueden afectar linfáti-cos supraclaviculares, glándula suprarenal y testículos. Enestos dos casos presentamos lugares atípicos que afectanel sistema nervioso. Debemos tener en cuenta que a vecesla forma de presentación de los síntomas pueden confun-dirse con otras patologías. En algunas oportunidades estetipo de pacientes jamás han hecho un chequeo urológico yen nuestra sagacidad como médicos llegamos a encontrarel origen del problema: la próstata.(AU)

We present two different cases of involve-ment of the nervous system due to prostate cancer. Weknow that atypical metastases can also affect supraclavic-ular lymphatics, adrenal gland and testicles. In these caseswe present atypical places in the nervous system. We musttake into account that sometimes the shape the presentationof symptoms can be confused with other pathologies. Insome cases, this type of patient has never had a urologicalcheck-up and in our sagacity as doctors we come to findthe origin of the problem: the prostate.(AU)

Bilateral nephrectomy as an extreme measure management for methicillin-resistant staphylococcus aureus (MRSA): A case report.

Methicillin-resistant Staphylococcus aureus (MRSA) infections are cases of urgent management that often leads to hospitalizations in intensive care and prolonged management of antibiotic therapy. In this occasion, we present the case of a 38-year-old female patient with sepsis secondary to banal dermal infection due MRSA that complicates with infectious thrombus of the left renal vein associated with multiple foci of bilateral renal abscesses. As an extreme and exceptional measure, emergency bilateral radical nephrectomy was performed to save the patient's life.

Intraoperative radiotherapy during radical prostatectomy for intermediate-risk to locally advanced prostate cancer: treatment technique and evaluation of perioperative and functional outcome vs standard radical prostatectomy, in a matched-pair analysis.

OBJECTIVE: To evaluate a novel approach with intraoperative radiotherapy (IORT) administered in the surgical field, after pelvic lymphadenectomy (PL) and before radical retropubic prostatectomy (RRP), evaluating acute and late toxicity, complications and biochemical progression-free survival (bPFS), as the adequate treatment of locally advanced prostate cancer is still a controversial issue. PATIENTS AND METHODS: Between June 2005 and October 2007, 33 consecutive patients with intermediate-risk or locally advanced prostate cancer were selected for PL + IORT + RRP. IORT was delivered by a mobile linear accelerator in the operating room (electron beam, 12 Gy at 90% isodose). According to the pathological findings further adjuvant radio- or hormone therapy could be administered. The median follow-up was 16 months. This group was compared retrospectively with a historical group of 100 patients who had undergone RRP and further adjuvant therapy, selected with equivalent criteria. The comparison was conducted as a matched-pair analysis. The perioperative outcomes (surgical time, estimated blood loss, blood transfusions, days of catheterization, days of drainage, days of hospitalization), continence as the functional outcome, acute and late toxicity, rate of complications and bPFS were evaluated and compared. RESULTS: The baseline characteristics of the two groups were equivalent but the node count and the number of positive lymph nodes was higher in the IORT group. The IORT group had longer surgery, and a shorter hospital stay and catheterization. There were no differences in continence rate, and no major complications in either group. The acute and late toxicity and bPFS were equivalent. A retrospective comparison and the short follow-up were the major limitations. CONCLUSIONS: IORT administered before RRP seems a feasible approach, with little effect on the variables evaluated.