[Symptomatic leiomyoma of the kidney: renal mass with difficult preoperative diagnosis]. / Leiomioma renal sintomático: una masa renal de difícil diagnóstico.

Renal leiomyoma is a benign mesenchymal tumour that, albeit very rare, has to be ruled out when a renal mass has been diagnosed. This tumour can arise from any organ of the genitourinary tract with smooth muscle cells, being the renal capsule the most frequent origin. As its behaviour is not aggressive, nephron-sparing surgery is indicated. However, as it is difficult to preoperatively differentiate the leiomyoma from the adenocarcinoma, the former is commonly diagnosed after examination of the entire organ surgically removed.

Leiomioma renal sintomático: una masa renal de difícil diagnóstico / Symptomatic leiomyoma of the kidney: renal mass with difficult preoperative diagnosis

El leiomioma renal es un tumor mesenquimatoso benigno poco frecuente que, no obstante, se debe tener en cuenta ante el diagnóstico de una masa renal. Esta neoplasia puede originarse en cualquier órgano del aparato genitourinario que contenga músculo liso, siendo la cápsula renal la localización más frecuente. Dado el comportamiento benigno de la lesión, es subsidiario de la realización de una cirugía renal conservadora. No obstante, ante la dificultad para distinguirlo del adenocarcinoma, no será infrecuente que el diagnóstico se produzca tras el análisis histológico de una pieza de nefrectomía radical (AU)

[Reabsorption syndrome after transurethral resection (TUR) of the prostate: review of physiologic, diagnostic, and therapeutic features]. / Síndrome de reabsorción post-resección transuretral (R.T.U.) de próstata: revisión de aspectos fisiopatológicos, diagnósticos y terapéuticos.

In spite of the development of non-invasive strategies, surgical treatment of the prostate (TURP) and, mostly transurethral resection, is the most effective choice for patients suffering from benign prostatic hyperplasia who do not respond properly to pharmacological treatment. Absorption of hypotonic fluids used during TURP may cause hemodynamic and central nervous system disturbances. These symptoms, both taken separately or as a whole, are best known as "Transurethral prostatic resection syndrome" or "TURP syndrome". The original description of this syndrome dates from half a century ago; however, a number of items regarding its physiopathology and treatment remain unclear. We present a review of this pathological entity, compiling diagnostic and therapeutical approaches.

[Hybrid tumor of the penis: is this denomination correct?]. / Tumor híbrido de pene: es correcta dicha denominación?

OBJECTIVE: Few cases of verrucous carcinoma of the penis with foci of invasive squamous cell carcinoma have been reported and denominated "hybrid tumors". The accuracy of this term is discussed in this paper. METHODS/RESULTS: A huge penile mass in a patient that had undergone three previous operations for lesions diagnosed as verrucous carcinoma is reported. Partial penectomy was performed. Histological examination showed a very well-differentiated squamous cell carcinoma. PCR (polymerase chain reaction) did not detect any type of human papillomavirus (HPV) in the tumor. CONCLUSIONS: Verrucous carcinoma is a strictly-defined lesion with a different biological behaviour from that of squamous carcinoma. Preoperative deep biopsy may miss the squamous cell carcinoma. Definitive diagnosis can only be achieved by histological examination of the surgical specimen. In future, DNA studies could possibly support preoperative diagnosis of this lesion.

[Reconstructive surgery with polypropylene mesh associated with kidney transplant]. / Cirugía reconstructiva con malla de polipropileno asociada al trasplante renal.

OBJECTIVE: There is very little literature on hernial complications of the abdominal wall in association to renal transplantation. The present report aims to evaluate their incidence and type, as well as the intervention carried out and its results. MATERIAL AND METHOD: A retrospective analysis of a series of 650 renal transplantations has been carried out between 1978-1996 in our centre. A braided polypropylene mesh (Prolene) was used to repair abdominal wall defects and/or diagnosed hernias in 8 (1.2%) cases: 5 eventrations, 1 inguinal hernia and one combination of both: the last case required extensive debridement of the abdominal wall due to necrotizing fascitis. Mean time to eventration was 47.3 months (range 1-106). RESULTS: In all cases, the mesh was placed in the pre-peritoneal space. Two patients developed complications (one haematoma and one wound infection), though graft removal was not necessary in any case. Follow-up was 33.1 months (range 6-78) with no findings of hernial relapse. One patient started successful chronic ambulatory peritoneal dialysis (CAPD) 30 days after the intervention. CONCLUSIONS: The polypropylene mesh is a sound alternative in the treatment of hernial complications associated to renal transplantation, with acceptable morbidity, and efficacy rates that in our series reached 100%.

[Verrucous carcinoma of the penis. A report of 6 new cases and a review of the diagnostic and therapeutic aspects]. / Carcinoma verrucoso de pene. Aportación de seis nuevos casos y revisión de aspectos diagnósticos y terapéuticos.

Verrucous carcinoma of the penis accounts for 5-17.8% of total carcinomas in the referred location that are diagnosed in our environment. Six cases of this rare neoplasia have been treated in our service and revised retrospectively. The epidemiological, clinical, diagnostic and therapeutic aspects of our series are analyzed and the issues around them discussed. Eventually, the benign biological behaviour of this tumour warranting conservative surgical treatment is ratified. In selected cases where the therapeutic modalities used do not yield material for histopathological analysis (laser, cryotherapy, etc.) prior obtention of a deep biopsy of the lesion to identify the likely presence of a well differentiated epidermoid carcinoma is imperative. Also, every effort should be made to monitor the cases of associated premalignant conditions.