[Conservative surgery of epidermoid cyst of the testis]. / La chirurgia conservativa nelle cisti epidermoidi del testicolo.

Epidermoid cyst of the testis is a rare, benign testicular tumor. It is estimated that epidermoid cyst of the testis represent less than 1% of all testicular tumors. Opinion is divided as to the best treatment for this condition. The majority opinion favours excision of the tumour and preservation of the testis, although some recommend radical inguinal orchiectomy. We present a case of a 26 years old man with an epidermoid cyst of the testis and submitted to organ preserving surgery. Organ preserving surgery with the excision or enucleation of the epidermoid cyst suffices, having not been reported relapse or metastasis after such treatment. The longest reported follow up time is 37 years. The conservative management of epidermoid cyst is an alternative with important psycho logical benefits and without jeopardizing life.

Elective conservative surgery for renal carcinoma versus radical nephrectomy: a prospective study.

OBJECTIVE: To identify criteria with which to select candidates for conservative nephrectomy, and to compare the results of radical and conservative nephrectomy in two homogeneous groups of patients with renal carcinoma, in a prospective study. PATIENTS AND METHODS: Forty patients (27 men and 13 women, mean age 49.9 years, range 23-76) with renal carcinoma (T1-T2 NOMO, < 4 cm in diameter) were enrolled in the study between 1988 and 1993 and followed for a maximum of 98 months (mean 70.1). The patients were divided into two groups: Group A comprised 19 patients (mean age 51.4, SD 13.7 years, mean tumor size 3.34, SD 0.64 cm) who underwent partial nephrectomy: Group B comprised 21 patients (mean age 48.7, SD 14.7 years, mean tumour size 3.21, SD 0.56 cm) who were selected for radical nephrectomy. The survival and progression of disease were assessed. RESULTS: Survival did not differ between the groups; one patient from each group died from distant metastases. There were no cases of local recurrence and multifocal neoplastic lesions were found in one patient during surgery. CONCLUSION: This prospective study confirms the results of retrospective studies that conservative surgery is as effective as radical surgery for renal carcinoma; however, its clinical application is limited by the risk that the renal carcinoma is multifocal.

[Ureteral calculi: comparison of echographic and radiologic scanning]. / Calcolosi ureterale: sistemi di puntamento ecografico e radiologico a confronto.

The ureteral calculi can be treated, today in situ with extracorporeal shock wave lithotripsy. In our study we have used three different lithotriptors, two with fluoroscopic scanning, one with ultrasound scanning. The patients we have treated with ultrasound scanning lithotriptor Dornier MPL 9000 were 48 (22M-26F), while 210 patients were treated with fluoroscopic scanning lithotriptor, respectively 23 (15M-8F) with Direx Tripter XI and 187 with Dornier HM3. The ureteral calculi were so localized: among the patients treated with ultrasound scanning lithotriptor 16 presented calculi in the upper third ureter between GPU and L3, 9 in the middle third ureter between L3 and the superior border of sacroiliac articulation, 9 in pelvic tract above the spinoischiatic line, 6 between this line and juxtabladder ureter and 8 in juxtabladder ureter. Among the patients treated with fluoroscopic scanning lithotriptors all together 58 presented calculi in the upper third ureter between GPU and L3, 29 in the middle third ureter between L3 and the superior border of sacroiliac articulation, 13 in the iliac tract of the ureter, 41 in pelvic tract above the spino-ischiatic line, 27 between this line and juxtabladder ureter and 42 in juxtabladder ureter. For every treatment the number of shock waves was 2500 and the number of treatments for every patients was 1, 3. We report 82% of patients stone-free at a follow up of three months for the patients treated with the MPL 9000, 87% of patients stone-free for Direx Tripter XI and 85% of patients stone-free for Dornier HM3.(ABSTRACT TRUNCATED AT 250 WORDS)