[Ureteral stenosis caused by systemic sclerosis?]. / Estenosis ureteral producida por esclerosis sistémica?

OBJECTIVE: To report a case of ureteral stenosis arising from a rare cause. METHODS/RESULTS: A 77-year-old female with ureteral stenosis and clinical symptoms compatible with systemic sclerosis is described. Chronic inflammatory changes compatible with systemic sclerosis were found in the stenotic ureter. CONCLUSIONS: Ureteral stenosis could be a symptom of connective tissue disease and medical treatment should be considered in these cases.

[Stenosis of the membranous bulbar urethra: our experience in termino-terminal urethroplasty]. / Estenosis de la uretra bulbo membranosa: nuestra experiencia en uretroplastia término terminal.

Between May 1989 and August 1996, the Urology Service, Polyclinic of Vigo, performed 24 termino-terminal urethroplasties in patients with bulbar or membranous urethral stenosis, measuring 1 to 2.5 cm long. The most frequent etiologies were iatrogenic (9/24) and traumatic rupture (7/24). After a mean follow-up of 5.4 years (1 year minimum) the success rate was 80% (19/24) and 20% (5/24) for restenosis, which were resolved through a single procedure of endoscopic internal urethrotomy in 3 of the 5 cases.

[Adrenal hemangioma of atypical presentation. Bibliographical Review]. / Hemangioma adrenal de presentación atípica. Revisión bibliográfica.

OBJECTIVE: To report a case of adrenal hemangioma presenting as spontaneous massive retroperitoneal hemorrhage that required surgical treatment without preoperative hormonal study. METHODS/RESULTS: Due to the intense pain and hemodynamic instability, the patient described herein was immediately submitted to laparatomy, adrenalectomy and drainage. The literature is reviewed with special reference to the clinical and radiological findings that could permit making a correct preoperative diagnosis. To our knowledge, a similar form of presentation has not been reported in the literature. The patient is asymptomatic 8 months postoperatively. CONCLUSIONS: Adrenal hemangioma is a rare tumor that usually presents as an incidental finding or with chronic pain in the abdominal flank. Although it is rarely malignant and some authors advocate conservative management based on the radiological findings, the difficulty lies in the similar evolution of other adrenal tumors that can produce similar findings. We therefore advocate surgical excision of adrenal incidentalomas due to their indeterminate histological and clinical behaviour.

[Primary malignant melanoma of the female urethra]. / Melanoma maligno primario de uretra femenina.

OBJECTIVES: Primary malignant melanoma of the female urethra is a very uncommon tumor type that carries a poor prognosis. An additional case is reported herein. METHODS/RESULTS: A case of primary malignant melanoma in the advanced stages is described. CONCLUSIONS: Several treatment options have been reported in the literature. The age of our patient, the presence of inguinal involvement and local invasion prompted us to choose symptomatic treatment.

[Bilateral renal angiomyolipoma associated with tuberous sclerosis. Right nephrectomy following arterial embolization]. / Angiomiolipoma renal bilateral asociado a esclerosis tuberosa. Nefrectomía derecha previa embolización arterial.

Presentation of the case of a 23-year old male diagnosed with bilateral renal angiomyolipomas associated to florid tuberous sclerosis, who presented with intense haematuria. The patient was treated conservatively by means of arterial selective embolization, later followed by nephrectomy due to persistence of bleeding. Assessment of the different therapeutic possibilities.

[Are blood glucose controls performed with portable dosimeters valid? A comparison of the reliability and validity of 3 commonly used models]. / Son válidos los controles de glucemia que se realizan con los dosímetros portátiles? Comparación de la fiabilidad y validez de tres modelos de uso habitual.

OBJECTIVE: To evaluate and compare the reliability and validity for both normal and high glycaemia values of three models of glycaemia self-analysers: Reflolux, Glucocard and One Touch. DESIGN: Descriptive and crossover study. Validation of a measuring appliance through its comparison with a standard appliance. PARTICIPANTS: The sample was composed of 90 blood specimens chosen by suitability sampling. MEASUREMENTS AND MAIN RESULTS: The glycaemia in the specimens was measured simultaneously by each one of the self-analysers and the central laboratory. There was high reliability (reproducibility) among the self-analysers, with correlation coefficients of 0.98, 0.97 and 0.98, with no statistically significant differences. As to intra-instrument reliability (repeatability), tested by analysing the variances of the differences, no statistically significant differences were found, except in the Glucocard self-analyser which lost precision at high glycaemia levels. Validity or accuracy, measured by the method of taking the average of the differences, showed a systematic bias in the Reflolux model, which had a value of 22.3 mg/dl above the reference model, and in the One Touch of -16.3 mg/dl. The Glucocard was the most accurate with a value of -1.78 mg/dl. CONCLUSIONS: Portable glycaemia dosimeters are very useful in following up diabetic patients because of their high reliability, but are not useful in the diagnosis of diabetes because of their lack of accuracy. Before beginning to use a portable dosimeter, its characteristics in terms of reliability and validity must be known, in order to evaluate correctly its findings.

[Multilocular cystic nephroma. Preoperative diagnosis with CAT]. / Nefroma quístico multilocular: Diagnóstico preoperatorio mediante TAC.

We report a case of multilocular cystic nephroma in a 45-year-old female patient who had been referred for urological evaluation on detecting a mass in the left lumbar region. Patient work up included CT evaluation, which proved to be the most useful in making the diagnosis. The literature is reviewed with special reference to the nature of this lesion and the existing controversy on whether it is an embryonary tumor or a congenital malformation.