Localized primary ureteral amyloidosis.

OBJECTIVE: To analyze a new case of primary localized amyloidosis of the ureter, describing the differential diagnosis with ureteral tumors and its pathogenic mechanism. METHOD: Description of the case of a male patient who presented clinical symptoms of renoureteral pain and hematuria and an image suspected of ureteral tumour undergoing laparoscopic nephroureterectomy. The pathological study confirmed amyloidosis of the ureter, AL by immunohistochemistry. RESULTS: This report further extends the slightly more than 50 published cases of primary localized amyloidosis of the ureter the clinical signs of which, pain and haematuria, are similar, showing stenosis and enlargement in an area of the ureteral wall on imaging techniques. In the majority of cases the diagnosis was obtained postoperatively, being necessary to exclude generalized and secondary affectation. CONCLUSIONS: Emphasis must be placed on the differential diagnosis of tumors of the ureter, especially in single-kidney patients, by using ureteroscopy and biopsy or preferably a careful cytological study. In our case a local inflammatory phenomenon could have been the basis of its pathogenesis.

Amiloidosis ureteral primaria localizada / Localized primary ureteral amyloidosis

OBJETIVO: Analizar un nuevo caso de amiloidosis ureteral primaria localizada, ahondando en el diagnóstico diferencial con los tumores ureterales y en su mecanismo patogénico.MÉTODO: Describimos el caso de un paciente varón, al que por clínica de dolor renoureteral y hematuria y sospecha por imagen de tumor ureteral, se practicó nefroureterectomía laparoscópica, confirmando el estudio histológico amiloidosis ureteral, AL por inmunohistoquímica. RESULTADOS: Viene a engrosar los escasos 50 casos publicados de amiloidosis ureteral primaria localizada, cuya manifestación clínica de dolor y hematuria es similar, encontrando estenosis y engrosamiento en una zona de la pared ureteral en técnicas de imagen. En la mayoría el diagnóstico fue postoperatorio, debiendo excluir afectación generalizada y secundaria.CONCLUSIONES: Hay que incidir en el diagnóstico diferencial con los tumores de uréter, sobre todo en pacientes monorrenos, mediante ureteroscopia y biopsia o preferible estudio exhaustivo citológico. En nuestro caso un fenómeno inflamatorio local, pudo ser la base de su patogénesis(AU)

OBJECTIVE: To analyze a new case of primary localized amyloidosis of the ureter, describing the differential diagnosis with ureteral tumors and its pathogenic mechanism.METHOD: Description of the case of a male patient who presented clinical symptoms of renoureteral pain and hematuria and an image suspected of ureteral tumour undergoing laparoscopic nephroureterectomy. The pathological study confirmed amyloidosis of the ureter, AL by immunohistochemistry.RESULTS: This report further extends the slightly more than 50 published cases of primary localized amyloidosis of the ureter the clinical signs of which , pain and haematuria, are similar, showing stenosis and enlargement in an area of the ureteral wall on imaging techniques. In the majority of cases the diagnosis was obtained postoperatively, being necessary to exclude generalized and secondary affectation.CONCLUSIONS: Emphasis must be placed on the differential diagnosis of tumors of the ureter, especially in single-kidney patients, by using ureteroscopy and biopsy or preferably a careful cytological study. In our case a local inflammatory phenomenon could have been the basis of its pathogenesis(AU)

[Secondary amyloidosis of the bladder and massive hematuria]. / Amiloidosis vesical secundaria y hematuria masiva.

OBJECTIVE: To report four additional cases of secondary amyloidosis of the bladder, an extremely rare condition, as shown by the cases reported in the literature. MATERIALS AND METHODS: Four clinical cases are reported, all of them occurring as hematuria, which was massive and fulminant and resulted in death in three patients. RESULTS: Secondary amyloidosis of the bladder is of the AA type, which is more common in females and mainly secondary to rheumatoid arthritis, but also to ankylosing spondylitis and long-standing chronic inflammatory conditions. Hematuria is the main and virtually only symptom. A pathological and immunohistochemical study confirmed diagnosis. All three patients who experienced massive, fatal hematuria had an intercurrent condition requiring urethral catheterization, which was the triggering factor. CONCLUSIONS: Despite its rarity, as shown by the few cases reported, secondary amyloidosis of the bladder should be considered in patients already diagnosed with systemic amyloidosis and/or the conditions reported who require simple urethral catheterization.

Amiloidosis vesical secundaria y hematuria masiva / Secondary amyloidosis of the bladder and massive hematuria

Objetivo: Dar a conocer cuatro nuevos casos de amiloidosis vesical secundaria, cuya manifestación clínica es extraordinariamente rara, si atendemos a los escasos casos publicados que no llegan a la treintena. Material y métodos: Describimos los cuatro casos clínicos, manifestados todos ellos por hematuria, siendo en tres masiva y fulminante, con evolución fatal. Resultados: La amiloidosis vesical secundaria corresponde al tipo AA, más frecuente en mujeres y secundaria sobre todo a artritis reumatoide, pero también a espondilitis anquilopoyética y procesos inflamatorios crónicos de larga evolución. La hematuria es el síntoma fundamental, prácticamente único. El estudio patológico e inmunohistoquímico confirma el diagnóstico. Se da la circunstancia de que los tres casos de hematuria masiva y fatal presentaron una patología intercurrente que precisó practicar un sondaje uretral, siendo este el desencadenante. Conclusiones: A pesar de su rareza, confirmada por los pocos casos publicados, habrá que pensar en ella ante pacientes ya diagnosticados de amiloidosis sistémica y/o con las patologías descritas, que precisen un simple sondaje uretral(AU)

Objective: To report four additional cases of secondary amyloidosis of the bladder, an extremely rare condition, as shown by the cases reported in the literature. Materials and methods: Four clinical cases are reported, all of them occurring as hematuria, which was massive and fulminant and resulted in death in three patients. Results: Secondary amyloidosis of the bladder is of the AA type, which is more common in females and mainly secondary to rheumatoid arthritis, but also to ankylosing spondylitis and long-standing chronic inflammatory conditions. Hematuria is the main and virtually only symptom. A pathological and immunohistochemical study confirmed diagnosis. All three patients who experienced massiva, fatal hematuria had an intercurrent condition requiring urethral catheterization, which was the triggering factor. Objective: To report four additional cases of secondary amyloidosis of the bladder, an extremely rare condition, as shown by the cases reported in the literature. Materials and methods: Four clinical cases are reported, all of them occurring as hematuria, which was massive and fulminant and resulted in death in three patients. Results: Secondary amyloidosis of the bladder is of the AA type, which is more common in females and mainly secondary to rheumatoid arthritis, but also to ankylosing spondylitis and long-standing chronic inflammatory conditions. Hematuria is the main and virtually only symptom. A pathological and immunohistochemical study confirmed diagnosis. All three patients who experienced massiva, fatal hematuria had an intercurrent condition requiring urethral catheterization, which was the triggering factor(AU)

[Carcinoma of the penis: review of our cases]. / Carcinoma de pene: revision de nuestra casuística.

A review is made of 36 carcinomas of the penis treated in the Urology Department of the "La Fe" Hospital. The most frequent decade for their appearance is the fifties. We establish their link with restricted hygiene and with fimosis, Queyrat's erythroplasia, leukoplasia and accuminated condyloma. The treatment given depends essentially on the clinical stage. We feel that within stage A, with minimum prepuce lesions, the ideal treatment is local excision and circumcision plus radiotherapy; in the case of minimal gland lesions radiotherapy; in the rest and when the former forms of therapy fail, partial amputation of the penis. We currently treat this stage with cryosurgery although we cannot give any results because of the limited period of development of the same. In stage B, we indicate amputation plus bilateral, ilio-inguinal lymphadenectomy plus radiotherapy. In stages C and D the treatment is palliative, on the basis of polychemotherapy.