[Segmental testicular infarction]. / Infarto segmentario de testículo.

We report the case of a 47 years old man previously diagnosed of left hidrocele. After having a recent mild left testicular pain, an ultrasonografic study revealed a solid hipoecoic testicular lesion rounded by a big hidrocele, suggesting a testicular neoplasm. Radical inguinal orchiectomy was made and pathologic study showed segmental testicular infarction. No malignancy was found. We review the literature of the topic.

Infarto segmentario de testículo / Segmental testicular infarction

Presentamos el caso de un varón de 47 años diagnosticado meses antes de hidrocele izquierdo que en estudio sonográfico reciente, realizado por dolorimiento testicular, presentaba lesión sólida nodular sugestiva de neoplasia testicular izquierda. Fue sometido a orquiectomía radical. El análisis de la pieza quirúrgica demostró la presencia de infarto segmentario con ausencia de tumor. Revisamos la bibliografía sobre el tema

We report the case of a 47 years old man previously diagnosed of left hidrocele. After having a recent mild left testicular pain, an ultrasonografic study revealed a solid hipoecoic testicular lesion rounded by a big hidrocele, suggesting a testicular neoplasm. Radical inguinal orchiectomy was made and pathologic study showed segmental testicular infarction. No malignancy was found. We review the literature of the topic

[Micropapillary carcinoma of the bladder: case report and review of the literature]. / Carcinoma micropapilar de vejiga: aportación de un caso y revisión de la bibliografía.

Micropapillary carcinoma is an uncommon pathologic variant of bladder carcinoma with aggressive behavior. Its usual presentation is like a high grade and high stage carcinoma and associated with other histologic types in different proportion. It doesn't differ clinically from normal transitional cell carcinoma of the bladder. Studies of molecular markers are still contradictories. Treatment should be early and aggresive, based on surgical therapy as radiotherapy and chemotherapy have shown limited results. We report a 72 year old man suffering from low urinary tract symptoms for years and recently presented gross hematuria. He was diagnosed as high stage micropapillary carcinoma. One year after radical cystectomy and subsequent chemotherapy based on carboplatin and gemcitabine, progression of the disease was shown on CT and the patient died 14 months after the diagnosis.

Carcinoma micropapilar de vejiga: aportación de un caso y revisión de la bibliografía / Micropapillary carcinoma of the bladder: case report and review of the literature

El carcinoma micropapilar (CMP) es una variante anatomopatológica infrecuente de carcinoma vesical de comportamiento agresivo. Se presenta habitualmente como carcinoma de alto grado, en estadios avanzados y asociado a otras formas histológicas en proporciones variables. No manifiesta signos clínicos diferenciales con el carcinoma vesical típico. Los estudios de marcadores moleculares son todavía contradictorios. El tratamiento debería ser precoz y agresivo, fundamentalmente quirúrgico, dado que la Radioterapia y la Quimioterapia han demostrado escasa eficacia hasta el momento. Presentamos el caso de un varón de 72 años con síntomas miccionales de larga evolución y hematuria macroscópica de reciente aparición que se diagnosticó de CMP en estadio avanzado. Al año dela cistectomía radical asociada a quimioterapia con carboplatino y gemcitabina se evidenció progresión rápida de la enfermedad y falleció a los 14 meses (AU)

Micropapillary carcinoma is an uncommon pathologic variant of bladder carcinoma with aggressive behavior. Its usual presentation is like a high grade and high stage carcinoma and associated with other histologic types in different proportion. It doesn´t differ clinically from normal transitional cell carcinoma of the bladder. Studies of molecular markers are still contradictories. Treatment should be early and aggresive, based on surgical therapy as radiotherapy and chemotherapy have shown limited results. We report a 72 years old man suffering from low urinary tract symptoms for years and recently presented gross hematuria. He was diagnosed as high stage micropapillary carcinoma. One year after radical cystectomy and subsequent chemotherapy based on carboplatin and gemcitabine , progression of the disease was shown on CT and the patient died 14 months after the diagnosis (AU)

[Florid glandular cystitis of the intestinal type with mucin extravasation: a lesion simulating a tumor]. / Cistitis glandular florida de tipo intestinal con extravasación de mucina: una lesión que simula un tumor.

A wide spectrum of glandular epitheliales metaplastic changes may be seen in the bladder. Extensive replacement of the urotelium with an epithelium resembling intestinal mucosa is recognised as a premalignant condition. However, the natural history of intestinal metaplasia of the urinary bladder and long-term outcome are unknown. We report a case of glandular cystitis with intestinal metaplasia in a young patient. Cystoscopy revealed a tumour well circumscribed measuring 4 cm on the trigone. Microscopic examination showed numerous glands lined by intestinal type epithelium without atipia, conforming to the appearance of the intestinal variant of cystitis glandularis. This case had prominent foci of basophilic mucin in the stroma. Rounded aggregates of mucin were occasionally surrounded by compressed connective tissue cells, simulating mucinous cyst. This case illustrates the extent to which cystitis glandularis may mimic a neoplasm on gross evaluation and the propensity of mucin extravasation to cause diagnostic difficulty, a finding documented only rarely previously, and we discuss its biologic significance.

Adenocarcinoma renal de células claras que debuta con metástasis vaginal / Clear cell kidney adenocarcinoma presented with vaginal metastasis

- Propósito: El Adenocarcinoma de Células Claras puede tener origen en diversos y distintos órganos pudiendo metastatizar en vagina, principalmente por vía linfática, presentando un pronóstico malo de supervivencia1.- Material y métodos: se presenta un caso clínico de una masa vaginal como forma de debut de un Adenocarcinoma Renal.- Resultados: ante una masa vaginal el diagnóstico diferencial debe incluir en primer lugar la patología local, pero no debe descartarse la patología a distancia 5.- Conclusiones: Las metástasis vaginales, al ser muy infrecuentes, son diagnósticos de exclusión en el que debemos incluir patología local y patología a distancia, siempre orientados por la Anatomía patológica del tumor (AU)

Cistitis glandular florida de tipo intestinal con extravasación de mucina: una lesión que simula un tumor / Florid cystitis glandularis of intestinal type with mucin extravasation: a mimic of tumour

En la vejiga se pueden observar una gran variedad de lesiones o cambios metaplásicos epiteliales. La sustitución extensa del urotelio por epitelio similar a la mucosa intestinal se ha considerado como una lesión premaligna. Sin embargo, la historia natural de la metaplasia intestinal y su comportamiento a largo plazo es desconocida. Presentamos un caso de cistitis glandular de tipo intestinal vejiga en un paciente joven. En la cistoscopia se observó un tumor bien circunscrito de 4 cm localizado en trígono. Histológicamente la lesión mostraba numerosas glándulas revestidas por epitelio de tipo intestinal sin atipia citológica correspondiente a la variedad intestinal de la cistitis glandular. Destacaba en este caso el depósito de un material basófilo en el estroma correspondiente a mucina. Se podía ver acúmulos de este material rodeados y comprimidos por tejido conectivo, simulando quistes mucosos. Este caso demuestra que en el estudio cistoscópico la cistitis glandular puede simular un tumor cuando la lesión es extensa. Y que la extravasación de mucina puede causar un problema de diagnóstico diferencial con un tumor maligno, un hallazgo que ha sido raramente documentado previamente. Se discute además el significado biológico de ese tipo de lesión (AU)

Sarcoma de Monte de Venus: una presentación infrecuente / Testicular germ-cell tumor in two siblings: a propos of a new case

Los sarcomas de partes blandas son raros. Tan sólo representan el 0,7 por ciento de los tumores malignos en el adulto, y el 1-3 por ciento de los tumores de vulva. Embriológicamente derivan del mesenquima primitivo y pueden asentar en cualquier parte del organismo.Existe gran variedad de tipos histológicos con más de 30 subtipos, siendo difícil la distinción entre ellos.A propósito de un caso de sarcoma en el Monte de Venus tratado en nuestro servicio realizamos una revisión de la bibliografía existente (AU)

[Extrinsic ureteral obstruction secondary to appendiceal mucocele]. / Obstrucción ureteral extrínseca secundaria a mucocele apendicular.

OBJECTIVE: To report a case of extrinsic ureteral obstruction arising from mucocele of the appendix and review the clinical, diagnostic and therapeutic aspects of this appendiceal pathology of interest in urology. METHODS: A 71-year-old female patient that had previously undergone radical gynecological surgery and postoperative radiotherapy presented with right lumbar pain. Patient evaluation by ultrasound, IVP and CT showed a pelvic mass causing right extrinsic ureteral obstruction. Release and reinsertion of the right ureter and appendectomy were performed. RESULTS: The anatomopathological study showed an appendiceal mucinous cystadenoma. The patient is asymptomatic after surgery. CONCLUSIONS: Appendiceal mucocele is a dilatation of the vermiform appendix due to collection of mucoid material that is frequently produced by a cystadenoma. The presenting feature is usually that of acute appendicitis. The definitive diagnosis is based on the anatomopathological findings. Treatment is by appendectomy for the benign tumors and by right hemicolectomy in a second stage procedure for malignant tumors. This appendiceal pathology should be taken into account in the differential diagnosis of right extrinsic ureteral obstruction.

[Post-surgical spindle cell nodule in kidney pelvis]. / Nódulo fusocelular post-quirúrgico en pelvis renal.

INTRODUCTION: The postoperative spindle cell nodule of the urinary tract is a being proliferative lesion similar to sarcoma in the microscopic exam. We present a case of modulein renal pelvis location. CASE: A woman presenting a stag horn lithiasis in left kidney was treated by LOC and percutaneous nephroscopy. Because of the large size of the stone a second intervention was required four weeks later. Then we discovered a 2 cm exophytic lesion in renal pelvis and removed it easily with a forceps. DISCUSSION: This kind lesion belong to the group of iatrogenic inflammatory pseudotumours, which are secondary to an injury that leads to a tissular repairing response. Differential diagnostic includes sarcomas. CONCLUSION: It is important that Urology and pathology specialist think of this tumour in patients having a recent surgical intervention. A mistake in the diagnosis would lead us to an unnecessary radical surgery.

Nódulo fusocelular post-quirúrgico en pelvis renal / The postoperative spindle cell nodule in renal pelvis

INTRODUCCIÓN: El nódulo fusocelular post-quirúrgico urinario es una lesión proliferativa benigna que simula anatomopatológicamente a los sarcomas. En este estudio presentamos un caso localizado en pelvis renal. CASO: Mujer con litiasis coraliforme en riñón izquierdo a la que se le practica LEOC y nefroscopia, debido a la gran superficie de la litiasis, la paciente se reinterviene 4 semanas más tarde para realización de 2º tiempo. En este procedimiento encontramos una lesión exofítica de 2 cm en pelvis renal que se extrae fácilmente con una pinza de cuerpos extraños. DISCUSIÓN: Estas lesiones están englobadas dentro del conjunto de pseudotumores inflamatorios yatrogénicos, cuya etiopatogenia es secundaria a una reparación del órgano ante una agresión. El diagnóstico diferencial debe establecerse con los sarcomas. CONCLUSIÓN: Es importante que tanto los urólogos como lo anatomopatólogos sospechen la existencia de esta lesión ante un antecedente reciente de cirugía, ya que un error diagnóstico nos puede llevar a realizar una cirugía radical innecesaria (AU)

[Retroperitoneal bronchogenic cyst mimicking adrenal gland tumor]. / Quiste broncogénico retroperitoneal simulando un tumor suprarrenal.

OBJECTIVE: To report a case of retroperitoneal bronchogenic cyst, an anomaly during the development of the primitive anterior intestine from which the bronchi and lungs are developed. METHODS/RESULTS: A 38-year-old male presented with left lumbar pain. Patient evaluation disclosed a left adrenal polycystic mass which was removed by surgery. Pathological analysis of the surgical specimen demonstrated a bronchogenic cyst. This case is compared with some of the few cases reported in the literature. CONCLUSIONS: Retroperitoneal bronchogenic cyst is a cause of retroperitoneal tumors in the splenic or hepato-renal region. Although it is uncommon, it should be taken into account when making the differential diagnosis.

[Inverted papilloma of the prostatic urethra]. / Papiloma invertido de uretra prostática.

The inverted papilloma is a rare urothelial tumor, and its localization at the prosthatic urethra is also exceptional. We present a case of inverted papilloma of the prostatic urethra in a 72 years-old male, with symptoms of urinary flow obstruction. The diagnose is obtained after urethrocistoscopy and transurethral resection at the same time. We discuss about the etiology, clinical presentation, diagnose and treatment of this rare tumor, making special attention to its malignancy ability.

Papiloma invertido de uretra prostática / Inverted papilloma of the prostatic urethra

El papiloma invertido es un raro tumor urotelial, y su localización en uretra prostática también es excepcional. Presentamos un caso de papiloma invertido de uretra prostática en un varón de 72 años con clínica de obstrucción al flujo urinario. El diagnóstico se obtuvo tras uretrocistoscopia y resección transuretral en el mismo acto. Discutimos sobre la etiología, forma de presentación clínica, diagnóstico y tratamiento de este raro tumor, haciendo especial hincapié en su capacidad de malignización (AU)

[Nephrogenic adenoma: study of 9 cases, including one of the urethra in a 14-year-old male]. / Adenoma nefrogénico: estudio de nueve casos, incluyendo uno de uretra en un varón de 14 años.

OBJECTIVES: To review our series of nephrogenic adenoma and compare our results with those reported in the literature. METHOD: The records of our Department of Pathology were reviewed to determine the cases of nephrogenic adenoma diagnosed at our center. The clinical features, diagnostic aspects, pathological findings, treatment and outcome are presented. RESULTS/CONCLUSIONS: Nephrogenic adenoma is a rare lesion, probably arising from nephrogenic metaplasia caused by injury to the urothelial mucosa. The site of presentation is frequently the bladder, followed by the urethra. The diagnosis is based on the histopathological findings, which can be occasionally equivocal. The cases described in the present series were benign. To date there is no established therapeutic approach. We performed TUR in two patients, antibiotic therapy was administered in one patient and 4 patients were managed conservatively. Two of our patients had no control evaluation following biopsy of the lesion. In 2 of the 4 patients that were managed conservatively, the lesion remitted spontaneously.

[Small cell undifferentiated carcinoma of the urinary bladder: report of a case]. / Carcinoma indiferenciado de células pequeñas en la vejiga urinaria: presentación de un caso.

Small cell carcinoma of the urinary bladder is an uncommon tumor. We report a case in a 80 year-old man. The patient had gross hematuria. Urographic and echographic studies revealed a sold tumor on the right wall of bladder. Pathologic study revealed a deeply invasive tumor composed of small, uniform, round and spindled shaped cells with hyperchromatic nuclei and numerous mitosis. The immunohistochemical reaction was positive for Neuron Especific Enolase and Keratin. No metastasis were found at clinical stating (T2 No Mo). We discuss the differencial diagnosis, prognosis and histogenesis of this tumor.