[Neuroendocrine tumor in a horseshoe kidney: relative risk of association of two related entities]. / Tumor neuroendocrino en el riñón en herradura: riesgo relativo de asociacion de dos entidades relacionadas.

OBJECTIVE: Primary renal neuroendocrine tumor (NET) is a very rare neoplasia with a higher frequency of appearance in horseshoe kidney (HK). From 1966, when Resnick published the first case, approximately 2 of each 10 new cases appear in kidneys with this malformation. From the diagnosis of a case of primary NET in a HK, we calculated the relative risk of their presentation as associated entities. METHODS: 63-year-old male with the incidental diagnosis of an 8 cm solid renal mass in the isthmus of a HK. At the time of diagnosis there were no signs of local-regional extension of the primary neoplasia neither metastasis. The patient underwent nephrectomy and pathologic study confirmed the diagnosis of NET. After a systematic review using multiple search platforms (Blackwell, Ovid, Proquest, PubMed, Science Direct, and Wiley) our case is No. 11 of NET in HK from a total of 57 renal NET. RESULTS: Despite its very low frequency 19.3% of NET present in HK. Using 1/400 as the incidence of HK in general population, the calculated relative risk in HK is 77 times greater than that of a normal kidney CONCLUSIONS: The relative risk of presentation of NET in HK is enormously superior than that of general population. This diagnosis must be suspected in patients with HK, mainly if the tumor is located in the renal isthmus. Due to its potentially aggressive clinical course and poor response to other therapies, measures for improvement of surgical treatment must be considered priority.

Tumor neuroendocrino en el riñón en herradura: riesgo relativo de asociación de dos entidades relacionadas / Neuroendocrine tumor in a horseshoe kidney: relative risk of association of two related entities

Objetivo: El tumor neuroendocrino (TNE) renal primario es una neoplasia muy rara aunque con una mayor frecuencia de aparición en el riñón en herradura (RH). Desde que en 1966 Resnik publicó el primer caso, aproximadamente 2 de cada 10 nuevos diagnósticos aparecen en riñones con esta malformación. A partir del diagnóstico de un caso de TNE primario en RH, calculamos su riesgo relativo de presentación como entidades asociadas Métodos: Varón de 63 años al que descubrimos incidentalmente una masa sólida de 8 cm. ubicada en el istmo de un RH. En el momento del diagnóstico no se evidenciaron signos de extensión locoregional, sospecha de otra neoplasia primaria extrarrenal. El paciente fue sometido a heminefrectomía y el estudio histológico confirmó el diagnóstico de TNE. Tras una revisión sistemática de la literatura utilizando múltiples plataformas (Blackwell, Ovid, Proquest, PubMed, Science Direct y Wiley), el nuestro, representa el caso decimoprimero de TNE en RH de un total de 57 TNE originados en riñón. Resultados: Pese a su escasa frecuencia, un 19.3% de los TNE se presentan en un RH. Utilizando una incidencia de RH en la población general de 1/400, el riesgo relativo calculado de TNE en RH respecto al de un riñón normal es 77 veces mayor. Conclusiones: El riesgo relativo de presentación de un TNE en el RH es enormemente superior al de la población general. Este diagnóstico debe sospechase en pacientes con RH, sobre todo si el tumor asienta en el istmo renal. Dado su potencial curso clínico agresivo y pobre respuesta a otras terapias, las medidas encaminadas a mejorar el tratamiento quirúrgico deben ser consideradas prioritarias (AU)

Objective: Primary renal neuroendocrine tumor (NET) is a very rare neoplasia with a higher frequency of appearance in horseshoe kidney (HK). From 1966, when Resnick published the first case, approximately 2 of each 10 new cases appear in kidneys with this malformation. From the diagnosis of a case of primary NET in a HK, we calculated the relative risk of their presentation as associated entities. Methods: 63-year-old male with the incidental diagnosis of an 8 cm solid renal mass in the isthmus of a HK. At the time of diagnosis there were no signs of local-regional extension of the primary neoplasia neither metastasis. The patient underwent nephrectomy and pathologic study confirmed the diagnosis of NET. After a systematic review using multiple search platforms (Blackwell, Ovid, Proquest, PubMed, Science Direct, and Wiley) our case is No. 11 of NET in HK from a total of 57 renal NET. Results: Despite its very low frequency, 19.3% of NET present in HK. Using I/400 as the incidence of HK in general population, the calculated relative risk in HK is 77 times greater than that of a normal kidney. Conclusions: The relative risk of presentation of NET in HK is enormously superior than that of general population. This diagnosis must be suspected in patients with HK, mainly if the tumor is located in the renal isthmus. Due to its potentially aggressive clinical course and poor response to other therapies, measures for improvement of surgical treatment must be considered priority (AU)

[Endoscopic treatment of the vesicoureteral reflux in children: preliminary experience with the subureteral injection of Coaptite]. / Tratamiento endoscópico del reflujo vesicoureteral en pediatría: experiencia preliminar con la inyección subureteral de Coaptite.

OBJECTIVE: To review our experience in the endoscopic treatment of vesicoureteral reflux (VUR) in children with the subureteral injection of calcium hydroxyapatite (Coaptite). METHODS: The serie includes thirteen children whose age ranged between 6 and 13 years. The Coaptite implant was injected subureterally to 20 ureteral units (UU) affected by VUR grades I-IV. VUR was unilateral in six patients (46%), bilateral in seven (54%). There were 7 primary cases and 6 secondary to bladder dysfunction and duplex systems. RESULTS: Mean follow-up was 19 months (6-28 months). VUR was cured in 75% of cases after a single injection. A second injection resolved 2 out of 4 treated UU (50%) rendering a global success rate of 85%. This cure rate was achieved for 13 and 7 procedures treating primary and secondary VUR, respectively. 77% of patients reported no adverse events with only 23% of them complaining of transient mild lumbar and hypogastric discomfort limited to the first postoperative day. In 2 children postoperative urinary infection was detected. CONCLUSIONS: Endoscopic subureteral injection with Coaptite is a simple technique well tolerated in children. In 85% of primary and secondary cases cure was achieved with minimal morbidity.