RESUMO
Müllerian derivatives are a frequent finding in patients with external genital ambiguity. In cases in which their removal is indicated, traditional surgical approaches are both invasive and associated with risks. We report a case of mixed gonadal dysgenesis in which a large prostatic utricle was successfully removed via laparoscopy.
Assuntos
Disgenesia Gonadal Mista/cirurgia , Laparoscopia , Ductos Paramesonéfricos/anormalidades , Disgenesia Gonadal Mista/diagnóstico por imagem , Disgenesia Gonadal Mista/genética , Humanos , Lactente , Cariotipagem , Masculino , Ductos Paramesonéfricos/cirurgia , UltrassonografiaRESUMO
AIMS: The authors compare their experience of 17 cases of sacrococcygeal teratoma (SCT) with the literature in an attempt to clarify the natural history of this tumor and to identify factors related to its prognosis and management. METHODS: The obstetrical, neonatal and surgical data were analyzed for 17 cases of SCT observed between July 1985 and December 1998. RESULTS: Three fetuses died in utero or shortly after birth. In the remaining 14, the tumors were removed. Twelve of the infants are currently tumor-free, with good sphincter control and lower-limb function. The remaining two died: one had a malignant tumor, and the other had a recurrence of an embryonal carcinoma. Recurrent tumors (mature histotypes) were also removed from two of the 12 patients who survived. CONCLUSIONS: Benign SCTs generally have favorable prognosis. Negative prognostic factors for SCT include solid tumors, those detected early in pregnancy, malignant histotypes, polyhydramnios, placentomegaly, and fetal hydrops.
Assuntos
Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/cirurgia , Teratoma/diagnóstico , Teratoma/cirurgia , Resultado do Tratamento , Peso ao Nascer , Cóccix , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Recidiva Local de Neoplasia , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Sacro , Neoplasias da Coluna Vertebral/mortalidade , Teratoma/mortalidadeRESUMO
The term "ureteropelvic junction disease" defines any form of hydronephrosis consequent to a congenital anomaly of the ureteropelvic junction. It is one of the most common congenital urological anomalies. Over one third of patients have an associated uropathy. The etiology is not clear: an error in the embryonic development with consequent abnormal anatomy and function of ureteropelvic junction is suggested. The clinical presentation is the determining factor in its management. The widespread use of pre- and neonatal sonography has originated a new population of asymptomatic patients with no clearcut indication for surgery. For these patients, a complete follow-up is required to prevent renal function impairment. Surgery is mandatory for symptomatic patients. When indicated, Anderson-Hynes pyeloplasty is the gold standard surgical technique.
