[Early-onset sarcomatoid renal carcinoma. Report of a new case and comparison of the same case with another appearing at a mature age]. / Carcinoma renal sarcomatoide de temprana aparición. Aportación de un nuevo caso y comparación del mismo con otro de aparición en edad madura.

OBJECTIVE AND METHODS: We report two new cases of this rare and aggressive tumour; one case appeared in the earliest age reported in the literature (case #2). We also review etiological, diagnostic and therapeutic features. RESULTS: Despite aggressive surgery and adjuvant chemotherapy it has a very poor prognosis, with disease progression within 6 months in both cases. CONCLUSIONS: Sarcomatoid renal cell carcinoma is an infrequent entity, extremely aggressive and requires radical surgery at the time of diagnosis due to its advanced stage, although results are poor. It can also appear in young people with the same aggressiveness than in adult age.

Carcinoma renal sarcomatoide de temprana aparición. Aportación de un nuevo caso y comparación del mismo con otro de aparición en edad madura / sarcomatoid renal cell carcinoma appearing at young age. A new case and comparison with another case appearing in a mature age

Objetivo y Métodos: Bajo el formato de casos clínicos aportamos dos nuevos casos de este raro y agresivo tumor, siendo la edad de presentación de uno de ellos (caso clínico nº 2) la más temprana recogida en la literatura. Asimismo, revisamos aspectos relativos a la etiología, diagnóstico y tratamiento. Resultados: A pesar de cirugía muy agresiva y tratamiento adyuvante, el pronóstico es infausto, con progresión de la enfermedad en los primeros 6 meses en ambos casos. Conclusiones: El carcinoma sarcomatoide de riñón es una entidad infrecuente, extremadamente agresiva y que requiere cirugía radical debido a su avanzado estado en el momento del diagnóstico, aunque con pobres resultados. Puede aparecer también en la juventud con la misma agresividad que en la edad adulta Carcinoma renal sarcomatoide. Regresión espontánea. Patología del tumor renal (AU)

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[Prognostic value of inverted papilloma of the lower urinary tract]. / Valor pronóstico del papiloma invertido del tracto urinario inferior.

OBJECTIVE: Inverted papilloma of the urothelium accounts for 2.2% of urothelial neoplasms. Its oncologic significance is unclear; its potential for recurrence and/or progression is not well-known. Our experience from 1976 to 1999 is reviewed. METHODS: From 1976 to 1999, 31 patients with urothelial inverted papilloma of the lower urinary tract have been treated in our service: 17 presented previous and/or synchronous association with urothelial carcinoma (group I) and 14 had primary inverted papilloma (group II). The recurrence and progression rates for each group were determined and compared. The overall recurrence and progression rates were also determined. Two patients (one from each group) were lost to follow-up. The remaining 29 patients had a mean follow-up of 51.3 months (range 3-125). RESULTS: 12 patients (41.4%) showed recurrence in the form of bladder carcinoma; 10 from group I (10/16; 62.3%) and 2 from group II (2/13; 15.4%) (p < 0.05). Mean time to recurrence was 17.9 months (range 3-58). Disease free interval was higher in group II (p < 0.05). Progression to infiltrating tumor was observed in three patients; all three had associated superficial bladder carcinoma (group I). The mean time to progression was 30.7 months (range 18-38). No statistically significant differences were found in the percentage of progression between both groups. CONCLUSIONS: Inverted papilloma of the lower urinary tract showed a high incidence of association with urothelial carcinoma and a high recurrence rate, even in primary tumors. Therefore it should be considered a tumor of low grade malignancy that should be followed regularly.

[Inferior vena cava leiomyosarcoma: report of a new case and review of the literature]. / Leiomiosarcoma de vena cava inferior: aportación de un nuevo caso y revisión de la literatura.

OBJECTIVE/METHODS: To present an additional case of leiomyosarcoma of the inferior vena cava and review the literature, with special reference to the etiology, diagnosis and treatment of this rare tumor. RESULTS: The patient was submitted to radical surgery and short course radiotherapy. Twelve months thereafter, the patient is asymptomatic and disease-free. CONCLUSIONS: Leiomyosarcoma of the inferior vena cava is a rare and aggressive tumor. Treatment is by aggressive and radical surgery.

[Bladder leiomyoma during pregnancy]. / Leiomioma vesical durante el embarazo.

OBJECTIVE: To describe an additional case of rapidly growing leiomyoma of the bladder in a pregnant woman. METHODS: A case of leiomyoma of the bladder in a woman at 8 months of pregnancy is presented. Transurethral resection was performed, but the tumor recurred a few weeks later. The tumor was resected by partial cystectomy after delivery. CONCLUSIONS: Leiomyoma of the bladder is an uncommon benign lesion that is successfully managed by surgical resection. The rapid recurrence of the tumor in our patient can be ascribed to the hormonal changes during pregnancy.

[Hemangiopericytoma of the renal sinus. Report of a case and review of the literature]. / Hemangiopericitoma del seno renal. A propósito de un caso y revisión de la literatura.

OBJECTIVES: Since the initial report of renal hemangiopericytoma by Black and Heinemann in 1955, only 24 cases of this rare vascular neoplasm, involving the renal capsule, parenchyma or sinus have been described in the world literature. Herein we describe an additional case and review the literature. METHODS: We report on a 65-old woman in whom a 5 x 4 cm solid mass was incidentally found in the left sinus. The tumor compressed the renal pelvis and caused hydronephrosis and parenchymal atrophy. A radical left nephrectomy was performed. Histological and immunological studies revealed a hemangiopericytoma of renal sinus soft tissues. RESULTS: The patient did well postoperatively and remains disease-free at the present time. CONCLUSIONS: Although there are other histological and clinical criteria indicative of worse prognosis, the malignancy of hemangiopericytoma is determined by the presence of hematogenous metastases.

[Granulomatous prostatitis. Analysis of 15 cases and review of the literature]. / Prostatitis granulomatosa. Análisis de 15 casos y revisión de la literatura.

OBJECTIVES: The present study describes our experience with granulomatous prostatitis, an uncommon disease entity, with special reference to the etiological factors and the clinical and pathological features. METHODS: 15 cases of granulomatous prostatitis seen at our department over a 2-year period were retrospectively analyzed. RESULTS: The most frequent etiological factor was surgery (TUR) or prostatic needle biopsy (53%). Prostate cancer was suspected in 8 patients based on the findings of DRE. CONCLUSIONS: The diagnosis of granulomatous prostatitis is based on the histological findings. Despite its low incidence, it is currently diagnosed more frequently due to the increase in TURP and prostatic biopsy procedures and the widespread use of intravesical BCG therapy for some superficial bladder tumors.

[Adrenal epithelial cyst of embryonal vestiges]. / Quiste epitelial suprarrenal de restos embrionarios.

A 10 x 6.5 cm cyst with ciliated cell lining was removed from a 43-year-old woman. The immunohistochemical studies demonstrated that the cyst cells expressed keratins (Lu 5+) and the adrenal cortical cells did not, suggesting that the cyst lining was not derived from adrenal cells. The presence of ciliated cells indicates that the cyst was derived from embryonal vestiges.

[Experimental suture of the rat ureter]. / Sutura experimental del uréter en la rata.

The urological complications of renal transplantation in the rat when the bladder dome is used prompted us to study the viability of uretero-ureteral anastomosis with microsurgical techniques. The purpose of the study was to improve certain aspects of the technique employed in renal transplantation in the rat. For the study we utilized 27 Wistar rats. The left ureter was transected and anastomosed by free extramucosal sutures using the 180 degrees biangulation technique. Two groups of 13 rats were studied. For group A, a 6-0 nylon guide was used for the anterior aspect, whereas for group B anastomosis was performed without a guide. A urographic study was performed prior to sacrifice 21 days post-operatively. The pathological analysis included determination of foreign body reaction at the anastomotic site and the status of the renal parenchyma. The findings demonstrated better results were achieved in comparison with the technique previously employed using the bladder dome. Although slightly longer, using a guide seems to afford more reliable results, and is a useful technique in renal transplantation.

[Malignant rhabdoid tumor of the kidney: 2 cases and a review of the literature]. / Tumor rabdoide maligno renal: presentación de dos casos y revisión de la literatura.

Report of the microscopic, ultrastructural and immunohistochemical findings of two malignant rhabdoid tumors of the kidney in two males aged 2 1/2 and 19 months. The incidence of this tumor in our files is 1.9% of all the renal tumors of infancy. Both cases were formally considered to be rhabdomyosarcomatous variants of nephroblastomas. Microscopically a slightly cohesive polygonal cell proliferation is shown. The cells have intracytoplasmatic hyaline inclusions ultrastructurally identifiable as intermediate filament bundles, showing positivity to vimentin in the immunohistochemical technique. Malignant rhabdoid tumors are referred to as very aggressive tumors with a poor response to treatment and a high mortality rate. Association with central nervous tumors and hypercalcemia has been reported. The clinical and pathologic features make it possible to differentiate them from nephroblastomas, although the histogenesis is not definitely established.