[Expression of p21ras in locally confined renal adenocarcinoma and its prognostic implications]. / Expresión de la proteína p21ras en el adenocarcinoma renal localmente confinado y sus implicaciones pronósticas.

OBJECTIVE: The p21ras protein is encoded by the three ras genes (H-, K- and N-ras) and participate in the regulation of normal cell growth and cell differentiation. The objective of this study is to determine the expression of this protein in locally confined renal cell carcinoma, as well as its relations with different histopathological variables and their prognostic implications. METHOD: 58 renal cell carcinomas, in pT1-T3a N0 M0 (TNM 1997) stages, treated by radical or partial nephrectomy with curative intention. We analysed different clinical and anatomopathological variables, as well as expression of p21ras in paraffinated tissue, using immunohistochemical techniques. RESULTS: The mean percentage of stained nuclei was 6.1%, with a range lying between 0 and 45%. We did not obtain statistically significant association between expression of p21ras and the tumour size (p = 0.698), the nuclear grade (p = 0.676) or the histopathological stage (p = 0.095). The survival analysis also did not show significant differences when we stratified the patients using the mean value of the sample as reference point (p = 0.134). CONCLUSIONS: Expression of p21ras was not demonstrated to be related to any of the histopathological variables analysed: size, grade and stage, or with survival. Therefore, this protein does not appear to be related to the evolution of renal cell carcinoma.

[Primary testicular lymphoma. Report of a case]. / Linfoma testicular primario. Presentación de un caso.

Case report of a primary testicular lymphoma in a sixty-two years old man, presenting initially as an enlargement of the testicle as the only symptom. Orchiectomy of left testicle was performed, with the diagnosis of Non-Hodgkin B lymphocytic lymphoma. The treatment applied was CHOP, presenting poor evolution with cerebral metastasis. He dead twenty-five months later diagnosis.

[Spontaneous extraperitoneal bladder rupture. Report of a case]. / Rotura vesical extraperitoneal espontánea. Presentación de un caso.

The spontaneous extraperitoneal bladder rupture is an uncommon event and the diagnosis is very difficult. It is defined like the rupture of bladder wall in absence of traumatism or iatrogenic techniques. The extravasation usually is produced into the peritoneal cavity, because of the greater weakness of the vesical dome. The diagnosis is based on the retrograde cystography, being necessary the surgical treatment in the intraperitoneal rupture, while the extraperitoneal one, could be treated in a conservative way with a vesical catheter. Here we present a case of spontaneous extraperitoneal bladder rupture, with oliguria, abdominal pain and a right hypochondrius mass as clinic presentation. Due to this, the diagnosis was made by the TAC, in which it was appreciated a continuity solution in the anterior bladder wall, with a contrast extravasation through the anterior abdominal wall. The retrograde cystography confirmed the definitive diagnosis. The treatment followed was based on the keeping of the vesical catheter and antibiotherapy.