[Ureteral triplication whitout other associates malformations]. / Triplicidad ureteral sin otras malformaciones asociadas.

We report a case of ureteral type III triplication according to Smith's classification, without associated anomalies of the urinary tract. The revision of the bibliography indicates the rarity of this maldformacion and its frequent association with other urinary and extraurinary malformations. The absence of associate malformations in this case increases his exceptionality.

Triplicidad ureteral sin otras malformaciones asociadas / Ureteral triplication whitout other associates malformations

Se presenta un caso de triplicidad ureteral tipo III según la clasificación de Smith, sin anomalías del tracto urinario asociadas. La revisión de la bibliografía indica la rareza de esta malformación y su frecuente asociación con otras malformaciones urinarias y extraurinarias, por lo que la ausencia de malformaciones asociadas hace más excepcional el caso presentado (AU)

We report a case of ureteral type III triplication according to Smith’s classification, without associated anomalies of the urinary tract. The revision of the bibliography indicates the rarity of this maldformacion and its frequent association with other urinary and extra urinary malformations. The absence of associate malformations in this case increases his exceptional (AU)

[Testicular tumors: association between preoperative clinical, radiological and immuno-serological factors, and histology and stage]. / Relación de los factores clínicos, ecográficos e inmunoserológicos preoperatorios con la histología y el estadío de las neoplasias testiculares.

OBJECTIVES: To evaluate and quantify the association between clinical, ultrasound and immunoserological data and histologic type and stage of testicular tumors. METHODS: We analyze a cohort of 80 patients who underwent orchiectomy for testicular neoplasia. Mean patient age was 30.4 years. Past medical history, first symptoms, time from first symptom to operation, physical examination and ultrasound data, and preoperative serum levels of alpha-fetoprotein and beta HCG were retrospectively collected. RESULTS: Patients with non seminomatous germ cell tumor (NSGCT) had a significantly lower mean age (23.7 yr.) than patients with pure seminoma (41.3 yr.), and these latter a significantly lower age than patients with non germinal tumors (50.7 yr.). Initial presentation with general malaise or lumbar pain increased 2.56 times the relative risk of having a tumor in advanced stage (higher than stage I) . Presence of gynecomastia increased 16.5 times the relative risk of having a non germ cell tumor, due to the inclusion of Leydig's tumors in this group. Detection of heterogeneous nodules by ultrasound increased 4.5 times the risk of having a non seminomatous germ cell tumor. Preoperative elevation of alpha-fetoprotein ruled out the existence of seminoma and non germ cell tumor; whereas preoperative elevation of beta HCG increased 3.21 times the risk of having a non seminomatous germ cell tumor. No significant association was shown between preoperative tumor markers and tumor stage. CONCLUSIONS: The existence of gynecomastia, age, detection of heterogeneous nodules on ultrasound, and preoperative alpha-fetoprotein and beta HCG are relevant data in relation to histological type of tumor. Lumbar pain or malaise are clinical data associated with tumor stage.

Relación de los factores clínicos, ecográficos e inmunoserológicos preoperatorios con la histología y el estadío de las neoplasias testiculares / Testicular tumors: association between preoperative clinical, radiological and immuno-serological factors, and histology and stage

OBJETIVO: Determinar y cuantificar larelación que existe entre los datos clínicos ecográficose inmunoserológicos y el tipo histológico y estadío delas neoplasias testiculares.MÉTODOS: Se analizó una cohorte de 80 casos sometidosa orquiectomía por neoplasia testicular. La mediade edad de los pacientes fue de 30,4 años. Se recogióde manera retrospectiva los antecedentes delpacientes, la naturaleza del primer síntoma, el tiempodesde el primer síntoma hasta la intervención, los datosde la exploración clínica y ecografía y los niveles preoperatoriosde alfa-fetoproteína y beta HCG.RESULTADOS: Los pacientes con Tumor de NoSeminmatoso de Células Germinales (TNSCG) teníanuna edad media (23,7 años) significativamente menorque la de los pacientes con seminoma puro (41,3años), y ésta, a su vez, significativamente menor que laedad de los pacientes con Tumores No Germinales(TNG) (50,7 años). La presencia como síntoma inicialde malestar general o dolor lumbar aumentó el riesgorelativo de padecer un tumor en un estadío avanzado(superior al estadío I) 2,56 veces. La existencia de ginecomástiaaumentó 16,5 veces el riesgo relativo depadecer un TNG, debido a la presencia en este grupode los tumores de Leydig. La observación de nódulosheterogéneos en la ecografía incrementó el riesgo depadecer un TGNS 4,5 veces. La elevación preoperatoriade la alfa-fetoproteína descartó la existencia de unseminoma y de un TNG, mientras que la elevación preoperatoriade la beta HCG aumentó el riesgo depadecer un TGNS 3,21 veces. No se observó unarelación significativa entre los niveles preoperatorios deambos marcadores y el estadío tumoral.CONCLUSIONES: La existencia de ginecomastia, laedad, la visualización de nódulos heterogéneos en laecografía y los niveles preoperatorios de alfa-fetoproteinay beta HCG son datos relevantes relacionadoscon el tipo histológico de tumor. La sensación de dolorlumbar o malestar general es un dato clínico relacionadocon el estadío tumoral

OBJECTIVES: To evaluate and quantify the ;;association between clinical, ultrasound and immunoserological ;;data and histologic type and stage of ;;testicular tumors. ;;METHODS: We analyze a cohort of 80 patients who ;;underwent orchiectomy for testicular neoplasia. Mean ;;patient age was 30.4 years. Past medical history, first ;;symptoms, time from first symptom to operation, physical ;;examination and ultrasound data, and preoperative ;;serum levels of alpha-fetoprotein and beta HCG were ;;retrospectively collected. ;;RESULTS: Patients with non seminomatous germ cell ;;tumor (NSGCT) had a significantly lower mean age ;;(23.7 yr.) than patients with pure seminoma (41.3 yr.), ;;and these latter a significantly lower age than patients ;;with non germinal tumors (50.7 yr.). Initial presentation ;;with general malaise or lumbar pain increased 2.56 ;;times the relative risk of having a tumor in advanced ;;stage (higher than stage I) . Presence of gynecomastia ;;increased 16.5 times the relative risk of having a non ;;germ cell tumor, due to the inclusion of Leydig`s tumors ;;in this group. Detection of heterogeneous nodules by ;;ultrasound increased 4.5 times the risk of having a non ;;seminomatous germ cell tumor. Preoperative elevation ;;of alpha-fetoprotein ruled out the existence of seminoma ;;and non germ cell tumor; whereas preoperative elevation ;;of beta HCG increased 3.21 times the risk of having ;;a non seminomatous germ cell tumor. No significant ;;association was shown between preoperative tumor ;;markers and tumor stage. ;;CONCLUSIONS: The existence of gynecomastia, age, ;;detection of heterogeneous nodules on ultrasound, and ;;preoperative alpha-fetoprotein and beta HCG are relevant ;;data in relation to histological type of tumor. Lumbar ;;pain or malaise are clinical data associated with tumor ;;stage