[Therapeutic effect of mitomycin C in the immediate postoperative period in patients with intermediate-risk non-muscle-invasive bladder tumors]. / Efecto terapéutico de mitomicina C en el postoperatorio inmediato de pacientes con tumores vesicales no músculo invasores de riesgo intermedio.

INTRODUCTION: Approximately 70-85% of transitional bladder cell carcinomas are non-muscle-invasive. After an initial surgery, around 60-90% will have a recurrence, being the highest risk period the first two years. Urothelium instability could be the main reason for recurrence in mid grade tumours, reason why a single dose of a chemotherapy after transurethral resection of the bladder (TURB) might be insufficient. That is why a deferred therapy in occasions associated with maintenance is recommended. PATIENTS AND METHODS: A prospective, controlled and randomized study was performed. We included non-muscle-invasive mid risk bladder tumours. All patients had initially a TURB performed and were randomized to receive a single dose of mitomycin C (MMC), in the immediate postoperative period. RESULTS: A total of 105 patients were included. Mean follow-up was 22, 70 +/- 8, 15 months. MMC was administered to 53 patients. Of these 66, 0% had no recurrence and 34.0% had a non-muscle-invasive recurrence. Of the 52 patients in the non MMC group, 53.8% had no recurrence and 44.2% had a non-muscle-invasive recurrence and only 1 patient had a muscle-invasive progression. We did not find significantly differences in time to recurrence in mid risk tumours when using immediate postoperative single dose of MMC or deferred therapy. There was only one case of myelosuppression. DISCUSSION: In mid risk non-muscle-invasive tumors, some studies suggest that early intravesical instillation of chemotherapy reduces the risk of recurrence after TURB. We could not show significantly differences when comparing postoperatorive MMC versus traditional deferred instillations.

[Therapeutic effect of mitomycin C in the immediate postoperatory in patients with low-risk non-muscle-invasive bladder tumours]. / Efecto terapéutico de mitomicina C en el postoperatorio inmediato de pacientes con tumores vesicales no músculo invasores de bajo riesgo.

INTRODUCTION: Bladder cancer is a disease with a high prevalence due to its recurrence rate. Transurethral resection of the bladder (TURB) is the treatment in initial stages. Nevertheless, a high percentage of non-muscle-invasive tumors treated will have a recurrence 1-2 years afterwards. Adjuvant quemotherapy or immunotherapy after TURB has been administered in order to decrease the rate of recurrence and to prevent progression. PATIENTS AND METHODS: A prospectived, controlled and randomized study was performed. We included 100 patients with non-muscle-invasive and bladder tumors the low grade. All patients had initially a TURB performed and were randomized to either receive or not a single dose mitomycin C (MMC) in the immediate postoperatory. RESULTS: All low grade tumors was less than 3 cm. Mean follow-up was 26.43 +/- 7.65 months. MMC was administered in 49 patients, of these, 67.3% had no recurrence and 32.7% had a non-muscle-invasive recurrence. Of the 51 patients in the non mitomycin, 51% had no recurrence while 47% had a non-muscle-invasive recurrence, and 2% had a muscle-invasive progression. We found significantly differences in time to recurrence among the two groups. SUMMARY: We found a greater time to recurrence in the group of single dose adjuvant MMC being this difference statistically significantly when comparing with the other group.

Efecto terapéutico de Mitomicina C en el postoperatorio inmediato de pacientes con tumores vesicales no músculo invasores de riesgo intermedio / Therapeutic effect of mitomycin C in the immediate postoperative period in patients with intermediate-risk non-muscle-invasive bladder tumors

Introducción: Aproximadamente del 70-85% de los carcinomas de células transicionales de vejiga no invaden la muscular propia. La recidiva después de la cirugía se cifra en un 60-90% de pacientes, siendo el periodo de alto riesgo los dos primeros años. La causa fundamental de recidiva en tumores de riesgo intermedio podría ser la inestabilidad del urotelio, por lo que la instilación única de un quimioterápico después de la RTU podría considerarse insuficiente, recomendándose un tratamiento diferido asociado con mantenimiento en algunos casos. Pacientes y Métodos: Estudio prospectivo, controlado y randomizado. Sólo se incluyeron pacientes con tumores vesicales no músculo-invasores de grado intermedio. Todos los pacientes fueron sometidos inicialmente a RTU y posteriormente randomizados para recibir Mitomicina C (MMC) postoperatoria en dosis única. Resultados: Se incluyeron 105 pacientes. La media de seguimiento fue de 22,70±8,15 meses. Se administró MMC en 53pacientes, de los cuales el 66% no recidivó y el 34% lo hicieron como tumor vesical no invasor. De los 52 pacientes que no recibieron MMC, el 53,8% no recidivaron, el 44,2% recidivaron como tumor no invasor y sólo un caso recurrió como tumor invasor.En cuanto al tiempo libre de enfermedad, no se encontraron diferencias significativas en los que se empleó MMC postoperatoriao tratamiento diferido. Sólo existió un caso de mielosupresión. Discusión: En tumores no músculo invasores de medio riesgo, diversos estudios sugieren que una instilación intravesical inmediata de un quimioterápico disminuye el riesgo de recidiva después de la RTU. No hemos logrado demostrar diferencias significativas al comparar la MMC postoperatoria frente a las instilaciones diferidas tradicionales (AU)

Introduction: Approximately 70-85% of transitional bladder cell carcinomas are non-muscle-invasive. After an initial surgery, around 60-90% will have a recurrence, being the highest risk period the first two years. Urothelium instability could be the main reason for recurrence in mid grade tumours, reason why a single dose of a chemotherapy after transurethral resection of the bladder (TURB) might be insufficient. That is why a deferred therapy in occasions associated with maintenance is recommended. Patients and methods: A prospective, controlled and randomized study was performed. We included non-muscle-invasive midrisk bladder tumours. All patients had initially a TURB performed and were randomized to receive a single dose of mitomycin C (MMC), in the immediate postoperative period. Results: A total of 105 patients were included. Mean follow-up was 22, 70±8, 15 months. MMC was administered to 53patients. Of these 66, 0% had no recurrence and 34,0% had a non-muscle-invasive recurrence. Of the 52 patients in the non MMC group, 53,8% had no recurrence and 44,2% had a non-muscle-invasive recurrence and only 1 patient had a muscle invasive progression. We did not find significantly differences in time to recurrence in mid risk tumours when using immediate postoperative single dose of MMC or deferred therapy. There was only one case of myelosuppression. Discussion: In mid risk non-muscle-invasive tumors, some studies suggest that early intravesical instillation of chemotherapy reduces the risk of recurrence after TURB. We could not show significantly differences when comparing postoperatorive MMC versus traditional deferred instillations (AU)

Efecto terapéutico de Mitomicina C en el postoperatorio inmediato de pacientes con tumores vesicales no músculo invasores de bajo riesgo / Therapeutic effect of mitomycin C in the immediate postoperatory in patients with low-risk non-muscle-invasive bladder tumours

Introducción: El cáncer vesical es una de las enfermedades con más alta prevalencia entre los distintos tipos de neoplasia debido a su tendencia a la recidiva. El tratamiento en las etapas iniciales es la resección transuretral (RTU). Sin embargo, después de la RTU de un tumor vesical no músculo invasor, un porcentaje alto recidivarán en 1-2 años. Por esta razón, se ha propuesto la administración de quimioterapia o inmunoterapia adyuvante después de la RTU en un intento de disminuir la recidiva y prevenir la progresión. Pacientes y métodos: Estudio prospectivo, controlado y randomizado. Se incluyeron 100 pacientes con tumores vesicales no músculo-invasores de bajo riesgo. Todos los pacientes sometidos inicialmente a RTU y posteriormente randomizados para recibir Mitomicina C (MMC) postoperatoria en dosis única. Resultados: Todos los tumores eran menores de 3 cm. La media de seguimiento fue de 26,43 ± 7,65 meses. Se administró MMC en 49 pacientes, de los cuales el 67,3% no recidivó y el 32,7% lo hicieron como tumor vesical no invasor. Delos 51 pacientes que no recibieron MMC, el 51% no recidivaron, el 47% recidivaron como tumor no invasor y el 2% como tumor invasor. Se encontraron diferencias significativas en cuanto al tiempo libre de enfermedad según se empleara MMC postoperatoria o nada. Conclusiones: Cuando evaluamos a los pacientes con carcinoma vesical no músculo invasor de bajo riesgo, pertenecientes a un solo centro sanitario y con dosis alta de MMC en dosis única tras la RTU, evidenciamos un mayor tiempo libre de enfermedad estadísticamente significativa frente a los casos en los que no se utilizó ningún tratamiento (AU)

Introductión: Bladder cancer is a disease with a high prevalence due to its recurrence rate. Transurethral resection of the bladder (TURB) is the treatment in initial stages. Nevertheless, a high percentage of non-muscle-invasive tumors treated will have a recurrence 1-2 years afterwards. Adjuvant quemotherapy or immunotherapy after TURB has been administered in order to decrease the rate of recurrence and to prevent progression. Patients and methods: A prospectived, controlled and randomized study was performed. We included 100 patients with non-muscle-invasive and bladder tumors the low grade. All patients had initially a TURB performed and were randomized to either receive or not a single dose mitomycin C (MMC) in the immediate postoperatory. Results: All low grade tumors was less than 3 cm. Mean follow-up was 26,43±7,65 months. MMC was administered in 49 patients, of these, 67,3% had no recurrence and 32,7% had a non-muscle-invasive recurrence. Of the 51 patients in the non mitomycin, 51% had no recurrence while 47% had a non-muscle-invasive recurrence, and 2% had a muscle invasive progression. We found significantly differences in time to recurrence among the two groups. Summary: We found a greater time to recurrence in the group of single dose adjuvant MMC being this difference statistically significantly when comparing with the other group (AU)

[Effectiveness and tolerability of zoledronic acid in the treatment of metastatic prostate cancer]. / Efectividad y tolerabilidad del acido zoledrónico en el tratamiento del cancer de próstata metastásico.

OBJECTIVES: To assess the effectiveness and tolerability of zoledronic acid in prostate cancer patients with bone metastases at the hormone-sensitive (HS) and hormone-independent (HI) stages. MATERIALS AND METHODS: A nationwide, observational, prospective, open and multi-centre trial was devised, with a total of 218 male patients diagnosed with prostate cancer at the HS stage (36%) or HI stage (64%) who were administered zoledronic acid (4 mg/IV/month for 6 months) in addition to their specific oncological treatment. Effectiveness was assessed by the following means: 1) Assessment of the improvement in pain and mobility; 2) Incidence and time to onset of skeletal-related events (SREs) and 3) Analysis of bone markers. Tolerability was assessed by means of registering the number and type of adverse effects. A satisfaction survey was carried out amongst the patients after the end of the trial. RESULTS: Out of the 218 patients, 170 (78%) were evaluable for effectiveness. A decrease in pain ratings at rest and during movement was observed in all patients, whether in the HS or HI groups (p < 0.0001). Improved mobility was observed likewise (p = 0.005), as was quality of life. The global incidence of skeletal events was 11.2%, with a time to onset of SREs of 10.7 months. There were no significant differences observed between HS vs. HI patients. Osteolysis markers (N-telopeptide) decreased significantly with the treatment across both the HS and HI groups. For safety reasons. 212 patients were evaluable (97.2%). The incidence of adverse drug reactions was 16% (34/212) and was found to be significantly higher in HS patients (22.4%) compared with HI patients (11.9%). Overall, the tolerability of zoledronic acid was good, with no significant morbidity in either group (HS and HI). 66% of the patients reported feeling satisfied or very satisfied. CONCLUSIONS: Zoledronic acid proved effective in the relief of pain, improving mobility and quality of life as well as reducing or delaying the occurrence of skeletal-related events in prostate cancer patients presenting metastatic bone disease, regardless of the phase, whether HS or HI, they found themselves in. Tolerability and patient satisfaction were rates as good.

Efectividad y tolerabilidad del ácido zoledrónico en el tratamiento del cancer de próstata metastásico / Effectiveness and tolerability oz zoledronic acid in the treatment of metastatic prostate cancer

Objetivos: Evaluar la efectividad y tolerabilidad del ácido zoledrónico en pacientes con cáncer de próstata y metástasis óseas en fase hormono sensible (HS) y hormono independiente (HI). Material y Métodos: Se diseñó un estudio de ámbito nacional, observacional, prospectivo, abierto, y multicéntrico, Se incluyeron un total de 218 varones diagnosticados de cáncer de próstata en fase HS (36%) o HI (64%) que recibieron, además del tratamiento oncológico específico, ácido zoledrónico (4 mg/IV/mes durante 6 meses). Se evaluó la efectividad mediante: 1) Evaluación de la mejoría del dolor y movilidad; 2) Incidencia y tiempo de aparición de eventos esqueléticos (TEE); y 3) Análisis de marcadores óseos. La tolerabilidad se estudió registrando el número y tipo de efectos adversos. Se realizó una encuesta de satisfacción al paciente tras finalizar el tratamiento. Resultados: De los 218 pacientes, 170 (78%) fueron evaluables para efectividad. En todos ellos, ya fueran del grupo HS o HI, se observó una disminución de la puntuación del dolor en reposo y en movimiento (p<0,0001), una mejora en la movilidad (p=0,005), y en la calidad de vida. La incidencia global de eventos esqueléticos fue del 11,2%, con un TEE de 10,7 meses. No hubo diferencias significativas entre los pacientes HS respecto a los HI. Los marcadores de osteolisis (N-telopéptido) descendieron significativamente con el tratamiento, tanto en los HS como HI. Para seguridad fueron evaluables 212 pacientes (97,2%). La incidencia de las reacciones adversas fue del 16% (34/212), siendo significativamente mayor en los pacientes HS (22,4%) con respecto a los HI (11,9%). Globalmente la tolerabilidad al ácido zoledrónico fue buena, sin morbilidad significativa entre ambos grupos (HS y HI).Un 66% de los pacientes contestaron sentirse satisfechos o muy satisfechos. Conclusiones: El ácido zoledrónico se mostró eficaz para aliviar el dolor, mejorar la movilidad y aumentar la calidad de vida y reducir o retrasarlos eventos esqueléticos en los pacientes con cáncer de próstata con enfermedad ósea metastásica sintomática, independientemente de la fase, HSo HI en que se encuentren. La tolerabilidad y la satisfacción de los pacientes fue buena (AU)

Objetives: To assess the effectiveness and tolerability of zoledronic acid in prostate cancer patients with bone metastases at the hormone-sensitive (HS) and hormone-independent (HI) stages. Materials and Methods: A nationwide, observational, prospective, open and multi-centre trial was devised, with a total of 218 male patients diagnosed with prostate cancer at the HS stage (36%) or HI stage (64%) who were administered zoledronic acid (4 mg/IV/month for 6 months) in addition to their specific oncological treatment. Effectiveness was assessed by the following means: 1) Assessment of the improvement in pain and mobility; 2) Incidence and time to onset of skeletal-related events (SREs) and 3) Analysis of bone markers. Tolerability was assessed by means of registering the number and type of adverse effects. A satisfaction survey was carried out amongst the patients after the end of the trial. Results: Out of the 218 patients, 170 (78%) were evaluable for effectiveness. A decrease in pain ratings at rest and during movement was observed in all patients, whether in the HS or HI groups (p<0,0001). Improved mobility was observed likewise (p=0,005), as was quality of life. The global incidence of skeletal events was 11.2%, with a time to onset of SREs of 10.7 months. There were no significant differences observed between HS vs. HI patients. Osteolysis markers (N-telopeptide) decreased significantly with the treatment across both the HS and HI groups. For safety reasons, 212 patients were evaluable (97.2%). The incidence of adverse drug reactions was 16% (34/212) and was found to be significantly higher in HS patients (22.4%) compared with HI patients (11.9%). Overall, the tolerability of zoledronic acid was good, with no significant morbidity in either group (HS and HI). 66% of the patients reported feeling satisfied or very satisfied. Conclusions: Zoledronic acid proved effective in the relief of pain, improving mobility and quality of life as well as reducing or delaying the occurrence of skeletal-related events in prostate cancer patients presenting metastatic bone disease, regardless of the phase, whether HS or HI, they found themselves in. Tolerability and patient satisfaction were rates as good (AU)

Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 años: patrón de presentación, manifestaciones clínicas y anatomo-patológicas (Parte I) / Changes in the clinical and anatomopathological presentation of prostate cancer in Oviedo in the last 10 years (Part I)

Objetivos: Describir el patrón de presentación tanto clínico como anatomo-patológico de los pacientes diagnosticados de cáncer de próstata en nuestro servicio, comparando los datos obtenidos en el año 1995 y en el 2004. Material y métodos: Se revisaron las 216 historias clínicas de los pacientes diagnosticados en 1995 y 2004, recogiéndose unos datos según un protocolo establecido. Resultados: La edad media al diagnóstico fue significativamente más baja en el año 2004. En ese año, prevaleció el incremento de la concentración de PSA como causa de diagnóstico, seguido por los síntomas urinarios del tracto urinario inferior (STUI), mientras que en el año 1995 destacaron los STUI y el tacto rectal sospechoso. Se observó una mayor proporción de tumores de alto grado en el año 1995, donde los tumores predominantes fueron los de alto riesgo mientras que en el año 2004 fueron los de bajo riesgo y encontramos una mayor proporción de tumores de bajo grado. Conclusiones: La migración de la estadificación clínico patológica hacia estadios más precoces descrita tras el uso generalizado del PSA en pacientes asintomáticos, se confirmó en nuestro estudio, como demuestra la mayor proporción de tumores de alto grado con Gleason entre 8-10 ng/ml diagnosticados en la serie del año 1995 y un mayor número de tumores de bajo grado en el año 2004

Objectives: To describe the clinical and pathological factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. Material and method: We review the 216 patients diagnosed in both years, recording several features. Results: The mean age was significatively lower in the year 2004. In that year, the increments of the PSA levels was the main reason for the diagnosis of the prostate cancer, followed by low urinary tract symptons (LUTS), while the LUTS was the main reason in 1995. There was a greater proportion of high grade tumors in 1995 and also in this year, high risk tumors were the most frequently found, while in 2004 low risk and low grade tumors were predominant. Conclusions: Due to the general determinations of PSA levels in asymptomatic patients in 2004, we found a greater proportion of high grade tumors in 1995 and lower grade tumors in 2004

Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 años: diagnóstico y tratamiento (Parte II) / Changes in the presentation pattern of the prostate cancer in Oviedo in the last 10 years: diagnostic and treatment (Part II)

Objetivos: Describir el patrón de diagnóstico y tratamiento en los pacientes diagnosticados de cáncer de próstata en nuestro servicio, comparando los datos obtenidos en el año 1995 y en el 2004. Material y métodos: Se revisaron las 216 historias clínicas de los pacientes diagnosticados en 1995 y 2004, recogiéndose unos datos según un protocolo establecido. Resultados: Se observaron diferencias significativas en las medias del número de cilindros obtenidos en las biopsias en el año 19952,3 frente a las del 20041,6. Respecto al tratamiento, en el año 1995 predominó la deprivación androgénica seguida de la prostatectomía radical mientras que en el año 2004 la terapia más utilizada fue la radioterapia (externa y/o braquiterapia), seguida por la deprivación androgénica y la prostatectomía radical. Resultaron factores independientes para plantear el tipo de tratamiento la edad (OR=5,6) y el grupo de riesgo (OR=2,8) en el año 2004 y únicamente la edad (>70 años vs <=70 años) en el año 1995. Conclusiones: La evolución experimentada en las distintas técnicas terapéuticas ha convertido al cáncer de próstata en una enfermedad multidisciplinar obteniendo una gran mejoría en los resultados del tratamiento. Pese a todo esto, el desconocimiento existente en la actualidad acerca de la historia natural del cáncer de próstata y de su evolución en la mayoría de los casos, hace que sea necesario la realización de grandes estudios prospectivos, los cuales se están llevando a cabo, para determinar si el cribado del cáncer de próstata mediante el uso del PSA puede ser útil o no

Objectives: To describe and compare the diagnostic and treatment factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. Material and method: We review the 216 patients diagnosed in both years, recording several features. Results: Significant differences were found in the mean of cylinders taken in the biopsies, being higher in 20041,6 than in 19952,3. Hormonal deprivation was the predominant treatment in 1995 followed by radical prostatectomy, while in 2004 radiotherapy (external beam or braquitherapy) was the most frequent therapy used followed by hormonal deprivation and radical prostatectomy. Independent factors to apply the treatment was the age (OR=5,6) and the risk groups (OR=2,8) in the year 2004 and only the age (>70 years vs <=70) in the year 1995. Conclusions: The evolution held in treatment therapies for prostate adenocarcinomas, made this disease in terms of treatment a multidisciplinary disease obtaining better results

[Changes in the clinical and anatomo-pathological presentation of prostate cancer in Oviedo in the last 10 years (part I)]. / Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 años: patrón de presentación, manifestaciones clínicas y anatomo-patológicas (parte I).

OBJECTIVES: To describe the clinical and pathological factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. MATERIAL AND METHOD: We review the 216 patients diagnosed in both years, recording several features. RESULTS: The mean age was significatively lower in the year 2004. In that year, the increments of the PSA levels was the main reason for the diagnosis of the prostate cancer, followed by low urinary tract symptons (LUTS), while the LUTS was the main reason in 1995. There was a greater proportion of high grade tumors in 1995 and also in this year, high risk tumors were the most frequently found, while in 2004 low risk and low grade tumors were predominant. CONCLUSIONS: Due to the general determinations of PSA levels in asymptomatic patients in 2004, we found a greater proportion of high grade tumors in 1995 and lower grade tumors in 2004.

[Changes in the presentation pattern of the prostate cancer in Oviedo in the last 10 years: diagnostic and treatment (part II)]. / Cambio en el patrón de presentación del cáncer de próstata en Oviedo en los últimos 10 aõs: diagnóstico y tratamiento (parte II).

OBJECTIVES: To describe and compare the diagnostic and treatment factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004. MATERIAL AND METHOD: We review the 216 patients diagnosed in both years, recording several features. RESULTS: Significant differences were found in the mean of cylinders taken in the biopsies, being higher in 2004 than in 1995. Hormonal deprivation was the predominant treatment in 1995 followed by radical prostatectomy, while in 2004 radiotherapy (external beam or braquitherapy) was the most frequent therapy used followed by hormonal deprivation and radical prostatectomy. Independent factors to apply the treatment was the age (OR=5,6) and the risk groups (OR=2,8) in the year 2004 and only the age (>70 years vs < or =70) in the year 1995. CONCLUSIONS: The evolution held in treatment therapies for prostate adenocarcinomas, made this disease in terms of treatment a multidisciplinary disease obtaining better results.

[Multiple urethral lithiasis. Report of a case]. / Litiasis uretral múltiple. A propósito de un caso.

OBJECTIVE: To report a case of multiple urethral calculi, an uncommon urological condition in our setting. The clinical, radiological and therapeutic aspects are discussed and the literature is briefly reviewed. METHODS/RESULTS: A 77-year-old male consulted at the emergency services of our hospital for dysuria, pollakiuria and difficulty in voiding. The patient also referred and indurated area in the penile ventral aspect. Radiological examination disclosed three calculi in the penile urethra with were successfully removed by meatotomty and urethrolithotomy. The patient is currently asymptomatic. CONCLUSIONS: Urethral calculus is uncommon in developed countries. "Milking" is not advocated due to the high incidence of urethral injury. Treatment is by simple urethrolithotomy in combination with other techniques (urethroplasty, diverticulectomy, etc.), if required.

[Synchronous bilateral renal adenocarcinoma. Our experience with conservative kidney surgery]. / Adenocarcinoma renal bilateral sincrónico. Nuestra experiencia con la cirugía conservadora renal.

OBJECTIVE: To present our experience with synchronous bilateral renal adenocarcinoma. The indications for conservative surgery, the different types and the controversies are discussed. METHODS: 5 patients with bilateral renal adenocarcinoma from our series of 320 renal adenocarcinomas were analyzed for gender, age at presentation, tumor location, size, presenting features and type of surgery performed. RESULTS: Bilateral renal adenocarcinoma accounted for 1.56% in our series. Mean age at presentation was 57.8 years (range 43-69 years). All 5 patients were male. All patients underwent conservative surgery by tumor excision or partial nephrectomy of the side with less involvement followed by delayed radical surgery of the contralateral side. Follow-up ranged from 19 months to 14 years. To date all patients are disease-free and only one is on dialysis 14 years postoperatively. CONCLUSIONS: Bilateral renal adenocarcinoma has been reported to account for 1.4%-5% of all renal masses. The incidence in our series was 1.56%. Conservative renal surgery is indicated in patients like those described herein to prevent the need for dialysis. In our view, conservative renal surgery is a good therapeutic option that carries a small risk of tumor multicentricity and future recurrence.

[Castleman's disease in the retroperitoneal region]. / Enfermedad de Castleman de localización retroperitoneal.

OBJECTIVE: To describe a case of Castleman's disease presenting as a retroperitoneal mass, with special reference to the differential diagnosis from other retroperitoneal lesions. The histological features, variants, clinical manifestations, etiopathogenesis and treatment of Castleman's disease are reviewed. METHODS: A 64-year-old male presented with voiding symptoms and hypogastric pain. An ultrasound scan showed a 5 x 6 cm mass located behind the bladder and above the prostate, which was confirmed by an abdomino-pelvic CT scan. RESULTS: Retroperitoneal sarcoma was suspected and the mass was resected. The histopathological analysis showed giant lymphoid hyperplasia (vascular hyaline variant of Castleman's disease). CONCLUSIONS: Retroperitoneal Castleman's disease is a lymphoproliferative disorder with two well-defined histological types and a mixed variant. Although this lesion is frequently localized to the mediastinum (71%), extrathoracic lesions have been described. Definitive diagnosis is based on the postoperative pathological findings.