[Mesenteric desmoid tumor mimicking a testicular cancer recurrence]. / Tumor desmoide mesentérico simulando una recidiva de cáncer testicular.

OBJECTIVE: Report of one case of desmoid tumor in a patient who had been treated of a testicular seminoma 26 months before, with excision of a retroperitoneal mass and chemotherapy. On followup he presented with a mesenteric abdominal mass which was clinically labeleled as a recurrence of the seminoma. RESULTS: Histologically it was reported as a mesenteric desmoid tumor. Differential diagnosis with gastrointestinal stromal tumor was performed with immunohistochemical studies. CONCLUSIONS: Desmoid tumor is rare. There are few cases reported in patients with history of previous testicular tumor. It should be included in the differential diagnosis of testicular tumor recurrences.

Tumor desmoide mesentérico simulando una recidiva de cáncer tesitular / Mesenteric desmoid tumor mimicking a testicular cancer recurrence

Objetivo: Presentar un caso de un tumor desmoide en un paciente tratado de un seminoma testicular que simulaba una recidiva del tumor testicular. Método: Presentamos el caso de un paciente de 41 años, tratado de un seminoma testicular 26 meses antes, mediante extirpación de una masa testicular retroperitoneal y quimioterapia, que presenta en el seguimiento, una masa abdominal mesentérica que se etiquetó clínicamente de recidiva de seminoma. Resultado: Histológicamente se informa de tumor desmoide mesentérico. Se hace diagnóstico diferencial con un tumor de estroma gastrointestinal mediante el estudio inmunohistoquímico. Conclusiones: El tumor desmoide es un tumor raro. Se han descrito pocos casos en pacientes afectos previamente de tumor testicular. Debe incluirse en el diagnóstico diferencial de las recidivas por tumor testicular (AU)

Objective: Report of one case of desmoid tumor in a patient who had been treated of a testicular seminoma 26 months before, with excision of a retroperitoneal mass and chemotherapy. On follow-up he presented with a mesenteric abdominal mass which was clinically labeleled as a recurrence of the seminoma. Results: Histologically it was reported as a mesenteric desmoid tumor. Differential diagnosis with gastrointestinal stromal tumor was performed with immunohistochemical studies. Conclusions: Desmoid tumor is rare. There are few cases reported in patients with history of previous testicular tumor. It should be included in the differential diagnosis of testicular tumor recurrences (AU)

[Solitary pararenal fibrous tumor]. / Tumor fibroso solitario pararrenal.

OBJECTIVES: To report a rare clinical case of solitary pararenal fibrous tumor, analyzing its pathological characteristics and prognosis by a bibliographic review. METHODS/RESULTS: We present the case of a 36-year-old male consulting for right flank colic pain, which was diagnosed of a solid mass in the lower pole of the right kidney and underwent right radical nephrectomy. Pathological study of the surgical specimen showed the presence of a solitary pararenal fibrous tumor. CONCLUSIONS: Solitary fibrous tumor is a rare neoplasia, being its pararenal localization even rarer. It is a tumor with benign behavior in up to 90% of the cases. The immunohistochemical study is the key to diagnosis.

Tumor fibroso solitario de la túnica vaginal / Solitary fibrous tumor of the tunica vaginalis testis

OBJETIVO: Añadir a la literatura un caso clínicopoco frecuente de tumor fibroso solitario pararrenal, analizando las características anatomo-patológicas del mismo así como su pronóstico mediante una revisión bibliográficade la literatura al respecto.MÉTODOS/RESULTADOS: Presentamos el caso clínico de un varón de 36 años que consultó por dolor cólico en fosa renal derecha, siendo diagnosticado de masa sólida en polo inferior riñon derecho, motivo por el que fue sometido a una nefrectomía radical derecha. El estudio histológico de la pieza evidenció la presencia de un tumor fibroso solitario pararrenal.CONCLUSIONES: El tumor fibroso solitario es una neoplasiamuy poco frecuente siendo su localización pararrenal aún menos frecuente, siendo una tumoración de comportamientobenigno en hasta un 90 % de casos. En su diagnósticoresulta clave el estudio inmunohistoquímico

OBJECTIVES: To report a rare clinical case of solitary pararenal fibrous tumor, analyzing its pathological characteristics and prognosis by a bibliographic review. METHODS/RESULTS: We present the case of a 36-year-old male consulting for right flank colic pain, which was diagnosed of a solid mass in the lower pole of the right kidney and underwent right radical nephrectomy. Pathological study of the surgical specimen showed the presence of a solitary pararenal fibrous tumor. CONCLUSIONS: Solitary fibrous tumor is a rare neoplasia, being its pararenal localization even rarer. It is a tumor with benign behavior in up to 90% of the cases. The immunohistochemical study is the key to diagnosis

Tumor fibroso solitario pararrenal / Solitary pararenal fibrous tumor

OBJETIVO: Añadir a la literatura un caso clínicopoco frecuente de tumor fibroso solitario pararrenal, analizando las características anatomo-patológicas del mismo así como su pronóstico mediante una revisión bibliográficade la literatura al respecto.MÉTODOS/RESULTADOS: Presentamos el caso clínico de un varón de 36 años que consultó por dolor cólico en fosa renal derecha, siendo diagnosticado de masa sólida en polo inferior riñon derecho, motivo por el que fue sometido a una nefrectomía radical derecha. El estudio histológico de la pieza evidenció la presencia de un tumor fibroso solitario pararrenal.CONCLUSIONES: El tumor fibroso solitario es una neoplasiamuy poco frecuente siendo su localización pararrenal aún menos frecuente, siendo una tumoración de comportamientobenigno en hasta un 90 % de casos. En su diagnósticoresulta clave el estudio inmunohistoquímico

OBJECTIVES: To report a rare clinical case of solitary pararenal fibrous tumor, analyzing its pathological characteristics and prognosis by a bibliographic review.METHODS/RESULTS: We present the case of a 36-year-old male consulting for right flank colic pain, which was diagnosed of a solid mass in the lower pole of the right kidney and underwent right radical nephrectomy. Pathologicalstudy of the surgical specimen showed the presence of a solitary pararenal fibrous tumor.CONCLUSIONS: Solitary fibrous tumor is a rare neoplasia,being its pararenal localization even rarer. It is a tumor with benign behavior in up to 90% of the cases. The immunohistochemicalstudy is the key to diagnosis

[Spontaneous regression of venous thrombus in a case of renal carcinoma]. / Regresión espontánea de trombosis venosa en un caso de carcinoma renal.

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1 % of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava.

[Relationship between LUTS (lower urinary tract symptoms) and quality of life]. / Relación entre síntomas del tracto urinario inferior y calidad de vida.

OBJECTIVES: To evaluate the impact of the lower urinary tract symptoms (LUTS) included in the IPSS on the quality of life and to determine the relationship between quality of life or total IPSS score and treatment. METHODS: Retrospective review of the IPSS questionnaire in 125 male patients who had consulted for LUTS between January 2001 and December 2003. Results were included in an Access database. Statistical analyses were done with the SPSS 11.0 software. RESULTS: 17% of the patients showed severe symptoms in accordance to the IPSS score. In the quality of life evaluation grouped into two categories, 88% referred good or indifferent quality of life. In the evaluation of the association between IPSS individual questions and quality of life there was a significant association for all questions. Patients reporting worse quality of life had a 6 times higher risk of receiving treatment. With a mean follow-up of two years, 91% of patients who were not on treatment continued without it. CONCLUSIONS: The most severe symptoms are, the worse the quality of life. The independent parameters that most influenced decision to start treatment were quality of life and total IPSS. Frequency, weak stream and hesitation may explain quality of life on each patient.

Regresión espontánea de trombosis venosa en un caso de carcinoma renal / Spontaneous regression of venous thrombus in a case of renal carcinoma

OBJETIVO: Describir el primer caso deregresión espontánea de trombosis de vena renal y cavainferior en un paciente con carcinoma de células renales.MÉTODO/RESULTADO: Se describe el caso de una mujerdiagnosticada de masa renal con trombosis de venasrenal y cava. En los estudios de extensión previos a lanefrectomía radical se constata la regresión de dicho tromboque se confirma posteriormente tras la nefrectomía.CONCLUSIÓN: La regresión espontánea de metástasisde carcinoma de células renales se estima menor al 1%.Este es el primer caso descrito en la literatura que afectaa una trombosis tumoral de venas renal y cava inferior

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1% of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava

Relación entre síntomas del tracto urinario inferior y calidad de vida / Relationship between LUTS (lower urinary tract symptoms) and quality of life

OBJETIVOS: Evaluar el impacto de los síntomasdel tracto urinario inferior (STUI) referidos en elcuestionario IPSS sobre la calidad de vida y determinarla relación entre calidad de vida o puntuación total delIPSS con el tratamiento.MÉTODOS: Revisión retrospectiva del cuestionario IPSSde 125 hombres que habían consultado por STUI entreenero del 2001 y diciembre de 2003. La mediana deseguimiento fue de 24 meses. Los resultados fueronrecogidos en una base de datos Access. Para la evaluaciónestadística se utilizó la versión 11.0 del SPSS.RESULTADOS: Según la puntuación del IPSS total el17% de los pacientes presentaba síntomas severos. Enla evaluación de la calidad agrupada en 2 categorías,el 88% referían buena o indiferente calidad. Al evaluarla asociación entre los resultados del IPSS de cada preguntay la calidad, existió asociación significativa paratodas las preguntas. Los pacientes con STUI importantetenían un riesgo 6 veces mayor de mala calidad. Lospacientes que respondieron con peor calidad presentabanun riesgo 6 veces mayor de recibir tratamiento.Con un tiempo de evolución de más de 2 años demedia, el 91% de los que no tenían tratamiento seguíansin él.CONCLUSIONES: Cuanto más graves sean los síntomaspeor es la calidad de vida. Los parámetros independientesque más influyeron en la toma de decisiónpara iniciar un tratamiento fueron la calidad de vida yla puntuación total del IPSS. La polaquiuria, el chorrodébil y la vacilación inicial pueden explicar la calidadde vida de cada paciente

OBJECTIVES: To evaluate the impact ofthe lower urinary tract symptoms (LUTS) included in theIPSS on the quality of life and to determine therelationship between quality of life or total IPSS scoreand treatment.METHODS: Retrospective review of the IPSS questionnairein 125 male patients who had consulted for LUTSbetween January 2001 and December 2003. Resultswere included in an Access database. Statistical analyseswere done with the SPSS 11.0 software.RESULTS: 17% of the patients showed severe symptomsin accordance to the IPSS score. In the quality of lifeevaluation grouped into two categories, 88% referredgood or indifferent quality of life. In the evaluation ofthe association between IPSS individual questions andquality of life there was a significant association for allquestions. Patients reporting worse quality of life had a6 times higher risk of receiving treatment. With a meanfollow-up of two years, 91% of patients who were noton treatment continued without it.CONCLUSIONS: The most severe symptoms are, theworse the quality of life. The independent parametersthat most influenced decision to start treatment werequality of life and total IPSS. Frequency, weak streamand hesitation may explain quality of life on eachpatient

[Treatment of a cavernous hemangioma of the bladder by endoscopical resection]. / Resección endoscópica como tratamiento del hemangioma cavernoso de vejiga.

OBJECTIVES: We report three cases of bladder hemangioma. METHODS: Three cases of cavernous hemangioma of the bladder with pathologic confirmation treated by endoscopical resection. RESULTS: There is no evidence of recurrence in either patient after resection. CONCLUSIONS: The endoscopical treatment of small bladder hemangiomas is an effective treatment.

[Cystic hamartoma of the renal pelvis: unfrequent finding]. / Hamartoma quístico de pelvis renal, un hallazgo infrecuente.

OBJECTIVES: This cystic hamartoma of the renal pelvis is a very unfrequent benign tumor. We report one case emphasizing its histology and performed a bibliographic review. METHODS: Mid age female patient with the incidental diagnosis of a renal mass taking up the pelvis. RESULTS: A radical nephrectomy was performed with the pathologic report of cystic hamartoma of the renal pelvis. CONCLUSIONS: It is a cystic renal tumor with well-defined histologic and immunohistochemical criteria, and it probably does not involve any danger for the patient's live.

[A new case of bladder endometriosis in a patient with a history of Cesarean section]. / Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea.

OBJECTIVES: To report one new case of endometriosis in a patient with history of caesarean section. METHODS: It is the case of a female patient presenting with voiding symptoms and hematuria, with a bladder tumor on ultrasound. RESULTS: After TUR of a retro trigonal tumor pathology report showed bladder endometriosis. Treatment was completed with hormone therapy, being the patient relapse free at one year follow-up. CONCLUSIONS: History of caesarean section is one of the possible etiologies of bladder endometriosis.

Un hueso de pollo como causa de gangrena de Fournier / A chicken bone as a cause of Fournier´s gangrene

OBJETIVO: La gangrena de Fournier es una fascitis necrotizante que afecta a la región perineal, perianal y genital, de evolución rápida y un prognóstico severo. Revisamos la literatura y aportamos un caso reciente. MÉTODOS: Presentamos el caso de un paciente varón que consultó por dolor escrotal con el antecedente de la expulsión de un hueso de pollo con las heces. RESULTADOS: A pesar de la cirugía agresiva y antibióticos de amplio espectro, el pronóstico es pobre y la mortalidad alta. CONCLUSIONES: El diagnóstico rápido y exacto es fundamental para conseguir un buen resultado. Los desbridamientos precoces, amplios y repetidos reducen la mortalidad (AU)

[Giant bladder diverticulum presenting as inferior vena cava syndrome]. / Divertículo vesical gigante que debuta como síndrome de vena cava inferior.

OBJECTIVES: To report the case of a giant bladder diverticulum clinically presenting with symptoms of inferior vena cava compression. METHODS: Patient under study because of inferior limbs edema who underwent ultrasound that found a giant bladder diverticulum. RESULTS: Diverticulectomy plus adenomectomy were performed. CONCLUSIONS: Acquired giant bladder diverticula are very rare; they should be treated surgically to avoid possible complications.

Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea / New case of bladder endometriosis in a patient with history of caesarean section

OBJETIVO: Presentar un nuevo caso de endometriosis en una paciente con antecedentes de cesárea. MÉTODO: Se trata de una paciente que consulta por síndrome miccional y hematuria, con hallazgo ecográfico de neoformación vesical. RESULTADOS: Se practica RTU de neoformación retrotrigonal con el resultado anatomopatológico de endometriosis vesical, se completa el tratamiento con terapia hormonal, estando la paciente libre de recidivas al año de control. CONCLUSIONES: Entre las posibles etiologías de la endometriosis vesical se encuentra el antecedente de cesárea (AU)

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Divertículo vesical gigante que debuta como síndrome de vena cava inferior / giant bladder diverticulum presenting as inferior vena cava syndrome

OBJETIVO: Presentar el caso de un divertículo gigante de vejiga que debuta clínicamente con síntomas compresivos sobre la vena cava inferior. METODO: Paciente en estudio por edemas en miembros inferiores en el que bajo estudio de imagen mediante ecografía se objetiva divertículo vesical gigante. RESULTADOS: Se practica diverticulectomía mas adenomectomía prostática. CONCLUSIONES: Los divertículos vesicales gigantes adquiridos son procesos poco frecuentes que conviene tratar quirúrgicamente para evitar posibles complicaciones (AU)

[Extra adrenal pheochromocytoma. Report of two cases]. / Feocromocitoma extraadrenal. Presentación de dos casos.

OBJECTIVES: To review two cases of extra adrenal pheochromocytoma. METHODS: We present two cases: a 75-year-old patient with history of high blood pressure and intravesical tumor compatible with urinary bladder paraganglioma, and a 59-year-old patient with a retroperitoneal tumor arising from para-aortic ganglia. RESULTS: Diagnosis was made by CT scan and transurethral resection in the first case, all posterior extension studies were negative; in the second case retroperitoneal exeresis surgery was performed after CT scan. CONCLUSIONS: Extra adrenal pheochromocytomas are catecholamine producing tumours, which determines their clinical features; treatment should be surgical. A bibliographic review about this disease is performed.

[Utility of computerized tomography in determining the extent of infiltrating bladder tumors: our experience]. / Utilidad de la tomografia computarizada en la extensión del tumor vesical infiltrante: nuestra experiencia.

OBJECTIVES: To evaluate the reliability of bladder transitional cell carcinoma (TCC) staging, comparing findings on computerized tomography (CT) with pathologic results after radical cystectomy. METHODS: We retrospectively review 115 consecutive patients with bladder TCC undergoing radical cystectomy. Preoperative CT findings were compared with pathology results obtained after cystectomy and lymphadenectomy. RESULTS: We found that as a whole CT showed a tendency to local overstaging of 27.8% for tumours infiltrating bladder wall only, and understaging of 36.5% Regarding lymph nodes involvement, CT overstaged 4.6% of patients and understaged 23.8%. CT was capable to detect only 7.15% pN positive cases. CT was unable to detect the only patient with intra-abdominal metastatic involvement. CONCLUSIONS: Abdomino-pelvic CT has real limitations to detect extra vesical extension and lymph node metastasis in patients with bladder TCC.

[Clinical course of epidermoid carcinoma of the penis in our series]. / Análisis de la evolución del carcinoma epidermoide de pene en nuestra serie.

OBJECTIVES: To study the evolution of 49 patients with squamous cell carcinoma of the penis. METHODS: 49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases. RESULTS: There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis. CONCLUSIONS: Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.

Feocromocitoma extraadrenal. Presentaciónde dos casos / Extra adrenal pheochromocytoma. Report of two cases

OBJETIVO: Revisión de dos casos de feocromocitoma extraadrenal. METODO: Presentamos dos casos, paciente de 75 años con antecedentes de hipertensión arterial y tumoración intravesical compatible con paraganglioma de vejiga urinaria y paciente de 59 años con tumoración retroperitoneal dependiente de ganglios paraaórticos. RESULTADO: En el primer caso se realiza diagnóstico mediante TAC y resección transuretral del tumor con posteriores estudios de extensión negativos, y en el segundo caso igualmente tras TAC se practica cirugía de exéresis retroperitoneal. CONCLUSIONES: Se trata de tumores productores de catecolaminas, lo que determina sus manifestaciones clínicas, y que deben de ser tratados quirúrgicamente. Se realiza una revisión bibliográfica de esta patología (AU)