[Long-term paratesticular leiomyosarcoma. Conceptual and literature review]. / Leiomiosarcoma paratesticular de larga evolución. Revisión conceptual y de la literatura.

INTRODUCTION: To know the incidence and clinical and pathologic characteristics of the paratesticular leiomyosarcoma (LMS) with the contribution of a case of long evolution, studying the histopathologic criteria that must be valued for this type of tumours. MATERIAL AND METHODS: A 73-year-old patient includes for study with scrotal tumour present left side for 30 months. Histopathologic and imunohistochemical study is realized. Of equal form there is realized a bibliographical search of this type of tumours and their different subtypes across Medline and of not index-linked search. RESULTS: Our case is the second of greater evolution of international literature, first in greater of 60 years and one of those of smaller mitotic index (1 x 50 cga). Nevertheless, his atipia, tumorlike necrosis next to 50% of the injury and its pleomorphic properties, as well as his inmunophenotypic characterization corresponds with a well differentiated LMS, degree 1 (French Federation Cancer). We have found only 107 published cases of this type of sarcomas, of them 5 in our country, which gives to a profile of the low incidence of these tumours, that within sarcomas 1% do not reach. We included the clinical and pathologic profile of such. CONCLUSIONS: The long evolution of a paratesticular tumour and the absence of metastasis does not exclude its malignancy. The low incident of the LMSs in this location, implies that a protocol of actuation validate for such does not exist. We considered of great importance, its creation on the part of urologist, oncologists, radiologists and pathologists like he took control of located in retroperitoneal cavity and deep soft tissues.

Leiomiosarcoma paratesticular de larga evolución. Revisión conceptual y de la literatura / Long-term paratesticular leiomiosarcoma. Conceptual and literature review

Introducción: Conocer la incidencia y características clínico patológicas del leiomiosarcoma (LMS) paratesticular con la aportación de un caso de larga evolución, estudiando los criterios histopatológicos que deben valorarse en este tipo deneoplasias. Material y métodos: Se incluye para estudio un paciente de 73 años con tumoración escrotal izquierda presente desde hace 30 meses. Se realiza estudio histopatológico e inmunohistoquímico. De igual forma se realiza un examen bibliográfico de este tipo de tumores y sus diferentes subtipos a través de Medline y de búsqueda no indexada. Resultados: Nuestro caso es el segundo de mayor evolución de la literatura internacional, el primero en mayores de 60 años y uno de los de menor índice mitótico (1 x 50 cga). Sin embargo, su atipia, necrosis tumoral próxima al 50% de la lesión y su pleomorfismo, así como su inmunofenotipo se corresponde con un LMS bien diferenciado grado 1 (French Federation Cancer).Hemos encontrado tan solo 107 casos publicados de este tipo de sarcomas, de ellos 5 en nuestro país, lo que da un perfil de la baja incidencia de estas neoplasias, que dentro de los sarcomas no alcanzan el 1%. Incluimos el perfil clínico patológico de los mismos. Conclusiones: La larga evolución de una tumoración paratesticular y la ausencia de metástasis no excluye su malignidad. La baja incidencia de los LMSs en esta localización implica que no exista un protocolo de actuación consensuado para los mismos. Consideramos de gran importancia su creación por parte de urólogos, oncólogos, radiólogos y patólogos al igual que se hizo con los localizados en retroperitoneo y tejidos blandos profundos (AU)

Introduction: To know the incidence and clinical and pathologic characteristics of the paratesticular leiomyosarcoma (LMS) with the contribution of a case of long evolution, studying the histopathologic criteria that must be valued for this type of tumours. Material and metods: A 73-year-old patient includes for study with scrotal tumour present left side for 30 months. Histopathologic and imunohistochemical study is realized. Of equal form there is realized a bibliographical search of this type of tumours and their different subtypes across Medline and of not index-linked search. Results: Our case is the second of greater evolution of international literature, first in greater of 60 years and one of those of smaller mitotic index (1 x 50 cga). Nevertheless, his atipia, tumor like necrosis next to 50% of the injury and its pleomorphic properties, as well as his inmunophenotypic characterization corresponds with a well differentiated LMS, degree 1 (French Federation Cancer).We have found only 107 published cases of this type of sarcomas, of them 5 in our country, which gives to a profile of the low incidence of these tumours, that within sarcomas 1% do not reach. We included the clinical and pathologic profile of such. Conclusions: The long evolution of a paratesticular tumour and the absence of metastasis does not exclude its malignancy. The low incident of the LMSs in this location, implies that a protocol of actuation validate for such does not exist. We considered of great importance, its creation on the part of urologist, oncologists, radiologists and pathologists like he took control of located in retroperitoneal cavity and deep soft tissues (AU)

[Epididymis trombosed hemangioma in old patient. Presentation of 1 case with conceptual review and of the literature]. / Hemangioma epididimario trombosado en paciente mayor. Presentación de 1 caso con revisión conceptual y de la literatura.

INTRODUCTION: Though theoretically in the paratesticular region one can develop any type of benign tumour of soft tissues, they are the lipomas, leiomyomas and adenomatoid tumours the most usual whereas the hemangiomas are less common. We contribute a new case of epididymis intrascrotal hemangioma (HI), valuing the bibliography that allows us to know the incidence and clinic-pathologic characteristics of these tumours. MATERIAL AND METHOD: A 74-year-old patient includes for study with right scrotal tumour, who is practised orchiectomy. Hystopathologic study is realized. Of equal form there is realized a bibliographical examination of this type of tumours across Medline and of not index-linked search with conceptual review and of the literature. RESULTS: The injury corresponds with a HI cavernous trombosed of epididymis with testicular parenchyma respected. Your hystopathologic diagnosis does not present problems, whereas the clinical one and ultrasonographic study, reaches the whole spectrum of tumours, benign and malignant of soft tissues. The number of intrascrotal hemangiomas of epididymis described in the literature is very limited. CONCLUSIONS: The scrotal tumours are necessary a preoperatory clinical and sonographic study completely, in spite of the fact that they are diagnosed the majority after your surgical removal. The complex system of the tissues on the zone paratesticular implies that the differential enclosed diagnosis does not allow to differentiate, malignant tumours of benign. The low incident of many of these masses has determined the mistake of standardized protocols for your diagnosis but also for their unified treatment.

Fibrohistiocitoma maligno «inflamatorio» de cordón espermático con infiltración sobre leioma inguinal. Presentación de 1 caso con revisión conceptual y de la literatura / Inflammatory malignant fibrous histiocytoma of the spermatic cord infiltrating an inguinal leiomyoma. Case report with conceptual and bibliographic reviews

Objetivo: Estudiar los fibrohistiocitomas malignos (FHM) paratesticulares desde el punto de vista clínico-histológico, inmunohistoquímico y su histogénesis. Métodos: A través de Medline y búsqueda no indexada de la literatura científica internacional hemos encontrado un total de 77 casos de FHM paratesticulares que globalmente plantean problemas diagnósticos, terminológicos y terapeúticos. Resultado: Incluímos el caso número 78 de FHM de cordón espermático que presenta unas especiales características (no descritas hasta la fecha) de fistulización cutánea e infiltración de un leiomioma inguinal, con confirmación histológica e inmunohistoquímica. Realizamos una revisión conceptual de este tipo de neoplasias incluyendo la valoración de las contradicciones y reclasificaciones que ha sufrido desde su primera descripción, lo que hace que sean subestimados y su prevalencia real en las series internacionales sea muy variable: del 7 al 37% de los sarcomas paratesticulares. También, el hecho de su baja incidencia ha condicionado una carencia de protocolos de diagnóstico y tratamiento. Conclusiones: Los tumores paratesticulares, aunque infrecuentes, tienen una alta tasa de malignidad. El concepto de FHM ha variado a lo largo de los últimos 15 años. Hoy, este término, es sinónimo de sarcoma pleomórfico indiferenciado y ha llegado a ser un diagnóstico de exclusión (Vimentina + / CD 68 + -ocasionalmente- sin diferencias ultraestructurales), reservándose el subtipo inflamatorio para aquellos que tienen un componente inflamatorio e histiocítico. Es imprescindible en esta localización la realización de una biopsia intraoperatoria, ya que incluso es difícil precisar preoperatoriamente, si una lesión es benigna o maligna. El diagnóstico diferencial tan solo se resuelve tras el estudio microscópico e inmunohistoquímico. Un leiomioma próximo a esta localización (inguinal) podría diagnosticarse y confundirse con un nódulo del FHM principal. Su inmunofenotipo nos permitió diagnosticarlo no solo como leiomioma (marcadores de actinas y desmina positivos), sino también observar la infiltración por el FHM (AU)

Objectives: To study paratesticular malignant fibrous histiocytomas (FHM) from the clinical, histological, immunohistochemical and histogenetic, point of view. Methods: Through Medline and not index-linked search of international scientific literature we have found a total of 77 cases of paratesticular FHM that globally create diagnostic, terminological and therapeutic problems. Results: We include the case number 78 of FHM of spermatic cord, that presents a few special characteristics (not described before) of cutaneous fistula and infiltration of an inguinal leiomyoma, with histological and immunohistochemical confirmation. We performed a conceptual review of this type of tumours, including the evaluation of contradictions and reclassifications that has undergone from its first description, which causes that they are underestimated and their real prevalence in international series is very variable: from 7 to 37 % of paratesticular sarcomas. Also, the fact of their low incidence has determined the lack of protocols for diagnosis and treatment. Conclusions: Paratesticular tumours, although infrequent, have a high rate of malignancy. The FHM concept has varied throughout the last 15 years. Today, this term is synonymous of pleomorphic undifferentiated sarcoma and has been an exclusion diagnosis (Vimentin [+] / CD 68 [+] -occasionally- without ultrastructural differences), reserving the inflammatory subtype for which they have an inflammatory and histiocytic component. The accomplishment of an intraoperatory biopsy is essential in this location, since it is even difficult to know preoperatively, if a lesion is benign or malignant. The differential diagnosis is only solved after microscopic and inmunohistochemical study. Leiomyoma next to this location (inguinal) could be diagnosed and confused with a nodule of the main FHM. Their immunophenotype allowed us to diagnose it not only as leiomyoma (myogenic markers were positive -non skeletal muscle-), but also to observe the infiltration by the FHM (AU)

Hemangioma epididimario trombosado en paciente mayor. Presentación de 1 caso con revisión conceptual y de la literatura / Epididymis trombosed hemangioma in old patient. Presentation of 1 case with conceptual review and of the literature

Introducción: Aunque teóricamente en la región para testicular puede desarrollarse cualquier tipo de tumor benigno de tejidos blandos, son los lipomas, leiomiomas y tumores adenomatoides los más frecuentes, mientras que los hemangiomas son menos comunes. Aportamos un nuevo caso de hemangioma intraescrotal (H I), localizado en epidídimo, valorando la bibliografía que nos permita conocer la incidencia y características clínico patológicas de estos tumores. Material y métodos: Se incluye para estudio un paciente de 74 años con tumoración escrotal derecha, a quien se practica orquiectomía. Se realiza estudio histopatológico. De igual forma se realiza un examen bibliográfico de este tipo de tumores a través de Medline y de búsqueda no indexada con revisión conceptual y de la literatura. Resultados: Se corresponde la lesión con un HI cavernoso trombosado de epidídimo con parénquima testicular respetado. Su diagnóstico histopatológico no presenta problemas, mientras que el clínico y ultrasonográfico, alcanza todo el espectro de tumores de partes blandas, benignos y malignos. El número de hemangiomas intraescrotales epididimarios descritos en la literatura es muy reducido. Conclusiones: Los tumores escrotales, precisan de un estudio preoperatorio clínico y ecográfico completo, a pesar de que la mayoria son diagnosticados tras su extirpación quirúrgica. El complejo sistema tisular de la zona paratesticular implica que el diagnóstico diferencial incluso no permita diferenciar tumores malignos de benignos. La baja incidencia de muchas de estas neoplasias ha condicionado la falta de protocolos estandarizados para su diagnóstico pero también para su tratamiento unificado (AU)

Introduction: Though theoretically in the para testicular region one can develop any type of benign tumour of soft tissues, they are the lipomas, leiomyomas and adenomatoid tumours the most usual whereas the hemangiomas are less common. We contribute a new case of epididymis intrascrotal hemangioma (H I), valuing the bibliography that allows us to know the incidence and clinic-pathologic characteristics of these tumours. Material and Metod: A 74-year-old patient includes for study with right scrotal tumour, who is practised orchiectomy. Hystopathologic study is realized. Of equal form there is realized a bibliographical examination of this type of tumour sacross Medline and of not index-linked search with conceptual review and of the literature. Results: The injury corresponds with a HI cavernous trombosed of epididymis with testicular parenchyma respected. Your hystopathologic diagnosis does not present problems, whereas the clinical one and ultrasonographic study, reaches the whole spectrum of tumours, benign and malignant of soft tissues. The number of intrascrotal hemangiomas of epididymis described in the literature is very limited. Conclusions: The scrotal tumours are necessary a preoperatory clinical and sonographic study completely, in spite of the fact that they are diagnosed the majority after your surgical removal. The complex system of the tissues on the zone paratesticular implies that the differential enclosed diagnosis does not allow to differentiate, malignant tumours of benign. The low incident of many of these masses has determined the mistake of standardized protocols for your diagnosis but also for their unified treatment (AU)

Sarcoma de partes blandas: una patología infrecuente con clínica habitual / Soft tissue sarcoma: an uncommon disease with common symptoms

Los sarcomas de partes blandas son un grupo de tumores poco frecuentes que pueden originarse en cualquier parte del cuerpo, aunque la mayoría ocurre en las extremidades. Tradicionalmente han sido tratados con cirugía escisional y radioterapia, reservando el uso de la quimioterapia para la enfermedad avanzada. Preservar la función de la extremidad afecta es el objetivo ideal en el tratamiento de los sarcomas de tejidos blandos de extremidades. Una cuidadosa evaluación preterapéutica es fundamental en su tratamiento. Estos tumores son mejor tratados en centros multidisciplinarios especializados en el tratamiento de esta enfermedad. Presentamos un caso de sarcoma localizado en muslo derecho en un paciente de 43 años que acudió a la consulta por dolor en la extremidad inferior derecha

Soft-tissue sarcomas are uncommon tumors that can arise anywhere in the body, although most of them occur in the limbs. They have been traditionally managed by wide excisional surgery and radiotherapy, the use of chemotherapy being reserved for advanced disease. Function-preserving limb conservation is the goal of treatment for soft-tissue sarcomas of the limbs. Accurate pretreatment evaluation is critical for treating soft-tissue sarcomas. These tumors are best treated in multidisciplinary centers that specialize in treating this disease. We present a case of sarcoma localized in right thigh in a 43 year old man who presented in the consulting room due to pain in the right lower limb

Neonatal juvenile xanthogranuloma. Report of a case with fine needle aspiration cytologic findings in a soft tissue mass.

BACKGROUND: Juvenile xanthogranuloma is an infrequent, benign histiocytic lesion, the recognition and diagnosis of which by fine needle aspiration biopsy are important for ascertaining whether a case will have a benign course or spontaneous regression. CASE: A case of juvenile xanthogranuloma was located in the upper lip of a newborn male. CONCLUSION: Juvenile xanthogranuloma has characteristic cytologic features that may allow recognition in fine needle aspiration cytology smears.

Primary angioleiomyoma of the iliac bone: clinical pathological study of one case with flow cytometric DNA content and S-phase fraction analysis.

We report on a primary angioleiomyoma of the right iliac bone in a 28-year-old woman. To our knowledge this is the 16th reported case of a primary leiomyoma of bone, the 9th reported primary osseous angioleiomyoma and the first description of a primary angioleiomyoma located in the iliac bone. The problems of differentiating primary leiomyoma of bone from primary or metastatic leiomyosarcoma of bone are stressed. A literature review of primary leiomyomas of bone is presented.

[Genitourinary malacoplakia]. / Malacoplaquia genitourinaria.

Malacoplakia is a chronic inflammatory disease the etiology of which remains obscure. It has a very low incidence and affects primarily the genitourinary tract, although it has been described in some other organs. This paper presents a historic insight of the clinical cases diagnosed in this centre, and includes a review and update of several issues related to this entity such as pathogenesis, pathological anatomy and treatment. Also, the peculiarities related to the involvement of each separate organ with regard to diagnosis, prognosis and treatment are described.