RESUMEN
A multivesicular hydatid cyst was removed from the left kidney of a 26-year-old woman by retroperitoneal laparoscopy to avoid contamination of the abdominal cavity. A scolicidal agent (20% hypertonic saline) was injected around the kidney initially and then instilled into the cyst after the contents had been evacuated. There were no complications and no anaphylactic shock. This appears to be the first reported case of treatment of renal hydatid cyst by laparoscopy.
Asunto(s)
Equinococosis/cirugía , Enfermedades Renales/cirugía , Laparoscopía/métodos , Adulto , Animales , Equinococosis/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Enfermedades Renales/diagnóstico por imagen , Medición de Riesgo , Resultado del Tratamiento , Ultrasonografía DopplerRESUMEN
The authors report a case of giant retroperitoneal liposarcoma. The diagnosis was suspected after scanography and magnetic resonance imaging and confirmed by the histological analysis of the extracted piece after surgical treatment. Postoperative evolution was favourable after one year without recurrence or distant metastasis. The authors discuss the pathologic and therapeutic aspects and the prognosis of retroperitoneal liposarcoma.
Asunto(s)
Liposarcoma/diagnóstico , Neoplasias Retroperitoneales/diagnóstico , Anciano , Humanos , MasculinoRESUMEN
The combination of renal tuberculosis and renal cancer is rare. The authors report the case of a patient who was followed for multifocal pulmonary, hepatic and renal tuberculosis. The diagnosis of associated renal tumour was raised in the presence of suggestive radiological images. Tumourectomy was performed after tuberculostatic therapy, and histological examination revealed renal cell carcinoma associated with caseo-follicular tuberculous granulomas. The outcome was favourable after a follow-up of 2 years. The objective of this study is to analyse the pathogenesis, diagnostic features and treatment modalities of this exceptional combination.
Asunto(s)
Carcinoma de Células Renales/etiología , Neoplasias Renales/etiología , Nefritis/complicaciones , Tuberculosis Renal/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Nefritis/microbiologíaRESUMEN
Prostate cancer is frequently complicated by bone metastases. However some metastatic sites remain rare and unusual. The authors report an exceptional case of prostatic carcinoma presenting with orbital metastasis. A 71-year-old man was admitted with ocular protrusion and decreased visual acuity of the left eye. In addition to the ophthalmological disorders, clinical examination revealed a left temporoparietal swelling with a suspicious prostate on digital rectal examination. Brain MRI revealed an osteolytic process involving the left sphenoid bone with intra-orbital invasion. Another osteolytic site was observed in the left temporoparietal region with intracranial and extracranial components. PSA was 13,327 ng/ml. Prostatic biopsy confirmed the diagnosis of prostatic carcinoma. Treatment comprised cranial radiotherapy combined with anti-androgen endocrine therapy and corticosteroids. Six weeks after treatment, the patient obtained an improvement of visual acuity and regression of exophthalmos and the temporoparietal swelling. Orbital metastasis of prostatic carcinoma raises the problem of ophthalmic emergency. Cranial radiotherapy and anti-androgen endocrine therapy allowed regression of the symptoms without modifying the unfavourable course of the disease.
Asunto(s)
Neoplasias Orbitales/secundario , Neoplasias de la Próstata/patología , Anciano , Humanos , MasculinoRESUMEN
The authors report a case of idiopathic retroperitoneal fibrosis (RPF) in a 38-year-old man presenting with obstructive acute renal failure. The initial management consisted of urinary diversion by bilateral double-J ureteric stenting. After restoration of normal renal function, CT urography demonstrated retroperitoneal fibrosis surrounding the two ureters. Surgical treatment was performed by laparoscopy using four trocars. The operation consisted of detachment of the ascending and descending colon followed by release of the ureters from the lumbar segment to the pelvic segment and finally intraperitonealization of the ureters. The operating time was six hours, the postoperative course was uneventful and the double-J stents were removed at the third week. Laparoscopic treatment of RPF is a treatment option providing all of the benefits of minimally invasive surgery. In the light of this case and a review of the literature, the authors describe the laparoscopic treatment of idiopathic retroperitoneal fibrosis.
Asunto(s)
Laparoscopía , Fibrosis Retroperitoneal/cirugía , Adulto , Humanos , MasculinoRESUMEN
Adrenal myelolipoma is a rare, benign, non-secreting tumour composed of adipose and haematopoietic tissue. The authors report a rare case of giant adrenal myelolipoma in a 53-year-old patient presenting with low back pain and a palpable flank mass on examination. CT scan suggested the diagnosis and surgical resection was indicated in view of the size and symptomatic nature of this mass. Histological examination confirmed the diagnosis. The outcome was favourable without recurrence after a follow-up of one year. The diagnosis of adrenal myelolipoma is based on radiology. Conservative management is generally sufficient for small asymptomatic tumours, but resection is required for large (> 5 cm) and/or symptomatic tumours.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Mielolipoma , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/cirugía , Femenino , Humanos , Persona de Mediana Edad , Mielolipoma/diagnóstico , Mielolipoma/cirugíaRESUMEN
OBJECTIVE: Horseshoe kidney is a malformation of the upper urinary tract that usually remains asymptomatic. The authors report the various therapeutic modalities for urological diseases associated with horseshoe kidney. MATERIAL AND METHOD: Review of a series of 36 pathological horseshoe kidneys, associated with renal stones in 19 cases, ureteropelvic junction syndrome in 8 cases, tumour in 5 cases, pyonephrosis in 2 cases and trauma in 2 cases. RESULTS: The authors stress the very specific characteristics of this rare malformation and review the therapeutic approach to each type of urological disease associated with horseshoe kidney. CONCLUSION: The topographic and vascular characteristics must be taken into account before treating any urological disease associated with horseshoe kidney.
Asunto(s)
Enfermedades Renales/terapia , Riñón/anomalías , Adolescente , Adulto , Femenino , Humanos , Enfermedades Renales/etiología , Masculino , Persona de Mediana EdadRESUMEN
Upper urinary tract tumours are exceptional in the context of renal polycystic disease. The authors report the case of Mrs B. F., 56 years old, who presented with left loin pain associated with haematuria. Clinical examination was normal and ultrasound examination revealed bilateral renal polycystic disease with a mass in the left renal sinus. CT urography showed a tumour arising from the renal pelvis suggestive of an upper urinary tract tumour. The laboratory assessment revealed normal renal function and normal urine cytology. Treatment consisted of radical nephroureterectomy with resection of a bladder cuff. Histological examination revealed a urothelial tumour of the renal pelvis with negative surgical margins. In the light of this case, the authors discuss the diagnostic difficulties and specificities, the treatment and the outcome of this unusual clinical association.
Asunto(s)
Carcinoma de Células Transicionales/complicaciones , Neoplasias Renales/complicaciones , Enfermedades Renales Poliquísticas/complicaciones , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/cirugía , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/cirugía , Persona de Mediana Edad , Enfermedades Renales Poliquísticas/diagnóstico , Enfermedades Renales Poliquísticas/cirugíaRESUMEN
In a 60-year-old man admitted for right epididymo-orchitis with scrotal fistula and urine leak via the rectum, the diagnosis of tuberculosis was based on histological examination of a tissue sample of the scrotal fistula. The fistula was successfully treated with tuberculostatic drugs and cystostomy.
Asunto(s)
Enfermedades de la Próstata/diagnóstico por imagen , Enfermedades de la Próstata/cirugía , Enfermedades del Recto/diagnóstico por imagen , Enfermedades del Recto/cirugía , Tuberculosis/diagnóstico por imagen , Antituberculosos/uso terapéutico , Fístula , Humanos , Masculino , Persona de Mediana Edad , Orquitis/etiología , Enfermedades de la Próstata/patología , Radiografía , Enfermedades del Recto/patología , Tuberculosis/tratamiento farmacológico , Tuberculosis/patologíaRESUMEN
Chronic irritation induced by stones and urinary stasis can be responsible for squamous and sometimes glandular metaplasia of the urothelial epithelium with secondary carcinomatous transformation. The authors report two cases of tumour of the renal pelvis associated with stone pyonephrosis in one case and ureteropelvic junction syndrome in the other.