RESUMEN
OBJECTIVE: To report a case of ureteral endometriosis, an uncommon disease in the urological practice that is diagnosed late and may cause irreversible damage to the upper urinary tract. METHODS/RESULTS: A case of unilateral ureteral endometriosis is presented. After attempting hormonal therapy and endourological management, the patient eventually underwent aggressive surgical treatment. CONCLUSIONS: The diagnosis of ureteral endometriosis should be considered in women presenting with noncalculous renal obstruction, particularly premenopausal women of low parity or those who have had previous pelvic surgery. Only a high index of suspicion and the radiological supports may help to reduce the number of alarming nephrectomies associated to this condition.
Asunto(s)
Endometriosis , Enfermedades Ureterales , Adulto , Endometriosis/diagnóstico , Endometriosis/cirugía , Femenino , Humanos , Enfermedades Ureterales/diagnóstico , Enfermedades Ureterales/cirugíaRESUMEN
OBJECTIVE: To emphasize that adrenal cysts are an uncommon finding and in most cases incidentally discovered during evaluation for nonspecific abdominal pain or even at outopsy. METHODS: We report a case of a non-hypers-creting right adrenal cyst in a middle-aged woman. RESULTS: A complete hormone, radiological and sometimes isotopic evaluation are required to make an accurate diagnosis and to determine the adequate treatment. CONCLUSION: Surgical resection is usually prompted by an inaccurate diagnosis and failed conservative treatments.
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Enfermedades de las Glándulas Suprarrenales/patología , Quistes/patología , Adulto , Femenino , HumanosRESUMEN
OBJECTIVE: To describe an additional case of multilocular cystic nephroma, with special reference to the sonographic features of a renal cystic lesion. METHODS: The clinical and radiological features of a kidney tumor in a 61-year-old female patient were retrospectively analyzed. RESULTS: The preoperative diagnosis was that of a complex multicystic renal mass suggestive of a renal carcinoma. Radical nephrectomy was performed; histopathological analysis of the surgical specimen disclosed a multilocular cystic nephroma. An ultrasound scan 18 months earlier had demonstrated a simple renal cyst in the same site. CONCLUSIONS: Multilocular cystic nephroma is a tumor that is difficult to diagnose preoperatively. Making an accurate differential diagnosis is of interest, since it will permit conservative treatment. The case described herein supports the hypothesis with regard to the pathogenesis of this lesion, since it had previously showed sonographic features of a simple renal cyst.
Asunto(s)
Neoplasias Renales/diagnóstico por imagen , Tumor de Wilms/diagnóstico por imagen , Femenino , Humanos , Neoplasias Renales/cirugía , Persona de Mediana Edad , Ultrasonografía , Tumor de Wilms/cirugíaRESUMEN
OBJECTIVE: To describe a rare variety of spermatic cord tumor, with special reference to the differential diagnosis. The literature is briefly reviewed. METHODS: The clinical and pathological features of a tumor located in the right inguino-scrotal region of a 27-year-old male patient are described. RESULTS: The preoperative evaluation disclosed an irregular mass in the right hemiscrotum that was unconnected to the testis. The patient underwent orchidectomy and resection of the tumor. Pathological analysis of the surgical specimen revealed a hemangioma of the spermatic cord. CONCLUSIONS: Hemangioma of the spermatic cord is a very uncommon tumor, it is a slow growing, indolent, benign scrotal lesion that must be distinguished from other paratesticular masses or tumors with similar clinical features. Ultrasound and other diagnostic imaging techniques are not useful in making the preoperative differential diagnosis.
Asunto(s)
Hemangioma/patología , Cordón Espermático/patología , Neoplasias Testiculares/patología , Adulto , Hemangioma/diagnóstico por imagen , Hemangioma/cirugía , Humanos , Masculino , Cordón Espermático/diagnóstico por imagen , Cordón Espermático/cirugía , Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/cirugía , UltrasonografíaRESUMEN
OBJECTIVE: To describe a case of vasitis nodosum causing spontaneous recanalization of the vas deferens. METHODS: Herein we describe a patient who had undergone vasectomy 9 years earlier. A nodule in the vas deferens arising from granulomatous reaction had progressed to vasitis nodosum, causing spontaneous recanalization of the vas deferens. RESULTS: Vasitis nodosum may be more frequent than it is considered to be although clinical problems rarely arise. CONCLUSION: Confusion may arise in distinguishing the histological features of vasitis nodosum from those of adenocarcinomatous neoplasia. Although rarely, its growth may cause recanalization of the vas deferens in vasectomized patients.
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Enfermedades de los Genitales Masculinos/patología , Granuloma/patología , Complicaciones Posoperatorias/patología , Conducto Deferente/patología , Vasectomía , Adulto , Eyaculación , Femenino , Enfermedades de los Genitales Masculinos/etiología , Granuloma/etiología , Humanos , Masculino , EmbarazoRESUMEN
OBJECTIVE: Extragondal germ cell tumors are rare and have a high affinity for the midline structures. Herein we describe a young, male patient with a retroperitoneal primary tumor. METHODS/RESULTS: The unorthodox form of presentation of germ cell tumors corroborates their embryologic gonadal origin which is distant from the site of presentation. CONCLUSION: The diagnostic algorithm, chemotherapeutic and surgical treatment guidelines utilized in the management of primary gonadal germ cell tumors with retroperitoneal involvement remain applicable in this rare form of presentation.
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Germinoma , Neoplasias Retroperitoneales , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bleomicina/administración & dosificación , Cisplatino/administración & dosificación , Terapia Combinada , Etopósido/administración & dosificación , Germinoma/diagnóstico , Germinoma/tratamiento farmacológico , Germinoma/cirugía , Humanos , Escisión del Ganglio Linfático , Masculino , Neoplasias Retroperitoneales/diagnóstico , Neoplasias Retroperitoneales/tratamiento farmacológico , Neoplasias Retroperitoneales/cirugíaRESUMEN
OBJECTIVE: To report a case of paratesticular tumor involving the right testis. METHODS/RESULTS: A middle-aged male with a small paratesticular tumor involving the right testis is described. Treatment was by transscrotal surgical excision. The histological analysis of the surgical specimen disclosed a mesothelial tumor and no evidence of malignancy. CONCLUSION: Although the preoperative diagnosis of adenomatoid tumor is relatively simple when the epididymis is involved, localization in the testis is relatively difficult to determine. Surgical exploration of all intrascrotal and intratesticular tumors are advocated due to the risk of malignancy.
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Teratoma , Neoplasias Testiculares , Humanos , Masculino , Persona de Mediana Edad , Teratoma/patología , Neoplasias Testiculares/patologíaRESUMEN
OBJECTIVES: To review the more relevant clinical aspects of extrarenal angiomyolipoma, an uncommon disease entity. METHODS: The patient was a middle-aged female in whom an irregular right extrarenal mass had been detected. The pathological analysis disclosed a hamartoma. RESULTS: Complete resection of this lesion achieved cure. METHODS: Angiomyolipoma is a benign tumor that generally involves one or both kidneys. Extrarenal angiomyolipoma is extremely uncommon and may warrant the use of diagnostic tools distinct from the widespread algorithm and may require aggressive maneuvers to make the correct diagnosis.
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Angiomiolipoma , Neoplasias Renales , Adulto , Angiomiolipoma/diagnóstico , Femenino , Humanos , Neoplasias Renales/diagnósticoRESUMEN
OBJECTIVES: To report our experience in the diagnosis and treatment of this type of urologic trauma. The results are analyzed in order to determine the best therapeutic approach and the literature reviewed. METHODS: The series comprised 9 males; 6 had rupture of the posterior urethra and 3 had anterior urethral trauma. Four cases underwent suprapubic drainage and delayed definitive treatment; early realignment of the urethra was performed in 3 cases, and the only patient with a penetrating injury immediately underwent a repair procedure. Urethral urethrotomy sufficed in one patient with partial rupture of the anterior urethra. Delayed treatment consisted of end-to-end anastomosis; one patient required pubic partial resection. RESULTS: Good results were achieved by end-to-end anastomosis; 3 patients have been discharged and one required internal urethrotomy. Two of these patients have remained impotent. The patients submitted to early realignment of the urethra are managed well with regular dilatation and internal urethrotomy in some cases. CONCLUSIONS: We found suprapubic drainage and delayed repair superior to early realignment in those cases with posterior urethral injury. In our view, delayed end-to-end anastomosis, with or without pubic resection can be performed in virtually all cases. We advocate immediate repair of penetrating injuries to the anterior urethra.
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Uretra/lesiones , Accidentes de Trabajo , Accidentes de Tránsito , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Rotura/etiología , Uretra/cirugía , Cateterismo UrinarioRESUMEN
OBJECTIVES: The present study reviews vascular testicular tumors, a very rare pathology. To our knowledge, only 17 cases have been reported since 1921. METHODS/RESULTS: We describe a case of a 16-year-old male who consulted for a mass of sudden onset. Pathological examination disclosed a testicular angioma. CONCLUSIONS: Despite the advancements of the imaging techniques, there are no signs that indicate the nature of vascular testicular neoplasms. The good prognosis of these tumors underscores the importance of the anatomopathological differential diagnosis.
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Hemangioma Cavernoso , Neoplasias Testiculares , Adolescente , Hemangioma Cavernoso/diagnóstico , Humanos , Masculino , Neoplasias Testiculares/diagnósticoRESUMEN
OBJECTIVES: To draw attention to the possibility that distant intestinal metastasis can arise from transitional urothelial carcinoma located in the bladder. METHODS: Two female patients developed distant metastasis during treatment of the tumor by transurethral resection of the bladder. RESULTS: Following complicated transurethral resection with perforation of the peritoneal cavity, the patients developed intestinal obstruction from metastatic transitional cell carcinoma. CONCLUSIONS: Direct or distant seeding of tumor cells on previously undamaged peritoneal serosa produced with the resectoscope may not be exceedingly unlikely.
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Carcinoma de Células Transicionales/complicaciones , Carcinoma de Células Transicionales/cirugía , Neoplasias Intestinales/complicaciones , Obstrucción Intestinal/etiología , Complicaciones Intraoperatorias , Siembra Neoplásica , Peritoneo/lesiones , Neoplasias de la Vejiga Urinaria/cirugía , Anciano , Carcinoma de Células Transicionales/etiología , Femenino , Humanos , Neoplasias Intestinales/etiología , Persona de Mediana EdadRESUMEN
OBJECTIVES: The present article describes an additional case of blue nevus of the prostate, a rare benign lesion which must be distinguished from the more aggressive lesions. METHODS/RESULTS: This lesion was incidentally discovered in a patient who had a biopsy of the prostate. The microscopic examination disclosed the presence of melanin in the epithelium of the prostate gland. CONCLUSIONS: Extracutaneous blue nevus does not progress to malignancy and must be distinguished from the more aggressive lesions.
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Nevo Azul , Neoplasias de la Próstata , Anciano , Humanos , Masculino , Nevo Azul/diagnóstico , Neoplasias de la Próstata/diagnósticoRESUMEN
OBJECTIVE: To determine the best diagnostic approach and management of cystic renal mass. METHODS: Four cases are described and the literature reviewed. RESULTS: Of the 4 cases of cystic renal mass, 2 had a previous history of renal trauma. Puncture and aspiration of the cystic content were performed in three cases; cytology was positive for malignancy in one, which was confirmed by the histologic analysis. Two cases underwent nephrectomy although one of the post-traumatic cases had a preoperative diagnosis of pararenal pseudocyst. The literature review showed a significant controversy exists concerning the diagnostic approach and treatment. CONCLUSIONS: We advocate an approach free from tenets, where all the appropriately chosen diagnostic tools may be valid. If doubts persist after diagnostic evaluation, nephrectomy should be performed.
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Enfermedades Renales/diagnóstico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We report a case of inverted Y duplication of the ureter, incidentally found in a man consulting for hematuria. The diagnostic and therapeutic aspects are briefly discussed.
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Uréter/anomalías , Anciano , Humanos , Masculino , Uréter/diagnóstico por imagen , UrografíaRESUMEN
We describe the unusual case of a young male who presented lower urinary tract obstruction secondary to a bladder-prostate embryonal rhabdomyosarcoma. Initially he was treated with multiagent chemotherapy and radiotherapy in an attempt to preserve bladder function, but eventually radical cystoprostatectomy was warranted to control tumor growth. The objectives of chemotherapy and radiotherapy, partial and/or radical surgery and the main prognostic factors are briefly discussed.
Asunto(s)
Neoplasias de la Próstata , Rabdomiosarcoma Embrionario , Neoplasias de la Vejiga Urinaria , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Cistectomía , Humanos , Masculino , Pronóstico , Próstata/patología , Prostatectomía , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/terapia , Dosificación Radioterapéutica , Rabdomiosarcoma Embrionario/patología , Rabdomiosarcoma Embrionario/terapia , Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
The florid post-TUR syndrome observed in one of our patients prompted us to conduct a prospective study on 100 males undergoing TUR to determine the natremia levels that could herald the presentation of this syndrome. Several parameters were evaluated, including pre- and post-operative serum sodium levels, total volume of irrigant used, and the weight of the resected prostate. Although the natremia levels dropped significantly in 4 patients, only the patient who had motivated this study developed symptoms and evidently no conclusions can be drawn on the basis of a single observation.
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Hiponatremia/etiología , Complicaciones Posoperatorias/etiología , Prostatectomía/efectos adversos , Sodio/sangre , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , SíndromeRESUMEN
Although it is widely extended, outpatient urological practice is rarely referred to in the scientific publications. Our experience in the outpatient center is presented. The characteristics of the outpatient, the facilities of the area where we practice and the unique doctor-patient relationship are described. A proposal is made to provide a wide range of diagnostic and therapeutic urological services at the outpatient centers.
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Atención Ambulatoria , Enfermedades Urológicas/terapia , Adulto , Anciano , Atención Ambulatoria/métodos , Femenino , Humanos , MasculinoRESUMEN
We report a rare case of a young male patient with a single duodenal metastasis from a renal cell tumor nine years after nephrectomy that presented as upper GI tract hemorrhage. The clinical and pathological aspects of this uncommon intestinal metastasis are briefly discussed.
Asunto(s)
Carcinoma de Células Renales/secundario , Enfermedades Duodenales/etiología , Neoplasias Duodenales/secundario , Hemorragia Gastrointestinal/etiología , Neoplasias Renales/patología , Carcinoma de Células Renales/complicaciones , Neoplasias Duodenales/complicaciones , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Herein we describe an additional case of inverted papilloma of the bladder that had been incidentally discovered. Cystoscopy was required to make the diagnosis, which was confirmed anatomo-pathologically. The clinical and histological features of this disease entity are briefly discussed.
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Papiloma Invertido/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A case of von Hippel Lindau disease in a young female is described. Currently, surgery is unwarranted, since these patients only present cystic disease. However, subsequent control evaluations may indicate surgery since these cysts can easily progress to a carcinoma. The literature is briefly reviewed, with special reference to the therapeutic aspects of current day patient management.