RESUMO
Tumours derived from sex cords and primitive gonadal stroma account for 4% of total testicular tumours. The low frequency of Sertoli's cells tumour (SCT) and the uneven study and follow-up of patients makes analysis of this tumoral entity difficult. This paper contributes one case report of a Sertoli's giant cell tumour calcified in a 13-year old patient, and reviews the clinical aspects, clinico-pathological varieties believed to require assessment in patients with this type of disease. This type of tumour is considered benign in its biological behaviour, although some malignant forms have also been described. SCT is actually an heterogeneous tumoral pathogenic entity with regard to pathogenic and prognostic aspects. Our final conclusions show that the clinico-pathological variety, age, size and associated clinical manifestations appear to be related to the prognosis.
Assuntos
Tumor de Células de Sertoli/patologia , Neoplasias Testiculares/patologia , Adolescente , Humanos , Masculino , Prognóstico , Tumor de Células de Sertoli/classificação , Neoplasias Testiculares/classificaçãoRESUMO
Shock-wave extracorporeal lithotripsy (SWEL) is admittedly the choice method for most ureteral calculi (UC). Treatment of 1.674 UC was carried out with a Lithostar (Siemens). Endourologic support manoeuvres (ESM) were used in 11.7% patients. To determine their statistical influence on treatment's result variables such as site, size, calculus density, obstruction and functionality of the renal unit, as well as presence of ureteral malformation, were analyzed. With an average of 1.3 sessions (9100 waves) success rate was 91.8% cases. Only the variables of size, obstruction and function showed statistical significance, thus identifying through a multistep logistic regression test the subgroup of calculi less likely to succeed (calculi > 1 cm2, with severe uropathy and functional annulment or delay). Complication were rare (7.5%) and minimally relevant. We conclude than SWEL is the first choice treatment for UC regardless the location. Ureteroscopy (UR) should be considered as the first option particularly in distal (iliopelvic ureter), obstructive calculi and those of difficult radiological study.