RESUMO
OBJECTIVE: We present a clinical case of inverted papilloma of the anterior urethra in a male patient. METHODS/RESULTS: 40 years-old man, without antecedents. The patient presented with dysuria and urethral bleeding on three occacions. Preliminary studies included radiographic voiding urethrocystography which revealed anterior urethral filling defect. Cystourethroscopy under anaesthetic was performed, allowing endoscopic resection of the tumour causing the filling defect. The Pathologic study of the resected specimen reported urethral inverted papilloma. CONCLUSIONS: Inverted papilloma located in the male urethra is rare. The most frequent clinical manifestations are dysuria and haematuria, although urethral bleeding may present when located in the anterior urethra. Diagnosis is based on clinical symptoms, ultrasound, endoscopy and mictional urethrocystography which allows detection of urethral filling defect. Treatment consists of transurethral resection of the lesion. Annual post-operative endoscopiy control is recommended.
Assuntos
Papiloma Invertido , Neoplasias Uretrais , Adulto , Humanos , Masculino , Papiloma Invertido/diagnóstico , Neoplasias Uretrais/diagnósticoRESUMO
OBJECTIVE: To report a case of prostate lymphoma and a brief review of the literature. METHODS/RESULTS: A 70 year-old mele patient was referred to the Urology departament with a clinical picture of prostatism, with acute urinary retention (AUR). Surgery with retropubic prostatectomy was performed, and pathology revealed a primary prostate lymphoma. The patient was referred to the departament of Oncology where he received polychemotherapy and radiotherapy. The patient is currently followed by regular visits to Urology outpatients service. The case study is followed by a brief bibliographic review, where we analyse clinical menifestations of this entity, complementary studies useful for diagnosis (laboratory test, trasrectal prostate biopsy, transuretral resection, ultrasound and computerised axial tomography), treatment options (surgery, polychemotherapy, radiotherapy) as well as survival in these patients. CONCLUSIONS: Of the cases reviewed, mean age at diagnosis was 57 years. Clinical debut was with prostate symptoms, with or without AUR and sometimes manifestations of renal failure due to obstructive uropathy, as well as general symptoms (astenia, anorexia, weight loss). PSA values remain unaltered in prostate lymphoma patients. Histologic diagnosis may be made by transrectal prostate biopsy, although transurethral resection (TUR) may be necessary for confirmation. Ultrasound and CT scan are of great utility for diagnosis of both local and distant tumors. From a therapeutic point of view, surgery for the obstruction of the lower urinary tract (TURP or retropubic prostatectomy) may be necessary, as well as the cyclophosphamide based polychemotherapy with corticosteroids and other cytostatic agents, and radiotherapy; intratecal chemotherapy has also been used adjuvant bone marrow transplantation.
Assuntos
Leucemia Linfocítica Crônica de Células B/patologia , Neoplasias da Próstata/patologia , Idoso , Humanos , MasculinoRESUMO
OBJECTIVE: To report one case of obstructive anuria due to ureteral compression by an external iliac artery aneurysm in a patient with a single kidney. METHODS/RESULTS: We report the case of a 76-year-old male with a single kidney presenting at the emergency department with left lumbar pain and anuria for several days. Hydronephrosis of the solitary left kidney due to an aneurysmatic tumor of the external iliac artery was diagnosed after performing various tests (ultrasound, arteriography). Emergency percutaneous nephrostomy was performed with subsequent vascular repair of the aneurysm. The outcome was favourable. CONCLUSIONS: Aorto-iliac aneurysm constitutes a rare cause of obstructive anuria. Patients affected are usually males over 50 years of age, smokers, with a history of diabetes mellitus, arterial hypertension (AHT), chronic obstructive pulmonary disease (COPD), etc. Diagnosis is based on clinical symptoms, outstandingly lumboabdominal pain, and the finding of a beating abdominal tumor, as well as signs of a renal failure. Useful complementary studies for diagnosis include ultrasound, intravenous urography (IVU), arteriography and computerised axial tomography (CT). Surgical treatment of the aneurysm generally relieves the obstruction.
Assuntos
Anuria/etiologia , Aneurisma Ilíaco/complicações , Obstrução Ureteral/etiologia , Idoso , Humanos , MasculinoRESUMO
OBJECTIVE: To report the case of a left complete triple ureter with ureteral pyelocalicial system draining independently into the bladder in a patient consulting for episodes of right renal colic. METHODS/RESULTS: 27-year-old female patient consulting for episodes of right renal colic. Several studies including intravenous urography and CT scan were performed revealing a right renal lithiasis and a double ureteral pyelocalicial system on the right side; the left kidney showed three pyelocalicial systems with three ureters, draining each of them separately into the bladder. CONCLUSIONS: The anomalies of ureter number are generally diagnosed by signs and symptoms of obstruction, infection, lithiasis, hematuria, pain, reflux, and ureterocele. Cases of triple ureter are generally are accompanied by other ureteral number anomalies of the opposite kidney. Intravenous urography is an effective diagnostic tool, although CT scan ultrasound may also help to clarify the diagnosis.