RESUMO
OBJECTIVES: Papillary renal cell carcinoma is a malignant neoplasia which represents 5-10% of all renal cell carcinomas. We perform a bibliographic review, and detail the clinical, diagnostic and therapeutic aspects of the case, as well as its postoperative outcome. METHODS: 55-year-old patient who was admitted in the urology department from the emergency room. On physical examination we detected a mass in the left flank and left upper abdominal quadrant, painful on flank percussion, and gross hematuria also. It was a patient who debuted with left lumbar-abdominal pain and hematuria with clots after a physical effort. Blood tests, ultrasound, x-rays and surgical treatment were performed. RESULTS AND CONCLUSIONS: On evaluation of the ultrasound and x-ray films it was concluded that it was a significant renal tumor. Left radical nephrectomy was performed and pathology reported papillary renal cell carcinoma. Postoperative outcome was satisfactory after three months.
Assuntos
Carcinoma Papilar/patologia , Carcinoma de Células Renais/patologia , Doenças Renais Císticas/etiologia , Neoplasias Renais/patologia , Carcinoma Papilar/complicações , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , NefrectomiaRESUMO
OBJECTIVES: Peyronie's disease is a plastic penile induration which represents a well-known problem affecting men in their middle age, who suffer penile incurvation during erections, pain and poor consistency at the site of incurvation. There is no satisfactory treatment for this disease. A patient with Peyronie's disease who received propoleum treatment for a giardiasis infection referred spontaneous improvement of this penile incurvation as treatment cycles were repeated. So, we decided to treat a group of patients with this pathologic entity with propoleum to evaluate its efficacy. METHODS: Initially, 25 patients were studied, only 13 completed the study 6 months later. VARIABLES: age, penile incurvation, presence or not of pain with erections, detection and measurement (cm) of the fibrous plaque on physical examination and ultrasound, and description of its radiologic characteristics. Propoleum powder (300 mg) was administered for 6 months. RESULTS: Patient age was predominantly between 51 and 60 years. Upward deviation was the most frequent presentation; it disappeared in 2 patients in the "Improved" group. Most patients had no pain. 3 patients out of 13 had no plaque on examination at the end of treatment. Regarding incurvation 10 patients improved, 2 improved slightly, and only one improved somewhat during the first three months but then after remained the same. Penile x-ray was not useful as a diagnostic test; penile ultrasound was greatly useful. CONCLUSIONS: Penile incurvation improved in 77% of the patients. Fibrous plaques were reduced more than 0.5 cm on ultrasound (average 0.64 cm).
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Produtos Biológicos/uso terapêutico , Induração Peniana/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVES: To determine the optimal dose for propoleum caps in Peyronie's disease. METHODS: We evaluated two groups of 17 patients each, analyzing pain and plaque size on physical and ultrasound examination, before and after treatment. Group A patients received caps with 300 mg of propoleum powder daily for six months, and Group B 900 mg. RESULTS: Predominant ages were between 41 and 70 years. More than half the patients in group A had pain; more than half the patients in group B did not have pain; considering both groups there were more patients without pain. Physical reduction of the plaque: Group A: 0.6 cm, Group B: 0.8 cm. Ultrasound reduction of the plaque: Group A: 1.3 cm, Group B: 0.8 cm. In the higher dose group (B) clinical and ultrasound improvement started earlier. 79.4% of the treated patients evaluated preferred improvement or slight improvement, being this result statistically significant. CONCLUSIONS: Pain is not always an accompanying symptom in Peyronie's disease. Both doses administered reduced the size of the plaque, but the higher one has an earlier improvement. We may consider propoleum administered in this way another treatment option for this disease, with good results and low cost.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Produtos Biológicos/uso terapêutico , Induração Peniana/tratamento farmacológico , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: To report a rare case of left renal cell carcinoma causing simultaneous acute left varicocele. We also performed a bibliographic review. METHODS: We present the case of a male adult who was diagnosed as having a left varicocele during a medical exam at his work center and referred to the urology clinic. On physical examination a left flank and hypochondrium mass was found. We analyze the diagnostic tests performed and possible therapies. RESULTS: With the diagnosis of left hypernephroma the patient underwent surgery. A big lower pole and medial portion kidney tumor displacing neighbor structures was found, and left radical nephrectomy was performed. CONCLUSIONS: Although it was easy to diagnose a hypernephroma with the diagnostic tests performed, the clinical presentation is not frequent, neither is the sudden onset of left varicocele. Currently, after 8 years of follow-up, the patient has normal blood-ultrasound tests.
Assuntos
Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Varicocele/etiologia , Carcinoma de Células Renais/diagnóstico por imagem , Humanos , Neoplasias Renais/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Varicocele/diagnóstico por imagemRESUMO
OBJECTIVES: To report this case of bladder leiomyoma, benign tumor of the bladder, due to its low frequency (0.43%) and to perform a bibliographic review. METHODS AND RESULTS: Case of a 46 year old female who refers a history of voiding symptoms, macroscopic haematuria with clots, asthenia, anorexia and right flank pain for 15 days prior to consultation. After blood tests, X ray tests, ultrasound and CT scan she underwent hysterectomy, anexectomy, radical cystectomy and ureteral reimplantation to a Mainz II sigmoid pouch. Currently, 44 months after surgery her outcome has been satisfactory. CONCLUSION: Bladder leiomyoma, a disease without specific symptoms, is occasionally found in pathological evaluation; biopsy is the confirmative diagnostic test. They are rarely found outside the uterus and gastrointestinal tract.
Assuntos
Carcinoma de Células de Transição/patologia , Leiomioma/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias da Bexiga Urinária/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Se hace un estudio de los resultados obtenidos en 20 pacientes operadas por presentar fístula vesicovaginal. Se les realiza sutura por vía abdominal y se deriva la orina por catéteres ureterales y sondas uretral y suprapúbica, utilizando el decúbito supino. Se analiza tiempo de comienzo de la incontinencia, etiología, viabilidad del feto, examen físico, utilización de catéteres y sondas y su tiempo de permanencia y estado de la incontinencia al alta