RESUMEN
OBJECTIVE: We report two cases of patients diagnosed with lymphoepithelioma-like carcinomas of the urinary tract. We review the literature of this rare entity. The objective is to clarify the clinical and therapeutic characteristics. METHODS: We present a retrospective review of medical records of two patients diagnosed with lymphoepithelioma-like carcinomas, one in the renal pelvis and the other in the bladder. We review the epidemiology, diagnosis and therapeutic alternatives. RESULTS: Case 1: A 74-year-old women with past medical history of left radical nephrectomy and retroperitoneal lymphadenectomy six years before for renal pelvis carcinoma type pure lymphoepithelioma-like, stage pT4R0pN1cM0. She received adjuvant chemotherapy with Cisplatin and Gemcitabine. Five years later, she presented tumor recurrence in the left ureteral meatus, this lesion was resected. The pathology reported a high-grade urothelial carcinoma with marked lymphoid component, stage pT1. At follow-up, one year after the last recurrence, the patient was asymptomatic. In tomography control, no local or distant recurrences were objectified. Case 2: A 82-year-old men with diagnosis of muscleinvasive bladder cancer. The tumor caused right obstructive uropathy without extracapsular, regional or remote extension. We performed a radical cystoprostatectomy with bilateral pelvic lymphadenectomy and urinary diversión type cutaneous transureterostomy. The pathology reported a urothelial bladder carcinoma type mixed lymphoepithelioma-like, stage pT4aR1pN2cM0. At six months follow-up, the patient had liver and spleen lesions and retroperitoneal adenopathic nodes, all suggestive of metastases. He is currently receiving symptomatic treatment of their disease. CONCLUSIONS: We emphasize the clinical importance involved in the diagnosis of this entity. The diagnosis influence the aggressiveness of treatment and disease-specific survival. Therefore, concomitant transitional cell carcinoma defines the prognosis. The role of immunohistochemical staining is fundamental, allowing us to confirm the presence of the epithelial component.
Asunto(s)
Carcinoma de Células Transicionales , Neoplasias Renales , Pelvis Renal , Neoplasias de la Vejiga Urinaria , Anciano , Anciano de 80 o más Años , Carcinoma de Células Transicionales/diagnóstico , Carcinoma de Células Transicionales/terapia , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/terapia , Masculino , Estudios Retrospectivos , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
We report a case of a large malignant solitary fibrous kidney tumor. A complete surgical resection of the primary tumor and peritoneal disease was carried out, and a histological examination confirmed the initial diagnosis. We describe and discuss the characteristics of this rare kidney neoplasm.
RESUMEN
OBJECTIVES: To report a new case of bladder mullerianosis. METHODS: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated. RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up. CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its published reports. We support the option of an endoscopic surgery for these patients.