[Scrotum-perineal granular cell tumor in pediatric age: A case report.] / Tumor de células granulares escroto-perineal en edad pediátrica: a propósito de un caso.

OBJECTIVE: Report a case of a scrotum-perinea lGranular Cell Tumor (GCT) in pediatric age. METHODS: To report a case. RESULTS: A 12 years old men with a multiple GCT history, located in both extremities, abdomen and scrotum perineal region. Surgical excision of all lesions and a genetic studyare performed to rule out Noonan syndrome. CONCLUSION: GCT or Abrikossoff tumor is a tumor witha very low incidence, especially in pediatric age. The most frequent form of presentation a solitary nodule and the most common behavior is in the form of a benign tumor. Immunohistochemistryis crucial for its diagnosis, the main characteristicis positivity for the S100 protein. Although scrotal location is very rare, it must be considered in the differential diagnosis of scrotal mass. Surgical excision is the treatment of choice.

OBJETIVO: Exposición de un caso de Tumor de Células Granulares (TCG) escroto-perineal en edad pediátrica.MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se trata de un paciente de 12 años de edad con historia de TCG múltiples, localizados en ambas extremidades, abdomen y región escroto-perineal. Se realiza exéresis quirúrgica de todas las lesiones y se lleva a cabo estudio genético para descartar síndrome de Noonan.CONCLUSIÓN: El TCG o Tumor de Abrikossoff es un tumor con una incidencia muy baja, sobre todo en edad pediátrica. La forma de presentación más frecuente es la de nódulo solitario y el comportamiento más habitual es como tumor benigno. La inmunohistoquímica resulta crucial para su diagnóstico, siendo lo más característico su positividad para la proteína S-100. Aunque la localización escrotal es muy poco frecuente, hay que considerarla en el diagnóstico diferencial de masa escrotal. La exéresis quirúrgica es el tratamiento de elección.

[Metastasis of breast carcinoma in the ureter. Presentation of a clinical case.] / Metástasis de carcinoma de mama en uréter. Presentación de un caso clínico.

OBJECTIVE: To assess the importance of long-term close follow-up in patients with breast carcinoma. MATERIALS AND METHODS: To present a case report. RESULTS: A case of a 55-year-old woman with history of lobular carcinoma of the breast is presented. She received neoadjuvant treatment, surgery and complementary chemotherapy and radiotherapy. In radiologic imaging studies, multiple bone metastases were diagnosed. The patient consulted for left lumbar pain. Radiologic studies revealed left hydronephrosis secondary to soft tissue lesion in pyeloureteral junction with renal functional impairment. A biopsyperformed using an endoscopic approach (ureteroscopy), diagnosed a metastasis of breast carcinoma in the ureter. CONCLUSION: Metastatic lesions in the ureter are extremely rare, even less frequent the ones with breast origin with around ten cases published worldwide. With the previous diagnosis of breast carcinoma, the probable ureteral compromise should be considered especially in patients with clinical and radiological symptoms of urinary tract obstruction. A well-timed and proper diagnosis may influence in prognosis and survival.

OBJETIVO: Resaltar la importancia del seguimiento estrecho a largo plazo de pacientes con antecedente de carcinoma de mama.MATERIALES Y MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se presenta el caso de una mujer de 55 años de edad con antecedente de carcinoma lobulillar de mama. Recibió tratamiento neoadyuvante, cirugía y quimioterapia y radioterapia posterior. En estudio de imagen de control se diagnosticó de metástasis óseas múltiples. La paciente consultó por dolor lumbar izquierdo de varios meses de evolución, en estudio de imagen se observó hidronefrosis izquierda secundaria a lesión de partes blandas en unión pieloureteral con alteración funcional renal. En biopsia realizada mediante abordaje endoscópico (ureteroscopia) se diagnosticó de metástasis de carcinoma de mama en uréter.CONCLUSIÓN: Las lesiones metastásicas en uréter son extremadamente infrecuentes siendo aún menos frecuentes las de origen mamario con alrededor de diez casos publicados mundialmente. Con el diagnóstico previo de carcinomade mama, el probable compromiso ureteral debe ser tomado en cuenta especialmente en pacientes con síntomas clínicos y radiológicos de obstrucción de la vía urinaria. Un diagnóstico oportuno es posible que influya en el pronóstico y supervivencia posterior.

Laparoscopic Abdominopexy: Surgery for Vaginal Prolapse.

OBJECTIVES: We present a new surgery based on the round ligament anatomy that is called laparoscopic abdominopexy, which uses a synthetic mesh without fixation at any pelvic point. The aim of this study is to provide a step-by-step description of the laparoscopic abdominopexy technique and present the first anatomical and functional results of the procedure. METHODS: This prospective cohort study included patients with apical and anterior vaginal prolapse who were subjected to laparoscopic abdominopexy. Before and after surgery, the Pelvic Organ Prolapse Quantification (POP-Q) scale, Overactive Bladder Questionnaire-Short Form (OABq-SF), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to evaluate the vaginal prolapse stage, storage, and sexual symptoms, respectively. The surgical technique is described step by step. RESULTS: Twenty patients were included with follow-up times between 6 and 25 months. The mean surgical time was 78.4 minutes. A statistically significant improvement was observed in the Aa (P ≤ 10-5), Ba (P ≤ 10-5), C (P = 5 × 10-5), D (P = .002) and tvl (P = .02) POP-Q points and in OABq-SF (22.2%; P = .02). Successful surgery was observed in 100% of patients for the apical compartment and 90% of patients for the anterior compartment. CONCLUSION: Laparoscopic abdominopexy is a quick, safe, and reproducible surgical technique with beneficial anatomical and functional results that preserve the pelvic floor anatomy.