Metastatic non-muscle invasive bladder can-cer with cervical lymph node metastasis.

Bladder cancer is a common cancer that may present as superficial, invasive, or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for significant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limi-ted case reports about early metastasis in the literature.

[TERTIARY PERITONITIS]. / PERITONITIS TERCIARIA.

Tertiary peritonitis is an intraabdominal infection that arises in some patients with secondary peritonitis, despite receiving appropriate treatment. Recently described, it is a syndrome of late peritonitis and we are still lacking a precise and widely adopted definition. Diagnosis is difficult and treatment is complex. Among other therapeutic efforts, this entity requires early and repeated surgical treatment, either on demand or scheduled laparotomy, or even laparostomy. Prognosis is poor, and mortality can reach up to 60% of patients. We present the most interesting aspects of this disease.

[Splenic-thoracic transit: a rare evolution of hydatid disease]. / Transito esplenotorácico: una rara evoución de la hidatidosis.

We report a case of splenic hydatid cyst, an unfrequent localization of hydatid disease that usually presents with hydatid cysts in other organs (but not in this case). Primary spleen infestation generally occurs trough arterial blood supply, after the oncosphere of Echinococcus granulosus travels from host's digestive tube to the left atrium, passing trhough hepatic and pulmonar filters; other routes are also possible. Migration of an abdominal hydatid cyst into the thoracic cavity (phenomena called abdominal thoracic hydatid transit) occurs in 3.5% to 5% of liver cysts, and is quite exceptional in splenic cysts. Clinical manifestations are mainly thoracic, the diagnosis is based on serological tests and imaging studies, and surgical treatment is always required. Taking advantage of this unusual case, we remember the pathogenesis of splenic hydatid disease as well as the pathophysiology of transdiaphragmatic transit of abdominal hydatid disease.

[Peculiarities of the surgery in the elderly. I. General considerations]. / Peculiaridades de la cirugía en el anciano. I. Consideraciones generales.

Geriatric surgery has experienced a great development over the past decades, not only because of the aging of the population, but also because of the better understanding of the aging process and technical progress. All these circumstances have expanded surgical supply to the elderly, as well as similar results to those earned in younger patients. In this paper, we review the concept of elderly, population aging, pathophysiology of aging, the peculiarities of illness in the elderly and the impact of aging on surgical practice. After considering the concept of surgical risk, we discuss preoperative evaluation of the old patient, plus aspects related to the surgery itself and postoperative recommendations. Finally, we conclude with some ethical considerations about surgery in the elderly.

[Hereditary digestive hamartomatous polyposis syndromes]. / Síndromes de poliposis digestivas hereditarias hamartomatosas.

Several hereditary syndromes with multiple digestive hamartomatous polyps are described; they are produced by germline mutations. All of them are associated to an increased risk of colorectal cancer and other neoplasms, by the suppressor class of the mutated gens probably. The Peutz-Jeghers syndrome, the Juvenile plyposys syndrome, the PTEN hamartomatous tumor syndrome, and other less frequent hamartomatous syndroms are described.

Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis

ABSTRACT Bladder cancer is a common cancer that may present as superficial, invasive, or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for significant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limited case reports about early metastasis in the literature.