RESUMO
Leiomyomas may originate from any anatomic location of smooth muscle in the genitourinary system but are uncommon neoplasms. Five unusual cases of leiomyomas arising from the renal pelvis, bladder, spermatic cord, and glans penis are presented. The leiomyoma arising from the glans penis in a three-year-old boy is the first case of a leiomyoma in that location noted in the literature. A review of leiomyomas from each genitourinary structure of origin is presented.
Assuntos
Leiomioma/patologia , Neoplasias Urogenitais/patologia , Pré-Escolar , Feminino , Humanos , Neoplasias Renais/patologia , Pelve Renal/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Penianas/patologia , Neoplasias da Próstata/patologia , Escroto/patologia , Glândulas Seminais/patologia , Cordão Espermático/patologia , Neoplasias Testiculares/patologia , Neoplasias Ureterais/patologia , Neoplasias Uretrais/patologia , Neoplasias da Bexiga Urinária/patologia , Ducto Deferente/patologiaRESUMO
Leukemic infiltration of the urinary tract is most common in the kidneys. Other areas are involved much less frequently. We report a case of leukemic infiltration of the penis.
Assuntos
Leucemia Linfoide/patologia , Neoplasias Penianas/patologia , Neoplasias Penianas/radioterapia , Idoso , Radioisótopos de Cobalto/uso terapêutico , Humanos , Irídio/uso terapêutico , Leucemia Linfoide/radioterapia , MasculinoAssuntos
Escolha da Profissão , Emprego , Medicina , Especialização , Humanos , Países Baixos , Inquéritos e QuestionáriosRESUMO
Germ cell testicular tumors constitute a highly lethal group of neoplasms. Although recent diagnostic and therapeutic developments have altered the prognosis in this disease, delay in diagnosis and occasional mismanagement of patients continue to inhibit further improvement in survival. A ten-year retrospective study of germ cell tumors of the testis at West Virginia University Medical Center confirms confirms the need for patient education and physician awareness of the potential seriousness of all testicular masses. A high index of suspicion and an aggressive approach to management are advocated to improve long-term survival.
Assuntos
Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Testiculares/diagnóstico , Adulto , Disgerminoma/diagnóstico , Disgerminoma/terapia , Humanos , Masculino , Metástase Neoplásica , Neoplasias Embrionárias de Células Germinativas/terapia , Prognóstico , Estudos Retrospectivos , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/terapia , Fatores de Tempo , West VirginiaRESUMO
A review of the literature on the assessment of medical problem-solving by means of written tests reveals serious short-comings. Most important is the low correlation repeatedly found among cases, which suggests the inability of the measures to assess a general problem-solving ability. The literature further suggests that instruments should focus on the brief period of time after the first encounter of a clinical problem and warns against the effects of cueing. Based on these considerations a new measure for the assessment of medical problem-solving was developed. This test, called Simulation of Initial Medical Problem-Solving (SIMP), consists of a number of short case histories, followed by an open-ended question. Reliability analysed by means of generalizability theory proved satisfactory and concurrent validity was established by a significant correlation with a global judgement of performance in a simulated patient encounter. The moderate correlation between cases is interpreted as an acceptable correlation among test items and leads to the conclusion that a reliable and valid test of clinical problem-solving should consist of a substantial number of different cases.