Adrenal ganglioneuroma.

OBJECTIVE: To present one case of adrenal ganglioneuroma incidentally diagnosed in an adult. METHODS/RESULTS: 44-year-old woman with a 2.3 cm incidentaloma in the left adrenal gland diagnosed by CT scan. At 6 months, MRI was performed and a left adrenal nodule 3.7 cm was shown. Due to the progressive growth of the mass, surgery was indicated and left laparoscopic adrenalectomy was carried out. The final pathologic diagnosis was adrenal ganglioneuroma. CONCLUSIONS: The ganglioneuroma is a tumor composed of Schwann cells and ganglion cells. Its location in the adrenal gland is unusual, most frequently affecting other regions. Being asymptomatic lesions, they are often detected incidentally when performing imaging tests. There are radiological features that differentiate them from other adrenal masses. The treatment of choice is surgery, with adrenalectomy.

Supernumerary testicle: case report and bibliographic review.

OBJECTIVE: We report a case of supernumerary testis, a rare anomaly with only around 100 cases reported in the literature. METHODS: We describe the case of a 26-year-old man who consulted for a left paratesticular tumor. Physical examination and ultrasound showed a 2-cm nodular lesion over the left epididymis. The lesion was confirmed as supernumerary testis by surgical examination and biopsy and was subsequently excised, given the malignancy potential. RESULTS: The supernumerary testis was evaluated using two standard classifications, one assessing function and embryological development, and the other assessing topography, anatomy, and reproductive potential. CONCLUSIONS: The differential diagnosis for an intrascrotal mass should include the possibility of a supernumerary testis; hence, surgical examination and biopsy are necessary. Supernumerary testes should be excised in the case of pain, dysplasia, or in situ carcinoma, or whenever the biopsy is inconclusive.

Neuroendocrine carcinoma of the urinary bladder. 15-year retrospective analysis.

OBJECTIVES: Neuroendocrine tumors (NET) are cancers found in the bronchopulmonary tract, where they were first described in 1926. The tumors are associated with poor prognosis due to their high metastatic potency even after radical treatments associated with other neo- or adjuvant therapies. NET of the urinary bladder is a rare tumor and accounts for 0.5% of bladder tumors. METHODS: The study was designed as an observational, descriptive and retrospective study of 13 patients diagnosed, treated, and followed for NET of the urinary bladder at the Hospital and University Complex of Albacete, Albacete, Spain between 1995 and 2010. RESULTS: The sample was composed of 11 men and 2 women. Mean patient age at the time of diagnosis was 71 (range, 57-88; SD, 6.98) years. T4 (6 patients) was the most common T tumor stage, followed by T2 (5 patients) and T3 (2 patients). In the case of N tumor stage, the most common was N2. In the remaining 3 patients, the degree of lymph node involvement could not be assessed. Six presented distant metastasis at the time of diagnosis. Eleven patients presented small-cell NET on histology. Seven underwent radical surgery (radical cystectomy). All other patients were treated by deep transurethral resection of bladder tumor, except for 1 patient treated by partial cystectomy. Adjuvant chemo-therapy (usually an association of carboplatin/cisplatin and etoposide) was administered to 4 patients. Of these 4 patients, 2 were also treated by pelvic radiotherapy. Two patients survived more than 5 years following diagnosis. In fact, at the time the study data was collected only 4 patients had survived and 2 presented tumor recurrence. Of the 9 deaths, 8 occurred within 6 months of diagnosis and 1 at 24 months. All of them were the result of the disease itself. CONCLUSIONS: Neuroendocrine tumor of the urinary bladder is a rare, aggressive tumor with high metastatic potential that should be considered in the differential diagnosis of urinary bladder neoplasms. Despite various multimodality treatments have been used prognosis is poor.

Vaginal metastasis of a clear renal cell carcinoma.

OBJECTIVE: Remember that kidney cancer is a disease whose incidence is increasing due to increased use of additional imaging tests, which is changing the way of diagnosis, making the classic clinical syndrome synonymous with advanced illness. METHODS: We report the case of a patient with a right renal tumor with renal vein involvement that in the natural course of the disease showed a vaginal metastasis of clear renal cell carcinoma, which was treated with surgical excision. RESULTS: This case is a clear example of how unpredictable is the clinical evolution of this disease and how little we know about the way of dissemination. CONCLUSIONS: Local excision, with or without radiotherapy, or radiotherapy alone are recommended in cases of unique metastasis after nephrectomy.

Primary retroperitoneal tumors: review of our 10-year case series.

OBJECTIVES: To investigate our case series of patients with primary retroperitoneal tumors over the past 10 years, analyzing clinical symptoms, diagnostic tests, tumor pathology, surgical data, concomitant cancer treatments, recurrence and survival rates. METHODS: Retrospective analysis of 37 patients with primary retroperitoneal tumors diagnosed at our hospital over the past 10 years. RESULTS: Computed tomography (CT) was the imaging technique used most often and the most accurate. Tumors were malignant in 83% of patients and benign in 17%. Complete tumor resection was performed in 73% of cases; the most common approach was midline laparotomy. Neighboring organs were also removed in 51.8% of cases in which radical resection was performed. The recurrence rate was 45% in patients who underwent surgery. Median time to onset of recurrence following open surgery was 23 months. Repeat resection was performed in 66% of cases with recurrence. Five-year survival following total resection of malignant tumors was 44%. The mean patient survival after repeat resection was 9.8 months. CONCLUSIONS: Primary retroperitoneal tumors are rare and usually malignant. Surgery is the treatment of choice and complete tumor resection is the main factor that determines prognosis.

Local and distant recurrence of the chromophobe renal cell carcinoma. / Recidiva local y a distancia del carcinoma renal cromófobo.

INTRODUCTION: There is still limited knowledgeabout surveillance and optimal management for patientswith recurrent chromophobe renal cell carcinoma. OBJECTIVE: Describe our experience in the diagnosis andmanagement in recurrent chromophobe renal cell carcinoma. MATERIAL AND METHOD: Review of medical records ofpatients with chromophobe renal cell carcinoma, selectingthose cases that developed recurrence. RESULTS: Of the 23 patients, 4 developed recurrence andwere the subjects of our analysis. The mean age was 61.5years. Surgical treatment of primary renal tumor consistedof three radical nephrectomies and one partial nephrectomy.The mean time from nephrectomy to disease recurrencewas 6.7 years. One patient had recurrence in the retrovesicalarea, another in bone, and the two others in theretroperitoneum. The treatment for retrovesical recurrencewas an incomplete metastasectomy followed by temsirolimusand subsequent removal of the residual mass, stayingstable. The other three cases were unresectable surgicallyand received sunitinib. One patient now has a stable diseaseand the two others died. CONCLUSIONS: Chromophobe renal cell carcinomashowed a greater tendency to metastasize, so requires asurveillance protocol based on the risk of recurrence.

INTRODUCCIÓN: Existe un conocimientolimitado respecto al manejo óptimo y seguimiento del carcinomarenal cromófobo recidivante. OBJETIVO: Describir nuestra experiencia en el diagnósticoy tratamiento del carcinoma renal cromófobo recidivante. MATERIAL Y MÉTODO: Revisión de las historias clínicasde 23 pacientes diagnosticados de carcinoma renal cromófobo,seleccionando aquellos casos que desarrollaronrecidiva. RESULTADOS: De los 23 pacientes, 4 desarrollaron recidivay fueron los casos de nuestro análisis. La edad mediafue de 61,5 años. La cirugía del tumor renal primario consistióen tres nefrectomías radicales y una parcial. La mediadel tiempo desde la nefrectomía hasta la recidiva fue de6,7 años. Un paciente tuvo recidiva retrovesical, otro óseay los otros dos en retroperitoneo. El tratamiento para la recidivaretrovesical fue una metastasectomía parcial seguidade temsirolimus y posterior exéresis de la masa residual,manteniéndose estable. Los otros tres casos fueron irresecablesquirúrgicamente y recibieron sunitinib, de los cuáles,un paciente está estable y los otros dos fallecieron. CONCLUSIONES: El carcinoma renal cromófobo presentóuna mayor tendencia a metastatizar, por lo que requiereun protocolo de vigilancia basado en el riesgo de recidiva.

[Bladder leiomyomas.] / Leiomiomas vesicales.

Bladder leiomyomas are rare benign tumors; their common presentation are irritative and obstructive urinary symptoms. The treatment is complete surgical resection. OBJECTIVE: To present our experience in the diagnosis and the treatment of bladder leiomyoma. METHODS: A series of three clinical cases. RESULTS: In our series, two patients were women and one was man. The mean age was 33 years. Two women presented with irritative urinary symptoms and palpation of a pelvic mass, and the man was asymptomatic. Ultrasound showed the presence of an adnexal mass with left hydronephrosis in a female patient, bladder tumor in another female patient and pelvic mass of unknown etiology in the male patient. CT scan and MRI demonstrated the bladder origin of the lesion. A biopsy confirmed a bladder leiomyoma. Surgical treatment was partial cystectomy in all patients, and in one of them, nephrectomy was performed. During follow-up, all patients were asymptomatic and without recurrence. CONCLUSIONS: Imaging studies guide to diagnosis. Transurethral resection is recommended in lesions smaller than 3 cm. and enucleation or partial cystectomy in larger lesions. Prognosis is good.

Los leiomiomas vesicales son tumores benignos infrecuentes, causan sintomatología miccional y su tratamiento es quirúrgico. OBJETIVO: Presentar nuestra experiencia en el diagnóstico y tratamiento del leiomioma vesical. MATERIAL Y METODO: Serie de 3 casos clínicos. RESULTADOS: De los 3 casos, 2 fueron mujeres y 1 fue hombre. La edad media fue 33 años. Las dos mujeres presentaron síntomas miccionales irritativos y palpación de una masa pélvica, y el hombre cursó asintomático. La ecografía halló una masa anexial e hidronefrosis izquierdas en una paciente, tumoración vesical en otra paciente y masa pélvica de etiología no definida en el paciente varón. La tomografía y la resonancia magnética demostraron el origen vesical de la lesión. La biopsia confirmó el diagnóstico de leiomioma. Se realizó cistectomía parcial en todos los casos, con nefrectomía en uno de ellos. Durante el seguimiento no ocurrió recidiva tumoral. CONCLUSIONES: Los estudios de imagen nos orientan al diagnóstico. La resección transuretral está indicada en lesiones menores de 3 cm. y la enucleación o cistectomía parcial en lesiones de mayor tamaño. Su pronóstico es bueno.

Local and distant recurrence of the chromophobe renal cell carcinoma / Recidiva local y a distancia del carcinoma renal cromófobo

INTRODUCTION: There is still limited knowledge about surveillance and optimal management for patients with recurrent chromophobe renal cell carcinoma. OBJECTIVE: Describe our experience in the diagnosis and management in recurrent chromophobe renal cell carcinoma. MATERIAL AND METHOD: Review of medical records of patients with chromophobe renal cell carcinoma, selecting those cases that developed recurrence. RESULTS: Of the 23 patients, 4 developed recurrence and were the subjects of our analysis. The mean age was 61.5 years. Surgical treatment of primary renal tumor consisted of three radical nephrectomies and one partial nephrectomy. The mean time from nephrectomy to disease recurrence was 6.7 years. One patient had recurrence in the retrovesical area, another in bone, and the two others in the retroperitoneum. The treatment for retrovesical recurrence was an incomplete metastasectomy followed by temsirolimus and subsequent removal of the residual mass, staying stable. The other three cases were unresectable surgically and received sunitinib. One patient now has a stable diseaseand the two others died. CONCLUSIONS: Chromophobe renal cell carcinoma showed a greater tendency to metastasize, so requires a surveillance protocol based on the risk of recurrence

INTRODUCCIÓN: Existe un conocimiento limitado respecto al manejo óptimo y seguimiento del carcinoma renal cromófobo recidivante. OBJETIVO: Describir nuestra experiencia en el diagnóstico y tratamiento del carcinoma renal cromófobo recidivante. MATERIAL Y MÉTODO: Revisión de las historias clínicas de 23 pacientes diagnosticados de carcinoma renal cromófobo, seleccionando aquellos casos que desarrollaron recidiva. RESULTADOS: De los 23 pacientes, 4 desarrollaron recidiva y fueron los casos de nuestro análisis. La edad media fue de 61,5 años. La cirugía del tumor renal primario consistió en tres nefrectomías radicales y una parcial. La media del tiempo desde la nefrectomía hasta la recidiva fue de6,7 años. Un paciente tuvo recidiva retrovesical, otro ósea y los otros dos en retroperitoneo. El tratamiento para la recidiva retrovesical fue una metastasectomía parcial seguida de temsirolimus y posterior exéresis de la masa residual, manteniéndose estable. Los otros tres casos fueron irresecables quirúrgicamente y recibieron sunitinib, de los cuáles, un paciente está estable y los otros dos fallecieron. CONCLUSIONES: El carcinoma renal cromófobo presentó una mayor tendencia a metastatizar, por lo que requiere un protocolo de vigilancia basado en el riesgo de recidiva

Leiomiomas vesicales / Bladder leiomyomas

Los leiomiomas vesicales son tumores benignos infrecuentes, causan sintomatología miccional y su tratamiento es quirúrgico. Objetivo: Presentar nuestra experiencia en el diagnóstico y tratamiento del leiomioma vesical. Material y metodo: Serie de 3 casos clínicos. Resultados: De los 3 casos, 2 fueron mujeres y 1 fue hombre. La edad media fue 33 años. Las dos mujeres presentaron síntomas miccionales irritativos y palpación de una masa pélvica, y el hombre cursó asintomático. La ecografía halló una masa anexial e hidronefrosis izquierdas en una paciente, tumoración vesical en otra paciente y masa pélvica de etiología no definida en el paciente varón. La tomografía y la resonancia magnética demostraron el origen vesical de la lesión. La biopsia confirmó el diagnóstico de leiomioma. Se realizó cistectomía parcial en todos los casos, con nefrectomía en uno de ellos. Durante el seguimiento no ocurrió recidiva tumoral. Conclusiones: Los estudios de imagen nos orientan al diagnóstico. La resección transuretral está indicada en lesiones menores de 3 cm. y la enucleación o cistectomía parcial en lesiones de mayor tamaño. Su pronóstico es bueno

Bladder leiomyomas are rare benign tumors; their common presentation are irritative and obstructive urinary symptoms. The treatment is complete surgical resection. Objective: To present our experience in the diagnosis and the treatment of bladder leiomyoma. Methods: A series of three clinical cases. Results: In our series, two patients were women and one was man. The mean age was 33 years. Two women presented with irritative urinary symptoms and palpation of a pelvic mass, and the man was asymptomatic. Ultrasound showed the presence of an adnexal mass with left hydronephrosis in a female patient, bladder tumor in another female patient and pelvic mass of unknown etiology in the male patient. CT scan and MRI demonstrated the bladder origin of the lesion. A biopsy confirmed a bladder leiomyoma. Surgical treatment was partial cystectomy in all patients, and in one of them, nephrectomy was performed. During follow-up, all patients were asymptomatic and without recurrence. Conclusions: Imaging studies guide to diagnosis. Transurethral resection is recommended in lesions smaller than 3 cm. and enucleation or partial cystectomy in larger lesions. Prognosis is good

[Spermatic cord sarcomas: current status and report of four cases]. / Sarcomas de cordón espermático: estado actual y presentación de cuatro casos clínicos.

OBJECTIVE: To study and review spermatic cord sarcomas, including symptoms, diagnosis, and treatment. METHODS/RESULTS: We review the Spanish and international literature and report 4 new cases: 2 patients with well-differentiated spermatic cord liposarcomas (1 treated by simple tumorectomy), 1 patient with liposarcomatous degeneration of a previously excised atypical lipoma, and 1 patient operated for a malignant retroperitoneal fibrous histiocytoma with subsequent local recurrence in the paratesticular region. CONCLUSIONS: Spermatic cord sarcomas are rare entities that usually appear as painless paratesticular mass. They are diagnosed by imaging studies (ultrasound, computed tomography, magnetic resonance) and confirmed by histological examination. Spermatic cord sarcomas are treated surgically; the efficacy of adjuvant treatments such as chemotherapy or radiation therapy is still under debate.

[Impact of surgical treatment of female stress urinary incontinence on the quality of life of patients]. / Impacto de la cirugía de la incontinencia urinaria de esfuerzo en la calidad de vida de las pacientes.

OBJECTIVES: To evaluate the quality of life of patients with stress urinary incontinence (SUI) operated in the Department of Urology at the Complejo Hospitalario Universitario in Albacete (CHUA). METHODS: Between November 2001 and December 2005, 126 patients with SUI have completed a questionnaire in our centre, before and after undergoing surgery with sling techniques. The questionnaire was the King's Health Questionnaire (KHQ), which is a specific instrument for the measurement of quality of life in patients with urinary incontinence. RESULTS: Mean patient's age was 57.09 years (DE: 9.57). Twelve women (9.5%) had history of previous urinary incontinence surgery. Mean urinary incontinence evolution time was 114.48 months, with a median of 96 months. 38 patients (30.2%) did not present cystocele, 61 (48.4%) presented grade III cystocele, 25 (19.8%) grade II, and 2 (1.6%) grade I. Before surgery, the scale with best score was Personal relationships, with a mean score of 26.8, whereas the scale with worst scores was Impact of urinary incontinence, with a mean score of 82.96. All operations performed consisted in various techniques of transvaginal slings, except one case (0.8%) in which the Kelly technique was performed. Impact of urinary incontinence was the scale with a greater number of patients improving after surgery; 82.9% of the patients (101 cases) gave a better score. The scales showing greater differences of the mean value comparing before/after surgery were impact of urinary incontinence, limitation on the daily life activity, and limitation on social activity. Personal relationships and General health were the two with the smallest improvements. CONCLUSIONS: Surgery demonstrated to improve the symptoms secondary to this disease, therefore, it results in an improvement of the quality of life that is evident in all scales of the questionnaire, mainly in the impact of urinary incontinence, limitations on physical activity, limitations on daily life, and limitation on social activity scales.

[Retroorbital metastasis in the initial diagnosis of prostate cancer]. / Metástasis retroorbitaria en el diagnóstico inicial del cáncer de próstata.

OBJECTIVE: To describe one case of advanced prostate cancer first presenting with binocular diplopia due to retroorbital metastasis. METHODS: We present the case of a 54-year-old patient with the diagnosis of disseminated prostate cancer treated by complete androgen blockade. RESULTS: After the start of hormonal treatment, the patient initially improved although survival was limited. CONCLUSIONS: Orbital metastasis is an infrequent site for prostate cancer dissemination which implies a limited survival oscillating between 7,5-30 months. In our case survival was 10 months from diagnosis.

[Ambulatory surgery in a urology department. Analysis of the period 2003-2006]. / Cirugía ambulatoria en un Servicio de Urología. Análisis del período 2003-2006.

OBJECTIVES: When talking about day surgery we have to differentiate between minor and major ambulatory surgery. Ambulatory surgery enables the patient to stay in the hospital not more than a few hours, showing similar safety and efficacy than conventional surgery. The objective of this paper is to evaluate the results of an ambulatory surgery program. METHODS: Descriptive retrospective study of the results of the Ambulatory Surgery in a Urology Department, including 4,185 patients in a four-year period, from January 1st 2003 to December 31st 2006. RESULTS: In the study period the global substitution rate was 83.6%. The hospital admission rate was 2.5%, most of which were early admissions. Major complications appeared in 26 patients (0.6%), being major bleeding the predominant one. Most complications were minor or mild, and pain at the site of the surgical wound was the most frequent problem found. CONCLUSIONS: The increase and continuous promotion of ambulatory surgery are more than justified. The high satisfaction among patients undergoing this type of surgery, with a very low number of complications registered, provides us with a valuable tool for health-care expenditure control.

[Bellini duct carcinoma: report of two cases]. / Carcinoma de los ductos de Bellini: aportación de dos nuevos casos.

OBJECTIVE: We report two cases of collecting duct carcinoma that were diagnosed in our hospital in a six-month period. METHODS/RESULTS: The first case was a 75years-old woman showing in CT scan a mass in the left kidney which infiltrated perinephric fat. The second case was a 72-years-old that showed in a CT scan a right renal pelvis lesion, involving inferior vena cava and renal vein. After surgical resection by radical nephrectomy in both cases, we confirmed the histological diagnosis of collecting duct carcinoma. CONCLUSIONS: Collecting duct carcinoma is a rare variant of renal cell carcinoma which originates from the epithelium of the collecting tubule. It is characterized by both its aggressiveness and peculiar histological and immunohistochemical diagnosis, that separates it from the rest of renal tumors.

[Late lymph node metastasis in renal cell carcinoma. Case report]. / Metástasis ganglionar tardía de carcinoma de células renales. Aportación de un caso.

OBJECTIVE: To report one case of late metastasis of a clear cell carcinoma treated by radical surgery. METHODS/RESULTS: Patient with history of radical nephrectomy and lymphadenectomy six years before presenting with regional lymph node metastasis in a followup diagnostic test. After treatment with immunotherapy, stopped because of intolerance, surgery of the metastatic lymph node mass was decided. CONCLUSIONS: Renal cancer is an unpredictable tumor in terms of oncological behaviour, so that it may metastasize any time in its evolution, even after radical surgery and several years free of disease. Surgery for the metastases of renal cancer is a good therapeutic option, with good long-term results, when they are isolated and accessible to surgery.

[Voiding symptoms changes after vaginal sling surgery for female stress urinary incontinence]. / Cambios en la sintomatología miccional de la incontinencia urinaria de esfuerzo tras la cirugía con técnicas de cabestrillo transvaginal.

OBJECTIVES: To evaluate the changes in voiding symptoms in female patients with stress urinary incontinence (SUI) undergoing transvaginal sling techniques over a five-year period in the Department of Urology at the University Hospital of Albacete. METHODS: Between November 2001 and December 2005 126 patients with SUI (mean age 57.09 years; 36-78) underwent transvaginal sling techniques (Sling in Fast, TVK TOT). All patients were evaluated clinically and urodynamically. RESULTS: Average body mass index (BMI) was 28.14 kg/m2 (SD 4.66; 95% CI: 27.32-28.96). 92 patients (73%) presented between 2-4 previous pregnancies. 99 patients (80.9%) have had birth labour between 2 and 4 times. All of them were vaginal birth labours except 12 cases (9.5%) in which caesarean section had been performed. Daytime voiding frequency after surgery was over 120 minutes in 112 patients (88.9%). Night-time voiding frequency was equal or less than twice in 110 patients (87.3%). 104 patients (82.5%) presented at least two leaking episodes per day, and 105 patients (83.3%) needed to wear one pad per day or less during the last week before follow-up visit. The number of urinary leak episodes per day diminished in 114 patients (90.5%) with a mean decrease of 9.65 episodes (95% CI: 8.56-10.79) (p < 0.0001). Ninety-four patients (76.4%) were completely dry. CONCLUSIONS: Development of new surgical techniques for the treatment of SUI have improved results and diminished the number of complications, an expression of which is the favourable evolution of voiding changes after surgery.

[Bladder endometriosis. Report of two cases and bibliographic review, with special focus on Spanish articles]. / Endometriosis vesical. Revisión de la literatura, con especial referencia a la española y aportacion de dos nuevos casos.

OBJECTIVES: To study and review the etiopathogenic hypothesis for endometriosis and the clinical features, diagnosis and treatment of bladder endometriosis. METHODS/RESULTS: We report two cases and review the international bibliography, collecting the cases published by Spanish authors. CONCLUSIONS: Bladder endometriosis is a rare pathological entity, but its diagnosis should be considered in fertile women with urinary tract symptoms during menstruation. Diagnosis is obtained by various imaging tests (ultrasound, CT scan, MRI), and is confirmed with cystoscopy and biopsy. The treatment may be surgical (TUR, partial cystectomy) and/or medical (hormonal).

Determination of vhl gene mutations in sporadic renal cell carcinoma.

OBJECTIVE: Characterization of the molecular status of the vhl gene and its relationship to the usual prognostic factors could help establish new diagnostic and therapeutic strategies. This study determines the presence of vhl gene mutations in tumor tissue from patients with sporadic renal cell carcinoma, the relationship between the mutations and classic prognostic factors, and the possible impact on protein function. MATERIALS AND METHOD: Cross-sectional analytical study investigating vhl gene mutations in tumor tissue by PCR testing of the gene exons and automatic sequencing in 96 patients with sporadic renal cell carcinoma. The characteristics of the mutations detected, as well as their relationship with various clinical and pathological parameters and the possible impact on protein function, were analyzed. RESULTS: Twenty-two mutations were found in 21 patients (21.9%); 68.2% were point mutations. The mutations were associated only with tumor histotype and were located in protein functional domains. Three mutations were detected in the intron position; 73.7% were considered relevant to protein function. CONCLUSION: The percentage of vhl gene mutations in sporadic renal cell carcinoma was relatively low, mutations were seen more often in clear cell carcinoma and were not related to the classic clinical prognostic factors. Mutations of the vhl gene produce important changes in the protein, causing it to lose its tumor suppressor function.

[Malignant melanoma of the penis. Report on one case]. / Melanoma mauligno de pene. Aportación de un caso clínico.

OBJECTIVES: Due to the fact that melanoma of the penis is rare, we perform a bibliographic review about the subject and analyze the diagnostic criteria, clinical stages and therapeutic options. METHODS: We report one case that was diagnosed and treated in our department. RESULTS: 85-year-old male who presented with hematuria and a red brownish irregular elevated lesion in the glans penis. Partial penectomy was performed. CONCLUSIONS: Melanoma of the penis is a rare tumoral entity. It accounts for about 1% of all penile malignant pathologies. It has bad prognosis due to fast metastosic dissemination (regional lymph nodes and other organs) and delayed diagnosis. First choice treatment is partial penectomy with or without bilateral inguinal lymphadenectomy (depending upon degree of tumor invasiveness). In cases with metastasis treatment is palliative with chemotherapy and immunotherapy