[Late metastasis in thyroid gland after nephrectomy for renal clear cell carcinoma]. / Metástasis tardía en glándula tiroidea tras nefrectomia por carcinoma renal de células claras.

Renal carcinoma natural history is unpredictable. Spontaneous metastases regression after nephrectomy, as well as late recurrence are suggestive of this peculiar human neoplasm. tumor metastases localized to thyroid gland are uncommon in clinical practice; and carcinoma of the kidney, breast, lung, melanoma and gastrointestinal tract tumors are responsible for the majority of them. This paper reports on a patient with metachronous thyroid gland metastases after fourteen years of renal carcinoma nephrectomy, with one year after hemithyroidectomy recurrence on cervical striated muscle followed by surgical excision. Therapeutical aspects are briefly reviewed in literature, emphasizing surgical treatment and the need of all-life follow-up, with more alert attitude toward thyroid gland after renal cell carcinoma nephrectomy.

[Ureteral obstruction secondary to inflammatory iliac aneurysm]. / Obstrucción ureteral secundaria a aneurisma ilíaco inflamatorio.

Inflammatory iliac aneurysms are uncommon and account for 1-2% of total abdominal aneurysms. These aneurysms are more susceptible to present urological symptoms and are difficult to diagnose because of their uncommon incidence and location in the deep pelvis which makes them little accessible to physical examination. This case report presents one patient with right obstructive uropathy secondary to extrinsic ureteral trapping due to inflammatory iliac aneurysm which evolved favourably after ureterolysis, endoaneurysmectomy and interposition of aortoiliac graft. A brief review of diagnostic and therapeutic aspects in the literature is included. The relevance of a high degree of suspicion to diagnose this entity in patients with otherwise explainable vesical irritative symptoms, haematuria or renal failure is highlighted.

[Renal carcinoma and von Hippel-Lindau disease]. / Carcinoma renal y enfermedad de Von Hippel Lindau.

Von Hippel Lindau disease is a highly uncommon autosomic dominant condition characterised by the presence of cerebellar hemangioblastomas, retina angioma, pancreas, kidney and epididymal cysts, and renal cells carcinoma. This article describes the case report of a male patient with Von Hippel Lindau disease which presented as a jaundice secondary to biliary obstruction due to pancreatic cystic mass. After urological examination, bilateral cystic lesions and right renal solid lesion were detected requiring surgical treatment. A review is made of the diagnostic and therapeutic aspects, highlighting the significance of early diagnosis and treatment.

[Giant urethral lithiasis]. / Litiasis uretral gigante.

Calculi in the male urethra are rare and are generally associated with urethral disorder (diverticuli, stricture, complication posturethroplasty, etc.). Treatment is generally by excision and resolution of the underlying cause. We report a case of urethral calculus, of apparently idiopathic etiology, that had treated by endoscopic ultrasonic disruption. The importance of preoperative etiologic diagnosis is underscored.

[Ectopic ureter in prostatic urethra. Unusual discovery in an adult]. / Uréter ectópico en uretra prostática. Descubrimiento inusual en adulto.

OBJECTIVE: Ectopic ureter is a congenital anomaly more frequent in the female, in the pediatric age and is commonly left-sided. The present article reports an uncommon case without the common features of this anomaly. METHODS/RESULTS: We report on a 67-year-old man with complete duplex system and ectopic obstructive megaureter in the prostatic urethra with a silent onset. The diagnostic and therapeutic aspects in the literature are briefly discussed. CONCLUSION: Because this anomaly is asymptomatic and incidentally discovered because of contralateral disease, the approach is conservative.

[Vesicovaginal fistula in an 8-year-old girl]. / Fístula vesicovaginal en niña de ocho años.

We report a case of vesicovaginal fistula in an 8-year-old girl caused by a foreign body in the vagina. The foregoing condition was associated with vesical lithiasis. Correction of the fistula was performed during the same surgical procedure for stone removal, without waiting for 3-6 months to elapse as advocated by most of the authors. A review of the literature revealed only one such case has been reported earlier.

[Inappropriate antidiuretic hormone secretion syndrome: a rare manifestation of prostatic adenocarcinoma]. / Síndrome de secreción inadecuada de hormona antidiurética: una rara manifestación de adenocarcinoma prostático.

OBJECTIVE: Prostatic cancer can produce signs and symptoms by local growth, direct invasion or distant metastases. In rare occasions, these tumors can show a clinical variance due to trophic factors, biologically active, secreted in neoplastic environment but with systemic relevance. These syndromes are called paraneoplastic syndromes. This uncommon condition is described herein. METHOD/RESULTS: We report a case of inappropriate antidiuretic hormone secretion as the presenting feature of advanced prostatic carcinoma. The pathogenic features, diagnostic and therapeutic aspects are reviewed. CONCLUSIONS: Although its frequency is low, we must consider prostatic carcinoma in patients with inappropriate antidiuretic hormone secretion syndrome. When the acute situation is resolved, hormonal treatment in disseminated carcinomas will return to normal the clinical and analytical parameters derived from this syndrome.

[Paratesticular rhabdomyosarcoma]. / Rabdomiosarcoma paratesticular.

We report a case of paratesticular rhabdomyosarcoma in a 5-year-old boy who was submitted to radical orchidectomy via the inguinal approach and high ligation of the spermatic cord. Clinical and retroperitoneal staging classify this case under group I of the Intergroup Rhabdomyoma Study. Adjuvan chemotherapy with 12 courses of VAC have achieved a good clinical course to date (14 months after surgery) and a good outcome is predicted. We review the literature and discuss the features of this mesenchymal tumor.

["Sand-clock" lithiasis on prostatic transurethral resection bed]. / Litiasis en "reloj de arena" sobre celda de resección transuretral prostática.

OBJECTIVES: Although uncommon, prostatic surgical bed lithiasis may present among post-TURP complications. The present study underscores the importance of diagnosis and treatment. METHODS/RESULTS: We report on a patient with magnesium ammonium phosphate hourglass lithiasis in the prostatic surgical bed one year and a half following transurethral resection due to adenomyomatous prostatic hyperplasia that was successfully treated by intracorporeal lithotripsy with the Lithoclast. The physiopathological, clinical, diagnostic and therapeutic aspects are discussed. CONCLUSIONS: This condition should be suspected in patients with dysuric syndrome post-TURP. The importance of simple complementary diagnostic procedures as DRE and plain abdominal films in discarding lithiasis in underscored. We consider retrograde endoscopic manipulation and ultrasonic lithotripsy or penumatic lithotripsy with the Lithoclast to be the safest procedures for this type of lithiasis.

[Ureteral endometriosis]. / Endometriosis del uréter.

OBJECTIVES: Ureteral involvement due to endometriosis is uncommon. Its silent onset and the progression of ureteral obstruction, if undiagnosed, can lead to the loss of the renal unit. The present case is described to underscore the importance of early diagnosis. METHODS/RESULTS: We report on a patient with obstructive uropathy secondary to intrinsic ureteric endometriosis that had undergone nephrectomy due to parenchymal destruction. One year following resection of the endovesical portion, recurrence in the ureteral stump was observed. The clinical features, the diagnostic and clinical aspects are briefly discussed. CONCLUSIONS: Although ureteric involvement is uncommon, renal function of patients with pelvic endometriosis must be followed closely by analyses, ultrasound and/or intravenous urography for early detection of this condition.

[Advanced tubercular disease of urogenital tract]. / Enfermedad tuberculosa avanzada del tracto urogenital.

OBJECTIVE: The genitourinary tract is one of the most common sites of extrapulmonary tuberculosis (30%-33%), followed by the lymphatic tissue, skeletal system and gut. Due to the diagnostic methods and therapeutic modalities currently available, it is infrequent to find advanced tuberculosis with extensive genitourinary involvement. METHODS/RESULTS: Herein we describe a patient with advanced genitourinary tuberculosis characterized by loss of right renal unit, left hydronephrosis due to ureterovesical junction stricture, contracted bladder, prostatic caseation and urethral stricture. Right nephrectomy and bladder substitution ileocystoplasty were performed. The clinical features, diagnostic and therapeutic aspects are discussed and the literature briefly reviewed. CONCLUSION: Extensive genitourinary tuberculosis is uncommon. The importance of early diagnosis and treatment is emphasized in order to avoid the irreversible sequelae.

[Metachronous metastasis in ureteral stump secondary to ipsilateral renal adenocarcinoma]. / Metástasis metacrónica en muñón ureteral secundaria a adenocarcinoma renal ipsilateral.

OBJECTIVES: Ureteral metastasis from renal adenocarcinoma is uncommon. The rarity of this disease prompted us to report on the present case, with special reference to diagnosis. METHODS/RESULTS: A patient with metachronous metastasis in the ureteral stump from clear cell renal adenocarcinoma resected three years earlier is described. The etiopathogenic, clinical, diagnostic and therapeutic aspects are briefly reviewed. CONCLUSIONS: Ureteral metastases, although uncommon, are generally ipsilateral to the renal tumor and arise from aggressive renal carcinomas that are locally advanced with vascular and/or lymphatic spread. We underscore the importance of retrograde pyelography and ureterorenoscopy in the diagnostic workup of all patients with gross hematuria following nephrectomy due to hypernephroma.

[Multiple giant ureteral lithiasis]. / Litiasis ureteral gigante múltiple.

OBJECTIVES: Ureteral calculi are usually small and arise from the kidney. The term 'giant' has been applied to ureteral stones that are more than 5 cms in length and/or 50 gms or more in weight. The low incidence of this condition prompted us to report this case. METHODS/RESULTS: Herein we describe a patient with multiple giant ureteral calculi with no evidence of underlying ureteral lesion, who required nephroureterectomy due to the damage caused to the renal unit by the obstructive uropathy. The literature is briefly reviewed, with special reference to the diagnostic and therapeutic aspects. CONCLUSIONS: Giant ureteral calculi are uncommon. They may cause scanty urological symptoms and might therefore be missed. If undiagnosed, renal function may be compromised by the obstructive uropathy.

[Primary prostatic infiltration by Burkitt's lymphoma]. / Infiltración prostática primaria por linfoma de Burkitt.

OBJECTIVE: Genitourinary tract involvement arising from non-Hodgkin lymphoma occurs in 10% of patients; prostatic infiltration is uncommon and accounts for less than 0.1%. The uncommon clinical onset of this infrequent condition prompted us to report on the present case. METHODS/RESULTS: A 41-year-old male patient with lower urinary tract outflow obstruction arising from prostatic enlargement secondary to non-Hodgkin lymphoma (Burkitt's lymphoma) is described. Treatment with chemotherapy achieved good results. The clinical features, diagnostic and therapeutic aspects are discussed and the literature briefly reviewed. CONCLUSION: The present case emphasizes the need to include non-Hodgkin lymphoma in the differential diagnosis of lower urinary tract outflow obstructive symptoms in young men with prostatic enlargement.