RESUMO
OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors.
Assuntos
Tumores do Estroma Gastrointestinal/complicações , Hemoperitônio/etiologia , Neoplasias Renais/complicações , Neoplasias Retroperitoneais/complicações , Idoso de 80 Anos ou mais , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/cirurgia , Hemoperitônio/terapia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Masculino , Radiografia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Ruptura EspontâneaRESUMO
Bladder cancer (BC) is one of the most common tumors in the world. Cystoscopy and tissue biopsy are the standard methods in screening and early diagnosis of suspicious bladder lesions. However, they are invasive procedures that may cause pain and infectious complications. Considering the limitations of both procedures, and the recurrence and resistance to BC treatment, it is necessary to develop a new non-invasive methodology for early diagnosis and multiple evaluations in patients under follow-up for bladder cancer. In recent years, liquid biopsy has proven to be a very useful diagnostic tool for the detection of tumor biomarkers. This non-invasive technique makes it possible to analyze single tumor components released into the peripheral circulation and to monitor tumor progression. Numerous biomarkers are being studied and interesting clinical applications for these in BC are being presented, with promising results in early diagnosis, detection of microscopic disease, and prediction of recurrence and response to treatment.
RESUMO
Urethral stricture (US) affects most commonly the anterior portion of the urethra, concretely the bulbar, with a significant incidence in men. Open urethroplasty is the gold standard treatment. However, stricture recurrence (SR) remains a current subject of concern. The aim of the present review is to provide an updated literature summary on surgical urethroplasty techniques for bulbar US and prognostic factors for SR, comparing the different approaches. For short strictures, excision and primary anastomosis (EPA) is the preferred option, with success rates exceeding 90%. Substitution techniques are usually required for longer strictures (>2-3cm). Buccal mucosa graft (BMG) remains the first choice as it complies with ideal features, with no significant differences regarding the site of graft implantation. Stricture length, time since urethroplasty and number of previous urethral interventions are risk factors for failure. Also, surgeon's experience affects technique selection and future outcomes. There seems to be consensus on a higher SR rate following substitution techniques compared to EPA, which appears to be influenced by the stricture length, usually longer in the former group. Furthermore, there is a trend in favor of endoscopic management of SR, except for long and complex recurrences where grafts should be used. In conclusion, multiple urethroplasty techniques are available and selection must be carefully individualized, focusing on stricture characteristics, patient's history, and surgeon's experience. Well-designed studies with clear definitions and follow-up protocols are still necessary to develop standardized guidelines on the management of bulbar US.
Assuntos
Mucosa Bucal , Recidiva , Uretra , Estreitamento Uretral , Estreitamento Uretral/cirurgia , Estreitamento Uretral/patologia , Humanos , Masculino , Mucosa Bucal/transplante , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Anastomose Cirúrgica/métodos , Resultado do TratamentoRESUMO
We report a case of a rare congenital malformation, a urogenital sinus cyst in a young patient with non-specific symptoms for several months. A 21-year-old male presented with vague and intermittent abdominal pain. Ultrasound scan showed a retrovesical hypoechoic collection (approximately 6 cm) and left renal agenesis, compatible with a possible congenital malformation. These findings were confirmed by MRI. A laparoscopic excision of the cyst was performed with no complications. Pathology report confirmed a urogenital sinus cyst. The postoperative recovery was uneventful and the patient was discharged within 48 h. Urogenital sinus cysts are rare entities with few cases described in the literature. Imaging techniques such as ultrasound, CT or MRI may help with diagnosis. Therapeutic modalities range from observation to needle aspiration or surgical removal. In our case, we chose a laparoscopic approach to minimize morbidity and achieve an early recovery.
Assuntos
Anormalidades Congênitas/diagnóstico por imagem , Cistos/diagnóstico por imagem , Nefropatias/congênito , Glândulas Seminais/anormalidades , Anormalidades Congênitas/cirurgia , Cistos/cirurgia , Humanos , Rim/anormalidades , Rim/diagnóstico por imagem , Rim/cirurgia , Nefropatias/diagnóstico por imagem , Nefropatias/cirurgia , Masculino , Glândulas Seminais/diagnóstico por imagem , Glândulas Seminais/cirurgia , Ultrassonografia , Adulto JovemRESUMO
Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...
Paciente de 40 años de edad, sin alergias medicamentosas conocidas y sin antecedentesde interés, que es traído a Urgencias por dispositivo de cuidados críticos por politraumatismo tras accidente de moto...
Assuntos
Nefropatias , Constrição Patológica , HumanosRESUMO
OBJECTIVE: Testicular epidermoid cyst is a rare clinical entity that accounts for 1% of testicular neoplasias. METHODS AND RESULTS: We report two cases of testicular epidermoid cysts in a 18 and 19 year old males with a painless testicular lesion. Testicular US was carried out showing a hypoechoic nodule in both cases. With the suspicion of testicular neoplasm inguinal orchiectomy was carried out with placement of testicular prostheses in the same act. The pathology report was testicular epidermoid cyst in both cases. CONCLUSIONS: Testicular epidermoid cysts are an uncommon benign entity. When there is a suspicion of this diagnosis, based on tumor markers and ultrasound or MRI images, testicular parenchyma-sparing surgery must be attempted.