[Vasa praevia rupture in velamentous insertion of the umbilical cord: the importance of prenatal diagnosis]. / Rotura de vasa previa en una inserción velamentosa de cordón umbilical. Importancia del diagnóstico prenatal.

Vasa praevia is a rare condition in which the foetal blood vessels cross the foetal membranes of the lower segment of the uterus below the presenting part. It has a high foetal mortality due to foetal exsanguination resulting from foetal vessels tearing when the membranes rupture. Prenatal diagnosis can reduce or even prevent foetal mortality, but it requires a high level of suspicion. For this reason, pregnant women with risk factors of vasa praevia should be examined using transvaginal ultrasound in combination with colour Doppler, and if the diagnosis is made, elective delivery by caesarean and aggressive resuscitation of the new born is indicated.

[Mature cystic teratoma of the testis (dermoid cyst). Case report and literature review]. / Teratoma quístico maduro testicular (quiste dermoide). Aportación de un caso y revisión de la literatura.

SUMMARY OBJECTIVES: Case report of a mature cystic teratoma (dermoid cyst), pseudopilomatrixoma like variant. METHOD: 53-year old patient with a left testicular mass, diagnosed as mature cystic teratoma of the testis(dermoid cyst), the pilomatrixoma-like variant, after radical orchiectomy. Tumoral markers were negative and no extension was observed. The patient is disease-free after 6 months follow-up. RESULTS: Testicular teratoma is a tumour composed of cells derived from the three embryonic layers (ectoderm, endoderm and mesoderm). They can appear at any age, but they are much more prevalent in childhood. They appear at any age, but are much more common in childhood, where they comprise up to 30% of all tumours. They are much less prevalent in adults,representing only 7% of all testicular germ cell tumours CONCLUSIONS: Prepubertal cases are invariably benign in nature, regardless of their histology. However, cases which appear after puberty are potentially malignant, even if histologically pure. Mature cystic teratoma (dermoid cyst) is the only exception to this rule, as no malignant degeneration of these types of tumours has been published.

[Hourglass retroperitoneal ganglioneuroma]. / Ganglioneuroma retroperitoneal en reloj de arena.

INTRODUCTION: Ganglioneuromas are neuroblastic tumours with a higher degree of histological differentiation and clinical benignity. They are well defined, encapsulated tumours that are made up of mature ganglionar cells. They are located mainly in the sympathetic ganglia of the mediastinum and the retroperitoneum. In this latter place they can be very large and even penetrate through the intervertebral foramen in the spinal canal in the shape of an hourglass and produce medullar compression. They are tumours that are produced in childhood or infancy. CASE REPORT: In the course of the diagnosis of an acute digestive haemorrhage in a 29 year old female patient, an abdominal computerised axial tomography (CAT) scan revealed, by chance, an abdominal retroperitoneal tumour that had introduced itself into the spinal canal in the shape of an hourglass. The patient had had lumbar pain that irradiated to the anterior side of the abdomen although up to that moment it was not considered very important. From the CAT scan and magnetic resonance imaging of the lumbar region a large, solid tumour was detected which protruded out in the shape of an hourglass from the vertebral canal at the point between L2 and L3. The patient was submitted to a surgical intervention in two stages and the tumour was removed. Because it was highly vascularised, hours before the intervention an arterial embolization of the tumour was performed in order to limit surgical bleeding. CONCLUSIONS: Due to the unspecific and late symptomatology of ganglioneuromas, we maintained the therapeutical criterion of carrying out a biopsy puncture, as well as a follow up and control if the histological study did not show up any kind of malignity. Because of the possibility of this kind of tumour becoming malign and the fact that there is little chance of guaranteeing a correct diagnosis by means of biopsy puncture, extirpation should be carried out as completely and early as possible

Surgery with computerized virtual reality for the automatic detection of tumors.

We present a novel and highly accurate system based on informatics engineering capable of automatic detection of tumors directly in the operating field. The system can identify the outlines of the tumor, determine whether it is malignant or not, detect lymphadenopathy and determine whether nodes are metastasized or not. The highly elaborate system, based on artificial vision, has been used in 30 gastric and 5 pancreatic neoplasms, among other tumor types. Images of the surgical field were recorded with a video camera connected to a computer, which was operated by the engineer. Questions asked by the surgeon during the procedure were processed immediately and sent to the virtual reality helmet worn by the surgeon, to the TV monitor in the operating room, or to both. The system is based on purely physical and mathematical processes that work reliably; in this sense it is free from errors and is self-consistent, operator errors or hardware failure excepted. In all cases tested here the system correctly identified the tumor as benign or malignant, revealed the extension of the tumor, and detected lymph node metastases. In every case these results were confirmed by histological examination.

[Bladder schistosomiasis: report of 2 new cases with different anatomoclinical features and review of the literature]. / Esquistosomiasis vesical: aportación de dos nuevos casos con presentaciones anatomo-clínicas diferentes y revisión de la literatura.

This paper reports two cases of vesical schistosomiasis in two black patients treated in this Service over the last three years. A description is made of the different anatomo-clinical presentations of these two cases, commenting on the characteristics of this disease, its pathogenesis, diagnosis and treatment, and stressing the slight increase in its frequency in our environment as a consequence of the increased migratory movements of people from endemic regions into our country.