[Secondary bilateral testicular plasmacytoma. Case report and review of the literature]. / Plasmocitoma testicular bilateral secundario. Aportación de un caso y revisión de la literatura.

Testicular plasmacytoma is a very unfrequent plasma cells neoplasm. It is usually an incidental autopsy finding devoid of clinical expression, but it presents sometimes as part of a multiple myeloma and is exceptionally its only location. Bilateral involvement is extremely unfrequent. We report the case of a 58-years-old man diagnosed with multiple myeloma in complete remission who complains about progressive enlargement of both testicles. After ultrasonography and PAAF, bilateral testicular plasmacytoma is diagnosed. Treatment includes surgery (orchiectomy), radiotherapy and chemotherapy. Prognostic is worse when multiple myeloma is associated.

[Urogenital tuberculosis. Starting with haematuria and a bladder mass]. / Forma de presentación seudotumoral de tuberculosis urogenital: caso clínico.

We describe here in a case of genitourinary tuberculosis presenting with a haematuria and a bladder tubercle. Though imaging studies made genitourinary tuberculosis diagnostic feasible, the clinical presentation made runing out malignancy mandatory. Bladder tubercle was endoscopicary removed and histopathological analysis performed.

[Localized amyloidosis of the seminal vesicles]. / Amiloidosis localizada de vesículas seminales.

Amyloidosis of the seminal vesicles is a common finding in autopsies, with increased incidence in older population. It is usually asymptomatic. We report a case of symptomatic localized amyloidosis of the seminal vesicles, with hemospermia and suprapubic pain. Diagnosis was achieved through ultrasound-guided transrectal biopsy. Systemic amyloidosis must be ruled out through proper evaluation. Seminal vesicle enlargement secondary to amyloid deposit may be misdiagnosed as carcinomatous invasion.

[Bilateral obstructive uropathy secondary to inguinoscrotal bladder hernia]. / Uropatía obstructiva bilateral secundaria a hernia vesical inguinoescrotal.

Bladder hernia is present in an important number of cases of inguinal hernias. Massive inguinoscrotal bladder hernias are rarer. The association of massive bladder hernia and bilateral ureterohydronephrosis is not often found. According to our knowledge, there have been only seven cases documented in the last ten years. Therefore, we will present a case of renal failure secondary to inguinoscrotal bladder hernia with bilateral obstructive uropathy. Once we have analyzed a clinical case, we will give the diagnosis and treatment for those hernias.

[Early diagnosis of prostate cancer in patients with prostate symptoms by DRE, PSA, TRU and DPSA]. / Diagnóstico precoz del cáncer de próstata en pacientes con sintomatología prostática mediante TR, PSA, ECOTR y DPSA.

Presentation of our experience in the early diagnosis of prostate cancer in patients with signs and symptoms of prostatism. Over a one year period (96-97), 316 patients underwent biopsy based on clearly defined criteria according to the diagnostic algorithm used in our centre: suspicious DRE and/or PSA > or = 10 ng/mL, and in patients with PSA between 4 and 10 ng/mL in the presence of suspicious TRU or when DPSA was > or = 0.15. The ratio of the 136 (43%) prostate cancer diagnosed relative to biopsy +/- was 1:1.32. It is concluded that early diagnosis in a selected population is useful and shows good diagnostic yield. The diagnostic algorithm used is more than acceptable with 43% positive biopsies and a good ratio between biopsy +/-. With a cutoff of 0.15 DPSA is a good method to improve PSA significance in patients in the difficult PSA range of 4 to 10 ng/mL.

[Left supraclavicular adenopathy with a neuroendocrine pattern of unknown cause: prostatic carcinoma metastasis]. / Adenopatía supraclavicular izquierda con patrón neuroendocrino de causa desconocida: metástasis por carcinoma de próstata.

Contribution of a case report of a male patient presenting with single left supraclavicular adenopathy of initially unknown origin and histologic pattern of neuroendocrine nature, finally traced to the prostate. It is believed that in any male over 45 diagnosed with carcinoma of unknown origin in the supradiaphragm lymph nodes, prostate carcinoma metastasis should also be ruled out using PSA immunostaining and by measuring serum PSA, serum alkaline phosphatase and DRE.

[Bladder tumor in pregnancy]. / Tumor vesical durante el embarazo.

Diagnosis of tumours during pregnancy is quite unusual, considering the low frequency of neoplasias in this period (1/1000 pregnancies) as well as the low incidence of bladder cancer in patients under 30, which makes the coincidence of both phenomena quite uncommon. The paper contributes the case of a 28-year old female diagnosed with bladder cancer during her pregnancy.

[Report of a new case of small-cell carcinoma of the bladder and review of the literature]. / Aportación de un nuevo caso de carcinoma de células pequeñas de localización vesical y revisión de la literatura.

We report a case of small cell carcinoma of the urinary bladder in 71-year-old male patient. Oat cell of the urinary bladder is extremely uncommon, and up to date only 135 cases have been reported in word literature. Histologic, microscopic, and immunohistochemical characteristics are similar to oat cell carcinoma of the lung and other extrapulmonary oat cell carcinomas. We conclude this report with immunohistochemical study with PGP 9.5, neuron-specific enolase a synaptophisine.

[Four new cases of urothelial inverted papilloma]. / Cuatro nuevos casos de papiloma invertido urotelial.

Urothelial inverted papilloma account for 2.2% of all urothelial tumours. The preferred location is the bladder; they occur singly and are generally benign, although the majority of authors agrees in treating this entity as a tumour of low aggressiveness. The report contributes four cases of inverted papilloma, three in male patients and the fourth in a female. One was located in the renal pelvis. A revision is made of the etiology, clinical signs and symptoms, diagnosis and treatment, as well as their relationship to surface carcinoma, as it occurs asynchronously in one of the cases described.

[The relationship of cavernous oxygen tension with erectile dysfunction of vascular origin]. / Relación de la tensión de oxígeno cavernosa con la disfunción eréctil de origen vascular.

OBJECTIVE: To determine the intracavernous partial oxygen pressure in different etiological groups of erectile dysfunction: psychogenic (control group), arterial and veno-occlusive and the value of intracavernous gasometry as an indicator of the degree of severity of impotence. METHODS: A total of 16 patients were evaluated according to the diagnostic protocol utilized to determine the etiology of erectile dysfunction. Intracavernous blood samples were obtained during the initial phase of gasometry and PO2 was determined by standard gasometric methods. RESULTS: After injection of the vasoactive drug, the mean intracavernous PO2 was 92.4 +/- 1.27 for the control group, 62.2 +/- 0.85 for the group with arterial impotence, and 76.8 +/- 1.45 for the group with venous impotence, demonstrating a statistically significant difference (p < 0.01). CONCLUSIONS: Intracavernous gasometry, in combination with other diagnostic tests, is useful for evaluating the degree of severity of erectile dysfunction. The reduction in cavernous oxygen tension, which induces cavernous tissue fibrosis, can be considered to be a common mechanism in arterial and venous impotence.

[Spontaneous bladder perforation secondary to bladder candidiasis]. / Perforación vesical espontánea secundaria a candidiasis vesical.

Presentation of an spontaneous vesical perforation secondary to vesical candidiasis in a patient with in-dwelling catheter due to BPH. Analysis of etiological factors, clinical signs and symptoms, diagnosis and management of both entities.

[Percutaneous treatment of Fraley syndrome]. / Tratamiento percutáneo del síndrome de Fraley.

OBJECTIVE: A case of upper calyx obstruction of the left kidney from an artery encroaching on the infundibulum is described. Treatment was by percutaneous insertion of a prosthesis. The results show the usefulness of the percutaneous approach in the treatment of this condition. METHODS: A Palmaz prosthesis was inserted into the obstructed infundibulum through a nephrostomy. Intravenous urography was performed immediately postoperatively and at 3, 6 and 12 months. RESULTS: No complications were observed postoperatively. At one-year follow-up the patient is asymptomatic and the urographic controls show improvement. CONCLUSIONS: Percutaneous insertion of a prosthesis in the treatment of infundibular stenosis had achieved good results in the case described herein, although a larger series and long-term follow-up are required to determine the usefulness of this approach.

[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.

[Immunoprophylaxis of superficial tumors of the bladder with interferon alfa-2b. Our experience]. / Inmunoprofilaxis de los tumores superficiales de vejiga con interferon alfa 2b. Nuestra experiencia.

OBJECTIVE: The present study was conducted to determine the usefulness of prophylactic therapy with alpha 2b interferon for superficial bladder tumors. METHOD: Following complete TUR, alpha 2b infereron was administered to 36 patients at a dose of 50 million IU weekly for 3 months and monthly for 9 months. Patients were evaluated every 3 months on the basis of their clinical and analytical data and the cystoscopic findings. RESULTS: Twenty-six patients completed treatment and were evaluable. The follow up and disease-free period was 25.70 months. Recurrence was observed in 38.4% of the patients and tumor progression in 3.8%. CONCLUSIONS: Alpha 2b interferon is useful in the prevention of tumor recurrence. Its utility is similar to that of other drugs currently used.

[The role of vascular radiology in the diagnosis of "suspicious" images of the upper urinary tract]. / Papel de la radiología vascular en el diagnóstico de las imágenes "sospechosas" del tracto urinario superior.

Accurate diagnosis of "suspect" lesions from the Upper Urinary Tract (U.U.T.) is of major significance for implementing an appropriate treatment. There are many diseases and situations which may condition the occurrence of a suspect image, i.e., of a repletion defect of the U.U.T., in the U.I.V., the vascular imprints being just one of them. This paper contributes two cases where the suspect lesion was due to this cause and vascular radiology was decisive to reach a diagnosis.

[Our experience with mitomycin C in the prophylaxis of superficial bladder tumors; retrospective study]. / Nuestra experiencia con mitomicin C como profilaxis en los tumores superficiales de vejiga; estudio retrospectivo.

From 1984 to 1991, fifty-one patients completed prophylactic endovesical treatment with mitomycin C after transurethral resection of a bladder carcinoma Ta, Tl. The mean disease-free period was 31.2 months; twenty patients had recurrences (39.2%) and five (9.8%) had a progression in tumor stage. No statistically significant differences were found relative to the recurrences and tumor number, stage and size. The patients with prior tumors had recurrences before (p < 0.05) and more times (p < 0.01) than the primary group.

[Prospective and randomized study comparing mitomycin C and interferon alpha 2b in the prevention of superficial tumors of the bladder]. / Estudio prospectivo y aleatorio comparando mitomicin C e interferon alfa 2b en la profilaxis de los tumores superficiales de vejiga.

Contribution of our experience in 66 patients included in a prospective randomized study to compare the efficacy of Mitomycin C (MMC) and Alpha 2B Interferon (IFN) in the prevention of relapse of vesical surface tumours. Thirty-five patients were included in the MMC arm, 29 of which completed the treatment. Thirty-one patients were included in the IFN arm, 26 of which are evaluable. MMC was given endovesically at a rate of 30 mg weekly for one month, and then monthly to complete one year. Through the same route, 50 million units of IFN were given weekly for 3 months, and then monthly to complete one year. Within the MMC arm, three patients (10.3%) showed progress, twelve patients (451.3%) relapsed, and seventeen (58.7%) are disease free. With regard to IFN treated patients, one patient (3.8%) showed progress, ten (38.4%) relapsed, and sixteen (61.6%) are disease free. We conclude that there are no significant differences between these two drugs.

[The ovarian vein syndrome. Its treatment by percutaneous embolization and a review of the same]. / Síndrome de la vena ovárica. Tratamiento por emoblización percutánea y revisión del mismo.

Since Clark first described the ovarian vein syndrome in 1964, there has been much controversy over its existence. We report two cases of ovarian vein syndrome whose presenting feature was lumbar pain. Following treatment by percutaneous coil embolization of the corresponding ovarian vein, the symptoms rapidly improved and the patients are asymptomatic at 8 and 21 months follow up. We underscore the importance of symptomatic relief over the radiologic findings. The most important aspects and controversies of this syndrome are briefly reviewed.

[Endometrial carcinoma of the prostate. Report of a case]. / Carcinoma endometroide de próstata. A propósito de un caso.

Endometrial Carcinoma is an uncommon intraductal prostatic tumour, the origin (either from prostatic epithelium or Müellerian) and management (traditional hormonal therapy vs. progestagens) of which has been the subject of vigorous debate. Currently and with the help of the immunohistochemical techniques its origin has finally been confirmed as being prostatic, thus justifying the use of the traditional hormonal therapy applied in prostate acinous carcinoma. The paper contributes one case of Endometrial Carcinoma confirmed by immunohistochemical techniques, as well as a review of the main landmarks in the study of these tumours.