[Small cell carcinoma of the bladder. Report of a new case]. / Carcinoma de células pequeñas de vejiga. Aportación de un nuevo caso.

Contribution of a case report of vesical small cell carcinoma (SCC) seen at our Centre and managed with partial cystectomy and systemic chemotherapy (CMT) with M-VAC. SCC is an uncommon neoplasia of the bladder usually associated with an aggressive behaviour. The effectiveness of radical surgery has not been demonstrated, so a conservative treatment was chosen which has allowed to preserve a high quality of life until now, 36 months after diagnosis. The studies of local and distant relapses show no signs of residual disease.

[Fibrino-necrotic ulcers in endovesical chemoprophylaxis in superficial bladder carcinoma: our case histories]. / Ulceras fibrinonecróticas en la quimioprofilaxis endovesical en el carcinoma superficial de vejiga: nuestra casuística.

Presentation of one study on the incidence of fibrino-necrotic ulcers in patients undergoing endovesical chemoprophylaxis with mitomycin C. A description is made of these lesions evaluating their likely relationship to infectious processes. The paper concludes stating the need of endoscopic monitoring and the absence of proven prognostic factors.

[Spontaneous bladder rupture: report of a case]. / Rotura vesical espontánea: a propósito de un caso.

Contribution of one case of spontaneous vesical fracture in a patient with no urinary pathological background. Presentation of this picture is highly uncommon. In this case, a major alcoholic intake stands out as the unleashing factor which provoked vesical overdistension with an intraperitoneal posterior fracture. A review is made of the various etio-pathogenic mechanisms which can originate this pathology, as well as the diagnostic and therapeutic methodology.

[Echodensitometry: a new echographic diagnostic possibility]. / Ecodensitometría: una nueva posibilidad diagnóstica ecográfica.

The determination and quantification of grey levels in the echography scale, designated by some authors Echodensitometry, is viewed as a new method for diagnosis using ultrasound techniques. This paper advances the results from a study conducted with an echographer equipped with an echographic density measuring device. This model analyzes the number of pixels in the image showing the most frequent level of grey. Normal and pathological parenchymatous urological organs (kidney, prostate and testicle) have been examined. Normal organs show a gaussian distribution of grey with a predominant level of typical grey for each of them. When affected by an acute inflammatory process the organs maintain their gaussian distribution but the predominant grey is lower (darker) due to the edema and the hyperaemia. When the inflammatory process becomes chronic, distribution, although somewhat irregular, is still gaussian but with higher predominance of grey (lighter) probably due to the fibrosis. The tumoral cases of our study also showed a gaussian curve even more irregular and with levels of variable grey. When specific areas of the tumour are analyzed the findings are very distinct depending on whether the areas are hypo or hyperechoic. Hyperechoic areas produce highly irregular maps. Research should be directed to provide more complex, although easy to perform systems of analysis which can correlate adequately with the histological study. It would be desirable that the equipment would be standardized to allow analysis of 'in vitro' images. If and when these objectives can be accomplished we would be able to venture into an echography histological diagnosis, something nowadays yet impossible.

[Incidence and characteristics of multiple neoplasms in urologic patients]. / Estudio de la incidencia y características de las neoplasias múltiples en pacientes urológicos.

The incidence and features of malignant primary multiple (MPM) neoplasias found in clinical urological patients have been analyzed so as to determine the actual magnitude of the problem and to obtain a better knowledge of this disease. For this reason, case histories of patients with MPMN, where at least one of the involved neoplasia was urological, were retrospectively studied. The study included a 9-year follow-up period and followed the Warren and Gates inclusion criteria. The number of MPMN patients was 23, representing an incidence of 6.1% among patients with urological neoplasias. Mean age at the time of discovery of the second tumour was 77.1 years. In the 15 patients with metachronic tumours, the time interval between the first and second tumours ranged between 1 to 25 years (average 5.4 years). The most frequently observed tumour association was bladder transitional carcinoma and prostate adenocarcinoma. The cause of death was always the second neoplasia.

[Simple calculation of prostatic weight with transrectal echography]. / Cálculo sencillo del peso prostático mediante ecografía transrectal.

The appraisal of the prostate weight with transrectal ultrasound scanning is simplified with the use of a simple mathematical formula of an ovoid volume. Such a method does not prolong the examination time but provides an acceptable reliability, and therefore it can be used as a substitute to planimetry, more subject to the observer's error and more time consuming for the physician, even when part of the examination can be made by replaying the video.

[Is the early diagnosis of prostatic cancer possible using transrectal echography?]. / Es posible el diagnóstico precoz del cáncer de próstata mediante ecografía transrectal?

One of the major challenges of using prostate transrectal ultrasound scanning as a procedure to diagnose through images is the theoretical possibility of reaching an early diagnosis of prostate cancer. This paper compiles the author's experience in this field. Based on 142 established diagnosis of prostate cancer since 1984, the conclusion being reached is that prostate cancer has no pathognomonic signs, and therefore it is impossible to make an early diagnosis just by using the images obtained with transrectal ultrasound scanning. This procedure could be used, however, to select patients with scan abnormalities (Alarm signs) who should have a biopsy performed. The support of ultrasound-led transperineal biopsy of the prostate is currently indispensable to achieve an early diagnosis. This paper suggests that a biopsy should be done at the appearance of just one alarm sign, although this may involve a large number of cancer negative biopsies. The almost null incidence of complications from transperineal biopsies enhances this reasoning.

[Complicated spermatocele as a cause of scrotal mass with solid appearance. Ultrasonographic findings]. / Espermatocele complicado como causa de masa escrotal de aspecto solido. Hallazgos ecográficos.

We report an atypical case of spermatocele in which sonographic findings demonstrated an intraescrotal mass fixed to the testicle, apparently solid and with important vascularity, being these findings suspicious of malignant tumor. We recommend to include complicated spermatocele in the differential diagnosis of ecographically solid masses.

[Osteoblastic differentiation in primary renal tumor: a rare histologic finding]. / Diferenciación osteoblástica en tumor renal primario: una rareza histológica.

Presentation of one case of renal carcinoma which interest lies in the osteoblastic differentiation presented by the sarcomatoid component. The rarity of this tumour type in major series of sarcomatoid renal carcinomas published is emphasized. Also, a description of its most relevant singularities is made.

[Blue nevus of the prostate]. / Nevus azul de la próstata.

The presence of melanin in the prostatic gland's stroma is a histopathological finding of extreme rarity. It receives the name of blue nevus as a result of its similitude to the skin's blue nevus. The paper describes the finding of melanin stores in the fibromuscular stroma of a patient's prostate and reviews the theories on its source.

[Fever and leukemoid reaction in bladder cancer: report of a case]. / Fiebre y reacción leucemoide en cáncer vesical: a propósito de un caso.

The authors present a unique case of bladder cancer that presented as paraneoplastic syndrome of fever and leukemoid reaction. Furthermore, the patient had a left renal tumor histologically similar to the bladder tumor. We discuss whether the foregoing was a metastatic or a primary tumor coexisting with a bladder tumor. The neoplastic syndromes affecting patients with bladder neoplasms are briefly discussed.

[Ultrasonography diagnosis of ureteral ectopy in prostatic urethra]. / Diagnóstico ecográfico de ectopia ureteral en uretra prostática.

A 54-year-old male who consulted for an episode of right-sided nephric colic is described. A urological ultrasound scan disclosed grade I hydronephrosis in the upper half of the right kidney and an anechoic tubular image ending in the prostate gland. A subsequent urographic evaluation confirmed the diagnosis of ectopic ureter in prostatic urethra.

[Embryonal carcinoma in the cryptorchid testis: apropos a case]. / Carcinoma embrionario en testículo criptorquídico: a propósito de un caso.

We report a case of testicular embryonal carcinoma in a patient with bilateral cryptorchidism. The diagnostic and therapeutic aspects of this disease entity are discussed. Although scrotal ultrasound constitutes an effective diagnostic method, it does not provide pathognomonic images that permit determining tumor histology as shown in the present case. Treatment of this tumor type depends on the degree of tumor spread: for stage I: inguinal orchidectomy and stage II: orchidectomy+lymphadenectomy. The need for adjuvant chemotherapy in these cases is discussed. In our view, it must depend on each specific case.

[Transrectal echography of the prostate: current evaluation]. / Ecografía transrectal de próstata: evaluación actual.

Our results with transrectal ultrasonography of the prostate are updated herein. Since the specifically urologic ultrasound (Aloka SSD 520) equipped with a sectorial transrectal probe of 5 MHz, became available in our service in 1984, we have performed over 1,700 transrectal ultrasound procedures. From the outset, we established several lines of investigation whose partial results have been published over these past years. Our main interest has been and continues to be that of describing an unequivocal echo pattern that would define prostate cancer in any stage, particularly in its early stages. To date, no finding has proved to be pathognomonic. However, we believe that we have encountered some aspects that have been poorly described to date that allow us to determine the current role of transrectal US in the urologic setting. We support the concept of integral urologic ultrasonography, one that encompasses all of our activities. The present article is a synthesis of a major part of our investigative effort and includes our statistical data and current points of view. Our own experience has taught us that things may turn out to be different from what they initially appear to be. Thus, we cannot rule out that our views will not change in the future. We have therefore attempted not to be rigid with respect to our claims. We must add, however, that except for numerical changes and variations in the degree of significance of specific findings, no major modifications have had to be made during this period. We have divided the study into various parts. Each one reviews a specific pathology (cancer, prostatitis, adenoma...), some procedures (biopsy, puncture, sonometry), and a comparative study between classical and transrectal US (digital rectal examination and US). In all of the foregoing, we have presented our results and some considerations in the discussion. Finally, our current views regarding transrectal US are presented succinctly in the conclusions.

[Bladder tumors: false recurrences]. / Tumores vesicales: falsas recidivas.

The use of the new cytostatics for prophylactic therapy of superficial bladder tumor recurrence has been associated with fibrino-necrotic ulcers and eosinophilic cystitis. We underscore the problems in making the differential diagnosis which sometimes present with true tumor necrosis. We describe the characteristic features of both pathological conditions which permit these to be recognized before endoscopic maneuvers are performed. Their presenting features and course are analyzed.

[Paraneoplastic syndromes in urology]. / Los síndromes paraneoplásicos en urología.

The paraneoplastic syndromes in patients with malignant urological tumors are reviewed herein. Some general aspects of these syndromes are briefly described and discussed. Similarly, the different urological tumors in which paraneoplastic syndromes have been observed are briefly reviewed. These are very common in renal cancer and cancer of the prostate, uncommon in bladder cancer and rare in testicular cancer.

[Ureteral ectopy: report of a case of ureteral communication with vulva]. / Ectopia ureteral: a propósito de un caso de desembocadura ureteral en vulva.

We report an uncommon case of ureteral ectopia opening to the contralateral vulva in a 20-year-old patient with a long history of night and day urinary incontinence. Since the ectopic ureter drained the superior pelvis of the right kidney, pyelo-pyelic anatomosis was performed and the defunctionalized ureter was abandoned. A completely satisfactory result was achieved. We briefly discuss this rare pathology and describe the simple, yet effective treatment.

[Diagnosis of renal vein and inferior vena cava thrombosis: report of a new case]. / Diagnóstico de la trombosis de vena renal y cava inferior: a propósito de un nuevo caso.

Renal vein thrombosis is a rare pathology whose diagnosis entails difficulty. A case of renal vein and inferior vena cava thrombosis is described herein. We briefly discuss its association with the nephrotic syndrome, the diagnostic methods and therapeutic approaches.