RESUMO
A survey of upper urinary tract stone composition was carried out over 8 years (1974-1982) in 1147 patients, following a previous survey (1966-1974). Trends in the development of stone formation were found. The most obvious differences were fewer pure calcium oxalate (0.75 versus 5.50%) and uric acid stones (6.11 versus 13.30%) and more mixed stones than in our previous study. In most ethnic groups urinary stones were composed of calcium oxalate/calcium phosphate. A higher prevalence of stones in Israeli-born Jews was noted, in comparison with our previous survey. Age group analysis showed this increase to be limited to the 21-50-year-old group, in contradistinction to a clear decrease in stone formation in Israeli-born Arabs and Jews under the age of 20 years.
Assuntos
Cálculos Urinários/epidemiologia , Adulto , Fatores Etários , Oxalato de Cálcio/análise , Fosfatos de Cálcio/análise , Inquéritos Epidemiológicos , Humanos , Israel , Pessoa de Meia-Idade , Cálculos Urinários/análise , Cálculos Urinários/etnologiaRESUMO
Multilocular cystic masses of the kidney present a diagnostic challenge because they may be malignant. Renal cell carcinoma with multilocular cysts has been reported. We present 4 cases in which the preoperative differential diagnosis was between a benign and a malignant multilocular cystic kidney mass. Our results, combined with those of 33 previously reported cases, reveal that only 32% of cases were diagnosed correctly preoperatively. In 21% of these patients the preoperative clinical evaluation did not correctly diagnose malignancy: 24% of them yielded false negative and 21% false positive results. Angiography was more accurate than CT, US or aspiration of cysts. Frozen section was inaccurate in 55% of cases. There is no reliable diagnostic test to distinguish between a malignant and a benign multilocular cystic mass. Invasive angiography is more accurate than other modalities. A therapeutic decision has to be made between nephron-sparing and radical surgery in each case. When nephron-sparing surgery is considered, the possible need to perform radical nephrectomy in second-look surgery must be taken into account.
Assuntos
Neoplasias Renais/diagnóstico , Doenças Renais Policísticas/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Doenças Renais Policísticas/patologia , Doenças Renais Policísticas/cirurgia , ReoperaçãoRESUMO
We report a case of a benign villous adenoma of the prostatic urethra causing urethral obstruction in a 45-year-old man. Villous adenoma of the prostatic urethra is rare. Hematuria was the presenting sign in most reported cases. However, some lesions were discovered unexpectedly on endoscopic examinations for the assessment of lower urinary tract disease. Villous adenoma of the urethra is composed of prostatic type tissue. The presence of the PSA marker in its epithelium indicates a common embryologic origin with the prostate.
Assuntos
Adenoma/diagnóstico , Coristoma/diagnóstico , Doenças Prostáticas/diagnóstico , Doenças Uretrais/diagnóstico , Obstrução Uretral/etiologia , Adenoma/patologia , Adenoma/cirurgia , Coristoma/patologia , Coristoma/cirurgia , Hematúria , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Prostáticas/patologia , Doenças Prostáticas/cirurgia , Doenças Uretrais/patologia , Doenças Uretrais/cirurgiaRESUMO
We present a 54-year-old man with a testicular metastasis originating from a transitional cell carcinoma of the urinary bladder. Initially, radical cystectomy and ileal-conduit urinary diversion were performed, followed 9 months later by urethrectomy for local recurrence. A year later he presented with a tumorous right testis proved to harbor transitional cell carcinoma.