[Subcutaneous metastasis as the first manifestation of kidney cancer dissemination]. / Metástasis subcutáneas como primera manifestación de la diseminación del cáncer renal.

Presentation of an uncommon form of distant primary dissemination of renal adenocarcinoma (RA) 5 years after radical surgery, the subcutaneous metastasis. The patient underwent surgical resection of metastasis, and later developed early pulmonary, mediastinal and new skin metastasis. A review is made of the incidence, therapeutical approach and prognostic value of skin metastasis due to RA.

[Scrotal verrucous carcinoma]. / Carcinoma verrucoso escrotal.

Cancer of scrotum is of interest, despite its relative infrequency, because of its historical importance (was the first known occupational cancer) and also of its aggressive behavior. We report a rare case of verrucous carcinoma in a 67 years old man, without recrudescence six months after surgical treatment.

[Adrenal gland carcinoma. Clinical, pathologic, and therapeutic study]. / Carcinoma suprarrenal. Estudio clínico, patológico y terapéutico.

From 1973 to 1991, 13 patients [4 females (30%) and 9 males (70%)] were diagnosed with adrenal carcinoma at our hospital. The mean age at the time of diagnosis was 47.4 years (range 29 to 72 yrs). Eleven patients (85%) presented with abdominal symptoms and 8 (61%) with paraneoplastic syndrome. At the time of diagnosis, 3 (23%) had clinical or radiological signs of metastasis. Five patients (38.5%) had regional involvement and 5 (38.5%) had localized disease. The preoperative imaging studies disclosed an abnormal IVP in 8 of 13 patients (61%); 7 of 10 (70%) had an abnormal ultrasound scan and the CT scan was abnormal in 9 out of 9 patients (100%). Seventy-three percent of the tumors were classified as anaplastic or poorly differentiated carcinoma and 27% as differentiated carcinoma. Complete surgical excision was performed in 8 cases and op'DDD was administered in 4 cases. The five-year survival rate was 30%. We can conclude that early diagnosis, staging and histopathology have a significant effect on survival and surgical excision is the only treatment associated with medium or long-term survival.

Spontaneous rupture of a neobladder.

The spontaneous rupture of neobladder is an extremely rare entity of which there only exists one formerly reported case in the world literature. It is far more common after enterocystoplasty for augmentation (19 reported cases). We describe here the spontaneous rupture of a neobladder 8 months after performing cystectomy and bladder replacement by an enterocystoplasty in order to treat a bladder carcinoma. In this case the patient showed symptoms and signs of acute peritonitis. The diagnosis was carried out using a cystogram and the treatment consisted of a laparotomy with closure of the perforation and drainage of the peritoneal cavity.

Rupture of the ureteropelvic junction by nonpenetrating trauma.

This paper reports an experience in the early diagnosis and treatment of pelviureteric avulsion, whether or not it is associated with parenchymal damage; such avulsion in itself must be evaluated first, as it determines the treatment required and conditions the prognosis.

Surgery of pelvic renal ectopia: a new approach.

We present 5 patients with ectopic pelvic kidneys who underwent surgery for associated disorders. In addition, the kidneys were repositioned to a higher location where they are less likely to interfere with vaginal delivery at a later date. Ectopic kidneys are mobile, and the vessels and ureters have sufficient length to allow for their repositioning.