[An alternative technique to prevent obturator nerve stimulation during lateral bladder tumours transurethral resection]. / Tecnica alternativa para prevenir la estimulación del nervio obturador durante la RTU vesical de neoformaciones en cara lateral.

OBJECTIVES: We presents an alternative to prevent the obturator nerve stimulation during TUBR. MATERIAL AND METHOD: We revise 400 bladder tumours corresponding to 218 patients, 46.8% of them localized in lateral bladder wall. An alternative technique is used for that blockade. RESULTS: There have been no adductor contractions in more than 95% of TUBR. CONCLUSIONS: The alternative technique may reduce the stimulation of the obturador nerve and the risk of bladder perforation.

[Skin metastases of primary transitional cell carcinoma of the prostate. Apropos of a case]. / Metástasis cutánea de carcinoma transicional primario de próstata. A propósito de un caso.

OBJECTIVE: To report on a rare case of cutaneous metastasis from primary transitional cell carcinoma of the prostate. METHODS: A 70-year-old patient with transitional cell carcinoma of the prostate presented with cutaneous metastasis in the left leg. RESULTS: The cutaneous lesion was resected. Pathological analysis of the specimen demonstrated cutaneous metastasis from transitional cell carcinoma. CONCLUSIONS: Primary transitional cell carcinoma of the prostate is an uncommon and aggressive tumor that can metastasize to distant, atypical sites, as in the case described herein.

[Synchronous bilateral renal adenocarcinoma. Our experience with conservative kidney surgery]. / Adenocarcinoma renal bilateral sincrónico. Nuestra experiencia con la cirugía conservadora renal.

OBJECTIVE: To present our experience with synchronous bilateral renal adenocarcinoma. The indications for conservative surgery, the different types and the controversies are discussed. METHODS: 5 patients with bilateral renal adenocarcinoma from our series of 320 renal adenocarcinomas were analyzed for gender, age at presentation, tumor location, size, presenting features and type of surgery performed. RESULTS: Bilateral renal adenocarcinoma accounted for 1.56% in our series. Mean age at presentation was 57.8 years (range 43-69 years). All 5 patients were male. All patients underwent conservative surgery by tumor excision or partial nephrectomy of the side with less involvement followed by delayed radical surgery of the contralateral side. Follow-up ranged from 19 months to 14 years. To date all patients are disease-free and only one is on dialysis 14 years postoperatively. CONCLUSIONS: Bilateral renal adenocarcinoma has been reported to account for 1.4%-5% of all renal masses. The incidence in our series was 1.56%. Conservative renal surgery is indicated in patients like those described herein to prevent the need for dialysis. In our view, conservative renal surgery is a good therapeutic option that carries a small risk of tumor multicentricity and future recurrence.

[Castleman's disease in the retroperitoneal region]. / Enfermedad de Castleman de localización retroperitoneal.

OBJECTIVE: To describe a case of Castleman's disease presenting as a retroperitoneal mass, with special reference to the differential diagnosis from other retroperitoneal lesions. The histological features, variants, clinical manifestations, etiopathogenesis and treatment of Castleman's disease are reviewed. METHODS: A 64-year-old male presented with voiding symptoms and hypogastric pain. An ultrasound scan showed a 5 x 6 cm mass located behind the bladder and above the prostate, which was confirmed by an abdomino-pelvic CT scan. RESULTS: Retroperitoneal sarcoma was suspected and the mass was resected. The histopathological analysis showed giant lymphoid hyperplasia (vascular hyaline variant of Castleman's disease). CONCLUSIONS: Retroperitoneal Castleman's disease is a lymphoproliferative disorder with two well-defined histological types and a mixed variant. Although this lesion is frequently localized to the mediastinum (71%), extrathoracic lesions have been described. Definitive diagnosis is based on the postoperative pathological findings.

[Renal cell carcinoma. Clinical onset with peritoneal carcinomatosis. Report of a case]. / Carcinoma de células renales. Presentación clínica debut con carcinomatosis peritoneal. A propósito de un caso.

Renal carcinoma accounts for 2-3% of malignant tumours in the adult, with high tendency for metastasis basically in liver, lymph nodes, lungs and bones. Intraperitoneal, gut, mesentery and omentum involvement is extremely rare affecting only 1% of patients with metastasis at post-mortem. Contribution of one case of renal carcinoma with initial presentation as intraperitoneal metastasis.

[Pelvic lipomatosis: cause of extrinsic ureteral obstruction. Report of a case]. / Lipomatosis pélvica, causa de obstrucción ureteral extrínseca. Presentacion de un caso.

Contribution of one case of pelvic lipomatosis, suspected through diagnostic imaging (CAT) and diagnosed by exploratory laparotomy, leading to severe unilateral ureterohydronephrosis and contralateral distal ureteral ectasia. The features of the disease, presentation form, diagnosis and treatment are discussed.

[Renal adenocarcinoma in young patients]. / Adenocarcinoma renal en pacientes jóvenes.

OBJECTIVE: To discover potential differences in known prognostic factors of renal adenocarcinoma in patients under 40 years of age. PATIENTS AND METHODS: A series of 246 patients with renal adenocarcinoma included 17 patients 40 years. Both groups were analyzed for sex, tumour size, histological characteristics and stage, examining the relative proportions within each group and looking for an association between those sets of data and age. RESULTS: No statistically significant associations were found, although it should be noted that in some cases data is incomplete. A larger proportion of low stages at least locally and a greater proportion of granule cell tumours was found in patients 40 years-old compared to those over 40. CONCLUSIONS: Existence of differences in the biological and histological characteristics of renal adenocarcinomas that develop at a younger age is not unlikely. The analysis of each factor and the survival rates in larger series should elucidate these questions, which will also be of interest to improve our understanding of the histogenesis of this type of tumours.

[Malignant bilateral pheochromocytoma and von Recklinghausen disease]. / Feocromocitoma bilateral maligno y enfermedad de Von Recklinghausen.

OBJECTIVES: To review the main features of malignant pheochromocytoma and its relationship to von Recklinghausen's neurofibromatosis. METHODS/RESULTS: We report on a case of malignant bilateral pheochromocytoma with hepatic and pulmonary metastasis, associated with von Recklinghausen's neurofibromatosis. Surgery achieved good results and the patient is well seven years postoperatively. CONCLUSIONS: Approximately 10% of the pheochromocytomas are malignant and treatment is principally by surgery. (131) metaiodobenzylguanidine may be useful in cases with metastasis, residual tumor or local relapse.

[Leydig cell tumor in the adult]. / Tumor de células de Leydig del adulto.

Presentation of 3 cases of Leydig's cells tumour in the adult seen in our hospital over the last 10 years. They account for 3% of all testicular tumours, 20 to 25% of them appearing during the pre-puberty period. Although an isolated testicular nodule is the most frequent symptom, gynaecomastia can be found in about 30% of adult patients, as it happened in 2 of our patients. Even though no malignant case has been described in children, up to 10% of cases in adults have metastasis, this being the only demonstration of malignant behaviour in these tumours, so radical orchiectomy is the choice therapy. Certain histological and hormonal parameters may be suggestive of the aggressive behaviour of this neoplasia which, however, we have not found in our series of all whom presented a good evolution after surgery. The most common diagnostic and therapeutic approaches, based on the different characteristic of the tumour, are reviewed.

[Our experience with renal adenocarcinoma (I): epidemiologic data]. / Nuestra experiencia en adenocarcinomas renales (I): Datos epidemiológicos.

OBJECTIVES: The present study was conducted to review the epidemiological factors of patients with renal cell carcinoma. METHODS: We reviewed the familial, social, cultural, toxic, occupational and pathological factors of 229 patients who were diagnosed as having renal cell carcinoma between 1975 and 1992 at our hospital. RESULTS: As in other series, we found a greater predisposition in male patients around the seventh decade. However, unlike other studies, we observed a greater predisposition in the lower social and cultural levels and rural population. Of the epidemiological factors related to adenocarcinoma of the kidney, smoking was the most common in this series (41.8%), followed by high blood pressure (15.7%) and toxic-occupational factors (8.2%). We found no correlation between these factors and tumor stage or survival. CONCLUSIONS: Our data show a greater predisposition for renal cell carcinoma in male patients, around the seventh decade, in the lower social and cultural levels and rural population. Smoking, high blood pressure and occupational exposure to toxic agents were the most common epidemiological factors.

[A new case of ectopic ureteral outlet into the seminal vesicle]. / Nuevo caso de desembocadura ectópica de uréter en vesícula seminal.

We report an additional case of ectopic ureter opening into the seminal vesicle in a patient who had consulted for nephric colic from calculus in dysplastic kidney and urinary tract infection. The clinical features, the diagnostic and therapeutic aspects of this rare malformation are briefly reviewed.

[Renal adenocarcinomas associated with other malignant neoplasms]. / Asociación de adenocarcinomas renales y otras neoplasias malignas.

The renal adenocarcinoma is not a frequent tumour within the scope of multiple neoplasias, at least in the clinical series. Conversely, it appears at a higher relative rate in the post-mortem series. This paper submits a review of renal adenocarcinoma associated in life to other malignant neoplasias, enumerating their major clinical and epidemiological data. Also, it reviews the literature with regard to frequency and etiology, applying the data to our series. The paper concludes that hypernephroma is not a tumour frequently associated with others in life, given its tendency to be secondary to other primary ones, therefore its development depending on survival to the initial tumour. It also emphasizes the need for adequate anamnesis aimed to detect multi-cancer syndromes and the etiology of multiple neoplasias. Further studies are needed to understand the scope of multiple neoplasias and their relative risk.