Nodular colitis: endoscopic image an unusual finding.

An 82-year-old male with a history of high blood pressure, COPD, chronic myeloid leukemia, and stage-4 chronic renal failure. Admitted to hospital for lower-limb cellulitis and severe COPD exacerbation, he received antibiotic therapy and bronchodilators. During his hospital stay he developed severe anemia and had an hematochezia event with no diarrhea. A complete colonoscopy found small (4-7 mm) nacreous elevated lesions, circumferential in shape, in the cecum and ascending colon with some bleeding stigmata and submucosal bleeding suggestive of infectious colitis; stool culture was negative and Clostridium difficile toxins were positive. The condition was histologically confirmed.

[Castleman's disease of the neck]. / Enfermedad de Castleman cervical.

Castleman's disease is an uncommon benign lymphoid disorder usually found in the mediastinum (70 %) which is thought to be due to antigenic hyperstimulation of unknown origin. Two histological subtypes may be found in relation to two different clinical patterns with clinical and therapeutic implications. Diagnosis is frequently accomplished only by histological analysis after surgery since no specific features have been found in imaging studies. Surgical excision is both diagnostic and curative in localized forms, whereas additional therapies are required in multicentric forms. This report is of Castleman's disease presenting as a neck mass, an infrequent occurrence, with an analysis of management controversies and a review of the literature.

[Low grade fibromixoid sarcoma: a purpose of 3 cases and review of the bibliography]. / Sarcoma fibromixoide de bajo grado: a propósito de 3 casos y revisión de la bibliografía.

BACKGROUND: Low grade fibromyxoid sarcoma or tumor Evans is a variety of soft tissue sarcoma that represents 1% of all malignancies. More common in limbs and trunk (50%), we present 3 new cases of retroperitoneal reviewing their characteristics and performing a literature review. CLINICAL CASE: In the retroperitoneal location highlights the poor specificity of clinical symptoms, demonstrating, according to their growth and size, as an abdominal tumor, usually painless, or by compression and/or invasion of nearby structures. In cases that present the most important finding was the presence of a palpable abdominal tumor without other symptoms despite remarkable infiltration of other organs that should be included in surgical resection. CONCLUSIONS: We emphasize the difficulty of correct diagnosis preoperatively because preoperative studies are inconclusive and only the histological and immuno-histo-typing chemistry allow precise identification.

Antecedentes: el sarcoma fibromixoide de bajo grado o tumor de Evans es una variedad de sarcoma de partes blandas que representa el 1% de todos los tumores malignos. Más frecuente en extremidades y tronco (50%), presentamos tres nuevos casos de localización retroperitoneal. Se revisan sus características y se realiza actualización bibliográfica. Casos clínicos: en su localización retroperitoneal destaca lo inespecífico de su sintomatología clínica, se manifiesta en función de su crecimiento y tamaño, como una tumoración abdominal, habitualmente indolora, o por la compresión y/o invasión de estructuras próximas. Los casos presentados se manifestaron, por la presencia de tumoración abdominal, sin otra sintomatología; a pesar de infiltrar a otros órganos. Conclusiones: el diagnóstico preoperatorio es difícil, y debe tenerse la presunción clínica para solicitar el estudio histológico, con tipificación inmuno-histo-química para su dentificación precisa.

[Malignant recurrence of a penile cutaneous horn]. / Recidiva malignizada de cuerno cutáneo peneano.

OBJECTIVES: To report one case of malignant recurrence of a cutaneous horn of the glans penis. METHODS: We report the case of a 66-year-old male patient presenting with penile discomfort over several months. Physical examination showed a corneal lesion in the glans-penis, the biopsy of which was reported as hyperkeratosis on top of pseudoepiteliomatous hyperplasia. Partial penectomy of the glans penis was performed after recurrence three months later. RESULTS: Pathological study of the specimen identified a microinvasive squamous cell carcinoma in the base of the lesion. The patient is disease-free after two years of follow-up. CONCLUSIONS: We emphasize the capacity the penile cutaneous horn has to become malignant. We also point out the need for observation of these lesions after excision.

[Metacronous transitional cell carcinoma of the prostatic urethra in a patient with history of nephroureterectomy for upper urinary tract urothelial tumor]. / Carcinoma transicional de uretra prostatica meta-crónico en paciente con antecedente de nefroureterectomía por tumor uroteual del tracto urinario superior.

OBJECTIVES: We report one case of Metacronous transitional cell carcinoma (TCC) of the prostatic urethra in a patient with history of left nephroureterectomy 22 years before for urothelial neoplasia of the upper urinary tract. METHODS: We describe the case of a 56-year-old male patient who presents with oligosymptomatic hematuria for several months. Cystourethroscopy showed irregular hyperemic lesions in the prostatic urethra, cold biopsy of which showed urothelial atypia. Pathology report of fragments of a posterior transurethral resection (TUR) was compatible with high-grade superficial transitional cell neoplasia. Instillation of Bacillus Calmette-Guerin (BCG) was indicated. Reevaluation TUR was performed. RESULTS: Pathologic report of new samples showed TCC infiltrating the prostatic stroma. The extension study showed ilioobturator adenopathies. Chemotherapy did not achieve significant results. Radical surgery was rejected. CONCLUSIONS: We emphasize the notable metachronous character of the transitional cell carcinoma of the prostatic urethra with respect to the upper urinary tract TCC. We also point out the metastasic capacity of these neoplasias, as well as the bad prognosis of those cases in which chemotherapy is not effective.

[Infiltrative small cell carcinoma of the bladder. New case report: treatment with radical surgery and chemotherapy]. / Carcinoma vesical infiltrante de celulas pequeñas. Descripcion de un nuevo caso tratado con cirugia radical mas quimioterapia.

OBJECTIVES: To report a new case of infiltrative small cell bladder cancer. METHODS: We describe the case of a 60-year-old male patient who consulted for monosymptomatic hematuria over a few weeks. Cystoscopy showed a neoplasia in the anterior wall of the bladder. Pathological analysis of the TUR chips was compatible with infiltrative small cell tumor. After a negative staging study radical cystectomy plus adjuvant chemotherapy were indicated. RESULTS: Pathological study of the surgical specimen confirmed the diagnosis with involvement of the surrounding fat. There is no evidence of neoplasic involvement after 24 months follow-up. CONCLUSIONS: We point out the validity of a radical surgical approach for this tumor, also emphasizing the importance of adjuvant chemotherapy. We concur with other authors in the need of multicentric studies to outline the most effective surgical option, due to the limited number of cases of this entity.