[Surgical stratification of renal carcinoma with extension into inferior vena cava]. / Estratégia quirúirgica en el carcinoma de células renales con extensión a la circulación venosa.

Renal cell carcinoma with inferior vena cava thrombus is relatively uncommon and complicates radical nefrectomy. During the past twenty years our hospital have substantially contributed to the surgical stratification of renal cell carcinoma with extension into inferior vena cava through different techniques. The reason for this article is to discuss the mote efficient and appropiate surgical technique for this pathology. We believe that the diagnosis of vena caval invasion and level of tumoral extension is based on radiological examinations and it is crucial for the success of the surgery. We consider that the use of vena caval filter applied preoperatively could prevent the risk of thromboembolism during and after the surgery. The use of prosthetic grafts is unusual, because the long standing obstruction caused by the tumor thrombus will develope extensive collateral circulation which works as a natural veno-venous bypass. Finally, we try to avoid the use of veno-venous and cardiopulmonar bypass with or without complete hypothermic circulatory arrest due to the high association with adverse outcomes and mortality.

Self-expanding metallic ureteral stents for treatment of ureteral stenosis after kidney transplantation.

The incidence of post-renal transplantation ureteral stenosis ranges from 2%-12%. Because the role of self-expanding ureteral metallic stents for its treatment has been scarcely reported, the aim of this study was to evaluate the efficacy of Nitinol stents. Eleven ureteral stenoses in patients with chronic graft dysfunction (8 cases) or high surgical risk (3 cases) were treated by antegrade percutaneous implantation of Nitinol stents through a nephrostomy tract. The mean follow-up period was 48 +/- 7 months (range, 3-85 months). The patency rate at the moment of return to dialysis, death, or last check-up was 73% (8/11). Three patients (27%) developed stent occlusion. Two patients were treated using a trans-stent double-J catheter and 1 patient using stent removal and pyeloureterostomy using the native ureter. The mean percentage decrease in serum creatinine (Cr) level after stent implantation was 41% (range, 14%-63%). Nitinol ureteral stent implantation is an effective alternative for the treatment of ureteral stenosis in patients with chronic graft dysfunction or high surgical risk.

[Primary testicular lymphoma. Report of a new case and review of the literature]. / Linfoma testicular primario. Aportación de un nuevo caso y revisión de la literatura.

Primary testicular lymphoma is an uncommon testicular tumour that accounts for no more than 9% of all testicular tumours in those series with higher incidence; testicular lymphoma as haematopoietic tumours are also rare accounting for just 1% of all lymphomas; but due to their highly malignant histopathology they may become highly aggressive tumours. Patient age at presentation is over 60 years old which makes it the most frequent tumour for this age group. There is no standard protocol to treat this malignancy due to lack of extensive series. We contribute one case and make a literature review discussing the current therapeutic trends for this disease.

[Sarcomatoid carcinoma of the kidney. Report of a new case and review of the bibliography]. / Carcinoma sarcomatoide de riñón. Aportación de un nuevo caso, y revisión de la bibliografía.

We report a new case of sarcomatoid renal cell carcinoma, in a male of 67 years old, with locoregional recidive four months after first surgery, with two episodes of retroperitoneal hemorrhage after second surgery. The objective of this work is to contribute a new case and of doing one revision.

[Late recurrence of penile epidermoid carcinoma]. / Recidiva tardía de carcinoma epidermoide de pene.

OBJECTIVE: We report a recidive of penis carcinoma after 21 years of surgery. METHODS: This is the case of a male of 85 years old, with partial penectomy; by epidermoid carcinoma. In physics exploration, that it displays excrecente lesion at level of gland of 1 month of evolution. Biopsy being the result of epidermoid carcinoma reason why is made. Total penectomy, a with cutaneus uretrostomy. RESULTS: The histopathological study of the piece, confirm a epidermoid carcinoma well differentiated.