[Synchronous and bilateral inverted papilloma of the kidney pelvis. Conservative treatment]. / Papiloma invertido bilateral y sincrónico de pelvis renal. Tratamiento conservador.

Contribution of a new case of inverted papilloma (IP) of the upper urinary tract (UUT) with the idiosyncrasy of being bilateral and synchronic, a fact not found in the reviewed literature, treated with radical surgery on the left side and conservatively on the right one. Discussion on this pathology is addressed, emphasising its benign biological behaviour, which does not eliminate some cases of malignization. Treatment has to be conservative, and so we stress the relevance of defining a suspicion state to make pre- and peri- operative diagnosis in which endourological methods, that allow both direct visualization and the taking of a biopsy, play a preeminent role. Subsequent strict monitoring is essential due to the likelihood of relapse and malignant changes.

[Retroperitoneal paraganglioma. Infrequent pathology]. / Paraganglioma retroperitoneal. Patología poco frecuente.

Presentation of 3 cases of retroperitoneal paraganglioma non pre-operatively diagnosed: one dependent of the Zuckerkandl's organ with ultrasound examination showing a panelled cystic mass, and two located in the renal parahilar area, all accidental findings during renal surgery. Lack of appropriate pre-operative background and diagnosis produced a hypertensive crisis in one patient during removal manoeuvres which was entirely controlled. After a 4-, 2- and 1-year follow-up, respectively, patients remain asymptomatic and disease-free. An analysis of the most relevant features in these retroperitoneal tumorations was carried out from a clinical, diagnostic, therapeutic and prognostic point of view.

[New location of aggressive angiomyxoma: the bladder]. / Nueva localización del angiomixoma agresivo: la vejiga.

Presentation of one case of aggressive angiomyxoma with vesical location in a 31-year-old female patient who underwent partial surgery, and who 8 years later remains disease-free. Emphasis is made on the low frequency of these tumours, of which only 26 cases are described in the international literature. All these cases have been located in soft areas of the pelvis and the perineum, with the exception of the one presented here, the first one with a vesical location. Clinical behaviour is characterized by the absence of metastasis and a great tendency to local relapse, 70% of cases reported.

[Physiopathology of hypertrophic stenosis of the pylorus: a proposal]. / Fisiopatologia de la estenosis hipertrófica de piloro: una propuesta.

The aim of this report is finding a physiopathologic explanation for the Infantile Hypertrophic Pyloric Stenosis. We studied two groups: The group one were children with infantile hypertrophic pyloric stenosis (n = 43) and the group two were infants who died at one month old due to a non-related cause. We studied the pylorus in both groups, took biopsies and found neurological and muscular lesions with muscular hypertrophy and degeneration of the myenteric plexus of Auerbach. We suggest the diagram of self-maintenance of the lesions.

[Primary malignant melanoma of the nasal cavity]. / Melanoma maligno primario de la cavidad nasal.

We report a case of primary malignant melanoma of the nasal cavity in an adult white man, 69 years old, who appeared with recurrent epistaxis of several months duration. Inspection of the nasal cavity revealed a greyish polypoid tumor in the right fossa close to the septum.

[Protocol proposal for the histological report of the primary tumor in patients with cutaneous melanoma from the Task Force for Cutaneous Melanoma of the Valencian Community]. / Propuesta de protocolo para el informe histológico del tumor primario de los pacientes con un melanoma cutáneo del Grupo de Trabajo para el Melanoma Cutáneo de la Comunidad Valenciana.

This text compiles a histological protocol proposal for cutaneous melanoma agreed by the Task Force for Cutaneous Melanoma of the Valencian Community. It brings together the protocol itself and, in addition, includes a description of each of the proposed variables that has shown to have a greater prognostic impact in previous works.

Experimental contributions to the study of the embryology of the vagina.

BACKGROUND: Acién's hypothesis, deduced from patients with malformations of the female genital tract, especially those with renal agenesis and ipsilateral blind hemivagina, affirms the embryology of the human vagina as deriving from the Wolffian ducts and the Müllerian tubercle and could explain the embryological origin of all the female genital malformations reported. In this study, we investigated the hypothesis in rats. METHODS: Twenty-five pregnant rats were used to analyse female embryos (64) from day 15 (stage indifferent) to day 20 postcoitum (vagina completely formed). We performed transverse and longitudinal sections of embryos, haematoxylin-eosin tinction and immunohistochemical staining using markers specific to Wolffian derivatives. We also analysed the presence of these markers in the vagina of four adult rats. RESULTS: The Müller ducts converge until they fuse into one tube, but caudally they diverge and finally they fuse with the 'urogenital sinus bulbs' that are actually the distal portion of the Wolffian ducts according to the immunohistochemical marking with GZ1 and GZ2. The Müllerian tubercle is observed between those elements. Then, the immunohistochemical staining can be seen all along the completely formed vagina, which is also observed in the vagina of the adult rat. CONCLUSION: We prove the participation of Müller tubercle and Wolffian ducts in the formation of the vagina in rats, so we confirm experimentally Acién's hypothesis about the human vagina embryology.

[Cystic duplication of the rectum]. / Duplication kystique du rectum.

Cyst or intestinal duplications can arise anywhere along the gut, however those located in the rectum are very rare and only a few dozen cases have been reported. The reason that induced us to report this patient is double: first to present a new case of rectal duplication diagnosed at 45 days old that had a normal barium enema previously, second to confirm once more that the muscular complex of the rectum can be cut in the posterior middle line without any damage to the rectal continence function, as Peña's surgical approach for anorectal atresias. The case reported correspond to a newborn weighing 2,850 grs who had exomphalos of 5 cm. Wide with an integral sac and was operated by primary closure. When he was 10 days old, and because he had some intestinal disturbances compatible with malrotation, a barium enema was done that was normal. He was discharged and returned 30 days later because of striped feces and constipation. Rectal examination showed a retrorectal tumor located at left posterolateral space. Ultrasound showed a cystic mass and barium enema displayed a narrowed rectum channel. First we did a Wangesteen colostomy. Ten days later, by a sagittal posterior approach cutting the Levator and Muscular Complex of the rectum in the middle line and without opening the lumen, a tumor like a nut, sharing its muscular coat with the rectum, was excised. The Muscular Complex and the Levator were repaired with the aid of the electrostimulator. After the 7 day postoperation we made some rectal dilatations and closure of colostomy at 21 day.(ABSTRACT TRUNCATED AT 250 WORDS)