Hematoma escrotal idiopático / Idiopathic scrotal hematoma

Los hematomas escrotales son entidades patológicas frecuentes en la práctica clínica habitual. La relativa exposición del escroto a potenciales traumatismos (accidentes de tráfico, deportes violentos, agresiones intencionadas, etc.), la no despreciable cifra de iatrogenia quirúrgica (en relación con la gran cantidad de cirugías locorregionales que se realizan diariamente: vasectomías, cirugía herniaria, cirugía del varicocele, del escroto, etc.) y la cada vez mayor utilización de terapias anticoagulantes, así lo demuestran. Lo que ya no es tan frecuente es la aparición de lo que proponemos denominar hematomas escrotales criptogenéticos. Estas entidades forman una abigarrada miscelánea debida a afecciones infrecuentes, e incluso idiopáticas (de causas imposibles de filiar), como los 2 casos objeto de esta comunicación. Su diagnóstico es difícil y debe ser preciso para un correcto abordaje de su tratamiento, evitando cirugías innecesarias o llevando a cabo aquellas que estén indicadas, ya que en no pocos casos puede tratarse de una enfermedad grave. Los hematomas escrotales idiopáticos o criptogenéticos suelen ser manifestaciones locales de complejas dolencias sistémicas o asociaciones de ellas en un mismo paciente y momento. Por todo lo anteriormente expuesto, un enfoque multidisciplinar se impone, así como la utilización de todos los medios diagnósticos disponibles y una vigilancia estrecha hasta la resolución. Los 2 casos que comunicamos intentan ilustrar lo dicho y ayudar, a través de su conocimiento, a resolver posibles futuras situaciones similares(AU)

Scrotal hematomas are frequent pathological conditions in the usual clinical practice. These include the relative exposition of the scrotum to potential traumatisms (traffic accidents, violent sports, intentional aggressions, etc.), the large number of surgical iatrogenia (in relation to the large number of locoregional surgeries performed daily: vasectomies, hernia surgery, varicocele surgery, scrotal surgery, etc.) and the increasingly greater use of anticoagulant therapies. However, the appearance of what we propose to call cryptogenic scrotal hematomas is not so frequent. These conditions form a miscellaneous collection due to infrequent, and even idiopathic conditions (with causes that are impossible to classify) such as the 2 cases being reported herein. They are difficult to diagnose, and this diagnosis should be precise in order to correctly approach their treatment and to avoid unnecessary surgeries or to carry out those indicated, since it may be a serious condition in many cases. Idiopathic or cryptogenic scrotal hematomas are generally local manifestations of complex systemic conditions or associations of them in a single patient and time. Due to the above, a multidisciplinary approach must be made, using all the diagnostic means available, along with close monitoring until their resolution. An attempt is made in both cases reported to illustrate the above and to help, through their knowledge, to resolve possible future similar situations(AU)

Persistencia de pliegues mucosos ureterales-válvulas ureterales no obstructivas- en un niño de 11 años de edad / Persistence of ureteral mucosa folds-non obstructives ureterals valves-in a child 11 years old

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[Penile metastasis like first sign of esophagus carcinoma]. / Metástasis peneana como primera manifestación de un carcinoma esofágico.

We present a new case of penile metastatic disease. The original tumour has been situated in the esophagus, which is a rare clinical situation. But what becomes exceptional in our clinical case is that the penile metastasis was the first disease symptom, since until this moment the original tumour has been silent. Like the majority of these cases the prognosis was gloomy and the patient died in few months after the clinical beginning of the disease.

Metástasis peneana como primera manifestación de un carcinoma esofágico / Penile metastasis like first sign of esophagus carcinoma

Presentamos un nuevo caso de enfermedad metastásica en pene. El tumor primitivo se originó en el esófago, lo que es una rareza clínica. Pero lo que hace excepcional a nuestro caso clínico es que fue la metástasis peneana el primer síntoma de la enfermedad, ya que hasta entonces el tumor primitivo permanencia silente. Como en la mayoría de casos similares el pronóstico fue pésimo y el paciente falleció a los pocos meses del inicio clínico de la enfermedad metastásica peneana (AU)

We present a new case of penile metastatic disease. The original tumour has been situated in the esophagus, which is a rare clinical situation. But what becomes exceptional in our clinical case is that the penile metastasis was the first disease symptom, since until this moment the original tumour has been silent. Like the majority of these cases the prognosis was gloomy and the patient died in few months after the clinical beginning of the disease (AU)

[Paratesticular fibrous pseudotumor]. / Pseudotumor fibroso paratesticular.

OBJECTIVE: Benign testicular proliferative processes are known by the name of pseudotumors, because currently they are not considered real neoplasias. The paratesticular fibrous pseudotumor (PFP) is a rare entity the definition and etiopathogenesis of which is under great confusion. It is a process that misleads the clinical because they simulate neoplasias. This paper aims to help a better knowledge of this non-tumoral process and to avoid diagnostic confusions. METHODS/RESULTS: We review our series of PFP (three cases), which can be considered significant due to its oddity. We analyze the clinical picture, its behavior, imaging diagnostic tests, operative findings and outcomes. CONCLUSIONS: PFP is a rare entity which may misleads the clinical because it may be diagnosed as a neoplasia and lead to aggressive treatment (orchiectomy) which in case of a proper diagnosis could be avoided. The analysis of our series of three cases, with their contribution, and a literature review may help the clinical practice of urologists by recognizing this disease.

Pseudotumor fibroso paratesticular / Paratesticular fibrous pseudotumor

Objetivos: Los procesos proliferativos benignos testiculares se conocen con el nombre de pseudotumors, al no ser considerados en la actualidad verdaderas neoplasias. El Pseudotumor Fibroso Paratesticular (PFP) es una entidad sobre las que existe gran confusión en su definición y etiopatogenia. Se trata de un proceso que confunde al clínico al aparecer simulando neoplasias. La presente comunicación puede ayudar a conocer mejor este proceso no tumoral y evitar confusiones diagnósticas. Métodos/Resultados: Revisamos nuestra serie de PFP (tres casos) sobre esta rara entidad, por lo que dada su rareza puede considerarse significativa. Analizamos su clínica, su comportamiento antes los estudios diagnósticos por imagen, hallazgos operatorios y evolución. Conclusiones: El PFP es una rara entidad que puede confundir al clínico al ser diagnosticado como una neoplasia, y conllevar tratamientos agresivos (orquiectomía) que de realizar un exacto diagnóstico podrían obviarse. El análisis de una serie de tres casos, con sus aportaciones, y la revisión de la literatura efectuada pueden ayudar en la practica clínica al urólogo a reconocer esta enfermedad (AU)

Objective: Benign testicular proliferative processes are known by the name of pseudotumors, because currently they are not considered real neoplasias. The paratesticular fibrous pseudotumor (PFP) is a rare entity, the definition and etiopathogenesis of which is under great confusion. It is a process that misleads the clinical because they simulate neoplasias. This paper aims to help a better knowledge of this non-tumoral process and to avoid diagnostic confusions. Methods/Results: We review our series of PFP (three cases), which can be considered significant due to its oddity. We analyze the clinical picture, its behavior, imaging diagnostic tests, operative findings and outcomes. Conclusions: PFP is a rare entity which may misleads the clinical because it may be diagnosed as a neoplasia and lead to aggressive treatment (orchiectomy) which in case of a proper diagnosis could be avoided. The analysis of our series of three cases, with their contribution, and a literature review may help the clinical practice of urologists by recognizing this disease (AU)

[Thigh abscess: a very rare complication of retropubic adenomectomy]. / Abceso en muslo: rarísima complicación de una adenomectomía retropúbica.

OBJECTIVE: Usual complications of retropubic adenomectomy are well-known. Despite their low incidence, urologists face them relatively often in their daily practice due to the frequent performance of this technique, and they usually have satisfactory outcomes. We want to attract attention to the presence of a thigh abscess as an exceptional complication of adenomectomy. It is such on oddity that may pose very important diagnostic problems, with negative implications due to treatment delay. The knowledge of it may be decisive at the time of diagnosis and enable a fast decision-making process. METHODS/RESULTS: We present the case ofa great thigh abscess as a complication of adenomectomy. We performed a detailed description of its presentation and avatars occurred until diagnosis and treatment, fortunately successful. We collect the pathogenic mechanisms of dissemination and comment on bibliography. CONCLUSIONS: The presence of a thigh abscess as a late complication of adenomectomy is an exceptional entity requiring a rapid diagnosis to an enable successful treatment, because it is a severe complication.

Abceso en muslo: rarísima complicación de una adenomectomía retropúbica / Thigh abscess: a very rare complication of retropubic adenomectomy

Objetivo: Las complicaciones habituales de la adenomectomía retropúbica son perfectamente conocidas. A pesar de su baja incidencia, la amplia utilización de esta técnica hace que en el día a día el urólogo se enfrente a ellas con relativa frecuencia, y se resuelvan satisfactoriamente. Queremos llamar la atención sobre la presencia de un absceso de muslo como complicación excepcional de la adenomectomía. Es una rareza tal que nos puede plantear importantísimos problemas en su diagnóstico, con las negativas implicaciones que ello acarrea al demorar el tratamiento. Su conocimiento puede ser decisivo a la hora del diagnóstico y permitir una rápida toma de decisiones. Método/Resultado: Presentamos un caso de un gran absceso de muslo como complicación de una adenomectomía. Se efectúa una detallada descripción de su presentación y los avatares que acaecieron hasta su diagnóstico y tratamiento, afortunadamente exitoso. Recogemos los mecanismos a través de los cuales se produce la diseminación y comentamos la bibliografía. Conclusión: La presencia de un absceso en muslo como complicación tardía de una adenomectomía es una entidad excepcional que requiere un rápido diagnóstico que permita su tratamiento exitoso, pues se trata de una grave complicación (AU)

Objective: Usual complications of retropubic adenomectomy are well-known. Despite their low incidence, urologists face them relatively often in their daily practice due to the frequent performance of this technique, and they usually have satisfactory outcomes. We want to attract attention to the presence of a thigh abscess as an exceptional complication of adenomectomy. It is such an oddity that may pose very important diagnostic problems, with negative implications due to treatment delay. The knowledge of it may be decisive at the time of diagnosis and enable a fast decision-making process. Methods/Results: We present the case of a great thigh abscess as a complication of adenomectomy. We performed a detailed description of its presentation and avatars occurred until diagnosis and treatment, fortunately successful. We collect the pathogenic mechanisms of dissemination and comment on bibliography. Conclusions: The presence of a thigh abscess as a late complication of adenomectomy is an exceptional entity requiring a rapid diagnosis to an enable successful treatment, because it is a severe complication (AU)