ABSTRACT
OBJECTIVE: We report two cases of patients diagnosed with lymphoepithelioma-like carcinomas of the urinary tract. We review the literature of this rare entity. The objective is to clarify the clinical and therapeutic characteristics. METHODS: We present a retrospective review of medical records of two patients diagnosed with lymphoepithelioma-like carcinomas, one in the renal pelvis and the other in the bladder. We review the epidemiology, diagnosis and therapeutic alternatives. RESULTS: Case 1: A 74-year-old women with past medical history of left radical nephrectomy and retroperitoneal lymphadenectomy six years before for renal pelvis carcinoma type pure lymphoepithelioma-like, stage pT4R0pN1cM0. She received adjuvant chemotherapy with Cisplatin and Gemcitabine. Five years later, she presented tumor recurrence in the left ureteral meatus, this lesion was resected. The pathology reported a high-grade urothelial carcinoma with marked lymphoid component, stage pT1. At follow-up, one year after the last recurrence, the patient was asymptomatic. In tomography control, no local or distant recurrences were objectified. Case 2: A 82-year-old men with diagnosis of muscleinvasive bladder cancer. The tumor caused right obstructive uropathy without extracapsular, regional or remote extension. We performed a radical cystoprostatectomy with bilateral pelvic lymphadenectomy and urinary diversión type cutaneous transureterostomy. The pathology reported a urothelial bladder carcinoma type mixed lymphoepithelioma-like, stage pT4aR1pN2cM0. At six months follow-up, the patient had liver and spleen lesions and retroperitoneal adenopathic nodes, all suggestive of metastases. He is currently receiving symptomatic treatment of their disease. CONCLUSIONS: We emphasize the clinical importance involved in the diagnosis of this entity. The diagnosis influence the aggressiveness of treatment and disease-specific survival. Therefore, concomitant transitional cell carcinoma defines the prognosis. The role of immunohistochemical staining is fundamental, allowing us to confirm the presence of the epithelial component.
Subject(s)
Carcinoma, Transitional Cell , Kidney Neoplasms , Kidney Pelvis , Urinary Bladder Neoplasms , Aged , Aged, 80 and over , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/therapy , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Male , Retrospective Studies , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapyABSTRACT
OBJETIVO: Presentar dos casos de pacientes diagnosticados de carcinomas linfoepiteliales del tracto urinario. Realizamos una revisión de la literatura de esta infrecuente entidad, con el fin de aclarar las características clínicas y terapéuticas. MÉTODOS: Revisión retrospectiva de la historia clínica de dos pacientes diagnosticados de carcinomas linfoepiteliales, uno en pelvis renal y el otro en vejiga. RESULTADOS: Caso 1: Mujer de 74 años. Se le realiza una nefrectomía radical izquierda y linfadenectomía retroperitoneal por carcinoma de pelvis renal tipo linfoepitelioma like puro, estadio pT4R0pN1cM0. Recibe quimioterapia adyuvante. A los cinco años presenta recidiva tumoral en el meato ureteral izquierdo que se reseca; es informado como carcinoma uroterial de alto grado, con marcado componente linfoide, estadio pT1. Al año de seguimiento de la recidiva la paciente se encuentra asintomática y sin recaída local ni a distancia. Caso 2: Varón de 82 años diagnosticado de carcinoma vesical infiltrante. Se le realiza una cistoprostatectomía radical con linfadenectomía pélvica y derivación urinaria. El resultado es un carcinoma urotelial de vejiga tipo linfoepitelioma- like puro, estadio pT4aR1pN2cM0. A los seis meses se objetiva la aparición de metástasis de órganos sólidos y ganglionares. Actualmente se encuentra con tratamiento sintomático de su enfermedad. CONCLUSIONES: Destacar la importancia clínica que implica el diagnóstico de esta entidad, ya que puede influir en el tratamiento y la supervivencia específica de la enfermedad, siendo el carcinoma uroterial concomitante el que marque el pronóstico. El papel que desempeñan las tinciones inmunohistoquímicas es fundamental, ya que nos permiten confirmar la presencia del componente epitelial
OBJECTIVE: We report two cases of patients diagnosed with lymphoepithelioma-like carcinomas of the urinary tract. We review the literature of this rare entity. The objective is to clarify the clinical and therapeutic characteristics. METHODS: We present a retrospective review of medical records of two patients diagnosed with lymphoepitheliomalike carcinomas, one in the renal pelvis and the other in the bladder. We review the epidemiology, diagnosis and therapeutic alternatives. RESULTS: Case 1: A 74-year-old women with past medical history of left radical nephrectomy and retroperitoneal lymphadenectomy six years before for renal pelvis carcinoma type pure lymphoepithelioma-like, stage pT4R0pN1cM0. She received adjuvant chemotherapy with Cisplatin and Gemcitabine. Five years later, she presented tumor recurrence in the left ureteral meatus, this lesion was resected. The pathology reported a high-grade urothelial carcinoma with marked lymphoid component, stage pT1. At follow-up, one year after the last recurrence, the patient was asymptomatic. In tomography control, no local or distant recurrences were objectified Case 2: A 82-year-old men with diagnosis of muscleinvasive bladder cancer. The tumor caused right obstructive uropathy without extracapsular, regional or remote extension. We performed a radical cystoprostatectomy with bilateral pelvic lymphadenectomy and urinary diversión type cutaneous transureterostomy. The pathology reported a urothelial bladder carcinoma type mixed lymphoepithelioma-like, stage pT4aR1pN2cM0. At six months follow-up, the patient had liver and spleen lesions and retroperitoneal adenopathic nodes, all suggestive of metastases. He is currently receiving symptomatic treatment of their disease. CONCLUSIONS: We emphasize the clinical importance involved in the diagnosis of this entity. The diagnosis influence the aggressiveness of treatment and disease-specific survival. Therefore, concomitant transitional cell carcinoma defines the prognosis. The role of immunohistochemical staining is fundamental, allowing us to confirm the presence of the epithelial component
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urologic Neoplasms/pathology , Epithelial Cells/pathology , Carcinoma/pathology , Immunohistochemistry , Pelvic Neoplasms/pathology , Kidney Pelvis/pathology , Urinary Bladder Neoplasms/pathology , Lymph Node Excision , Nephrectomy , Hematuria/etiologyABSTRACT
We report a case of a large malignant solitary fibrous kidney tumor. A complete surgical resection of the primary tumor and peritoneal disease was carried out, and a histological examination confirmed the initial diagnosis. We describe and discuss the characteristics of this rare kidney neoplasm.
ABSTRACT
OBJECTIVES: To report a new case of bladder mullerianosis. METHODS: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated. RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up. CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its published reports. We support the option of an endoscopic surgery for these patients.
Subject(s)
Urinary Bladder Diseases/pathology , Adult , Female , Humans , Mullerian Ducts , Urinary Bladder Diseases/surgeryABSTRACT
OBJETIVO: Descripción de un nuevo caso de mullerianosis vesical.MÉTODO: Presentamos el caso de una paciente mujer de 30 años con antecedentes de aborto, que refiere molestias miccionales coincidiendo con las menstruaciones. Una ecografía vaginal demostró la existencia de lesión exofítica vesical, confirmada posteriormente por cistoscopia. Se indicó resección transuretral.RESULTADOS: En el estudio histopatológico de los tejidos obtenidos se objetivó un componente glandular mixto de tipo predominantemente tubárico, con elementos endometriales y endocervicales asociados. No evidencia de recidiva endoscópica tras un año de seguimiento.CONCLUSIONES: Aportamos un nuevo caso de mullerianosis vesical. Destacamos el escaso número de casos publicados. Defendemos la opción quirúrgica endoscópica en estas pacientes(AU)
OBJECTIVES: To report a new case of bladder mullerianosis.METHOD: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated.RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up.CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its pu-blished reports. We support the option of an endoscopic surgery for these patients(AU)