Focal reactive nodular gliosis: an extremely rare retinal astrocytic tumor.

Focal reactive nodular gliosis (FRNG) is an extremely rare benign retinal reactive astrocytic tumor that results from the proliferation of well-differentiated glial cells secondary to a variety of retinal conditions. We describe a case of this tumor in a 64-year-old male in association with a chorioretinal scar he has had since childhood. The symptom was sudden painful vision loss. In the clinical examination, iris rubeosis, posterior synechiae, cataract, vitreous haze and a suspected fundus mass were showed. B-scan ultrasonography demonstrated a retinal mass consistent with choroidal melanoma. The magnetic resonance imaging (MRI) showed a well-circumscribed mass with T1 hyperintensity and T2 hypointensity. Enucleation was performed and histopathologic and immunohistochemical studies confirmed the diagnosis of FRNG.

BRAF and NRAS prognostic values in conjunctival melanoma: analysis and literature review.

PURPOSE: Conjunctival melanoma is a rare and aggressive tumor with a propensity for regional and distant metastases. This study aimed to analyze BRAF/NRAS markers in conjunctival melanoma and their relationship with tumor recurrences and patient prognosis. METHODS: This retrospective, observational, single-center study included consecutive patients with an anatomopathological diagnosis of conjunctival melanoma, registered between January 1992 and December 2019. BRAF/NRAS mutations were analyzed using cobas®4800 kit (Roche®) in samples obtained by excisional or map biopsy. Additionally, the presence of other associated precancerous or tumor lesions was assessed. RESULTS: A total of 12 patients with positive histological samples for conjunctival melanoma were included (7 women, 5 men), with a mean age at diagnosis of 60 years and a mean evolution time of 6.38 ± 3.4 years. BRAF V600E mutation was observed in three biopsies (25%), similar to NRAS Q61X (25%). Recurrences occurred in all patients with positive BRAF or NRAS mutation, and five of these patients developed systemic dissemination (83.33%). Moreover, four of six patients with mutated BRAF or NRAS (66.66%) had histopathological findings of tumor or precancerous lesions. CONCLUSIONS: BRAF and NRAS mutations may be risk factors for recurrence and shorter survival in conjunctival melanoma, which would make these patients candidates for targeted therapies and comprehensive and individualized follow-up. All these data warrant standardized prospective studies.

BRAF and NRAS prognostic values in conjunctival melanoma: analysis and literature review / Análise do valor prognóstico dos marcadores BRAF e NRAS no melanoma da conjuntiva e revisão da literatura

ABSTRACT Purpose: Conjunctival melanoma is a rare and aggressive tumor with a propensity for regional and distant metastases. This study aimed to analyze BRAF/NRAS markers in conjunctival melanoma and their relationship with tumor recurrences and patient prognosis. Methods: This retrospective, observational, single-center study included consecutive patients with an anatomopathological diagnosis of conjunctival melanoma, registered between January 1992 and December 2019. BRAF/NRAS mutations were analyzed using cobas®4800 kit (Roche®) in samples obtained by excisional or map biopsy. Additionally, the presence of other associated precancerous or tumor lesions was assessed. Results: A total of 12 patients with positive histological samples for conjunctival melanoma were included (7 women, 5 men), with a mean age at diagnosis of 60 years and a mean evolution time of 6.38 ± 3.4 years. BRAF V600E mutation was observed in three biopsies (25%), similar to NRAS Q61X (25%). Recurrences occurred in all patients with positive BRAF or NRAS mutation, and five of these patients developed systemic dissemination (83.33%). Moreover, four of six patients with mutated BRAF or NRAS (66.66%) had histopathological findings of tumor or precancerous lesions. Conclusions: BRAF and NRAS mutations may be risk factors for recurrence and shorter survival in conjunctival melanoma, which would make these patients candidates for targeted therapies and comprehensive and individualized follow-up. All these data warrant standardized prospective studies.

RESUMO Objetivo: O melanoma da conjuntiva é um tumor raro e agressivo, com propensão à disseminação metastática regional e distante. Este estudo tem como objetivo analisar os marcadores BRAF e NRAS no melanoma da conjuntiva e sua relação com recidivas tumorais e com o prognóstico do paciente. Métodos: Este foi um estudo retrospectivo, observacional e unicêntrico de pacientes consecutivos com diagnóstico anatomopatológico de melanoma da conjuntiva feito entre janeiro de 1992 e dezembro de 2019. As mutações BRAF e NRAS foram analisadas com o kit cobas® 4800 (Roche®) em amostras obtidas através de biópsia excisional ou por mapa. Além disso, foi avaliada a presença de lesões pré-cancerosas ou tumorais associadas. Resultados: Foram incluídos 12 pacientes com amostras histológicas positivas para melanoma da conjuntiva (7 mulheres e 5 homens), com idade média ao diagnóstico de 60 anos e tempo médio de evolução de 6,38 ± 3,4 anos. A mutação BRAF V600E foi encontrada em 3 biópsias (25%), bem como a NRAS Q61X (25%). Ocorreram recidivas em todos os pacientes positivos para mutações de BRAF ou NRAS e 5 desses pacientes desenvolveram disseminação sistêmica (83,33%). Além disso, 4 dos 6 pacientes com BRAF ou NRAS mutante (66,66%) apresentaram achados histopatológicos de lesões tumorais ou pré-cancerosas. Conclusões: As mutações BRAF e NRAS podem ser fatores de risco para recorrência e menor sobrevida no melanoma da conjuntiva, o que tornaria esses pacientes candidatos a terapias direcionadas e a um acompanhamento mais abrangente e individualizado. Todos esses dados justificam mais estudos prospectivos padronizados.

Recurrent meningeal malignant tumor: Assessment of differences in the solitary fibrous tumor/hemangiopericytoma spectrum through a case report / Tumor maligno recurrente de origen meníngeo: evaluación de las diferencias de la entidad tumor fibroso solitario/hemangiopericitoma mediante un caso clínico

Solitary fibrous tumors (SFTs) are neoplasms that grow from mesenchymal fusiform cells. In the central nervous system, meninges are the common origin of these neoplasms. Although literature reports mostly SFT as benign neoplasm, malignancy data have been described in recurrences or metastatic lesions. Definitive diagnosis includes immunohistochemical profiles assessing cellular positivity for CD34, vimentin, CD99 and Bcl-2. Recent studies have demonstrated NAB2-STAT6 gene fusion as a distinct molecular feature of SFT with overexpression of the fusion protein NAB2-STAT6 in nuclei of these cells. Since several years, pathologists have grouped SFT and hemangiopericytomas (HPC) as different phenotypes of the same entity although both neoplasms do not share numerous features. This article, based on a case of a recurrent malignant SFT, aims to emphasize differences in the SFT/HPC spectrum due to the diagnostic, therapeutic and prognostic implications (AU)

Los tumores fibrosos solitarios (TFS) son neoplasias que crecen a partir de células mesenquimales y las meninges constituyen su origen preferente en el sistema nervioso central. Aunque la literatura relaciona la mayoría de los TFS como neoplasias benignas, se describen datos de malignidad en recidivas tumorales o lesiones metastásicas. El diagnóstico definitivo incluye el perfil inmunohistoquímico, que evalúa la positividad celular para CD34, vimentina, CD99 y Bcl-2. Estudios recientes han demostrado la fusión del gen NAB2-STAT6 como una característica molecular distintiva de los TFS, con sobreexpresión de la proteína de fusión NAB2-STAT6 en los núcleos de las células. Los patólogos han agrupado los TFS y los hemangiopericitomas como diferentes fenotipos de una misma entidad, aunque ambas neoplasias no comparten numerosas características. Este artículo, basado en un caso de una lesión maligna recurrente, tiene como objetivo enfatizar las diferencias en el espectro SFT/hemangiopericitoma por sus implicaciones diagnósticas, terapéuticas y pronósticas (AU)

Recurrent meningeal malignant tumor: Assessment of differences in the solitary fibrous tumor/hemangiopericytoma spectrum through a case report.

Solitary fibrous tumors (SFTs) are neoplasms that grow from mesenchymal fusiform cells. In the central nervous system, meninges are the common origin of these neoplasms. Although literature reports mostly SFT as benign neoplasm, malignancy data have been described in recurrences or metastatic lesions. Definitive diagnosis includes immunohistochemical profiles assessing cellular positivity for CD34, vimentin, CD99 and Bcl-2. Recent studies have demonstrated NAB2-STAT6 gene fusion as a distinct molecular feature of SFT with overexpression of the fusion protein NAB2-STAT6 in nuclei of these cells. Since several years, pathologists have grouped SFT and hemangiopericytomas (HPC) as different phenotypes of the same entity although both neoplasms do not share numerous features. This article, based on a case of a recurrent malignant SFT, aims to emphasize differences in the SFT/HPC spectrum due to the diagnostic, therapeutic and prognostic implications.

Histological Patterns of Epithelial Alterations in Keratoconus.

PURPOSE: The purpose of this study was to confirm the presence of specific patterns of epithelial response in corneal buttons from keratoconus patients. METHODS: This was a retrospective and descriptive study. 90 penetrating keratoplasty specimens obtained from patients diagnosed with keratoconus were evaluated using bright-field microscopy. Morphologically identifiable characteristics including epithelial cell density and epithelial thickness were analyzed on hematoxylin and eosin- (H&E-) and periodic acid of Schiff- (PAS-) stained slides. RESULTS: Three distinctive patterns of epithelial alteration of the central cornea were established. Pattern 3, in which the central epithelium was as thick as peripheral epithelium, was the commonest (44.4%), followed by the pattern 2, defined as central epithelium thinner than periphery epithelium (38.9%), and the uncommonest pattern was number 1, with central epithelium thicker than the periphery (16.7%). CONCLUSIONS: Three distinctive histologic patterns that could potentially have a diagnostic and prognostic value in keratoconus patients were found.

El linfograma duodenal como herramienta complementaria en el diagnóstico de la enfermedad celiaca del adulto / Duodenal lymphogram as a complementary tool in the diagnosis of celiac disease in adults

INTRODUCCIÓN: la enfermedad celiaca (EC) presenta un determinado patrón de infiltrado linfocitario en la mucosa duodenal. Gracias a la citometría de flujo como herramienta complementaria al diagnóstico de la EC, se pueden cuantificar y caracterizar los linfocitos intraepiteliales (LIE) a través de lo que comúnmente denominamos linfograma. Con este estudio, pretendemos describir nuestra experiencia con la técnica en el diagnóstico del paciente celiaco adulto. MÉTODOS: se han analizado retrospectivamente los linfogramas realizados en nuestro centro entre 2009 y 2017, que fueron en total 157. Catorce de ellos tenían un diagnóstico previo de EC y seguían una dieta sin gluten, 21 tuvieron un diagnóstico nuevo de EC y el resto fueron considerados no celiacos. Se ha estudiado la asociación de los valores del linfograma (LIE totales, linfocitos CD3- y linfocitos TcRγδ) con el diagnóstico de EC, el cumplimiento de la dieta sin gluten (DSG), el tiempo desde el diagnóstico y el título de inmunoglobulina A antitransglutaminasa tisular. RESULTADOS: el valor de área bajo la curva ROC de los linfocitos TcRγδ para el diagnóstico de EC varía entre 0,86 y 0,86. El porcentaje de linfocitos TcRγδ en pacientes celiacos en DSG es menor 12 (8,5) vs. 20,5 (8,7), p = 0,0153, aunque permanece elevado frente a los no celiacos 12 (8,5) vs. 6,7 (6), p = 0,135. El tiempo desde el diagnóstico y el título de IgA antitransglutaminasa tisular (anti-Tgt) se correlacionan con los valores del linfograma en el paciente celiaco. La infección por Helicobacter pylori y el tratamiento con antagonistas de receptores de angiotensina 2 (ARA2) se asocia a diferencias en el linfograma. CONCLUSIONES: el linfograma duodenal es una herramienta complementaria fiable en el diagnóstico del celiaco adulto. Sin embargo, el cumplimiento y la duración de la DSG, así como otros factores, pueden condicionar su capacidad diagnóstica

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Duodenal lymphogram as a complementary tool in the diagnosis of celiac disease in adults.

INTRODUCTION: celiac disease (CD) patients have a specific pattern of lymphocytic infiltrate in the duodenal mucosa. Flow cytometry is a complementary tool for the diagnosis of CD, which allows the quantification and characterization of intraepithelial lymphocytes (IELs) by what is commonly called a lymphogram. Here we describe our experience with this technique in the diagnosis of CD in adult patients. METHODS: lymphograms from 157 patients performed in our center between 2009 and 2017 were retrospectively analyzed. Fourteen patients had a previous diagnosis of CD and followed a gluten-free diet (GFD), 21 had a new diagnosis of CD and the remaining were considered as non-celiac. The association of the lymphogram results (total IELs, CD3- lymphocytes and TcRγδ lymphocytes) with the CD diagnosis, compliance with the GFD, time since diagnosis and IgA anti-TG2 titer were determined. RESULTS: the area under the ROC curve of TcRγδ lymphocytes for CD patients varied between 0.86 and 0.86. The percentage of TcRγδ lymphocytes in GFD-treated patients was lower; 12 (8.5) vs 20.5 (8.7), p = 0.0153. However, it remained high compared to non-CD; 12 (8.5) vs 6.7 (6), p = 0.135. The time since diagnosis and IgA anti-TG2 titer correlated with the lymphogram results. Helicobacter pylori infection and treatment with angiotensin receptor antagonist 2 (ARA2) were associated with differences in the lymphogram results in patients without CD. CONCLUSIONS: the duodenal lymphogram is a reliable complementary tool in adults for the diagnosis of CD. However, compliance and duration of the GFD and other factors may condition its diagnostic capacity.

Spectrum of conjunctival tumours in a Spanish series: A review of 462 cases.

INTRODUCTION: To report the spectrum and frequency of conjunctiva tumours in an ocular oncology unit analysing the clinical profile of benign, precancerous and malignant conjunctival lesions. METHODS: A retrospective case series of 462 consecutive patients diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid from 1992 to 2017. RESULTS: Among 462 consecutive patients, the tumour was classified as melanocytic in 252 (54.5%) and non-melanocytic in 210 (45.5). Two hundred forty-eight males (mean age 51.63 (SD = 23.20)) and 214 females (mean age 48.27 (SD = 21.77)) were included. Mean patient age at diagnosis was 50.07 years (range = 1-92 years). The majority of tumours were benign (n = 307 (66.5%)) followed by precancerous (n = 103 (22.3%)) and finally by malignant ones (n = 52 (11.3%)). Benign lesions were predominantly found in younger individuals rather than premalignant (p < 0.05) and malignant ones (p < 0.05). Most of the melanocytic lesions were benign (88.5%), most epithelial ones were precancerous (61.4%) and most lymphoid lesions were malignant (56.3%). Tumours involving one or four quadrants of the ocular surface usually were benign, unlike tumours involving three quadrants that were malignant (16 (48.5%) p < 0.05). The majority of benign lesions were detected on females (n = 163 (53.1%)) by routine examination (n = 178 (86.4%)). However, main complaint in malignant tumours was the growth of the lesion (n = 39 (76.5%)). CONCLUSION: Most of the conjunctival tumours were melanocytic, mostly benign, closely followed by those of epithelial origin, with a predominance of precancerous lesions. Melanocytic, epithelial and lymphoid tumours accounted for over 90% of cases. A trend was identified with benign lesions being found in younger female patients on routine examination.

Black and white box: Take good gross pathology photographs.

Macroscopic study of surgical samples sent to the histopathology lab provides the first diagnostic approach. Obtaining quality photographs of these pieces facilitates proper case documentation for publication, sharing, teaching and research.This device has been originally designed for enucleated eyes but it could be used for a wide diversity of human or animal samples including thyroids, pituitary glands, prostates… It can be coupled to any smartphone camera.The Black and White Box is an affordable and easy option for taking gross pathology photographs of high quality. In this work we provide full instructions on how to make it.

Infiltrative Intraocular Conjunctival Squamous Cell Carcinoma after Local Resection and Brachytherapy: Clinical and Pathological Findings.

A pseudophakic 70-year-old man presented to the clinic with a slow-growing conjunctival mass in the left eye. He was diagnosed with a conjunctival exophytic lesion suspicious of invasive conjunctival squamous cell carcinoma (CSCC). Excisional biopsy showed a well-differentiated CSCC with positive margins and the patient underwent adjuvant brachytherapy. Six weeks later, examination of the anterior segment revealed cells in the anterior chamber and a neurotrophic corneal ulcer with corneal perforation. Considering the high suspicion of intraocular invasion of CSCC, the left eye was enucleated. Histopathologic findings showed scarring of the ciliary body with fibrosis temporally. Nasally, the sclera showed a lobular infiltration of well-differentiated squamous carcinoma. The central cornea exhibited a large ulcer with perforation and infiltrating squamous cells adhering to the posterior surface. To our knowledge, this is the first documented case of an intraocular diffuse recurrence of CSCC after resection and adjuvant brachytherapy, with clinicopathologic correlation of radiation effects on the ocular tissues.

Choroidal melanoma recurrence after episcleral brachytherapy and transpupillary thermotherapy.

A 68-year-old man diagnosed with choroidal melanoma (CM) in the right eye underwent treatment with episcleral brachytherapy (I125) and transpupillary thermotherapy. Ultrasound, computed tomography, and magnetic resonance imaging were performed and revealed ocular recurrence of CM. Treatment with extended enucleation was performed. Macroscopic and microscopic examinations revealed extraocular extension and malignant cells, respectively. Immunohistochemistry demonstrated tumoral Melan-A and HMB-45 expression. No cytogenic abnormalities were detected with fluorescence in situhybridization of tumor cells using probes against chromosomes 3q27 and 8q24. The patient underwent adjuvant external beam radiotherapy for treatment of residual tumor tissue. This case represents the first reported case of recurrent CM with no cytogenetic abnormalities and the absence of metastatic disease, despite a number of the poorest prognostic factors.

Choroidal melanoma recurrence after episcleral brachytherapy and transpupillary thermotherapy / Recorrência melanoma de coroide após a braquiterapia episcleral e termoterapia transpupilar

ABSTRACT A 68-year-old man diagnosed with choroidal melanoma (CM) in the right eye underwent treatment with episcleral brachytherapy (I125) and transpupillary thermotherapy. Ultrasound, computed tomography, and magnetic resonance imaging were performed and revealed ocular recurrence of CM. Treatment with extended enucleation was performed. Macroscopic and microscopic examinations revealed extraocular extension and malignant cells, respectively. Immunohistochemistry demonstrated tumoral Melan-A and HMB-45 expression. No cytogenic abnormalities were detected with fluorescence in situhybridization of tumor cells using probes against chromosomes 3q27 and 8q24. The patient underwent adjuvant external beam radiotherapy for treatment of residual tumor tissue. This case represents the first reported case of recurrent CM with no cytogenetic abnormalities and the absence of metastatic disease, despite a number of the poorest prognostic factors.

RESUMO Um homem de 68 anos de idade com diagnóstico de melanoma de coroide no olho direito foi submetido a tratamento com braquiterapia episcleral (I125) e termoterapia transpupilar. Ultrassonografia, tomografia computadorizada e ressonância magnética foram realizadas para avaliar a presença de recorrência ocular ou doença sistêmica. Enucleação ampliada foi realizada para tratar a recorrência ocular. O exame macroscópico e microscópico revelou o tipo de célula tumoral e a extensão extraocular. Colorações por Melan-A e HMB-45 foram realizadas. A fluorescência por hibridização in situ com sondas para os cromossomos 3q27 e 8q24 não mostraram anormalidades citogenéticas. O paciente foi submetido a radioterapia externa adjuvante para o tratamento de tumor residual orbitário. Este caso representa a o primeiro relato de paciente sem anomalias citogenéticas e sem doença metastática, apesar de demonstrar alguns dos mais pobres fatores prognósticos.

Fibrous pseudotumor affecting the tunica vaginalis, epididymis and seminal duct.

OBJECTIVE: To report one case of advanced fibrous pseudotumour. METHODS: A 34-year-old patient presented with a painless lump on the right side of the scrotum. Examination revealed a hard tissue thickening attached to the tail and body of the right epididymis. The results of the ultrasound study were not clear and multiple differential diagnosis were considered. The lesion was surgically removed by partial right epididymectomy and resection of the affected tunica vaginalis and ductus deferens for anatomopathological study. RESULTS: The histopathological study revealed an evolved fibrous pseudotumour with bone metaplasia. CONCLUSION: Fibrous pseudotumour is a benign paratesticular lesion that grows slowly and painlessly. It is usually diagnosed by chance or in associated processes such as hydrocele. Differential diagnosis with malignant tumors avoids unnecessary radical treatment.

Pseudotumor fibroso que afecta a la túnica vaginal, el epidídimo y la vía seminal / Fibrous pseudotumor affecting the tunica vaginalis, epididymis and seminal duct

OBJETIVO: Presentamos un caso evolucionado de Pseudotumor fibroso. MÉTODOS: Varón de 34 años que consulta por bultoma escrotal derecho indoloro presentando a la exploración un engrosamiento de consistencia indurada fusionado a la cola y el cuerpo de epidídimo derecho. El estudio ecográfico no fue aclaratorio planteando múltiples diagnósticos diferenciales. Se realizó exéresis de la lesión precisando una epididimectomía parcial derecha y resección de la túnica vaginal y el conducto deferente afectados para su estudio anatomopatológico. RESULTADOS: El estudio histopatológico de la pieza quirúrgica correspondía a un pseudotumor fibroso evolucionado, con metaplasia ósea. CONCLUSIÓN: El pseudotumor fibroso es una lesión paratesticular benigna, de crecimiento lento e indoloro. El diagnóstico suele ser por hallazgo casual o por procesos asociados como el hidrocele. El diagnóstico diferencial con los tumores malignos evita tratamientos radicales innecesarios (AU)

OBJECTIVE: To report one case of advanced fibrous pseudotumour. METHODS: A 34-year-old patient presented with a painless lump on the right side of the scrotum. Examination revealed a hard tissue thickening attached to the tail and body of the right epididymis. The results of the ultrasound study were not clear and multiple differential diagnosis were considered. The lesion was surgically removed by partial right epididymectomy and resection of the affected tunica vaginalis and ductus deferens for anatomopathological study. RESULTS: The histopathological study revealed an evolved fibrous pseudotumour with bone metaplasia. CONCLUSION: Fibrous pseudotumour is a benign paratesticular lesion that grows slowly and painlessly. It is usually diagnosed by chance or in associated processes such as hydrocele. Differential diagnosis with malignant tumors avoids unnecessary radical treatment (AU)

Metástasis peneana de un tumor primario vesical / Penile metastasis from primary bladder tumour

OBJETIVO: Presentamos un caso de una metástasis cutánea originada desde un tumor vesical. MÉTODOS: Varón de 68 años diagnosticado de un carcinoma urotelial de alto grado de la ISUP con afectación de toda la pared vesical incluida la grasa perivesical y macrometástasis en la cadena ilio-obturatriz izquierda (T3N2MO) que presenta una induración en la cara dorsal del glande, no dolorosa y con áreas ulceradas no exudativas, de varios meses de evolución. Dado el resultado negativo de la serología, se biopsió la lesión para su estudio anatomopatológico. RESULTADOS: El estudio histopatológico de la lesión correspondía a una metástasis cutánea de carcinoma urotelial de alto grado. CONCLUSIÓN: Existen aproximadamente 370 casos de metástasis peneana descritos y en el 30-35% de los casos el tumor primario se localiza en la vejiga. La presentación de estas lesiones es muy heterogénea precisando para el diagnóstico definitivo el estudio anatomopatológico de la lesión (AU)

OBJECTIVE: We present a case of cutaneous metastasis caused by a bladder tumor. METHODS: 68 year old male, diagnosed with an ISUP high grade urothelial carcinoma, affecting the whole bladder wall, including the perivesicular fat and macroscopic metastasis in the left ilio-obturator chain (T3N2MO), who presents painless induration on the dorsal surface of the glans penis with non-exudative ulcerated areas, evolving over several months. Given the negative serology result, the lesion was biopsied for anatomopathological study. RESULTS: The histopathological study of the lesion corresponded to a cutaneous metastasis from high grade urothelial carcinoma. CONCLUSION: Approximately 370 cases of penile metastasis have been described and the primary tumor is located in the bladder in 30-35% of them. Presentation of these lesions is very heterogeneous and requires anatomopathological study of the lesion for definitive diagnosis (AU)

Testicular cancer: our experience after 10 years.

OBJECTIVES: Testicular cancer represents about 1% of malignant tumors in men. Of these tumors 95% are germ cell tumors (GCTs), which have a maximum incidence between the second and third decades of life. Our objective was to carry out a retrospective analysis of testicular tumor cases that had been diagnosed in our Health Area between the years 2000 and 2010. METHODS: We performed a retrospective descriptive study between the years 2000 and 2010 analyzing 43 patients treated for testicular cancer, including in the analysis tumor incidence, the patient's age, clinic attended, patient's time until appointment, presence of tumor markers, patient's time before treatment, use of testicular prostheses, histological type and their typical characteristics, oncological treatment, tumor progression and mortality rate. RESULTS: We found an incidence of 4-5 cases/100,000 population/year in our Health Area. Two-thirds of the cases were detected in Stage I, and 100% of these cases showed complete remission. Among those with higher stage tumors, two out of three patients were cured after chemotherapy. For the remaining one-third, rescue treatments managed to achieve a remission rate of 66%. Mortality was low and was linked to lymphoma or metastatic dissemination. CONCLUSION: The trend towards early diagnosis with detection during the initial cancer stages, together with current chemotherapy protocols, enables a high cure rate for testicular cancer. Mortality in our series was associated with primary or secondary lymphomas.

Cáncer testicular: Nuestra experiencia en 10 años / Testicular cancer: our experience after 10 years

OBJETIVO: El cáncer de testículo representa alrededor del 1% de los tumores malignos en el varón. El 95% corresponde a tumores germinales (TTG) cuya máxima incidencia tiene lugar entre la 2ª y 3ª década de la vida. Nuestro objetivo es realizar un análisis retrospectivo de los tumores testiculares diagnosticados en nuestra Área de Salud entre los años 2000 y 2010. MÉTODOS: Estudio descriptivo retrospectivo de los pacientes con cáncer testicular entre los años 2000 y 2010, analizándose un total de 43 pacientes, con evaluación de la incidencia, edad, presentación clínica, tiempo hasta la consulta, marcadores tumorales, tiempo hasta el tratamiento, solicitud de prótesis testicular, tipo histológico y características anatomopatológicas propias, tratamiento oncológico, progresión tumoral y mortalidad. RESULTADOS: En nuestro área de salud encontramos una incidencia de 4-5 casos-/100000habitantes/año. Las dos terceras partes de los casos se detectaron en Estadio I, consiguiendo remisión completa en el 100%. En Estadios superiores hay curación en 2 de cada 3 pacientes tras la quimioterapia y en el tercio restante, los tratamientos de rescate consiguen la remisión en el 66%. La mortalidad es baja y asociada a afectación por Linfoma o a diseminación metastásica. CONCLUSIÓN: La tendencia al diagnóstico precoz con detección en estadios iniciales, asociado a los actuales protocolos de quimioterapia, permiten altos índices de curación en el cáncer testicular. La mortalidad en nuestra serie se asocia mayoritariamente a afectación por Linfoma primario o secundario(AU)

OBJECTIVES: Testicular cancer represents about 1% of malignant tumors in men. Of these tumors 95% are germ cell tumors (GCTs), which have a maximum incidence between the second and third decades of life. Our objective was to carry out a retrospective analysis of testicular tumor cases that had been diagnosed in our Health Area between the years 2000 and 2010. METHODS: We performed a retrospective descriptive study between the years 2000 and 2010 analyzing 43 patients treated for testicular cancer, including in the analysis tumor incidence, the patient’s age, clinic attended, patient’s time until appointment, presence of tumor markers, patient’s time before treatment, use of testicular prostheses, histological type and their typical characteristics, oncological treatment, tumor progression and mortality rate. RESULTS: We found an incidence of 4-5 cases/100,000 population/year in our Health Area. Two-thirds of the cases were detected in Stage I, and 100% of these cases showed complete remission. Among those with higher stage tumors, two out of three patients were cured after chemotherapy. For the remaining one-third, rescue treatments managed to achieve a remission rate of 66%. Mortality was low and was linked to lymphoma or metastatic dissemination. CONCLUSION: The trend towards early diagnosis with detection during the initial cancer stages, together with current chemotherapy protocols, enables a high cure rate for testicular cancer. Mortality in our series was associated with primary or secondary lymphomas(AU)

[Squamous cell carcinoma in a duplicated renal pelvis after percutaneous nephrolithotomy]. / Carcinoma de células escamosas en pelvis renal bífida, tras nefrolitotomía percutánea.

OBJECTIVE: To describe the clinical case of a patient presenting a squamous cell carcinoma in a duplicated renal pelvis, after percutaneous nephrolithotomy. METHODS/RESULTS: 60-year-old male patient who was diagnosed of a squamous cell carcinoma of the renal pelvis in the pathological study of a lower pole nephrectomy after percutaneous nephrolithotomy for staghorn calculi in the left lower pole renal moiety. The patient suffered a bladder recurrence one year and a half later. A radical cystoprostatectomy was performed, but the patient died in a few months due to metastasis. CONCLUSIONS: Squamous cell carcinoma of the renal pelvis is a rare tumor with poor prognosis, associated with stone disease and chronic infection. Taking biopsies from suspicious lesions during percutaneous nephrolithotomy may help early diagnosis and improve survival.