Impact of a One-Stop Hematuria Clinic on Overall Survival and Bladder Tumor Recurrence.

BACKGROUND AND OBJECTIVE: One-stop clinics have emerged as a tool to optimize the therapeutic management of cancer patients. The main purpose of this study was to assess the role of the one-stop hematuria clinic (OSHC), as compared to a conventional clinic (CC), on the overall and disease-free survival of patients with bladder cancer. METHODS: A five-year follow-up retrospective and single-center study was conducted in patients with primary bladder tumor diagnosed between 2006 and 2015. The primary outcomes were five-year overall survival and one-year relapse rate. RESULTS: A total of 394 patients (160 in OSHC and 234 in CC) were included. No differences were observed in terms of age, sex, smoking habit or risk group between the OSHC and CC groups. The average times from first symptom to diagnosis (24.9 ± 29.1 vs. 100.7 ± 93.6 days) and from first symptom to treatment (70.2 ± 34.0 vs. 155.0 ± 102.9 days) were significantly lower in the OSHC group than in the CC group (p < 0.001 each). There was no significant difference in the five-year survival rate between OSHC and CC (103/160 vs. 150/234, respectively; p = 0.951), although the proportion of relapses during the first year was significantly lower in the OSHC group (35/139, 25.2%) than in the CC one (74/195, 38.0%; p = 0.02). CONCLUSIONS: OSHC significantly reduced the diagnosis and treatment times. The early-relapse rate was significantly lower in the OSHC group, although the five-year survival rate was similar.

Impact of a One-Stop Hematuria Clinic on Overall Survival and Bladder Tumor Recurrence

Background and Objective: One-stop clinics have emerged as a tool to optimize the therapeutic management of cancer patients. The main purpose of this study was to assess the role of the one-stop hematuria clinic (OSHC), as compared to a conventional clinic (CC), on the overall and disease-free survival of patients with bladder cancer. Methods: A five-year follow-up retrospective and single-center study was conducted in patients with primary bladder tumor diagnosed between 2006 and 2015. The primary outcomes were five-year overall survival and one-year relapse rate. Results: A total of 394 patients (160 in OSHC and 234 in CC) were included. No differences were observed in terms of age, sex, smoking habit or risk group between the OSHC and CC groups. The average times from first symptom to diagnosis (24.9 ± 29.1 vs. 100.7 ± 93.6 days) and from first symptom to treatment (70.2 ± 34.0 vs. 155.0 ± 102.9 days) were significantly lower in the OSHC group than in the CC group (p < 0.001 each). There was no significant difference in the five-year survival rate between OSHC and CC (103/160 vs. 150/234, respectively; p = 0.951), although the proportion of relapses during the first year was significantly lower in the OSHC group (35/139, 25.2%) than in the CC one (74/195, 38.0%; p = 0.02). Conclusions: OSHC significantly reduced the diagnosis and treatment times. The early-relapse rate was significantly lower in the OSHC group, although the five-year survival rate was similar (AU)

Non-pancreatic Pseudocyst Presenting as a Giant Retroperitoneal Mass.

OBJECTIVE: To assess the non-pancreatic retroperitoneal pseudocyst in the differenctial diagnosis of retroperitoneal cystic masses. METHODS: To report a case. RESULTS: We present a case of a 50-year-old woman with symptoms of pain and a palpable abdominal mass. In imaging studies a 13-cm retroperitoneal cystic mass with left ureterohydronephrosis was observed. Surgical excision of the mass was performed with pathological diagnosis of non-pancreatic retroperitoneal pseudocyst. CONCLUSION: Non-pancreatic retroperitoneal pseudocyst is an entity with a very low incidence, benign, usually asymptomatic. It can grow compressing on adjacent structures. The definitive diagnosis is histopathological and the treatment is surgical. It's important to carry out complete exeresis to avoid recurrences.

[Usefulness of contrast enhanced ultrasound for evaluation of cystic renal masses.] / Utilidad de la ecografía con contraste en el estudio de las lesiones renales quísticas.

OBJECTIVE: Contrast enhanced ultrasound(CE) consists of the intravenous injection of gasmicrobubbles and their detection within the kidney in differentphases. CE is more accurate than contrast enhancedtomography for detection of septa and wall thicknessvascularization in cystic renal lesions. The purposes ofthis study are to confirm the usefulness of this tool in thecharacterization of complex cystic renal masses and toassess its histological correlation. MATERIALS AND METHODS: Retrospective observationalstudy of 78 patients with complex or indeterminatecystic renal masses who underwent a CE betweenJanuary 2015 - January 2020. RESULTS: Lesions with high suspicion of malignancy(Bosniak III and IV) were identified in 35 patients(45%). A surgical approach was taken in 23 (30%): 18patients with histology of renal cell carcinoma, and onlyin 4 the histology was benign. CE involved a change intherapeutic management due to better definition of thelesion in 48 patients (61.5%). CE has a sensitivity 100%,specificity 91.5%, PPV 81.8%, NPV 100%, and CE hadan important confidence level showed by the area underthe ROC curve (AUC = 0.968). CONCLUSIONS: CE is a useful tool in the characterizationof complex cystic renal lesions. It allows abetter definition of the Bosniak classification for thoseindeterminate or doubtful cases on CT that couldgenerate a change in the therapeutic attitude in manycases. It has a good image - histology relation.

OBJETIVO: La ecografía con contraste(EC) consiste en la inyección intravenosa demicroburbujas de gas y su detección dentro del riñón endistintas fases. En las lesiones renales quísticas la EC esmás sensible que la tomografía con contraste para valorarla vascularización de septos y tabiques. Los objetivosde este trabajo son confirmar la utilidad de esta técnicaen la caracterización de las lesiones renales quísticascomplejas y estudiar su relación anatomo-patológica MATERIAL Y MÉTODOS: Estudio observacionalretrospectivo de 78 pacientes con masas renales quísticascomplejas o dudosas en los que se les realizó una ECentre enero 2015 ­ enero 2020. RESULTADOS: En 35 pacientes (45%) se identificaronlesiones con alta sospecha de malignidad (BosniakIII y IV). En 23 (30%) se tomó una actitud quirúrgica: 18con anatomía patológica de carcinoma de células renalesy 4 con anatomía patológica benigna. En 48 pacientes(61,5%) supuso un cambio de actitud terapéuticadebido a la mejor definición de la lesión. La EC presentóuna sensibilidad 100%, especificidad 91,5%, VPP 81,8%,VPN 100%, con un nivel confianza diagnóstica mostradopor el área bajo la curva ROC (AUC = 0,968).CONCLUSIÓN: La EC es una herramienta útil en lavaloración de quistes renales complejos. Permite unamejor definición de la clasificación Bosniak para aquelloscasos indeterminados o dudosos en TC, que implicóun cambio de actitud terapéutica en muchos casos. Además,presenta una buena relación imagen-histología.

Utilidad de la ecografía con contraste en el estudio de las lesiones renales quísticas / Usefulness of contrast enhanced ultrasound for evaluation of cystic renal masses

OBJETIVO: La ecografía con contraste (EC) consiste en la inyección intravenosa demicroburbujas de gas y su detección dentro del riñón endistintas fases. En las lesiones renales quísticas la EC esmás sensible que la tomografía con contraste para valorar la vascularización de septos y tabiques. Los objetivosde este trabajo son confirmar la utilidad de esta técnicaen la caracterización de las lesiones renales quísticascomplejas y estudiar su relación anatomo-patológicaMATERIAL Y MÉTODOS: Estudio observacionalretrospectivo de 78 pacientes con masas renales quísticas complejas o dudosas en los que se les realizó una ECentre enero 2015 – enero 2020.RESULTADOS: En 35 pacientes (45%) se identificaron lesiones con alta sospecha de malignidad (BosniakIII y IV). En 23 (30%) se tomó una actitud quirúrgica: 18con anatomía patológica de carcinoma de células renales y 4 con anatomía patológica benigna. En 48 pacientes (61,5%) supuso un cambio de actitud terapéuticadebido a la mejor definición de la lesión. La EC presentóuna sensibilidad 100%, especificidad 91,5%, VPP 81,8%,VPN 100%, con un nivel confianza diagnóstica mostradopor el área bajo la curva ROC (AUC = 0,968).CONCLUSIÓN: La EC es una herramienta útil en lavaloración de quistes renales complejos. Permite unamejor definición de la clasificación Bosniak para aquellos casos indeterminados o dudosos en TC, que implicóun cambio de actitud terapéutica en muchos casos. Además, presenta una buena relación imagen-histología. (AU)

OBJECTIVE: Contrast enhanced ultrasound (CE) consists of the intravenous injection of gasmicrobubbles and their detection within the kidney in different phases. CE is more accurate than contrast enhanced tomography for detection of septa and wall thicknessvascularization in cystic renal lesions. The purposes ofthis study are to confirm the usefulness of this tool in thecharacterization of complex cystic renal masses and toassess its histological correlation.MATERIALS AND METHODS: Retrospective observational study of 78 patients with complex or indeterminate cystic renal masses who underwent a CE betweenJanuary 2015 – January 2020.RESULTS: Lesions with high suspicion of malignancy (Bosniak III and IV) were identified in 35 patients(45%). A surgical approach was taken in 23 (30%): 18patients with histology of renal cell carcinoma, and onlyin 4 the histology was benign. CE involved a change intherapeutic management due to better definition of thelesion in 48 patients (61.5%). CE has a sensitivity 100%,specificity 91.5%, PPV 81.8%, NPV 100%, and CE hadan important confidence level showed by the area under the ROC curve (AUC = 0.968). CONCLUSIONS: CE is a useful tool in the characterization of complex cystic renal lesions. It allows abetter definition of the Bosniak classification for those indeterminate or doubtful cases on CT that couldgenerate a change in the therapeutic attitude in manycases. It has a good image – histology relation. (AU)

The role of morphometric and respiratory factors in predicting the severity and evolution of urinary symptoms in patients with obstructive sleep apnea syndrome.

OBJECTIVES: To assess the severity, evolution, and behaviour of several urinary symptoms in patients with obstructive sleep apnea syndrome (OSAS) before and after the treatment with continuous positive airway pressure (CPAP). METHODS: A prospective study was performed on patients with a recent diagnosis of sleep apnea confirmed by nocturnal sleep polygraphy and absence of medical urological past history. The symptom incidence was analysed seeking predictive factors for initial nocturia, nocturnal polyuria (NP), and unfavourable International Prostate Symptoms Score (IPSS) before and after a 1-year period of treatment using a CPAP device. Morphometric variables (body mass index, BMI; neck and abdominal diameter) and functional respiratory variables (FEV1, FVC, and FEV1/FVC) were analysed. A multivariate analysis was performed with a calculation of Pearson's correlation coefficient to establish a linear relation between the variables. RESULTS: A total of 43 patients completed the two-step study (IPSS and bladder diary before and after the CPAP treatment). IPSS decreased by 3.58 points. Nocturia decreased to once per night. Neck diameter, FEV1, and FEV1/FVC significantly predicted the initial severity of some lower urinary tract symptoms (LUTS), (p=0.015, p=0.029, p=0.008, respectively). Neck diameter, abdominal perimeter, and FEV1/FVC significantly predicted the LUTS evolution throughout the study (p=0.023, p=0.007, p=0.05, respectively). CONCLUSION: Some pre-treatment morphometry and spirometry parameters such as abdominal or neck diameter, FEV1, and FEV1/FVC were predictive of the severity and evolution of LUTS in patients with OSAS.

Presentación inusual de metástasis de carcinoma prostático como masa mediastínica: descripción de un caso y breve revisión de la literatura / Unusual presentation of prostate carcinoma metastases as a mediastinal mass: description of a case and brief review of the literature

Objetivo: Considerar el cáncer de próstatametastásico en el diagnóstico diferencial de masas mediastínicas. Métodos: Presentación de un caso clínico.Resultados: Se presenta el caso de un paciente varónde 78 años con diagnóstico de cáncer de próstata en elque se objetiva una masa mediastínica compatible conmetástasis prostática. Conclusion: El mediastino es un lugar muy infrecuentede metástasis de cáncer de próstata, pero hay que considerarlo en el diagnóstico diferencial de masas mediastínicas. El tratamiento es el estándar del cáncer de próstatametastásico.(AU)

Objetive: To assess the metastasic prostatecancer in the differenctial diagnosis of mediastinal masses. Methods: To report a case. Results: We present the case of a 78-year-old male patient with a diagnosis of prostate cancer with a mediastinalmass compatible with prostate metastasis. Conclusion: Mediastinum is a very rare site for prostate cancer metastasis, but it must be considered in thedifferential diagnosis of mediastinal masses. Treatment isthe usual for metastatic prostate cancer.(AU)

[Unusual presentation of metastasis of prostate carcinoma as a mediastinal mass: A case report and a brief review of the literature.] / Presentación inusual de metástasis de carcinoma prostático como masa mediastínica: descripción de un caso y breve revisión de la literatura.

OBJECTIVE: To assess the metastasic prostatecancer in the differenctial diagnosis of mediastinal masses. METHODS: To report a case. RESULTS: We present the case of a 78-year-old male patientwith a diagnosis of prostate cancer with a mediastinalmass compatible with prostate metastasis. CONCLUSION: Mediastinum is a very rare site for prostatecancer metastasis, but it must be considered in thedifferential diagnosis of mediastinal masses. Treatment isthe usual for metastatic prostate cancer.

OBJETIVO: Considerar el cáncer de próstatametastásico en el diagnóstico diferencial de masas mediastínicas. MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se presenta el caso de un paciente varónde 78 años con diagnóstico de cáncer de próstata en elque se objetiva una masa mediastínica compatible conmetástasis prostática. CONCLUSIÓN: El mediastino es un lugar muy infrecuentede metástasis de cáncer de próstata, pero hay que considerarloen el diagnóstico diferencial de masas mediastínicas.El tratamiento es el estándar del cáncer de próstatametastásico.

Citología de orina por lavado y hematuria macroscópica monosintomática: experiencia sobre su utilidad en una consulta de alta resolución / Urine cytology by washing and monosymptomatic macroscopic hematuria: experience on its usefulness in a high-resolution consultation

Obejtivo: Evaluar la precisión y rentabilidad diagnósticas de la citología urinaria por lavadoen el estudio inicial de la hematuria macroscópica monosintomática en el contexto de una consulta de altaresolución.Métodos: Estudio retrospectivo, descriptivo y analítico de las pruebas diagnósticas solicitadas en la consulta de hematuria de alta resolución entre 2011 y 2018.Se evaluaron la ecografía de aparato urinario, la uretrocistoscopia y particularmente la citología de orina porlavado vesical. Las muestras de citología urinaria fueronrevisadas por el mismo patólogo. Resultados: 1122 pacientes con ecografía y cistoscopia. Se detectó tumor vesical en 354 pacientes(31,5%) y otros tumores urológicos en 33 casos (2,9%).Se recogió citología urinaria por lavado en 804 pacientes (71,4%), siendo positiva en 236 casos (29,4%).La sensibilidad y especificidad de la citología urinaria para detectar tumor urotelial fue del 55,1%, y del85,7%, respectivamente. En los pacientes con tumor vesical visible por cistoscopia la citología fue positiva en181 pacientes (52,1%). En los casos sin tumor vesicalvisible hubo 7 pacientes (0,87%) con citología positiva.En 433 pacientes con ecografía y cistoscopia negativas se recogió citología urinaria cuyo resultado fue negativo (38,6%).Conclusión: La citología urinaria por lavado tieneuna utilidad limitada en el estudio inicial de la hematuriamacroscópica de una consulta de alta resolución. Permite el diagnóstico de un reducido número de tumores uroteliales, obviando un porcentaje significativo de ellos.En caso de hematuria macroscópica monosintomáticay pruebas de imagen negativas, la citología urinariapodría usarse como prueba complementaria diferida.(AU)

Objetive: To report the diagnostic accuracy and liability of the instrumentalized urine cytology in the preliminary study of monosyntomatic grosshaematuria.Methods: A retrospective, descriptive and analyticstudy of the patients that complained of macroscopic hematuria at the one-stop clinic between 2011 and2018. The complementary tests requested were: kidney/bladder ultrasounds, urethrocystoscopy and urinaryinstrumentalized cytology. All the urine cytology sampleswere examined by the same pathologist.Reslts: 1122 patients were reviewed with ultrasonography and cystoscopy. Bladder tumor was detected in354 patients (31.5%) and other urological malignancieswere found in 33 cases (2.9%). Urinary instrumentalizedcytologies were collected in 804 patients (71.4%), being positive in 236 cases (29.4%). Sensitivity and specificity of urinary cytology for urothelial tumor detectionwere 55.1% and 85.7%, respectively. Cytology waspositive in 181 patients (52.1%) with visible bladdertumors through cystoscopy, in 7 patients (0.87%) withoutvisible bladder tumors. In 433 patients with ultrasonography and cystoscopy both negative, urine cytology wasperformed with a negative result (38.6%).Conclusion: the usefulness of instrumentalized urinary cytology to diagnose urothelial tumors is restrictedin terms of monosymptomatic gross haematuria one stopclinic. It allows the diagnosis of a very limited numberof cases tumors and leaves a significant number of themout. In case of gross hematuria and negative imaging,urine cytology can be requested as a differed complementary.(AU)

[Gross hematuria and usefulness of urinary cytology: Experience at hematuria one stop clinic.] / Citología de orina por lavado y hematuria macroscópica monosintomática: experiencia sobre su utilidad en una consulta de alta resolución.

OBJECTIVE: To report the diagnostic accuracy and liability of the instrumentalized urine cytology in the preliminary study of monosyntomatic gross haematuria. METHODS: A retrospective, descriptive and analytic study of the patients that complained of macroscopic hematuria at the one-stop clinic between 2011 and 2018. The complementary tests requested were: kidney/bladder ultrasounds, urethrocystoscopy and urinary instrumentalized cytology. All the urine cytology samples were examined by the same pathologist. RESULTS: 1122 patients were reviewed with ultrasonography and cystoscopy. Bladder tumor was detected in 354 patients (31.5%) and other urological malignancies were found in 33 cases (2.9%). Urinary instrumentalized cytologies were collected in 804 patients (71.4%), being positive in 236 cases (29.4%). Sensitivity and specificity of urinary cytology for urothelial tumor detection were 55.1% and 85.7%, respectively. Cytology was positive in 181 patients (52.1%) with visible bladder tumors through cystoscopy, in 7 patients (0.87%) without visible bladder tumors. In 433 patients with ultrasonography and cystoscopy both negative, urine cytology was performed with a negative result (38.6%). CONCLUSION: The usefulness of instrumentalized urinary cytology to diagnose urothelial tumors is restricted in terms of monosymptomatic gross haematuria one stop clinic. It allows the diagnosis of a very limited number of cases tumors and leaves a significant number of them out. In case of gross hematuria and negative imaging, urine cytology can be requested as a differed complementary.

OBJETIVO: Evaluar la precisión y rentabilidad diagnósticas de la citología urinaria por lavado en el estudio inicial de la hematuria macroscópica monosintomática en el contexto de una consulta de alta resolución.MÉTODOS: Estudio retrospectivo, descriptivo y analítico de las pruebas diagnósticas solicitadas en la consulta de hematuria de alta resolución entre 2011 y 2018. Se evaluaron la ecografía de aparato urinario, la uretrocistoscopia y particularmente la citología de orina por lavado vesical. Las muestras de citología urinaria fueron revisadas por el mismo patólogo. RESULTADOS: 1122 pacientes con ecografía y cistoscopia. Se detectó tumor vesical en 354 pacientes (31,5%) y otros tumores urológicos en 33 casos (2,9%). Se recogió citología urinaria por lavado en 804 pacientes (71,4%), siendo positiva en 236 casos (29,4%). La sensibilidad y especificidad de la citología urinaria para detectar tumor urotelial fue del 55,1%, y del 85,7%, respectivamente. En los pacientes con tumor vesical visible por cistoscopia la citología fue positiva en 181 pacientes (52,1%). En los casos sin tumor vesical visible hubo 7 pacientes (0,87%) con citología positiva. En 433 pacientes con ecografía y cistoscopia negativas se recogió citología urinaria cuyo resultado fue negativo (38,6%).CONCLUSIÓN: La citología urinaria por lavado tiene una utilidad limitada en el estudio inicial de la hematuria macroscópica de una consulta de alta resolución. Permite el diagnóstico de un reducido número de tumores uroteliales, obviando un porcentaje significativo de ellos. En caso de hematuria macroscópica monosintomática y pruebas de imagen negativas, la citología urinaria podría usarse como prueba complementaria diferida.

Metástasis de carcinoma de mama en uréter. Presentación de un caso clínico / Metastasis of breast carcinoma in the ureter. Presentation of a clinical case

OBJETIVO: Resaltar la importancia del seguimiento estrecho a largo plazo de pacientes con antecedente de carcinoma de mama. MATERIALES Y MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se presenta el caso de una mujer de 55 años de edad con antecedente de carcinoma lobulillar de mama. Recibió tratamiento neoadyuvante, cirugía y quimioterapia y radioterapia posterior. En estudio de imagen de control se diagnosticó de metástasis óseas múltiples. La paciente consultó por dolor lumbar izquierdo de varios meses de evolución, en estudio de imagen se observó hidronefrosis izquierda secundaria a lesión de partes blandas en unión pieloureteral con alteración funcional renal. En biopsia realizada mediante abordaje endoscópico (ureteroscopia) se diagnosticó de metástasis de carcinoma de mama en uréter. CONCLUSIÓN: Las lesiones metastásicas en uréter son extremadamente infrecuentes siendo aún menos frecuentes las de origen mamario con alrededor de diez casos publicados mundialmente. Con el diagnóstico previo de carcinoma de mama, el probable compromiso ureteral debe ser tomado en cuenta especialmente en pacientes con síntomas clínicos y radiológicos de obstrucción de la vía urinaria. Un diagnóstico oportuno es posible que influya en el pronóstico y supervivencia posterior

OBJECTIVE: To assess the importance of long-term close follow-up in patients with breast carcinoma. MATERIALS AND METHODS: To present a case report RESULTS: A case of a 55-year-old woman with history of lobular carcinoma of the breast is presented. She received neoadjuvant treatment, surgery and complementary chemotherapy and radiotherapy. In radiologic imaging studies, multiple bone metastases were diagnosed. The patient consulted for left lumbar pain. Radiologic studies revealed left hydronephrosis secondary to soft tissue lesion in pyeloureteral junction with renal functional impairment. A biopsy performed using an endoscopic approach (ureteroscopy), diagnosed a metastasis of breast carcinoma in the ureter. CONCLUSION: Metastatic lesions in the ureter are extremely rare, even less frequent the ones with breast origin with around ten cases published worldwide. With the previous diagnosis of breast carcinoma, the probable ureteral compromise should be considered especially in patients with clinical and radiological symptoms of urinary tract obstruction. A well-timed and proper diagnosis may influence in prognosis and survival

[Metastasis of breast carcinoma in the ureter. Presentation of a clinical case.] / Metástasis de carcinoma de mama en uréter. Presentación de un caso clínico.

OBJECTIVE: To assess the importance of long-term close follow-up in patients with breast carcinoma. MATERIALS AND METHODS: To present a case report. RESULTS: A case of a 55-year-old woman with history of lobular carcinoma of the breast is presented. She received neoadjuvant treatment, surgery and complementary chemotherapy and radiotherapy. In radiologic imaging studies, multiple bone metastases were diagnosed. The patient consulted for left lumbar pain. Radiologic studies revealed left hydronephrosis secondary to soft tissue lesion in pyeloureteral junction with renal functional impairment. A biopsyperformed using an endoscopic approach (ureteroscopy), diagnosed a metastasis of breast carcinoma in the ureter. CONCLUSION: Metastatic lesions in the ureter are extremely rare, even less frequent the ones with breast origin with around ten cases published worldwide. With the previous diagnosis of breast carcinoma, the probable ureteral compromise should be considered especially in patients with clinical and radiological symptoms of urinary tract obstruction. A well-timed and proper diagnosis may influence in prognosis and survival.

OBJETIVO: Resaltar la importancia del seguimiento estrecho a largo plazo de pacientes con antecedente de carcinoma de mama.MATERIALES Y MÉTODOS: Presentación de un caso clínico. RESULTADOS: Se presenta el caso de una mujer de 55 años de edad con antecedente de carcinoma lobulillar de mama. Recibió tratamiento neoadyuvante, cirugía y quimioterapia y radioterapia posterior. En estudio de imagen de control se diagnosticó de metástasis óseas múltiples. La paciente consultó por dolor lumbar izquierdo de varios meses de evolución, en estudio de imagen se observó hidronefrosis izquierda secundaria a lesión de partes blandas en unión pieloureteral con alteración funcional renal. En biopsia realizada mediante abordaje endoscópico (ureteroscopia) se diagnosticó de metástasis de carcinoma de mama en uréter.CONCLUSIÓN: Las lesiones metastásicas en uréter son extremadamente infrecuentes siendo aún menos frecuentes las de origen mamario con alrededor de diez casos publicados mundialmente. Con el diagnóstico previo de carcinomade mama, el probable compromiso ureteral debe ser tomado en cuenta especialmente en pacientes con síntomas clínicos y radiológicos de obstrucción de la vía urinaria. Un diagnóstico oportuno es posible que influya en el pronóstico y supervivencia posterior.

Laparoscopic Abdominopexy: Surgery for Vaginal Prolapse.

OBJECTIVES: We present a new surgery based on the round ligament anatomy that is called laparoscopic abdominopexy, which uses a synthetic mesh without fixation at any pelvic point. The aim of this study is to provide a step-by-step description of the laparoscopic abdominopexy technique and present the first anatomical and functional results of the procedure. METHODS: This prospective cohort study included patients with apical and anterior vaginal prolapse who were subjected to laparoscopic abdominopexy. Before and after surgery, the Pelvic Organ Prolapse Quantification (POP-Q) scale, Overactive Bladder Questionnaire-Short Form (OABq-SF), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were used to evaluate the vaginal prolapse stage, storage, and sexual symptoms, respectively. The surgical technique is described step by step. RESULTS: Twenty patients were included with follow-up times between 6 and 25 months. The mean surgical time was 78.4 minutes. A statistically significant improvement was observed in the Aa (P ≤ 10-5), Ba (P ≤ 10-5), C (P = 5 × 10-5), D (P = .002) and tvl (P = .02) POP-Q points and in OABq-SF (22.2%; P = .02). Successful surgery was observed in 100% of patients for the apical compartment and 90% of patients for the anterior compartment. CONCLUSION: Laparoscopic abdominopexy is a quick, safe, and reproducible surgical technique with beneficial anatomical and functional results that preserve the pelvic floor anatomy.

[Renal cell carcinoma metastases in rare anatomical locations: pituitary, thyroid and mammary glands. of our experience and report of three cases.] / Metástasis de carcinoma de células renales en localizaciones poco frecuentes: hipófisis, tiroides y mama. Revisión de nuestra experiencia y presentación de tres casos clínicos.

OBJECTIVE: Metastatic Renal Cell Carcinoma(RCC) may develop in different anatomical locationsand after a strict follow up within normal limits. We assessthe importance of close follow up in patients with historyof RCC through 3 clinical cases with unusual locations ofmetastatic RCC. METHODS: We present 3 cases of metastatic involvementof pituitary, thyroid and mammary glands. We retrospectivelyreview our data base on metastatic RCC with 76patients. DISCUSSION: There is not agreement about the time offollow up and image methods requested after surgery ofRCC. The reason is the development of late onset and atypicalplacement metastases. CONCLUSION: Metastatic disease of renal neoplasmscan occur at any time and at any location. It is importantto keep suspicion of metastatic renal disease in patients inthis background, even in those with good progress andregardless of the years that have passed since the initialdiagnosis.

OBJETIVO: El Carcinoma de Células Renales (CCR) metastásico puede presentarse en localizaciones anatómicas muy variables y tras varios años de seguimiento. En éste artículo resaltamos la importancia del seguimiento de pacientes con antecedente de CCR. MATERIAL Y MÉTODOS: A partir de la revisión de 76 casos de CCR metastásico que recibieron tratamiento sistémico, se presentan tres casos clínicos con afectación de glándulas hipófisis, tiroides y mama.DISCUSIÓN: Existe debate acerca del tiempo de seguimientotras una cirugía por CCR y los métodos de imagen de control por la posibilidad de aparición de metástasis tardías y en lugares atípicos.CONCLUSIÓN: Es importante mantener la sospecha de enfermedad renal metastásica en pacientes con antecedente de CCR, incluso en aquellos con buena evolución y sin tener en cuenta el tiempo transcurrido desde el diagnóstico inicial.

Metástasis de carcinoma de células renales en localizaciones poco frecuentes: hipófisis, tiroides y mama. Revisión de nuestra experiencia y presentación de tres casos clínicos / No disponible

Objetivo: El Carcinoma de Células Renales (CCR) metastásico puede presentarse en localizaciones anatómicas muy variables y tras varios años de seguimiento. En éste artículo resaltamos la importancia del seguimiento de pacientes con antecedente de CCR. Material y métodos: A partir de la revisión de 76 casos de CCR metastásico que recibieron tratamiento sistémico, se presentan tres casos clínicos con afectación de glándulas hipófisis, tiroides y mama. Discusión: Existe debate acerca del tiempo de seguimiento tras una cirugía por CCR y los métodos de imagen de control por la posibilidad de aparición de metástasis tardías y en lugares atípicos. Conclusión: Es importante mantener la sospecha de enfermedad renal metastásica en pacientes con antecedente de CCR, incluso en aquellos con buena evolución y sin tener en cuenta el tiempo transcurrido desde el diagnóstico inicial

Objective: Metastatic Renal Cell Carcinoma (RCC) may develop in different anatomical locations and after a strict follow up within normal limits. We assess the importance of close follow up in patients with history of RCC through 3 clinical cases with unusual locations of metastatic RCC. Methods: We present 3 cases of metastatic involvement of pituitary, thyroid and mammary glands. We retrospectively review our data base on metastatic RCC with 76 patients. DIscussion: There is not agreement about the time of follow up and image methods requested after surgery of RCC. The reason is the development of late onset and atypical placement metastases. Conclusion: Metastatic disease of renal neoplasms can occur at any time and at any location. It is important to keep suspicion of metastatic renal disease in patients in this background, even in those with good progress and regardless of the years that have passed since the initial diagnosis

Lymph node non-Hodgkin's lymphoma incidentally discovered during a nephrectomy for renal cell carcinoma.

We report the case of a left laparoscopic nephroureterectomy with the incidental discovery of a non-Hodgkin's lymphoma in one of the lymph nodes of the renal hilum. A laparoscopic nephroureterectomy was decided on for a 64-year-old man. Renal cell carcinoma in the kidney and one lymph node of the renal hilum with non-Hodgkin's lymphoma was found. Chemotherapy was not started for the lymphoma discovery. There are no signs of relapse after two years of follow up. Coexistence in the same patient is an extremely rare condition. We review the literature about this issue to clarify this association.

Right renal infarction: a new case report.

OBJECTIVE: To present a new case of renal infarction. METHODS: We report the case of an 84-year-old woman presenting with right flank colic pain of 24 hours of evolution and past history of acute myocardial infarction four months before. CONCLUSION: Renal infarction is a rare condition; in most of the cases it does not show specific symptoms and usually overlap with other more common urologic procedures, which results in a delay in diagnosis and treatment. The most conclusive imaging tests are i.v contrast CT scan or Doppler ultrasound but definitive diagnosis is achieved by angiography or CT angiography. Treatment is conservative, with parenteral and oral anticoagulation; invasive management is rare.

Infarto renal derecho. Presentación de un nuevo caso / Right renal infarction: a new case report

OBJETIVO: Presentar un nuevo caso de infarto renal. MÉTODOS: Se presenta el caso de una mujer de 84 años con dolor cólico en flanco derecho de 24 horas de evolución y con antecedente de infarto agudo de miocardio cuatro meses antes. CONCLUSIÓN: El infarto renal es una patología rara, dando lugar en la mayoría de los casos a una sintomatología inespecífica y solapable a otros procesos urológicos más frecuentes, lo que implica un retraso en su diagnóstico y en su tratamiento. Las pruebas de imagen más concluyentes son la Tc con contraste o la Eco-Doppler pero el diagnóstico de certeza es por angiografía o angio-Tc. Su tratamiento es conservador, anticoagulación parenteral y oral, el manejo invasivo es infrecuente (AU)

OBJECTIVE: To present a new case of renal infarction. METHODS: We report the case of an 84-year-old woman presenting with right flank colic pain of 24 hours of evolution and past history of acute myocardial infarction four months before. CONCLUSION: Renal infarction is a rare condition; in most of the cases it does not show specific symptoms and usually overlap with other more common urologic procedures, which results in a delay in diagnosis and treatment. The most conclusive imaging tests are i.v contrast CT scan or Doppler ultrasound but definitive diagnosis is achieved by angiography or CT angiography. Treatment is conservative, with parenteral and oral anticoagulation; invasive management is rare (AU)