RESUMEN
Primary localized amyloidosis urinary tract is rare. Localized amyloidosid only glands is a very rare entity. The clinical impression may resemble neoplastic disease but the diagnosis is confirmed by histochemical study. Biopsy of the lesion revealed dermal deposits of amorphous eosinophilic material. A case of patient with primary amyldosis of glands penis is reported. The literature is reviewed and the diagnostic and therapeutic options are discussed. This is the seventh reported case of localized amyloidosis of the glands penis.
Asunto(s)
Amiloidosis/diagnóstico , Enfermedades del Pene/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To describe a case of mucinous adenocarcinoma of the prostate. METHODS: A 77-year-old patient presented with urinary complaints. Patient evaluation showed an enlarged prostate and increased PSA levels. RESULTS: A prostate biopsy showed a glandular neoplasm with extensive mucinous differentiation and abundant lacunae of PAS positive mucus (mucinous adenocarcinoma). The patient remains well one year after the diagnosis. CONCLUSIONS: Mucinous adenocarcinoma of the prostate is a rare variant that should be recognized and does not necessarily imply a worse prognosis than other carcinomas of the prostate.
Asunto(s)
Adenocarcinoma Mucinoso/patología , Neoplasias de la Próstata/patología , Anciano , Humanos , MasculinoRESUMEN
OBJECTIVE: To describe a case of adenocarcinoma of the urinary bladder. METHODS: A 63-year-old patient consulted for gross hematuria. Ultrasound evaluation showed a bladder neoplasm and CT demonstrated extensive infiltration of adjacent structures. RESULTS: Histological analysis of the TUR specimen confirmed a muscle infiltrating glandular neoplasm (adenocarcinoma) with diffuse areas of cystitis glandularis. Patient evolution has been poor and he is now in the end stage of the disease. CONCLUSIONS: The morphology is not unlike that of colorectal carcinoma, which should be distinguished. The association of areas of cystitis glandularis indicates a possible relationship.
Asunto(s)
Adenocarcinoma/complicaciones , Cistitis/complicaciones , Neoplasias de la Vejiga Urinaria/complicaciones , Adenocarcinoma/patología , Cistitis/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
OBJECTIVE: To describe a case of atypical stromal hyperplasia of the prostate. METHODS: A 62-year-old patient presented with prostatic syndrome. Physical examination disclosed an indurated prostate and PSA determination showed increased levels. A prostate biopsy was performed. RESULTS: The histological analysis showed atypical stromal proliferation with elongated nuclei and immunohistochemical expression for vimentine, smooth muscle actin and CD34 with glandular hyperplasia. The diagnosis was that of atypical stromal hyperplasia of the prostate (prostatic stromal proliferation of uncertain malignant potential). CONCLUSIONS: A careful histological study is necessary to make the correct diagnosis of prostatic stromal proliferation of uncertain malignant potential. CD34 expression is a characteristic finding. As its name indicates, its evolution is uncertain.
Asunto(s)
Hiperplasia Prostática/patología , División Celular , Humanos , Masculino , Persona de Mediana Edad , Próstata/patología , Células del Estroma/patologíaRESUMEN
OBJECTIVE: To report on a rare case of Pacinian neurofibroma of the vulva. METHODS: A 27-year-old patient who presented with a vulvar tumor is described. Patient evaluation showed no other remarkable findings. RESULTS: The nodule was resected without difficulty. The histopathological analysis-demonstrated Pacinian neurofibroma with abundant concentric laminar structures. The immunohistochemical (CD34+), ultrastructural and histological analyses showed perineural cells. No signs of neurofibromatosis were found. CONCLUSIONS: Pacinian neurofibroma may present in the vulva and could probably arise from the so-called perineural fibroblasts.
Asunto(s)
Corpúsculos de Pacini/patología , Neoplasias de la Vulva/patología , Adulto , Femenino , HumanosRESUMEN
OBJECTIVE: To report a case of scrotal calculus in a hydrocele, attached to the parietal portion of the tunica vaginalis, complicating the differential diagnosis. METHODS: A 54-year-old patient with a clinical diagnosis of hydrocele is described. Ultrasound confirmed the diagnosis and demonstrated a calcified structure in the hydrocele fluid, attached to the parietal portion of the tunica vaginalis. A calculus of 1.7 cm diameter was found during the surgical procedure. CONCLUSION: The presence of calculus in a hydrocele does not change the prognosis or treatment of this condition, although some doubts may arise during sonographic assessment if it is attached to the parietal portion of the tunica vaginalis.
Asunto(s)
Calcinosis/diagnóstico , Escroto , Hidrocele Testicular/complicaciones , Hidrocele Testicular/diagnóstico , Cálculos Urinarios/complicaciones , Cálculos Urinarios/diagnóstico , Diagnóstico Diferencial , Enfermedades de los Genitales Masculinos/complicaciones , Enfermedades de los Genitales Masculinos/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: A case of granulomatous epididymitis is presented. METHODS: A 23-year-old patient consulted for nonspecific pain in the left supratesticular region. Physical examination showed a hard, indolent, enlarged epididymis. An ultrasound scan revealed normal testes with small bilateral hydrocele and left epididymal enlargement with calcifications. Resection was performed via the inguinal approach. RESULTS: The histopathological analysis demonstrated intense granulomatous reaction with multinucleated giant cells and foci of spermatozoal remnants. Staining for fungi and acid-fast bacilli were negative. CONCLUSION: The condition was diagnosed as nonspecific granulomatous epididymitis.
Asunto(s)
Epididimitis/diagnóstico , Granuloma/diagnóstico , Adulto , Humanos , MasculinoRESUMEN
OBJECTIVE: To report a case of hemosiderin-rich, pigmented renal cell carcinoma. METHODS: A 70-year-old patient referred several episodes of gross hematuria during the last few weeks, without any other symptoms. CT demonstrated a renal mass compatible with carcinoma. A right renal nephrectomy was performed. RESULTS: Anatomopathological analysis revealed a hemosiderin-rich, pigmented, papillary renal cell carcinoma localized to the renal capsule that stained blue with the iron staining method. The postoperative period was unremarkable and the patient is asymptomatic one year postoperatively. CONCLUSION: Papillary renal cell carcinoma can present as a pigmented lesion due to the accumulation of iron in the cytoplasm. This peculiar form must be distinguished from neuromelanin-pigmented lesions.
Asunto(s)
Adenocarcinoma Papilar/química , Adenocarcinoma Papilar/patología , Hemosiderina/análisis , Neoplasias Renales/química , Neoplasias Renales/patología , Anciano , Humanos , MasculinoRESUMEN
OBJECTIVE: To report a case of renal cell carcinoma associated with carcinoma of the colon. METHODS: A right renal mass was detected during US control evaluation of a patient that had undergone surgery for rectosigmoid carcinoma 4 months earlier. A previous abdominal CT scan revealed a renal mass with characteristics of malignancy. Fine-needle aspiration biopsy showed clear cell renal carcinoma. This case was considered as two different and synchronous primaries, and the patient was submitted to surgery. RESULTS: Intestinal adhesions secondary to radiotherapy were found intraoperatively, but there was no evidence of local intestinal recurrence, and therefore nephrectomy was performed. The histopathological study demonstrated clear cell renal carcinoma with intranuclear inclusions. CONCLUSIONS: Although the patient may have a previous history of carcinoma at another site, the finding of a renal mass excludes synchronous tumors and nephrectomy should be the treatment of choice. The finding of clear cells in the cytological study supports the interpretation that these lesions were different primaries. Renal carcinoma should be included among the neoplasms with intranuclear inclusions.
Asunto(s)
Adenocarcinoma de Células Claras/patología , Neoplasias del Colon/patología , Neoplasias Renales/patología , Neoplasias Primarias Múltiples/patología , Anciano , Núcleo Celular , Humanos , Cuerpos de Inclusión , MasculinoRESUMEN
OBJECTIVE: To describe an additional case of metastatic bladder tumor from gastric signet-ring cell adenocarcinoma. METHODS/RESULTS: Local recurrence was demonstrated by gastrointestinal endoscopy and biopsy in a 52-year-old female who underwent total gastrectomy for signet-ring cell gastric adenocarcinoma two years earlier. A CT scan showed bilateral hydronephrosis and diffuse thickening of the bladder wall. Bladder biopsy demonstrated signet-ring cell adenocarcinoma. Palliative treatment with ureteral catheterization was instituted. CONCLUSIONS: Signet-ring cell adenocarcinoma of the bladder is usually a primary tumor. Metastatic signet-ring cell adenocarcinoma to the urinary bladder is uncommon.
Asunto(s)
Carcinoma de Células en Anillo de Sello/secundario , Neoplasias Gástricas/patología , Neoplasias de la Vejiga Urinaria/secundario , Femenino , Humanos , Persona de Mediana EdadRESUMEN
We show a case of spontaneous extraperitoneal vesical perforation due to presence of a bladder cancer with urotelial origin.
Asunto(s)
Carcinoma/complicaciones , Neoplasias de la Vejiga Urinaria/complicaciones , Anciano , Humanos , Masculino , Peritoneo , Rotura EspontáneaAsunto(s)
Fístula Cutánea/etiología , Pielonefritis Xantogranulomatosa/complicaciones , Fístula Urinaria/etiología , Absceso/complicaciones , Infecciones por Bacteroides/complicaciones , Nalgas , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Proteus/complicaciones , Proteus mirabilisRESUMEN
OBJECTIVE: A case of rapidly metastasizing renal carcinoma is presented. METHODS: A 62-year-old man complained of fever for the past 6 weeks and weight loss. An abdominal CT disclosed two cystic hepatic lesions compatible with hydatid cysts and a mass in the upper pole of the left kidney suggestive of a carcinoma. The patient underwent resection of the kidney. RESULTS: Histopathological analysis demonstrated renal adenocarcinoma with pleomorphic areas. Immunohistochemical analysis showed a high cellular proliferation rate (Ki67) and intense expression of p53 and glycoprotein P. The patient developed metastasis to the brain four months later and pulmonary and cutaneous metastases shortly thereafter. CONCLUSIONS: Clear cell renal carcinoma can have a rapidly progressive course. Histological studies and determination of adverse immunohistological markers can be useful in these cases.
Asunto(s)
Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/análisis , Biomarcadores de Tumor/análisis , Carcinoma de Células Renales/secundario , Neoplasias Renales/química , Proteínas de Neoplasias/análisis , Proteína p53 Supresora de Tumor/análisis , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Biomarcadores de Tumor/genética , Neoplasias Encefálicas/secundario , Carcinoma de Células Renales/química , Carcinoma de Células Renales/genética , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Progresión de la Enfermedad , Equinococosis Hepática/complicaciones , Resultado Fatal , Genes p53 , Humanos , Antígeno Ki-67/análisis , Neoplasias Renales/genética , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Proteínas de Neoplasias/genética , Nefrectomía , Neoplasias Cutáneas/secundarioRESUMEN
OBJECTIVE: To report a case of erythrocytosis in a patient with a hydronephrotic horseshoe kidney and normal erythropoietin values. METHODS/RESULTS: A hydronephrotic horseshoe kidney was discovered during evaluation to determine the etiology of the erythrocytosis in a 23-year-old male with normal erythropietin values. Blood parameters returned to normal following heminephrectomy. The hydronephrosis had been caused by stenois of the pyeloureteric junction. CONCLUSIONS: Although erythropoietin values may be normal, hydronephrosis can cause secondary erythrocytosis.
Asunto(s)
Hidronefrosis/etiología , Enfermedades Renales Quísticas/complicaciones , Riñón/anomalías , Policitemia/etiología , Adulto , Diagnóstico Diferencial , Eritropoyetina/sangre , Humanos , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/cirugía , Riñón/diagnóstico por imagen , Riñón/cirugía , Enfermedades Renales Quísticas/diagnóstico por imagen , Enfermedades Renales Quísticas/cirugía , Masculino , Policitemia/diagnóstico , Policitemia Vera/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
This paper describes a case of systemic brucellosis accompanied by brucellar orchitis that resolved favourably. There was however a relapse at the testicular level inappropriately treated that triggered a new episode of systemic brucellosis.
Asunto(s)
Antiinfecciosos/uso terapéutico , Brucelosis/tratamiento farmacológico , Epididimitis/microbiología , Orquitis/microbiología , Adulto , Brucelosis/diagnóstico , Brucelosis/fisiopatología , Doxiciclina/uso terapéutico , Epididimitis/diagnóstico , Epididimitis/tratamiento farmacológico , Humanos , Masculino , Orquitis/diagnóstico , Orquitis/tratamiento farmacológico , Recurrencia , Rifampin/uso terapéutico , Estreptomicina/uso terapéuticoRESUMEN
OBJECTIVE: To report a case of urethral carcinoma presenting as scrotal abscess. METHODS: A 53-year-old man presented with swelling, redness and pain in the scrotum. He had a history of urethral stricture and multiple scrotal abscesses. Incision and drainage were performed and the patient was treated with antibiotics without improvement. Incision and drainage were repeated and a biopsy of the tissue edges of the abscess were performed. RESULTS: Histopathological analysis disclosed a squamous cell carcinoma arising from the urethra. CONCLUSION: Patients with a history of urethral stricture should be followed closely. A scrotal biopsy should be performed in patients who do not improve with antibiotic therapy.
Asunto(s)
Absceso/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Enfermedades de los Genitales Masculinos/diagnóstico , Escroto , Neoplasias Uretrales/diagnóstico , Absceso/cirugía , Carcinoma de Células Escamosas/patología , Diagnóstico Diferencial , Enfermedades de los Genitales Masculinos/cirugía , Humanos , Masculino , Persona de Mediana Edad , Escroto/cirugía , Neoplasias Uretrales/patologíaRESUMEN
OBJECTIVE: An additional case of Wunderlich syndrome arising from a ruptured simple renal cyst is presented. METHODS/RESULTS: A 50-year-old female presented with pain, a mass in the left renal fossa and hypovolemia that could not be managed conservatively. The imaging techniques disclosed a large collection of blood in the left perirenal area. Surgical drainage of the hematoma and nephrectomy were performed. A simple cyst containing blood was found in the lower pole of the kidney. Its wall had been ruptured and had caused the hemorrhage. CONCLUSIONS: If surgical management of hemorrhage is decided in a patient with Wunderlich's syndrome, a conservative procedure should be performed and nephrectomy avoided if the underlying condition is benign.
Asunto(s)
Hematoma/etiología , Enfermedades Renales/etiología , Enfermedades Renales Poliquísticas/complicaciones , Femenino , Hematoma/diagnóstico , Hematoma/cirugía , Humanos , Riñón/diagnóstico por imagen , Enfermedades Renales/diagnóstico , Enfermedades Renales/cirugía , Persona de Mediana Edad , Nefrectomía , Enfermedades Renales Poliquísticas/diagnóstico , Enfermedades Renales Poliquísticas/cirugía , Espacio Retroperitoneal , Síndrome , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
OBJECTIVE: To contribute our experience in the performance of ambulatory major surgery, through the creation of an integrated unit. Such units take advantage of existing resources both in terms of space and materials, as well as personnel, without the need to open separate ambulatory major surgery units that would involve greater resources expenditure. MATERIAL AND METHODS: 48 patients undergoing ambulatory major urology surgery were analyzed. The patients were admitted the same morning of the procedure and then, after leaving the operating theatre, they were moved to the reanimation room and later to the urology ward, where they were evaluated by the urologist on duty and discharged. A few days later the patients returned to the outpatient's clinic for re-evaluation. RESULTS: 48 patients underwent surgery, 44 male and 4 female. Mean age of patients was 34 (3-86) years. The procedures most frequently performed were: hydrocelectomy, vaginal peritoneum duct closure, orchiopexy, ureterorenoscopy due to ureteral lithiasis, internal urethrotomy, varicocelectomy, vesical tumor resection and circumcision in children. Only in two cases, hospital stay was longer than 12 hours and there was only one re-admission. CONCLUSIONS: Ambulatory major surgery integrated units may allow to perform this type of surgery in small units, with little resources and with a volume of patients not sufficient to create an independent unit.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Procedimientos Quirúrgicos Urológicos , Servicio de Urología en Hospital , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To report a case of renal cortical hemangioma. METHODS/RESULTS: A 38-year-old patient consulted for recurrent renal colic. The CT scan findings showed a cortical lesion in the right kidney that was compatible with a carcinoma. The patient underwent nephrectomy. Pathological analysis of the surgical specimen showed a 2.7 circumscribed cortical lesion that was found to be a hemangioma. CONCLUSION: Renal hemangioma localized to the renal cortex can mimic a carcinoma.