Vulvar leiomyosarcoma in Bartholin's gland area: a case report and literature review.

BACKGROUND: Malignant tumours of the vulvar soft tissue are very uncommon. When localized in the Bartholin's gland area these tumours can be mistaken for benign lesions, leading to a delayed diagnosis. CASE: A 52-year-old woman presenting with a vulvar nodule, which was diagnosed as a Bartholin's gland cyst and was referred to the hospital for surgical excision of the lesion. Pathologist report informed of a 6 cm diameter leiomyosarcoma of the vulva with compromised resection margins; extension studies did not suggest any additional lesions and radical hemivulvectomy with ipsilateral inguinal lymphadenectomy was performed. The patient subsequently received radiotherapy and chemotherapy. Twelve months later, a local recurrence was diagnosed and was removed surgically. After 4 years of follow-up the patient remains disease free. CONCLUSION: Any vulvar lesion with unusual characteristics or insidious evolution in labia majora or Bartholin's glands area should be carefully and promptly studied. This is particularly important in order to perform an effective surgical treatment in cases of leiomyosarcoma.

Metástasis miocárdica de un carcinoma epidermoide de cérvix en una mujer con trasplante renal / Myocardium metastases from an epidermoid carcinoma of the cervix in a woman with renal transplant

Propósito: La afectación metastásica cardíaca del carcinoma epidermoide de cérvix es muy rara; cuando se presenta suele ser en casos con diseminación generalizada, descubierta en la autopsia. Hay muy pocos casos descritos de metástasis cardíaca secundaria a un carcinoma escamoso de cervix, diagnosticada "in vivo" sin que exista recidiva local o evidencia de enfermedad a distancia y ningún caso descrito en mujer inmunocomprometida. Material y método: Presentamos el caso de una paciente de 54 años portadora de un trasplante renal, sometida a terapia inmunosupresora, que recibió tratamiento exitoso para un cáncer escamoso de cérvix, estadio IIB, a la que se diagnosticó una metástasos cardíaca de gran agresividad. Se describen los hallazgos histopatológicos y revisa la bibliografía existente. Conclusiones: El curso de las enfermedades tumorales en pacientes trasplantados es más agresivo que el esperado en los no transplantados, siendo muy importante intensificar el seguimiento de los supervivientes sometidos a tratamiento inmunosupresor para detectar los tumores malignos tan pronto como sea posible (AU)

[Signet-ring cell neoplasm. Unusual histologic variety as primary bladder tumor]. / Neoplasia de células en anillo de sello. Una variedad histológica rara como tumor vesical primario.

We report a case of primary signet-ring cell adenocarcinoma of the urinary bladder. It is a extremely rare tumor. Gross hematuria is the commonest clinical presentation as well as this case. Our patient presented with advanced tumour invasion into perivesical fat at dome. The treatment was partial cystectomy together with quimiotherapy. Medical literature are reviewed with special remark on histopathology and its bladder origin.

Neoplasia de células en anillo de sello. Una variedad histológica rara como tumor vesical primario / Signet-ring cell neoplasms. A rare histologic variety like primary vesical tumor

Presentamos un caso de carcinoma vesical primario de células en anillo de sello, siendo este tipo de tumor extremadamente raro. Al igual que la mayoría de los casos descritos, la forma de presentación fue la hematuria y el estadio elevado. La opción terapéutica elegida fue la cistectomía parcial más quimioterapia. Hacemos una revisión de la literatura y destacamos, desde un punto de vista histológico, su origen vesical (AU)

[Mullerian-type papillary serous tumor: exceptional pathology of the testis. Report of a case and discussion]. / Tumor seroso papilar tipo mülleriano: una patología excepcional del testículo. Presentación de un caso y discusión.

Within the exceptional tumoral pathology of the testis and paratesticular region are the common epithelial type tumors. Although, its histogenesis is under discussion, it has been interpreted as arising from the remnants of the müllerian duct, or from the mesothelium of the tunica vaginalis differentiating in a müllerian direction. Similarities with homologous ovarian tumors are well recognized and in generally we accept a good prognostic due to its low malignant potential or borderline type, more experience with these uncommon lesions is necessary to evaluate their biologic potential.

Tumor seroso papilar tipo mülleriano:una patología excepcional del testículo. Presentación de un caso y discusión / Serous papillar tumour müllerian type: a axceptional textis pathology. A case presentation and discussion

Dentro de la patología tumoral excepcional del testículo y paratestículo figuran los tumores de estirpe epitelial común, que aunque de histogénesis discutida se acepta que derivan de restos müllerianos o de diferenciación mesotelial de la vaginal. Guardan estrechas similitudes con sus equivalentes ováricos y en general, se les atribuye buen pronóstico debido a su carácter bordeline o de bajo potencial maligno, pero se precisa de más experiencia con estos raros tumores para evaluar su potencial biológico (AU)

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[Primary nontransitional neoplasms of the bladder]. / Neoplasias primitivas no transicionales de vejiga.

Revision of all primitive tumours of the bladder diagnosed in our Service between July 1990 and July 1998. Among a total of 703 neoplasms of the bladder only 14 were non-transitional primitive tumours, accounting for just 1.98%. Eleven were malignant neoplasms with a diagnosis of epidermoid carcinoma in nine cases, one adenocarcinoma and one bladder adenocarcinoma. The other three were benign tumours: one haemangioma and two leiomyomas. From a clinical perspective, the predominant symptom was haematuria, followed by irritative symptoms. The two leiomyomas were accidental findings during a gynaecological examination (ultrasound) and a diagnostic examination for a nephritic colic (urography). The diagnostic means used and the extension studies were the same as used for transitional neoplasms. In general, treatment of benign neoplasms was partial cystectomy or transurethral resection while it was radical surgery for the malignant tumours when the existing criteria were an indication for that type of surgery (cystoprostatectomy with bypass), since there are no definite criteria with regards to therapy due to the low incidence of these tumours. Only three of the 11 patients with malignant neoplasms are still alive. All the others died within one year of diagnosis, an evidence of the aggressiveness of these tumours. These cases were considered primitive bladder tumours once it was concluded that there was no relation with any previous or simultaneous transitional neoplasms and that there had been no primitive tumour in a different organ.

[Bladder carcinosarcoma: case report with immunohistologic study]. / Carcinosarcoma vesical: aportación de un caso con estudio inmunohistológico.

We present a new case of carcinosarcoma of the bladder. This tumor is generally considered to be a rare one, has an uncertain aetiology and very poor prognosis, composed by mesenchymal and epithelial elements. It is an aggressive tumor with a short clinical course. At present radical cystectomy is the treatment of choice.

[Complete testicular feminization syndrome. Report of a case]. / Síndrome de feminización testicular completa. A propósito de un caso.

A case of complete testicular feminization (Morris syndrome) in a male pseudohermaphrodite is described. The results of the hormone analyses and the histological features of the resected gonad are presented. The literature is reviewed with special reference to whether gonadectomy should be performed in the pre or post-pubertal period. We advocate early castration because of the high incidence of germ cell neoplasia and the possibility of virilization in case of incomplete androgenic resistance. Our approach is based on the satisfactory feminization achieved by exogenous estrogen therapy.

[Primary embryonic rhabdomyosarcoma of the prostate. An unusual location]. / Rabdomiosarcoma embrionario primitivo de próstata. Una localización excepcional.

We report on an 18-year-old patient with embryonal rhabdomyosarcoma of the prostate who presented with urinary retention. An ultrasound-guided percutaneous punction corroborated the presumptive diagnosis. The patient was submitted to the appropriate combined treatment modality of chemotherapy, radiotherapy and surgery; however, the virulence of tumor spread led to a fatal outcome less than one year following treatment.