Carcinoma transicional y priapismo metastásico / Transitional carcinoma and malignant priapism

El priapismo metastático es una rara entidad clínica que suele ser secundaria a tumores del aparato genitourinario y que se asocia a un mal pronóstico debido a que su presencia suele indicar diseminación metastática multiorgánica. Presentamos un caso de priapismo secundario a metástasis peneana por carcinoma transicional y realizamos una revisión de la literatura médica

Malignant priapism is rare and usually secondary to genitourinary tumors. The prognosis is poor since it generally indicates the presence of multiorgan metastasis. A case of malignant priapism or priapism secondary to penile metastasis from transitional carcinoma is presented and the literature is reviewed

[Transitional carcinoma and malignant priapism]. / Carcinoma transicional y priapismo metastático.

Malignant priapism is rare and usually secondary to genitourinary tumors. The prognosis is poor since it generally indicates the presence of multiorgan metastasis. A case of malignant priapism or priapism secondary to penile metastasis from transitional carcinoma is presented and the literature is reviewed.

[Rectal hemorrhage as a first sign of renal cell adenocarcinoma]. / Rectorragia como primera manifestación de adenocarcinoma de células renales.

Renal cell carcinoma accounts for 85% of all renal primary tumours, the remaining 15% tumours originating either in the renal pelvis or the renal capsule. Clinical signs and symptoms of renal adenocarcinoma can be classified in four groups: specifically urological signs and symptoms, unspecific general symptoms, paraneoplastic syndromes, and metastasis-derived symptoms. The classical triad consists of haematuria, pain and palpable abdominal mass; at present this triad appears in a minority of cases, and is usually a late finding. The number of cases diagnosed from unspecific signs and symptoms is increasingly larger. Routine use of ultrasound and CAT allows a higher number of diagnosis, which frequently occur in the less advanced stages. The present paper presents a case report of renal cell adenocarcinoma, diagnosed from an infrequent early symptom such as rectal bleeding.

Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position.

PURPOSE: Percutaneous nephroscopy is usually performed with the patient prone, which is uncomfortable for the patient and does not prevent damage to the colon. We assess the possibility of performing percutaneous nephroscopy using local anesthesia with the patient supine, and evaluate the advantages and complications. MATERIALS AND METHODS: A total of 557 consecutive percutaneous nephroscopies were attempted in 221 men and 242 women in the supine position. Patient age ranged from 8 to 87 years (mean 55.1). Patients are supine with a 3 l. serum bag below the ipsilateral flank. We catheterize the affected uretheral meatus with a 5F catheter through a flexible cystoscope. The tract is infiltrated with local anesthesia. The skin is punctured in the posterior axillary line which corresponds to approximately 1 cm. above the bag. We use an Alken set to dilate the tract to 30F, which is the size of the Amplatz sheath we commonly use. RESULTS: Nephroscopy was performed in 519 cases (93.1%). Mean operation time was 85 minutes (range 15 to 240). Serious bleeding occurred in 3 cases. The colon was never damaged in patients treated in the supine position. CONCLUSIONS: Percutaneous nephroscopy using local anesthesia with the patient supine is safe and easy. According to our experience the advantages in comfort to the patient and feasibility to the surgeon justify its use.

[Wilms' tumor. The experience of the University Clinical Hospital of Zaragoza]. / Tumor de Wilms. Experiencia del Hospital Clínico Universitario de Zaragoza.

OBJECTIVES: The present study reviewed the records of patients with Wilms' tumor treated at the University Hospital of Zaragoza from January, 1980 to January, 1995. METHODS: A retrospective study was conducted in 12 patients (5 boys and 7 girls) with Wilms' tumor, aged 9 months to 9.5 years, with special reference to the clinical symptoms and signs. RESULTS: In 9 of the 12 cases, the tumor was localized to the left kidney and 3 cases had right-sided involvement. No patient showed an unfavorable histological finding, intraoperative rupture or the associated phenotypic manifestations that are frequently described in cases with this tumor type. CONCLUSION: The mortality and survival rates are comparable with those reported by other authors in our country.

[Prenatal torsion of the spermatic cord]. / Torsión prenatal de cordón espermático.

OBJECTIVES: Considerations on a case of prenatal torsion of the spermatic cord. METHODS: Review of cases reported in the literature. RESULTS: Testicular torsion rarely occurs in the perinatal period. Nearly a hundred cases with surgical confirmation have been reported. CONCLUSIONS: Prenatal torsion is almost exclusively extravaginal, while postnatal extravaginal torsion is extremely rare. The possibility of finding a viable testis is extremely remote. The treatment should be directed at minimizing any potential perioperative complications by scheduling an elective operation after the neonate is medically stable.