[Pelvic lipomatosis: clinical review and report of 4 new cases]. / Lipomatosis pélvica: revisión clínica y aportación de cuatro nuevos casos.

First described by the end of the fifties, pelvic lipomatosis is an uncommon disease that develops as a result of an excessive proliferation of benign fat tissue within the perivesical and perirectal spaces. The compressive effect on the urinary, and to a lesser degree, the digestive and vascular structures result in the well-known symptoms. Diagnosis is reached through X-ray studies, primarily computerised tomography. Contribution of four new cases in young males diagnosed through imaging studies as well as biopsies in three of them. Evolution has been varying, with medical control of symptoms in two cases and renal function impairment due to upper obstructive uropathy in the other two.

Lipomatosis pélvica: revisión clínica y aportación de cuatro nuevos casos / Pelvic lipomatosis: clinical review and contribution of four new cases

Descrita a finales de la década de los cincuenta, la lipomatosis pélvica es una infrecuente entidad patológica caracterizada por la proliferación excesiva de tejido adiposo benigno en los espacios perivesical y perirrectal. Los efectos compresivos sobre las estructuras urinarias, y en menor medida, digestivas y vasculares originan la sintomatología. Los estudios radiológicos y, especialmente la tomografía axial computerizada, nos permiten el diagnóstico. Presentamos cuatro nuevos casos en varones jóvenes diagnosticados mediante estudio imagen, así como biopsias en tres de ellos. La evolución ha sido desigual, con control sintomático bajo tratamiento médico en dos casos y deterioro de la función renal por uropatía obstructiva alta en los otros dos (AU)

[BCG in superficial carcinoma of the bladder. Authors' experience]. / BCG en el carcinoma vesical superficial. Nuestra experiencia.

Contribution of 95 patients with surface vesical tumour managed with UTR and endovesical BCG. The response was absence of recurrence in 68.4% cases in Ta stage, 63% in T1 and 66.7% in 'in situ' carcinoma. Therapy tolerability was good, with few side-effects. We conclude that BCG endovesical instillation as co-adjunctive therapy to UTR in surface vesical tumours has been shown to be effective for the period under study.

[Leukoplakia of the upper urinary tract]. / Leucoplaquia del tracto urinario superior.

Leukoplakia is a morphological term that attempts to define keratinizing desquamative squamous metaplasia of the transitional epithelium. It is uncommon in the upper urinary tract (less than 100 cases have been reported) and has been attributed to infection or mechanical injury to the epithelium and/or genetic factors. We present a case of leukoplakia in a male patient with renal tuberculosis that had been in remission for the past 15 years. Eight years earlier he had intermittently passed keratin laminas (pathognomonic of leukoplakia) during the course of various episodes of nephritic colic. After discarding a reactivation of tuberculosis and malignancy of the metaplastic lesion, we continued conservative treatment with radiologic and cytologic control evaluations.

[Urinary diversions: our experience and selection approach]. / Derivaciones urinarias: nuestra experiencia y actitud de selección.

Retrospective review of 126 urinary by-passes performed in our service over the last 15 years where efficacy and complications arisen from the ureteroileal by-passes, ureterosigmoidostomy and skin ureterostomy are analyzed. Patients were found to be pre-operatively homogeneous with no statistically significant differences with regard to age, renal function or previous radiotherapy, except in the case of ureterostomies which are always initiated from a poorer renal function and general condition. It was concluded that there was no difference between the various Bricker types according to the anastomosis, which allows joint a comparison with other groups. After three months, Bricker's showed better radiologic evolution than Goodwin's (p less than 0.08) and a statistically lower number of complication (p less than 0.05) therefore establishing they should be the choice procedure versus any other type of by-pass. Literature review with regard to results and conditions of container reservoirs and vesical substitutions, evaluating their contraindications within the neoplastic scope and/or psychosocial range, as well as comparing the reflux, stenosis and infection rates with our series, make the ureteroileal by-pass a technique entirely legitimate at present.

[Adrenal masses discovered incidentally]. / Masas suprarrenales de aparición incidental.

The introduction of new diagnosis techniques has made the study of the suprarenal gland much more accessible. In particular, ultrasonography, CAT and MRI have contributed to the increased detection of suprarenal masses by chance, and this raises problems when it comes to deciding the attitude to take to the diagnosis of these masses. We present nine suprarenal tumours, most of which appeared in the course of follow-up of patients suffering from carcinoma of the bladder. On detecting a suprarenal mass, we carry out a morphological study with CAT as well as determination of hormonal activity and puncture with cytology of the mass, according to the schema proposed by Copeland. We comment on the most significant clinical aspects and on the criteria of action proposed by various authors.

[Spontaneous subcapsular hematoma. Report of 4 new cases]. / Hematoma subcapsular espóntaneo. Aportación de cuatro nuevos casos.

The Spontaneous Subcapsular Hematoma is an uncommon entity. In most cases it develops on a pathological kidney or in patients with coagulopathy. In the pathology reviewed we found a high index of tumoural pathology. We present 4 cases of Spontaneous Subcapsular Hematoma received in our service. As opposed to other series, in none of our patients could tumoural pathology be attributed as the primary cause of the hematoma.