[Non-venereal sclerosing lymphangitis of the penis. Report of two clinical cases]. / Linfangitis esclerosante no venérea del pene. Presentación de dos casos clínicos.

Nonvenereal sclerosing lymphangitis of the penis is a rare condition that preferably affects men aged between 20 and 40 years, and it is appeared like a hard cord or a nodular lesion in the sulcus coronarius penis. It is believed that it has origin in lymph vessels of the penis. Usually it is resolved in a self-limited way, so the initial treatment is conservative. We report two cases, and some etiopathogenic, diagnosis and therapeutic aspects are discussed.

Linfangitis esclerosante no venérea del pene. Presentación de dos casos clínicos / Non-venereal sclerosing lymphangitis of the penis. Two case reports

La linfangitis esclerosante no venérea del pene se trata de una patología poco frecuente, que afecta preferentemente a varones entre 20 y 40 años, y que se presenta como un nódulo o cordón indurado a nivel del surco coronario. Parece tener su origen en los vasos linfáticos del pene. Evoluciona habitualmente de manera autolimitada, por lo que el tratamiento inicial es conservador. Presentamos dos casos clínicos, comentando algunos aspectos etiopatogénicos, diagnósticos y terapéuticos (AU)

Adenocarcinoma vesical primario de células en anillo de sello. Aportación de un caso clínico / Signet-ring cell's primary bladder adenocarcinoma. A case is reported

El adenocarcinoma de células en anillo de sello primario de vejiga es una neoplasia muy poco frecuente y de alta agresividad. Sus aspectos clínicos y diagnósticos no se diferencian mucho del resto de las neoplasias vesicales, siendo importante el diagnóstico diferencial con un posible origen primario extravesical. Sólo responde a cirugía radical, siendo el pronóstico infausto. Presentamos un caso clínico (AU)

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Fractura de pene. Revisión de la literatura y presentación de dos casos / Fracture of the penis. Literature review and contribution of two cases

Presentamos dos casos de una patología poco frecuente como es la rotura de cuerpo cavernoso de pene, sometidos a tratamiento quirúrgico precoz con buenos resultados. Revisamos así mismo, los aspectos etiológicos, clínicos, diagnósticos y el tratamiento más apropiado (AU)

[Primary signet ring cell adenocarcinoma of the bladder. Report of a case]. / Adenocarcinoma vesical primario de células en anillo de sello. Aportación de un caso clínico.

Primary adenocarcinoma of ring cells's bladder is a neoplasm very uncommon and aggressive. Its clinic aspects and diagnosis don't differ too much from the rest of the bladder's neoplasm. It's important the differentiation from a possible primary extravesical origin. Radical surgery is the only treatment with sensitive answer, and the prognosis in awful. We report a case.

[Fracture of the penis. Review of the literature and presentation of 2 cases]. / Fractura de pene. Revisión de la literatura y presentación de dos casos.

We report two cases of a very uncommon pathology as is the rupture of the corpus cavernosum of the penis, undergoing early surgical management with good results. We also review the diagnostic, clinical and etiological aspects, and the most appropriate treatment.

[Bladder leiomyoma: review of the literature and report of 3 clinical cases]. / Leiomioma vesical: revisión de la literatura y presentación de tres casos clínicos.

Presentation of three cases of bladder leiomyoma in women. All cases were characterized for the unspecific clinical presentation and a difficult pre-operative diagnosis, where ultrasound, cystoscopies, CAT and PAAF were used as complementary methods. The certainty diagnosis was only obtained after the histological study of the surgical piece. Treatment was in all three cases surgical, and the pathoanatomical diagnosis was bladder leiomyoma.

[Spontaneous rupture of hydrocele: an unusual complication]. / Rotura espontánea de hidrocele: una complicación inusual.

Description of a case report of a male patient with a long standing pressure hydrocele that underwent spontaneous rupture while doing farm work although there was no previous trauma. The clinical signs were minimal scrotal discomfort, disappearance of turgescence and late ecchymosis and localized edema in penis and scrotum.

[Bilaterally synchronous mixed germ cell testicular tumor]. / Tumor testicular de células germinales mixto de aparición bilateral sincrónico.

OBJECTIVE: To report an uncommon case of bilateral synchronous mixed testicular germ cell tumor. METHODS: A young male had consulted at our urological services for a unilateral enlarged testis. A testicular tumor was suspected; scrotal US was performed, testicular tumor markers were determined and complementary studies to determine tumor extension were performed. RESULTS: The US findings suggested a chronic inflammatory condition with bilateral diffuse infiltration, tuberculosis was discarded and bilateral testicular tumor was suspected, which was confirmed by bilateral intraoperative biopsy. A bilateral radical orchidectomy was performed. Adjuvant chemotherapy with cisplatin, VP-16 and bleomycin was administered after bilateral radical orchidectomy due to the attending risk factors for tumor recurrence. The patient is disease-free one year postoperatively. CONCLUSIONS: Bilateral synchronous testicular germ cell tumors are rare. Scrotal US is a simple, noninvasive and efficient diagnostic imaging method; however, it does not provide pathognomonic images that could indicate the histological nature of the tumor.

[Leydig cell tumor]. / Tumor de células de Leydig.

OBJECTIVE: To describe a case of Leydig cell tumor of the testis, discuss the criteria for determining its benign or malignant nature and the clinical features according to patient age and the hormone profile. METHODS/RESULTS: Scrotal US evaluation for an associated pathology incidentally detected a hypoechoic, homogeneous mass with preserved borders. Biological testicular tumor markers were determined and the suspicion of a Leydig cell tumor prompted a hormone study. The diagnosis of Leydig cell tumor was confirmed by intraoperative biopsy and radical orchidectomy was performed. CONCLUSION: In the case described, the ultrasound findings prompted the etiological diagnosis given the characteristics of the lesion. The definitive diagnosis was based on the pathological findings. Although classified as benign Leydig cell tumor, radical orchidectomy is advocated.

[Retrocaval ureter: report of a case]. / Ureter retrocavo: aportación de un caso.

OBJECTIVES: An additional case of retrocaval ureter is described, with special reference to the diagnosis and treatment of this uncommon condition. METHODS/RESULTS: We report a case of retrocaval ureter in a patient who had consulted for urological infection. Patient data and clinical history are presented and discussed. CONCLUSIONS: The clinical and pathological significance of retrocval ureter depend on the degree of urinary flow obstruction and the associated complications. CT with iv contrast medium is useful in confirming the diagnosis in most of the cases. When indicated, treatment by surgery and urinary tract maneuvers generally achieve good results.

[Castleman's disease, plasma-cellular variety: unusual finding in our specialty]. / Enfermedad de Castleman, variedad plasmo-cellular: un raro hallazgo en nuestra especialidad.

Castleman's disease is a disorder of the lymph tissue, of undetermined etiology and with preferentially mediastinal location, although other lymphatic and extra-lymphatic locations are also possible. This entry appears under two varieties: the most frequent, hyalovascular type which generally does not have associated systemic symptoms, and the plasmocellular type associated to multisystemic symptoms in up to 50% cases, such as fever, anaemia, hypergammaglobulinemia, etc. Additional examinations beyond those usually available are not enough to establish a certainty diagnosis against other types of tumours, so an histopathological study is required prior to arrive to this definite diagnosis. Surgery is the choice therapy, although sometimes a favourable response to radiotherapy, used as alternating or adjuvant therapy, can be obtained. Corticoid therapy can be an effective option when dealing with systemic symptoms. The paper submits one case of Castleman's disease of the hyalinovascular type with retroperitoneal location which forced us to establish a differential diagnosis with other disorders in that region more frequent in our specialty. Definite clinical diagnosis was not possible surgery was chosen and the entire lesion removed. As certainty diagnosis was therefore histologic and, up to this point, the patient has shown no signs or symptoms of relapsing.

[Abdomino-scrotal hydrocele, an unusual disease, review of the literature, and report of a new case]. / Hidrocele abdomino-escrotal, una rara patologia, revisión de literatura y aportación de un nuevo caso.

Abdominal-scrotal hydrocele is an uncommon lesion, most specially during childhood. It is an entity, though, that should be included in the differential diagnosis of abdominal masses in children, and also considered as a likely cause of ureterohydronephrosis. Diagnosis is arrived at through ultrasound, CAT and occasional excretory urography. Radical surgical excision using inguinal access is the recommended approach, but sometimes the inguinoabdominal or pure abdominal approaches can be performed. Following surgical ablation the cure is complete, and includes remission of the ureterohydronephrosis when present. This paper reviews the literature, presents one case and discusses both the diagnostic possibilities and therapeutic alternatives.

[Congenital renal arteriovenous fistula treated with embolization]. / Fístula arteriovenosa renal congénita tratada mediante embolización.

We report on a patient with congenital renal arteriovenous fistula whose only clinical manifestation was hematuria. The diagnosis was confirmed by arteriography and treatment was by percutaneous embolization. Hematuria resolved immediately after treatment and most of the renal parenchyma was preserved. The patient has moderate arterial hypertension as a sequela, although it is currently controlled by drug therapy.

[Metastatic hypernephroma of the stomach]. / Hipernefroma metastásico de estómago.

We report a case of renal cell adenocarcinoma (T2-G3) metastatic to the stomach in a patient who underwent a left radical nephrectomy and presented hematemesis and melena two weeks postoperatively. We were prompted to report this case because metastasis to the stomach is rare and the literature is scant. Despite treatment by radical surgery, the short disease-free period following nephrectomy, the high histological grade (G3) and the aggressive nature of the tumor have resulted in a short survival.

[Renal adenocarcinoma in the isthmus of a horseshoe kidney]. / Adenocarcinoma renal en el istmo de un riñón en herradura.

A case of renal adenocarcinoma localized to the isthmus of a horseshoe kidney is described. We underscore the importance of complementary US and/or CT to urography to study the acquired pathologies of the horseshoe kidney because the pyelocaliceal distribution of these kidneys may not facilitate correct identification of certain space occupying lesions. The angiographic study is considered essential for planning surgery for this type of lesion.

[Seminal vesicle cyst and ipsilateral renal agenesis: frequent association]. / Quiste de vesícula seminal y agenesia renal ipsilateral: asociación frecuente.

Presentation of a new case of cyst of the seminal vesicle in one patient with ipsilateral renal agenesis, stressing the frequency of this association. The cyst become evident following confirmation of renal agenesis, and presented an unusual communication to the bladder due to previous surgery (transurethral resection). This diagnosis was only suspected in the computerized tomography and cystoscopy and later confirmed by deferentovesiculography. The relevance of exploring any possible dysplasia of the seminal tract in the presence of renal agenesis is stressed. From an embryological point of view, the close relationship during development of both urinary and reproductive systems appear to explain the coexistence of these two anomalies. The primary symptoms of the condition, including the unspecific ones, as in the present cases, are discussed. Differential diagnosis from other deep pelvic cysts is referred. Following a literature review and based in our personal experience, already published, our views on the different embryological, clinical, diagnostic and therapeutic considerations are established.

[Leydig cell tumor]. / Tumor de células de Leydig.

We report on a 44-year-old patient with Leydig cell tumor of the testis that had been incidentally detected following orchidectomy for a tumor. The clinical, hormonal and histological criteria currently used to distinguish the malignant from the benign form of this tumor and the different therapeutical alternatives are discussed.

[Non-venereal sclerosing lymphangitis of the penis]. / Linfangitis esclerosante no venérea del pene.

Non-venereal sclerosing lymphangitis of the penis is a rare condition that affects the distal lymphatics of this organ. It has been reported to be frequently associated with trauma to this area and, although it has a minimum inflammatory component, its etiology is unknown. A serpinginous nodular lesion in the sulcus coronarius penis may be observed by the patient. Because it is generally self-limiting, treatment is initially conservative and surgical excision is performed only if symptomatic lesions persist. The present study reports an additional case. The literature is reviewed and the possible etiopathogenic mechanisms and therapeutic alternatives are discussed.

[Renal arteriovenous fistula, up-date and presentation of a new case]. / Fístulas arteriovenosas renales, actualizacíon y presentación de un nuevo caso.

Renal arteriovenous fistulae (AVF) conform a pathology the urologist is not used to see. The basic purpose of this paper is to collect and update the current knowledge of this renal-vascular disorder, quite frequently forgotten when establishing the likely causes of haematuria. The paper describes the etiology of renal AVF and their generation mechanisms, as well as clinical presentations they can have. A most appropriate diagnostic method is still selective renal arteriography, which usually evidences the anomaly through indirect arteriographic signs. However, when the lesion is small it can be difficult to detect it. Finally, a discussion of therapeutical possibilities, both conservative and radical, and a case recently treated in out unit are presented.