[Infantile myofibromatosis. Relationship with the genitourinary tract. Case reports and bibliographic review]. / Miofibromatosis infantil. Su relación con el aparato genitourinario. Presentación de un caso y revisión de la literatura.

OBJECTIVE: To present a case of infantile myofibromatosis of visceral location and a review of the literature. METHOD/RESULTS: We report the case of an 11-year-old Caucasian girl hospitalized for abdominal tumorous mass, weight loss and lack of appetite. Physical examination showed: cutaneous-mucous paleness and a painless, palpable tumorous mass of 8-10cm in the right abdominal flank, of firm consistency with defined edges and extending past the midline. Blood test showed hemoglobin 90 mg/l and erythrocyte sedimentation rate of 130 mm/hour. Chest x-ray and bone study were normal, while abdominal x-ray showed intratumorous calcification, intravenous urographyc showed light displace downwards and outwards of the right kidney. Ultrasound showed a solid echogenic mass with a diameter of 11cm in the right abdominal flank, above and extending towards the lower portion of the right kidney. Surgical treatment for possible neuroblastoma was initiated, during which various tumorous growths were observed in the mesocolon, the largest measuring 7cm, which were removed. Macroscopic examination showed whitish well-defined tumorous growths of firm consistency with focal calcifications. Microscopic examination showed a proliferation of fibroblastic type cells, with some areas having smooth muscle cell characteristics. Diagnosis was myofibromatosis. CONCLUSIONS: Infantile myofibromatosis is the most common fibrous disorder of infancy and childhood, more commonly found between birth and two years of age, may also appear later in life. Etiology is unclear, but certain studies report estrogen involvement in its pathogenesis. Clinical symptoms depend on the location and extension of the lesion and age at presentation. Spontaneous relapse may occur. Prognosis is good in the absence of visceral damage, although generalized congenital myofibromatosis with visceral damage is associated with high mortality especially in the first months of life, due to its destructive capacity, obstruction of vital organs, growth inhibition or infection. Urologic concerns include possible infiltration of genito-urinary organs (kidney, corpus spongiosum) and its association with urologic abnormalities. Ultrastructural and immunohistochemical studies show that the tumor is composed of myofibroblasts, with estrogen receptors, displaying vimentin and smooth muscle actin immunoreactivity. Strict follow up is recommended in patients with congenital myofibromatosis to avoid or detect possible complications that may be life-threatening (Bone survey abdominal-pelvic ultrasound, echocardiogram, chest-abdominal CT and biopsy). The treatment of choice is surgical removal, with extensive excision to avoid possible relapse.

[Well-differentiated lymphocytic lymphoma of the prostate. Case report and bibliographic review]. / Linfoma linfocítico, bien diferenciado de la próstata, presentación de un caso y breve revisión de la literatura.

OBJECTIVE: To report a case of prostate lymphoma and a brief review of the literature. METHODS/RESULTS: A 70 year-old mele patient was referred to the Urology departament with a clinical picture of prostatism, with acute urinary retention (AUR). Surgery with retropubic prostatectomy was performed, and pathology revealed a primary prostate lymphoma. The patient was referred to the departament of Oncology where he received polychemotherapy and radiotherapy. The patient is currently followed by regular visits to Urology outpatients service. The case study is followed by a brief bibliographic review, where we analyse clinical menifestations of this entity, complementary studies useful for diagnosis (laboratory test, trasrectal prostate biopsy, transuretral resection, ultrasound and computerised axial tomography), treatment options (surgery, polychemotherapy, radiotherapy) as well as survival in these patients. CONCLUSIONS: Of the cases reviewed, mean age at diagnosis was 57 years. Clinical debut was with prostate symptoms, with or without AUR and sometimes manifestations of renal failure due to obstructive uropathy, as well as general symptoms (astenia, anorexia, weight loss). PSA values remain unaltered in prostate lymphoma patients. Histologic diagnosis may be made by transrectal prostate biopsy, although transurethral resection (TUR) may be necessary for confirmation. Ultrasound and CT scan are of great utility for diagnosis of both local and distant tumors. From a therapeutic point of view, surgery for the obstruction of the lower urinary tract (TURP or retropubic prostatectomy) may be necessary, as well as the cyclophosphamide based polychemotherapy with corticosteroids and other cytostatic agents, and radiotherapy; intratecal chemotherapy has also been used adjuvant bone marrow transplantation.

[Inverted papilloma of the anterior male urethra. Case report and bibliographic review]. / Papiloma invertido de la uretra anterior masculina. Presentación de un caso y breve revisión de la literatura.

OBJECTIVES: We report a clinical case of inverted papilloma of the anterior male urethra. METHODS/RESULTS: 40-year-old male without significant past medical history presenting with dysuria and referring three episodes of urethral bleeding. Preliminary studies included voiding cystourethrogram (VCUG) which revealed a filling defect in the anterior urethra. Urethrocystoscopy was performed under anesthesia, with resection of the tumor. Pathologic study reported a urethral inverted papilloma. CONCLUSIONS: Inverted papillomas of the male urethra are rare. The most frequent clinical manifestations are dysuria and hematuria, although they may present with urethral bleeding when located in the anterior urethra. Diagnosis is based on clinical symptoms, ultrasound, endoscopy and VCUG which enable detection of urethral filling defects. The treatment of choice is transurethral resection of the lesion. Annual endoscopic control is recommended after surgery.