Significado de la expresión colagenasa-3 (matrix metalloproteinase-13), p16 y p53 en el carcinoma vesical infiltrante: correlación con parámetros patológicos / Significance of the colagenase exoression (matrix metalloproteinase-13), p16 an p53 in the infiltrant bladder carcinoma: correlation with pathological parameters

Objetivo: Determinar si la expresión de p16, p53 y colagenaza-3 está asociada con la progresión y el pronóstico del carcinoma vesical infiltrante. Pacientes y métodos: Se realizó un estudio retrospectivo determinado la expresión inmunohistoquímica de p16, p53 y colagenasa-3 en muestras de 42 pacientes (32 hombres y 10 mujeres) sometidos a cistectomía radical por carcinoma vesical infiltrante. El tiempo medio de seguimiento fue de 35 meses (rango de 3 a 102 meses). Resultados: P16 resultó positiva en 16 (38.1%) pacientes, p53 en 28 (66,7%) y colagenaza-3 en 13 (31%) pacientes. La expresión de p16 se asoció con el tiempo libre de progresión y la supervivencia global. (p=0,15). El estadio patológico se asoció de forma significativa con el tiempo libre de progresión (p=0,0025) y el tamaño del tumo >3 cm (p=0,038). No se encontraron diferencias estadísticamente significativas entre la expresión de p53, p16 y colagenaza-3 con el estadio y tamaño. Conclusiones: Se encontró asociación estadísticamente significativa entre el estadio y el tamaño tumoral con el tiempo libre de progresión en nuestra serie. Sólo se observó un aumento del tiempo libre de progresión de tumores p16 negativos sin diferencias significativas. Estos hallazgos deben ser evaluados en estudios multicéntricos prospectivos

Objective: To determine whether the expresión of p16, p53 and collagenase-3 is associated with the progresión and prognosis of infiltrating bladder carcinoma. Patients and methods: A retrospective trial was carried out to determine the immunohistochemical expression of p16, p53 and collagenase-3 in sample from 42 (32 males and 10 females) undergoing radical cystectomy due to infiltrating bladder carcinoma. The mean follow-up time was 35 months (range: 3-102 months). Results: P16 proved positive in 16 (38.1%) patients, p53 in 28 (66.7%), and collagenase-3 in 13 (31%) patients. P16 expression was associated with progression-free time and with overall survival (p=0.15). The pathological stage was significantly associated with progression-free time (p=0.0025) and with a tumour size >3 cm (p=0.038). No statistically significant differences were found between the expression of p53, p16 and collagenase-3 and the stage and size. Conclusions: A statistically significant relationship was found between the tumour stage and size, and the progression-free time in our series. Increased progression-free time was only found in p16-negative tumours, but the differences were not statistically significant. These findings should be evaluated by prospective multicenter studies

[Recurrent hydrocele in a patient with familial mediterranean fever]. / Hidrocele recidivante en un paciente con fiebre mediterránea familiar.

OBJECTIVE: To report an uncommon case of familial Mediterranean fever with urological manifestations. METHODS/RESULTS: A case of recurrent hydrocele in a patient with familial Mediterranean fever is described. CONCLUSIONS: Although familial Mediterranean fever is characterized by an acute febrile stage and involvement of the serosa, it may manifest as recurrent hydrocele due to involvement of the urological serosa, as in the case described herein.

[Lymphomas of the urinary tract]. / Linfomas del tracto urinario.

OBJECTIVES: The present study discusses both primary and secondary malignant lymphoreticular proliferative tumors of the urinary tract. METHODS: Two patients with urinary tract involvement are described: one female and one male with bladder and prostate involvement, respectively. RESULTS: Both cases presented clinical features that were not distinct from those of other tumors of the urinary tract. CONCLUSIONS: The anatomopathological study is essential to the differential diagnosis of urinary tract involvement from non-Hodgkin lymphoma and discards other extralymphatic conditions.

[High-flow priapism]. / Priapismo de alto flujo.

OBJECTIVES: A case of traumatic high flow priapism that had been successfully treated by selective embolization of the internal pudendal artery is described. METHODS: High flow priapism was diagnosed in a patient who presented with painless prolonged erection. He had fallen down from a horse twelve days before. The intracavernous blood gas analysis had arterial characteristics and erection did not subside with conservative management. Selective embolization of the internal pudendal artery was performed after visualization of an arteriocavernous fistula. RESULTS: Priapism disappeared just after the procedure and sexual potency was preserved. CONCLUSIONS: Selective embolization of the internal pudendal artery is an appropriate treatment for traumatic high flow priapism.

[Perinephritic abscess as clinical presentation of pancreatitis]. / Absceso perinefrítico como presentación clínca de una pancreatitis.

Presentation of a female patient with pain in right hemiabdomen, suspected of perinephritic abscess. Emergency laboratory tests and X-rays evidenced presence of choledocholithiasis and acute pancreatic abscess which infiltrated cell and right perirenal space. The treatment established was surgical drainage of both the pancreatic cell and the retroperitoneal space. A good clinical history, differential diagnosis and immediate aggressive treatment facilitated a favourable evolution of such cases. The unusual perinephritic location of pancreatic abscesses is reported in the literature with a frequency of less than 2%.

[Klinefelter syndrome with hypogonadotropic hypogonadism and absence of Leydig cells]. / Síndrome de Klinefelter con hipogonadismo hipogonadotropo y ausencia de células de Leydig.

Klinefelter's syndrome is characterized by hypergonadotropic hypogonadism, 47,XXY karyotype, gynecomastia, azoospermia and testicular atrophy with hyalinization of seminiferous tubules and hyperplasia of Leydig cells. Some cases of Klinefelter's syndrome with unexplainably low levels of gonadotropins have been reported in the literature. Two additional cases of Klinefelter's syndrome with hypogonadotropic hypogonadism and absence of Leydig cells are described.

[Necrotizing vasculitis in the bladder]. / Vasculitis necrotizante localizada en vejiga.

The necrotizing lesion that affects the small and medium-sized arteries, commonly known as polyarteritis nodosa (PAN), usually have a systemic and variable involvement. Urothelial involvement at the level of the two ureters has been rarely described. We report a case of necrotizing vasculitis localized to the bladder that had manifested clinically as gross hematuria.