[Intravesical therapy: Influence on superficial bladder cancer recurrence]. / Terapia endovesical: influencia sobre la recidiva en el cáncer vesical superficial.

OBJECTIVES: To review the influence of various intravesical treatments on superficial bladder cancer recurrence. METHODS: We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different adjuvant treatment and follow-up schemes. RESULTS: The following factors were independent risk factors for a longer recurrence-free time: intravesical instillations, high dose BCG, and maintenance therapy in comparison to induction. CONCLUSIONS: The use of intravesical instillations independently increases the time to recurrence. It was demonstrated that recurrence was significantly later when high dose BCG and maintenance therapy were employed.

Terapia endovesical: influencia sobre la recidiva en el cáncer vesical superficial / Intravesical therapy: influence on superficial bladder cancer recurrence

OBJETIVOS: Revisar la influencia de distintos tratamientos endovesicales sobre la recurrencia del cáncer vesical superficial. METODOS: Se revisaron retrospectivamente un total de 473 neoplasias vesicales superficiales. A partir del diagnóstico y la RTU vesical, y en función del resultado anatomopatológico, se plantearon distintos esquemas de seguimiento y tratamiento complementario. RESULTADOS: Resultaron independientes para explicar mayor tiempo libre hasta la recurrencia superficial los siguientes factores: empleo de lavados endovesicales, tratamiento con dosis altas de BCG y terapia de mantenimiento frente a inducción. CONCLUSIONES: El empleo de instilaciones vesicales incrementaron de forma independiente el tiempo hasta la recidiva. Se demostró que la recurrencia se produjo significativamente más tarde cuando se habían empleado dosis altas de BCG y terapia de mantenimiento (AU)

OBJECTIVES: To review the influence of various intravesical treatments on superficial bladder cancer recurrence. METHODS: We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different adjuvant treatment and follow-up schemes. RESULTS: The following factors were independent risk factors for a longer recurrence-free time: intravesical instillations, high dose BCG, and maintenance therapy in comparison to induction. CONCLUSIONS: The use of intravesical instillations independently increases the time to recurrence. It was demonstrated that recurrence was significantly later when high dose BCG and maintenance therapy were employed

[Spontaneous regression of venous thrombus in a case of renal carcinoma]. / Regresión espontánea de trombosis venosa en un caso de carcinoma renal.

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1 % of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava.

Regresión espontánea de trombosis venosa en un caso de carcinoma renal / Spontaneous regression of venous thrombus in a case of renal carcinoma

OBJETIVO: Describir el primer caso deregresión espontánea de trombosis de vena renal y cavainferior en un paciente con carcinoma de células renales.MÉTODO/RESULTADO: Se describe el caso de una mujerdiagnosticada de masa renal con trombosis de venasrenal y cava. En los estudios de extensión previos a lanefrectomía radical se constata la regresión de dicho tromboque se confirma posteriormente tras la nefrectomía.CONCLUSIÓN: La regresión espontánea de metástasisde carcinoma de células renales se estima menor al 1%.Este es el primer caso descrito en la literatura que afectaa una trombosis tumoral de venas renal y cava inferior

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1% of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava

[Cystic hamartoma of the renal pelvis: unfrequent finding]. / Hamartoma quístico de pelvis renal, un hallazgo infrecuente.

OBJECTIVES: This cystic hamartoma of the renal pelvis is a very unfrequent benign tumor. We report one case emphasizing its histology and performed a bibliographic review. METHODS: Mid age female patient with the incidental diagnosis of a renal mass taking up the pelvis. RESULTS: A radical nephrectomy was performed with the pathologic report of cystic hamartoma of the renal pelvis. CONCLUSIONS: It is a cystic renal tumor with well-defined histologic and immunohistochemical criteria, and it probably does not involve any danger for the patient's live.

[Obstructive urethral angioleiomyoma]. / Angioleiomioma uretral obstructivo.

OBJECTIVES: To report one case of urethral angioleiomyoma because of the rare site, and to review its main characteristics. METHODS: We report one case of male urethra angioleiomyoma presenting with obstructive symptoms. RESULTS: We performed excision and end to end anastomosis of a small bulbar urethra stenosis. Pathology reported angioleiomyoma. CONCLUSIONS: Angioleiomyoma is a benign tumor arising from smooth muscle within blood vessel walls. It is extremely rare in the urethra. It is more common in females. Recurrence and metastasis are exceptional. It shows scarce or moderate cellularity with predominance of fusiform cells. They may express smooth muscle vimentin, desmin, and actin. The best therapeutic option is resection.

[A new case of bladder endometriosis in a patient with a history of Cesarean section]. / Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea.

OBJECTIVES: To report one new case of endometriosis in a patient with history of caesarean section. METHODS: It is the case of a female patient presenting with voiding symptoms and hematuria, with a bladder tumor on ultrasound. RESULTS: After TUR of a retro trigonal tumor pathology report showed bladder endometriosis. Treatment was completed with hormone therapy, being the patient relapse free at one year follow-up. CONCLUSIONS: History of caesarean section is one of the possible etiologies of bladder endometriosis.

Un hueso de pollo como causa de gangrena de Fournier / A chicken bone as a cause of Fournier´s gangrene

OBJETIVO: La gangrena de Fournier es una fascitis necrotizante que afecta a la región perineal, perianal y genital, de evolución rápida y un prognóstico severo. Revisamos la literatura y aportamos un caso reciente. MÉTODOS: Presentamos el caso de un paciente varón que consultó por dolor escrotal con el antecedente de la expulsión de un hueso de pollo con las heces. RESULTADOS: A pesar de la cirugía agresiva y antibióticos de amplio espectro, el pronóstico es pobre y la mortalidad alta. CONCLUSIONES: El diagnóstico rápido y exacto es fundamental para conseguir un buen resultado. Los desbridamientos precoces, amplios y repetidos reducen la mortalidad (AU)

Nuevo caso de endometriosis vesical en paciente con antecedentes de cesárea / New case of bladder endometriosis in a patient with history of caesarean section

OBJETIVO: Presentar un nuevo caso de endometriosis en una paciente con antecedentes de cesárea. MÉTODO: Se trata de una paciente que consulta por síndrome miccional y hematuria, con hallazgo ecográfico de neoformación vesical. RESULTADOS: Se practica RTU de neoformación retrotrigonal con el resultado anatomopatológico de endometriosis vesical, se completa el tratamiento con terapia hormonal, estando la paciente libre de recidivas al año de control. CONCLUSIONES: Entre las posibles etiologías de la endometriosis vesical se encuentra el antecedente de cesárea (AU)

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[Clinical course of epidermoid carcinoma of the penis in our series]. / Análisis de la evolución del carcinoma epidermoide de pene en nuestra serie.

OBJECTIVES: To study the evolution of 49 patients with squamous cell carcinoma of the penis. METHODS: 49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases. RESULTS: There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis. CONCLUSIONS: Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.

Análisis de la evolución del carcinoma epidermoide de pene en nuestra serie / Analysis of the evolution of squamous cell carcinoma of the penis in our series

OBJETIVOS: Se estudia la evolución de 49 pacientes con carcinoma epidermoide de pene. MÉTODOS: Se trata de 49 pacientes sometidos a cirugía por carcinoma epidermoide de pene (30 penectomías parciales, 11 totales y 7 circuncisiones).Se practicaron 27 linfadenectomías inguinales, superficial, profunda y en dos casos ilio-obturatriz, por persistencia de ganglios tras penectomía, a pesar de tratamientos antibióticos de 4 semanas o por alto estadio del tumor primario. Se objetivan metástasis ganglionares en 13 de los pacientes tratados, recibiendo posteriormente tratamiento adyuvante con QT, RT o combinación de ambos. Se realiza un seguimiento de los pacientes en función del estadio, Grado de diferenciación celular y existencia o no de ganglios positivos y metástasis a distancia. RESULTADOS: Se encuentran 5 tumores en estadio Ta y 26 T1 (63,2 per cent), 16 T2 (32,6 per cent) y 2 T3 (4,08 per cent). En cuanto al grado 81 per cent fueron GI, 16 per cent GII y 2 per cent GIII. Tras linfadenectomía se objetivan metástasis ganglionares en 13 de los pacientes (26,53 per cent). En 6 de los pacientes se produjo fallecimiento por diseminación del tumor, dos de ellos T2G2, un T2G1, tres T1G2; además dos pacientes T1G1 fallecieron por causas ajenas al proceso tumoral, siendo todos N+ clínicamente en el momento del diagnóstico. CONCLUSIONES: Por lo tanto se trata de un tumor agresivo cuya evolución dependerá sobretodo del estadio locorregional en el momento del diagnóstico y del grado de diferenciación celular que alcance, en función de los cuales se planteará la posibilidad de linfadenectomía versus vigilancia (AU)

[A chicken bone as cause of Fournier gangrene]. / Un hueso de pollo como causa de gangrena de Fournier.

OBJECTIVES: Fournier's gangrene is a synergistic infective necrotizing fascitis, which involves perianal, perineal and genital regions, with rapid evolution and severe prognosis. We perform a literature review and report a recent case. METHODS: We report the case of a male patient who presented with scrotal pain and history of excretion of a chicken bone in a bowel movement. RESULTS: Despite aggressive surgery and wide spectrum antibiotic, the prognosis severe and the mortality is high. CONCLUSIONS: Rapid and accurate diagnosis remains the key to achieving a successful outcome. Early, wide and repeated debridement procedures reduce the mortality.