Linfoma testicular primario. Presentación de dos casos y revisión de la literatura / Primary testicular lymphoma. Report of two cases and bibliographic review

Objetivo: Comunicación de dos casos clínicos con diagnóstico de linfoma testicular primario y revisión de la literatura existente sobre esta patología. Métodos/ Resultados: Descripción de dos casos de linfoma testicular primario en dos varones de 69 y 61 años. En ambos casos su motivo de consulta fue un aumento de volumen testicular derecho. Tras practicar una orquiectomía inguinal se diagnóstico, en el primer caso, un linfoma difuso tipo T de células grandes y medianas, estadio I (E)-A, que tras seguir tratamiento con quimioterapia (R-CHOP) se mantiene en remisión a los tres años. En el segundo caso, el diagnóstico fue de linfoma difuso de células grandes tipo B, que tras recibir distintas pautas de quimioterapia, falleció a los 14 meses del diagnóstico. Conclusiones: El linfoma testicular es una entidad muy poco frecuente, a pesar de ser considerado el tumor testicular más común en mayores de 60 años. En su mayoría se trata de linfomas no Hodgkin difusos de grado intermedio alto de malignidad e inmunofenotipo B, considerando como excepcionales los de tipo T. Su pronóstico es pobre debido a su gran tendencia a la propagación sistémica. Su tratamiento se basa en orquiectomía, quimioterapia y radioterapia, si bien no existe una pauta estandarizada del mismo (AU)

Objective: We report two cases of primary testicular lymphoma and performed a bibliography review about this pathology. Methods/Results: We describe two cases of primary testicular lymphoma in two male patients 69 and 61 yr. old respectively. In both cases, reason for consultation was increase of the right testicular size. After inguinal orchyectomy the diagnosis for the first case was large and medium T cell diffuse lymphoma, stage I (E)-A; three years after chemotherapy (R-CHOP) the patient is in complete remission. In the second case, the diagnosis was diffuse large B-cell lymphoma, and after receiving various chemotherapy regimens died 14 months after diagnosis. Conclusions: Testicular lymphoma is a very rare entity, despite being considered the most common testicular tumor in patients over the age of 60 years. Most of them are non-Hodgkin diffuse, intermediate or high grade of malignancy , B-cell immunophenotype, being T-cell exceptional. Prognosis is poor due to their high tendency to systemic dissemination. The treatment is based on orchiectomy, chemotherapy and radiotherapy, although there is not a standardized regimen (AU)

[Urinary continence after radial prostatectomy. Prognostic factors and recovery time]. / Continencia urinaria tras prostatectomía radical. Factores pronósticos y tiempo de recuperación.

OBJECTIVES: To assess the urinary continence after radical prostatectomy and its evolution over time. To analyse possible prognosis factors. MATERIAL AND METHODS: We have reviewed 101 patients that have undergone radical prostatectomy. We define "continent patient" as that one who doesn't require any type of urinary protection. By means of Kaplan-Meier method, we evaluate the recovery of continence along time. We analyze potential conditional factors (age, stage, surgery technique, surgery experience,...). The statistical tools used are: chi-square, Fisher, Cox regression, T-test and Kaplan-Meier. RESULTS: Median monitoring time: 27.33 months. 80% are continent patients, 48.7% of which reach maximum continence before the 3rd, month is due and 17.5% after the 6 months (2.5% between 9-12 months). Their probability of becoming "continents" during the first 4 months es 0.4692. patients under 70 years old recover continence before those who are over 70 years old (medians: 3.51 months and 5.67 months respectively, p = 0.0211). CONCLUSIONS: The recovery of continence takes place progressively and a 17.5% of patients reach plain recovery in the 6-12 months period after surgery. The evaluation of the surgery treatment to correct incontinence should consider the possibility of "spontaneous" recovery in a 2.5% of patients in the 9-12 months period after surgery. Age affects negatively the recovery time; it is significantly less for patients under 70.

[Retroperitoneal leiomyosarcoma]. / Leiomiosarcoma retroperitoneal.

We report a case of retroperitoneal leiomyosarcoma recurrence. This entity is rare, < 0.2% of all tumours in humans and 25-30% of retroperitoneal sarcomas. The diagnosis is usually delayed in relationship with scarce clinical signs which favorite the development of great tumour volume before diagnosis. The treatment is surgical, with wide margins excision. Radiotherapy and chemotherapy are not adequates for treatment of this pathological entity.

Continencia urinaria tras prostatectomía radical. Factores pronósticos y tiempo de recuperación / Radical extracorporeal lithotripsy cause hearing loss?

OBJETIVOS: Valorar la continencia urinaria tras prostatectomía radical (P.R.) y su evolución en el tiempo. Analizar posibles factores pronósticos. MATERIAL Y MÉTODOS: Revisamos 101 pacientes sometidos a P.R. Definimos como "paciente continente" aquel que no precisa ningún tipo de protección urinaria. Mediante el método de Kaplan-Meier se evalúa la recuperación de la continencia en el tiempo. Se analizan potenciales factores condicionantes (edad, estadio, técnica quirúrgica, experiencia quirúrgica...). análisis estadístico: Kaplan-Meier, chi-cuadrado, Fisher, t-test y regresión de Cox. RESULTADOS: Mediana de seguimiento: 27,33 meses. El 80 por ciento son continentes, adquiriendo la máxima continencia un 48,7 por ciento antes de los 3 meses, y un 17,5 por ciento después de los 6 meses (2,5 por ciento entre 9-12 meses). La probabilidad de que se hagan continentes durante los primeros 4 meses es del 0,4692. los pacientes < 70 años recuperan la continencia antes que los >70 años (mediana 3,51 meses y 5,67 meses respectivamente, p = 0,0211).CONCLUSIONES: La recuperación de continencia se establece progresivamente, mejorando hasta un 17,5 por ciento de pacientes entre los 6-12 meses. La valoración de tratamiento quirúrgico para corregir la incontinencia debe considerar la posibilidad de mejoría espontánea en el 2,5 por ciento de pacientes entre los 9-12 meses. La edad influye en el tiempo de adquisición de continencia, siendo menor en < 70 años (AU)

[Leiomyosarcoma of the urinary bladder]. / Leiomiosarcoma de vejiga urinaria.

We report a case of bladder leiomyosarcoma treated at our department. We review the published papers about this entity. We emphasize the low incidence of that pathology and the lack of consensus about treatment.

[Signet ring-cell adenocarcinoma in colocystoplasty]. / Adenocarcinoma de células en anillo de sello en colocistoplastia.

We report a case of signet ring-cell adenocarcinoma in augmentation colocystoplasty. We review the current literature about tumours developing in augmentation bladder.

Leiomiosarcoma retroperitoneal / Retroperitoneal leiomyosarcoma

Se presenta un caso de recidiva tumoral de un leiomiosarcoma retroperitoneal. Son tumores infrecuentes, representando < 0,2 por ciento de todas las tumoraciones del organismo, y de un 25-30 por ciento de los sarcomas retroperitoneales. Suelen diagnosticarse tardíamente debido a su vaga sintomatología, alcanzando grandes volúmenes tumorales. El tratamiento es la completa escisión quirúrgica con amplios márgenes, no habiendo demostrado utilidad otras terapias como la radioterapia o la quimioterapia (AU)

Leiomiosarcoma de vejiga urinaria / Leimyosarcoma of bladder urinary

Se presenta un caso de leiomiosarcoma vesical tratado en nuestro Servicio. Se revisa la literatura sobre el tema, remarcando su baja incidencia y la falta de criterio unánime desde el punto de vista terapéutico (AU)

Adenocarcinoma de células en anillo de sello en colocistoplastia / Signet ring-cell adenocarcinoma in augmentation colocystoplasty

Aportamos un caso de adenocarcinoma de células en anillo de sello en una colocistoplastia. Revisamos la bibliografía existente sobre tumoraciones desarrolladas en ampliaciones vesicales hasta la fecha actual (AU)

Quistes de inclusión epidérmica intraescrotal / Intrascrotal epidermial inclusion cysts

Se trata de un caso de quistes de inclusión epidérmica intraescrotales, manifestados clínicamente como tres masas extratesticulares. El paciente fue intervenido realizándose excisión de las masas por vía escrotal encontrándose asintomático en la actualidad. A propósito del caso y de las dificultades terminológicas halladas, se hace hincapié en el diagnóstico diferencial de diferentes lesiones quísticas. La revisión bibliográfica se realiza a través de la base de datos Medline, comprendiendo ésta, artículos de revisión sobre el tema desde 1966 a 1999 (AU)

[Pure prostatic leiomyoma]. / Leiomioma prostático puro.

We present a case of pure prostatic leiomyoma, benign and rare entity, diagnosed in a patient with prostatism. We review the published papers about this disease and the different subjects about etiology, clinic, histopathology, diagnosis and treatment.

Leiomioma prostático puro / Pure prostatic leiomyoma

Se presenta un nuevo caso de leiomioma de próstata puro, tumor benigno de presentación infrecuente, diagnosticado en un varón con prostatismo. Se realiza revisión de la literatura existente y se comentan los aspectos etipatogénicos, clínicos, anatomopatológicos, diagnósticos y terapéuticos (AU)

[Intrascrotal epidermal inclusion cysts]. / Quistes de inclusión epidérmica intraescrotal.

To del with a case of Intrascrotal epidermal inclusion cysts, clinical manifest like three scrotal masses. The patient was operated by transcrotally excision and he remains still asymptomatic. About this case and the terminology difficulties, we propose a differential diagnosis between different cystic lesion showed in the scrotum. The bibliography revision was performed by the Medline since 1966 until 1999.

[Leiomyoma of the bladder]. / Leiomioma vesical.

OBJECTIVE: To report a case of leiomyoma of the bladder, a benign tumor that accounts for 0.43% of bladder tumors. The literature is briefly reviewed. METHODS/RESULTS: A 64-year-old male with prostatic syndrome is described. The preoperative evaluation showed bladder lithiasis and signs compatible with prostatic hypertrophy, but no evidence of a bladder tumor. Endoscopic evaluation, however, revealed a tumor in the bladder neck. Transurethral resection of the tumor, prostate and endoscopic lithotripsy of the bladder were performed. The anatomopathological findings showed leiomyoma of the bladder. The postoperative course was unremarkable. CONCLUSION: Leiomyoma of the bladder does not present specific symptoms and is frequently an incidental finding. The diagnosis is based on the results of the anatomopathological analysis of the specimen.

[Ectopic thoracic kidney]. / Ectopia renal torácica.

We present a case of kidney ecthopy in a 62 years old male patient, discovered by chance during complementary explorations realized in the diagnostic process of an acute respiratory pathology. We review the literature related to this anomaly: 200 cases have been published to the date. The thoracic kidney is a rare kind of kidney ecthopy, tipically without synomathology & it requires no treatment.

[Renal oncocytoma: infrequent presentation form]. / Oncocitoma renal: una forma infrecuente de presentación.

Case report describing a solid renal mass as an incidental finding while evaluating a different condition. This is an oncocytoma infiltrating perirenal fat. The various aspects of the process are described.

[Acute kidney failure secondary to inguinoscrotal bladder hernia]. / Fracaso renal agudo secundario a hernia vesical inguinoescrotal.

Bladder hernia is not a rare pathological condition, with a frequency between 0.3% and 3%, reaching the 10% between patients older than 50 years. Massive bladder hernia is less frequent and very rarely ureterohydronephrosis is associated with this pathology, given that the trigone is the only portion remaining fixed after herniation. Five cases have been described in the literature reviewed affecting ureters. The present paper represents the fourth case of bilateral ureterohydronephrosis in the literature. The treatment is surgical correction of the inguinoscrotal hernia.

[Chromophobe renal carcinoma. Case report]. / Carcinoma cromófobo renal. Aportación de dos casos.

Human chromophobe renal cell carcinoma is an infrequent neoplasm, recently descripted (1985). It is very important to separate it from the renal cell carcinoma due to its better prognosis. Presentation of the clinical, radiographic and histological features of two cases of chromophobe renal cell carcinoma, diagnosed and treated in our Centre.

[Inverted papilloma of the ureter. Apropos of a case]. / Papiloma invertido de uréter. A propósito de un caso.

Presentation of one case of inverted papilloma of the renal pelvis, an uncommon entity with very few cases described in the international literature. The pathoanatomic presentation is that of a benign tumour, which would provide an option for conservative therapy through segmentary resection and termino-terminal anastomosis. Due to its low frequency, pre-operative diagnosis of this tumour is difficult, although the number of diagnosis could be increased with the use of endourologic techniques. In spite of the benign nature, it can be multifocal and relapsing. A close follow-up monitoring is recommended.