[Solitary cerebral metastasis of a renal cell carcinoma]. / Metástasis cerebral solitaria de un carcinoma de células renales.

The tumour dissemination to brain from renal cell carcinoma is a rare occurrence: generally, it's seen in advanced stages of the disease, such that occurred in our patient that indicated a poor prognosis. A lesion node, the size medle, located in the side left to brain, with of symptoms neurologic associated was found. Histological examination of the resection specimen revealed metastasis from a renal cell carcinoma.

[Hypernephroma in native kidney of patient with renal transplant]. / Hipernefroma en riñón nativo de paciente con trasplante renal.

The uremic patients, specially in periodic dialysis, may present bilateral kidneys cytes with high frequency. This pathology, known as acquired cyst renal disease, is found associated in its evolution with the emergence renal malignant disease. A patient who undergoing chronic dialysis and renal transplant subsequently developed an asymptomatic renal neoplasm. The epidemiological, clinical, diagnostic aspects and therapeutic of the acquired cysts renal and your association with renal cancer are analyzed.

Metástasis cerebral solitaria de un carcinoma de células renales / Solitary brain metastasis from renal cell carcinoma

La diseminación tumoral a cerebro por una neoplasia renal es un hecho poco habitual, ocurriendo generalmente en estadios muy avanzados, tal como ocurrió en el enfermo comunicado, y lleva asociado un mal pronóstico. Se trata de una lesión nodular, de moderado tamaño, localizada en el hemisferio izquierdo con síntomas neurológicos acompañantes; el estudio histológico después de la exéresis quirúrgica demostró una metástasis por carcinoma renal (AU)

The tumour dissemination to brain from renal cell carcinoma is a rare occurrence; generally, it’s seen in advanced stages of the disease, such that occurred in our patient that indicated a poor prognosis. A lesion node, the size medle, located in the side left to brain, with of symptoms neurologic associated was found. Histological examination of the resection specimen revealed metastasis from a renal cell carcinoma (AU)

Hipernefroma en riñón nativo de paciente con trasplante renal / Hipernephroma in native kidney of patient with renal transplant

Los pacientes urémicos, particularmente en programas de diálisis, pueden presentar sobre sus riñones quistes bilaterales con una frecuencia significativa. Esta entidad definida como patología renal quística adquirida se encuentra asociada en su evolución con la aparición de patología maligna renal. Se trata de un enfermo sometido a diálisis antigua y trasplantado renal que ulteriormente desarrolló una neoplasia renal asintomática. Se analizan los aspectos epidemiológicos, clínico-diagnósticos así como terapéuticos de la asociación de quistes renales adquiridos y cáncer renal (AU)

[Leiomyoma of the bladder]. / Leiomioma vesical.

OBJECTIVE: To present an additional case of leiomyoma of the bladder, a rare tumor that is frequently discovered incidentally, and to review the few cases reported in the Spanish literature, with special reference to the clinical aspects, complementary tests and treatment. METHODS: A case of leiomyoma of the bladder in a patient who had come to deliver after a full-term pregnancy is presented. Routine physical examination on admission revealed a tumor in the anterior aspect of the vagina. Ultrasound, radiological and endoscopic studies were performed. The Spanish literature is reviewed with special reference to the clinical aspects, complementary tests and treatment. RESULTS: After the diagnosis of a bladder tumor had been confirmed and the effects on the adjacent structures determined, TUR biopsy was performed. The anatomopathological analysis demonstrated leiomyoma of the bladder. CONCLUSION: The ultrasound and radiological images of leiomyoma localized to the bladder are sufficient to suspect the nature of the lesion, but the definitive diagnosis is based on the anatomopathological findings. The choice of the type of surgery, open or endoscopic, is based on tumor localization and size.

[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.

[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.

[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.

[Sarcoma of the bladder. Report of 2 cases]. / Sarcomas de vejiga. A propósito de dos observaciones.

Discussion of a retrospective study in our unit of two cases of vesical tumours of mesenchymal origin, in adult patients and with different maturation behaviour. The first patient started with haematuria and after an extensive follow-up period is now free from the disease. The second patient was an accidental finding causing death in the course of the immediate postoperative.

[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.

[Ectopic ureter in seminal vesicle with cystic dysplasia. A clinical case and review of the literature]. / Uretér ectópico en vesícula seminal con displasia quística. Caso clínico y revisión de la literatura.

A new case of ureter ectopic abouchement in seminal vesicle with cystic dysplasia is presented in one asymptomatic male attending the clinic on an infertility consultation. Suspected diagnosis was based on right kidney absence observed on abdominal echography, associated to severe oligoastenozoospermia seminograms and decrease in ejaculation volume. The computerized axial tomography revealed changes of the ipsilateral seminal vesicle. Diagnosis was confirmed by deferentovesicullography. Malformation embryological and anatomical aspects, as well as accompanying ipsilateral kidney dysplasia are commented. A review of both national and international literature is made supporting the unusual character of the clinical case presented.

[Correlation of serum prolactin, sperm count and motility. Prevalence of hyperprolactinemia in the infertile male]. / Relación de la prolactina sérica con el recuento y motilidad espermática. Estudio de prevalencia de la hiperprolactinemia en el varón infértil.

Serum prolactin (PRL) levels were measured in 147 males. All patients had no known tumor, endocrine disorder, or symptoms or signs of hyperprolactinemia. All patients denied taking any medication or agents that could alter PRL levels. Semen analyses revealed 34 patients were normospermic, 69 were oligospermic, 26 were azoospermic, and 18 were purely astenzoospermic. PRL levels for the patient groups were not statistically significantly different. PRL values were higher than the normal ranges in 12.2% of the overall study population. A lower incidence (6.19%) was observed for hyperprolactinemia in the normospermics. These findings are comparable to those described elsewhere. Serum testosterone did not drop significantly in the hyperprolactinemics. Similarly, the FSH and LH values did not change significantly. The possible role of PRL in male infertility and the effect of hyperprolactinemia of varying degrees and etiology on sperm count and motility are discussed.

[Polyuric dilatation of the urinary tract in congenital nephrogenic diabetes insipidus. Clinical and diagnostic aspects. Presentation of a case and review of the literature]. / La dilatación poliúrica del tracto urinario en diabetes insípida nefrogénica congénita. Aspectos clínicos y diagnósticos. Presentación de un caso con atrofia renal. Revisión de la literatura.

Massive polyuria existing in congenital nephrogenic diabetes insipidus can cause a more or less severe dilatation of the urinary tract in absence of obstruction. Clinical and diagnostic aspects of this pathology are presented relating then with other types of diabetes insipidus. One case of bilateral severe dilatation with evolution towards renal atrophia is presented. Mechanical obstruction was discarded. The disease was refractory to urinary concentration tests and therapy to reduce urine volume. The possible etiopathological mechanisms of functional obstruction and surgical alternatives directed to preserve the kidney function are explained and discussed. The current literature is reviewed but the cases reported are few due to the low incidence of urological affectation. Presence of kidney atrophia is exceptional.

[Bladder metastasis of a renal cell carcinoma]. / Metástasis vesical de un carcinoma de células renales.

We report on a patient with renal adenocarcinoma that subsequently metastasized to the bladder. Although involvement of any organ in this area can lead to secondary invasion of the bladder wall, hematuria presenting in a patient previously submitted to nephrectomy due to hypernephroma should prompt us to strongly suspect tumor spread to the bladder. The forms of metastatic spread and treatment are discussed. Good results were achieved in our patient who, with a follow-up of 1.5 years, has had no tumor recurrence.

[Pleomorphic bladder rhabdomyosarcoma in an adult male. Apropos of a case]. / Rabdomiosarcoma pleomórfico vesical en un varón adulto. A propósito de un caso.

We report on a 45-year-old male patient with a mesodermal tumor localized in the striated muscle of the bladder wall. The histopathologic analysis revealed a stage I pleomorphic tumor. The clinical and histologic features of this uncommon tumor type are described. Treatment by partial surgery and adjuvant chemo- and radiotherapy (CMT + XRT) have achieved good results. The patient is asymptomatic 44 months thereafter.

[Anderson-Hynes: results of the treatment of pyeloureteral junction syndrome]. / Anderson-Hynes: resultados en el tratamiento del síndrome de la unión pieloureteral.

This paper is a review of 63 cases of congenital Pyeloureteral Union Syndrome. A total of 47 patients were treated using the Anderson-Hynes reconstructive technique with 3-4 years follow-up. Incidence was analyzed by sex, age and side affected, without a clear predominance of one over the others being shown. Mean age at the time of diagnosis was 39-43 years. The predominant symptom is the presence of lumbo-abdominal pain (36.5%) but the lack of clinical symptoms is also frequent (25.3%). Pyelocalyceal lithiasis is the most frequent secondary pathology (28.5%). U.I.V. appears to be an irreplaceable means for diagnosis, achieving with this technique 93.6% of diagnosis. Hydronephrosis, in different degrees, and absence of ureteral contrast are the urographic signs most commonly found: 66% and 61% respectively. Using the Anderson-Hynes technique a rete of 85% good results can be obtained, with few complications and achieving disappearance of clinical symptoms and morphofunctional normality in a high percentage. Anderson-Hynes dismembered ureteropyeloplasty seems to be the choice technique for conservative surgical treatment of the P.U.U. syndrome.

[Imperforated hymen with hematocolpos diagnosed by urinary symptoms]. / Imperforación de himen con hematocolpos diagnosticado por síntomas urinarios.

We inform of the case of a hymenal membrane imperforation in a 14-year-old patient who consulted for urological symptoms. It is, therefore, a case of an uncommon disorder of a gynecologic origin which, through the occurrence of the menarche and the accumulation of successive menstruations, causes a hematocolpos. This gives rise to a clinical pattern of urinary discomfort as a mechanical effect due to space commitment.

[Bladder adenocarcinoma. Report of 2 new cases]. / Adenocarcinoma vesical. Aportación de dos nuevos casos.

Another two cases of bladder adenocarcinoma (ADC), seen in 1988, are described herein. The most important aspects relative to tumor origin--urothelial and embryonal--are discussed. We review its clinical features and diagnosis, not unlike those of transitional cell tumors, although histologically different. We underscore the therapeutic aspects and poor prognosis in most of the cases.

[Sarcomatoid carcinoma of the kidney: presentation of a case]. / Carcinoma renal sarcomatoide: presentación de un caso.

We describe a case of sarcomatoid variant, renal adenocarcinoma in a 69-year-old woman, whose death took place four months after the diagnosis was effected. We underline the form of clinical and radiological presentation, its low frequency, poor prognosis and difficult anatomopathological diagnosis.