Hipoqueratosis circunscrita palmar: tratamiento mediante crioterapia / Circumscribed Palmar Hypokeratosis: Treatment with Cryotherapy

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Enfermedad ateroembólica y hemorragia pulmonar / Atheroembolic disease and pulmonary haemorrhage

El síndrome de embolismo de colesterol se produce por la liberación de cristales de colesterol de placas ateroscleróticas ulceradas de grandes arterias. Puede afectar múltiples órganos simulando enfermedades sistémicas como las vasculítis, y debe ser incluido en el diagnóstico diferencial de los síndromes neumo-renales. El diagnóstico de embolismo de colesterol debería contemplarse en pacientes de edad, con enfermedad aterosclerótica previa, que desarrollan fallo renal o deterioro de una insuficiencia renal previa, y en los que aparecen hallazgos clínicos sugestivos de embolismos de colesterol periféricos, asociado a factores precipitantes, sin necesidad de demostración histológica. Este síndrome se ha asociado tradicionalmente a una alta morbi-mortalidad, aunque en recientes series se sugiere que un manejo agresivo con medidas de soporte, evitando factores precipitantes y el uso de corticoides a bajas dosis pueden proporcionar una mejoría en su pronóstico (AU)

[Cystic nephroma. Report of 5 cases]. / Nefroma quístico. A propósito de 5 casos.

OBJECTIVE: To report 5 cases of cystic nephroma and review the clinical, diagnostic and therapeutic aspects. METHODS: From 1974 to 1988, 5 cases of cystic nephroma were diagnosed at our hospital. Patient evaluation included IVP and renal US, and occasionally ascending urography, fine needle aspiration biopsy and CT. The cyst was removed through a lumbar incision in 4 patients and nephrectomy in one patient. RESULTS: The patients were followed by yearly ultrasound/urography for 1 to 15 years. No evidence of local recurrence or metastatic disease has been found. CONCLUSIONS: Cystic nephroma is an uncommon, benign kidney disease whose etiology is unknown. Although new imaging techniques are available, surgical excision and histologic analysis of the tumor are the only effective methods to distinguish benign from malignant cystic lesions of the kidney. Because it is a benign lesion, surgery must be conservative. Complete excision of the cyst is advocated. We found a well-encapsulated, noninfiltrating lesion that permitted surgical excision without difficulty in most of our cases. Herniation of some cysts into the urinary tract is a characteristic radiological sign.

[Prostatic rhabdomyosarcoma in adults]. / El rabdomiosarcoma de próstata en el adulto.

OBJECTIVE: To report on two adult patients with prostatic embryonal rhabdomyosarcoma. The literature is briefly reviewed and the clinical, diagnostic and therapeutic aspects of this unusual variety of prostate cancer are discussed. METHODS: Two patients, aged 27 and 34 years, with prostatic embryonal rhabdomyosarcoma are presented. Both cases showed tumor dissemination at the time of diagnosis. Both patients received chemotherapy. RESULTS: A 60% reduction in tumor volume was achieved in one patient, who subsequently underwent rescue surgery and, in spite of a recurrence, is still alive 3 years after the diagnosis. The other patient showed no response to chemotherapy. He refused rescue surgery and was lost to follow-up. CONCLUSION: Embryonal rhabdomyosarcoma of the prostate in the adult is an unusual and aggressive tumor, of rapid growth and progression. Early diagnosis and treatment without delay by radical surgery and chemotherapy are essential to improve the prognosis of this disease.

[Schistosomiasis (bilharziosis). Importance of cytology. Report of 2 cases]. / Esquistosomiasis (Bilharziosis). Importancia de la citología. A propósito de dos casos.

We report two cases of bilharziasis of the bladder in immigrants who presented with spontaneous hematuria. This condition was diagnosed by urine cytology. The current tide of immigration and tourism have led to an increased number of diseases acquired abroad. A simple, economic and rapid method for diagnosing schistosomiasis in patients at risk with hematuria is described.