[Primary choriocarcinoma of the bladder. A case report with immunohistochemical and ultrastructural study]. / Coriocarcinoma primario de vejiga urinaria. Aportación de un caso con estudio inmunohistoquímico y ultraestructural.

Some tumors frequently encountered in other organs and usually with a high grade of malignancy and a poor prognosis have been recently described in the urinary bladder, very often in close relationship with a pre-existing transitional cell carcinoma. Of these, primary choriocarcinoma of the urinary bladder is one of the most uncommon and its histogenesis much discussed. It is important to identify this tumor type, since a change in the oncologic treatment may be warranted. We report an additional case of this rare bladder tumor with clinicopathologic study and discuss the histogenetic and therapeutic aspects.

[Report of a new case of small cell carcinoma of the oat-cell type in the bladder and review of the literature]. / Aportación de un nuevo caso de carcinoma de células pequeñas tipo "oat cell" de localización vesical y revisión de la literatura.

We report an additional case of small cell carcinoma of the bladder with oat cell features in a 67-year-old male patient. This tumor, recently described at this site, has clinico-pathological features that make it distinct from other bladder tumors. Histologically, it closely resembles its pulmonary counterpart with positive results for epithelial markers and neuroendocrine differentiation. The latter has been confirmed by the observation of the typical neurosecretory granules at ultrastructural level. It generally presents in the elderly male patients. It is extremely aggressive and responds poorly to the commonly used treatment. The histogenesis of this rare tumor of the bladder has, as yet, not been elucidated. The different hypotheses that have been put forward are discussed.

[Obstructive uropathy in genital prolapse]. / Las uropatías obstructivas en los prolapsos genitales.

Two cases of genitourinary prolapse are presented, with a severe high obstructive uropathy complicated with lithiasis and infectious picture. Both cases were elderly patients and had had this problem for many years. They had received no urological or gynaecological examination that could have prevented later complications. As presentation frequency of this pathology is scarce, which undoubtedly is an index of health care, we have reviewed the existing literature to confirm the few descriptions currently reported. Incidence, different etiopathogenic theories explaining this picture, distinctive radiological data and treatment are analyzed.

[Retroperitoneal hematoma secondary to traumatic rupture of the psoas muscle]. / Hematoma retroperitoneal secundario a rotura traumática del músculo psoas.

Rupturing of the psoas muscle by closed injury as a result of the formation of a retroperitoneal hematoma is a very uncommon pathological entity, which may rise problems of differential diagnosis with kidney lesions. Supplementary explorations do not always clear up diagnostic doubts, and it is surgery, if indicated, that confirms the picture. We present a case of retroperitoneal hematoma of traumatic origin in a one-kidney ipsilateral patient, in whom the abdominal CAT revealed affection of the renal capsule associated with rupture of teh psoas. In the surgery carried out due to formation of an abscess in the hematoma we verified that the kidney was undamaged.

[Transverse testicular ectopy with common deferent duct]. / Ectopia testicular transversa con conducto deferente común.

Transverse testicular ectopia is a malfunction of which there are 65 cases described in the Western literature. The pathogeny is unknown, although in the cases in which it is associated with persistence of Mullerian residue, it is attributed to a defect in the secretion of MIF (Mullerian inhibiting factor). In the other cases the fundamental cause is considered to stem from alterations in the vascularization of the genital crest, which determines the type of testicular ectopia. We present a case of crossed testicular ectopia with common deferent duct in a three-year-old male, treated by means of descent and transposition via the interscrotal septum with modified Ombrédanne's technique.

[Signet ring cell adenocarcinoma of the bladder]. / Adenocarcinoma vesical de células en anillo de sello.

A case of primary signet-ring cell adenocarcinoma of the urinary bladder is described. The etiopathogenesis, pathological and clinical features, prognosis and treatment of this tumor type are discussed and the literature reviewed.

[Massive secondary psoriasiform dermatitis secondary to intravesical administration of mitomycin C]. / Dermatitis psoriasiforme masiva secundaria a instilación intravesical de mitomycin C.

We report on a patient who had been submitted to vesical diverticulectomy. Pathological examination of the surgical specimen revealed G2T1 urothelial carcinoma. Intravesical chemotherapy with mitomycin C was instituted. Following the sixth instillation, the patient developed widespread psoriasiform dermatitis and required admission to hospital. Remission was achieved with drug withdrawal and symptomatic treatment. The literature is reviewed.

[Ultrasonic diagnosis of prostatic adenocarcinoma. Prospective study of a sample of 159 patients]. / Diagnóstico ecográfico del adenocarcinoma de próstata. Estudio prospectivo sobre una muestra de 159 pacientes.

We studied the value of transrectal echography as the diagnostic means of prostate pathology. We carried out a prospective analysis of a sample of 159 patients, on whom we have anatomopathological documentation which we use as the reliability control for the clinical exploration by means of rectal touch and ultrasonography with transrectal transducer. We have obtained 137 prostate fibromuscular hyperplasias, 3 inflammatory pathologies and 19 adenocarcinomas. A 100% sensitivity in the echographic diagnosis of prostate adenocarcinoma was achieved for this sample.

[Immediate complications of radical cystectomy. Intestinal fistula: our experience in the treatment with somatostatin]. / Complicaciones inmediatas de la cistectomía radical. Fístula intestinal: nuestra experiencia en el tratamiento con somatostatina.

During the period of time between November 1986 and May 1988, 14 total cystectomies with one-step urinary derivations were performed in our Service. The surgical techniques utilized include: 7 Bricker, 2 Camey, 1 ileocecal segment derivation, 2 cutaneous transureterostomies and 2 cutaneous ureterostomies. Among the complications observed there were 3 intestinal fistulas which were treated at first in a conservative way with parenteral nutrition and somatostatin. An immediate response was obtained in all three cases with a decrease in the fistula deficit. Surgical treatment was required in two patients after a lack of response to conservative treatment. The fistula closed in the third patient, to open again spontaneously 15 days later. It was controlled with conservative means and closed again 45 days later.