[Eosinophilic cystopathy in association with infiltrative transitional cell carcinoma]. / Asociación de cistopatia eosinofilica con carcinoma transicional vesical infiltrante.

OBJECTIVES: To report a case of eosinophilic cystopathy associated to infiltrative transitional-cell carcino ma of the bladder in an adult. METHODS: We describe the case of a 79-year-old wo man who complains of meso and hipogastric pain since several months before, and to whom a parietal thickening of the bladder was detected by means of abdominal CT scan during the diagnostic work up for a digestive disease indicated by the Internal Medicine Service. Cistoscopy confirmed that finding, together with areas of greater endoluminal protrusion. Cold biopsy showed an inflammatory in filtrate with eosinophilic component. Transurethral resection was indicated. RESULTS: The pathological assessment was compatible with high-grade infiltrative transitional carcinoma of the bladder. The patient developed multiple lung metastases and died five months after surgery. CONCLUSIONS: Reports describing the coincidence of both entities are infrequent. We emphasize the importance of a correct filiation of apparently "pseudotumoral" endoluminallesions.

Asociación de cistopatia eosinofilica con carcinoma transicional vesical infiltrante / Eosinophilic cystopathy in association with infiltrative transitional cell carcinoma

OBJETIVOS: Presentación de un caso de cistopatía eosinofílica asociada a carcinoma vesical infiltrante de células transicionales en adulto.MÉTODO: Describimos el caso de una paciente mujer de 79 años que refiere dolor meso e hipogástrico de varios meses de evolución, y a la que se detecta en escáner abdominal un engrosamiento parietal vesical durante el estudio de descarte de patología digestiva por parte del Servicio de Medicina Interna. La cistoscopia permitió confirmar dicho hallazgo, junto a zonas de mayor protrusión endoluminal. La biopsia fría mostró la existencia de infiltrado inflamatorio con componente eosinofílico. Se indicó resección transuretral. RESULTADOS: El estudio anatomopatológico resultó compatible con carcinoma transicional vesical infiltrante de alto grado. Desarrollo de metástasis pulmonares múltiples y éxitus de la paciente cinco meses después de la cirugía.CONCLUSIONES: Infrecuencia de las descripciones de aparición coincidente de ambas entidades referidas. Destacamos la importancia de una correcta filiación de lesiones endoluminales aparentemente “pseudotumorales”(AU)

OBJECTIVES: To report a case of eosinophilc cystopathy associated to infiltrative transitional-cell carcino ma of the bladder in an adult.METHODS: We describe the case of a 79-year-old wo man who complains of meso- and hipogastric pain since several months before, and to whom a parietal thickening of the bladder was detected by means of abdominal CT scan during the diagnostic work up for a digestive disease indicated by the Internal Medicine Service. Cistoscopy confirmed that finding, together with areas of greater endolu minal protrusion. Cold biopsy showed an inflammatory in filtrate with eosinophilic component. Transurethral resection was indicated.RESULTS: The pathological assessment was compatible with high-grade infiltrative transitional carcinoma of the bladder. The patient developed multiple lung metastases and died five months after surgery.CONCLUSIONS: Reports describing the coincidence of both entities are infrequent. We emphasize the importance of a correct filiation of apparently “pseudotumoral” endoluminal lesions(AU)

Outcomes from the use of maximal androgen blockade in prostate cancer at health area with reference hospital type 2 (1st part). Quality of life: application of EORTC QLQ-C30 instrument.

OBJECTIVES: To analize the influence that maximal androgen blockade (MAB) exerts on quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005. METHODS: Basal, 12-month, 24-month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-PR25 to the population sample (n= 111), as well as a control sample (n= 100). We performed a comparative study of the outcomes between groups; between various time measurements in MAB patients; and inter-categories/ intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up). RESULTS: Cognitive and symptomatic fields were affected in patients with MAB at some specific time points. No field showed a significant constant worsening through the period of study for hormonally deprivated patients. A recovery is seen in the sociofamiliar field. Less academic level in MAB patients represents a distinguishing factor leading to worse outcomes in the health-related quality of life parameters analyzed here. CONCLUSIONS: There is a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied.

Resultados del uso en cáncer de próstata del bloqueo androgénico completo en área de salud del Hospital de Referencia Tipo 2 (2ª Parte). Calidad de Vida: Aplicación del instrumento EORTC QLQ-PR25 y resultados globales. Supervivencia ajustada a la calidad de vida, gasto farmacéutico y coste-utilidad / Outcomes of maximal androgen blockade in prostate cancer patients at a health area with Type 2 Reference Hospital (2nd part). Quality of life: application of EORTC QLQ-PR25 instrument and global results. Quality-of-life adjusted survival. Pharmaceutical expenses and cost-utility

OBJETIVO: Estudiar la calidad de vida en los pacientes diagnosticados entre los años 2000-2005 de adenocarcinoma de próstata en el área de salud de Zamora tratados con bloqueo androgénico completo (BAC). Repercusión farmacoeconómica.MÉTODOS: Aplicación basal, al mes 12, mes 24 y mes 36, del instrumento de medición de calidad de vida relacionada con la salud EORTC QLQ-PR25 a la muestra poblacional (n= 111) citada, así como a una muestra de sujetos control (n= 100). Estudio comparativo entre ambos grupos; entre las diferentes determinaciones temporales para los pacientes con BAC; e inter-categorías/ -intervalos de determinadas variables en pacientes con terapia de deprivación hormonal (tercer año de seguimiento). Análisis de los resultados globales de calidad de vida relacionada con la salud (QLQ-C30 + QLQ-PR25). Descripción del gasto farmacéutico en bloqueo androgénico. Análisis coste-utilidad a través del cálculo de los años de vida ajustados a la calidad (AVACs) obtenidos mediante el uso de los índices de ponderación preferencial correspondientes al instrumento EuroQol 5-D.RESULTADOS: Aparición de sofocos y deterioro de la esfera sexual como manifestaciones más significativas relacionadas con la hormonosupresión. Peor percepción subjetiva del estado general de salud y calidad de vida en pacientes tratados, frente a los sujetos no neoplásicos. La positividad gammagráfica, como factor de influencia negativa sobre la calidad de vida. La mayor parte de los pacientes sometidos a BAC presentan cifras de coste-utilidad menor de 5000 Euros/ AVAC.CONCLUSIONES: Repercusión negativa inicial del BAC sobre determinados aspectos calidad de vida, aunque matizable en función de cada esfera estudiada. Relativización del impacto económico de dicho tratamiento sobre el gasto farmacéutico total(AU)

OBJECTIVES: To study quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005 treated with maximal androgen blockade (MAB). To evaluate the pharmacoeconomics of the treatment.METHODS: Basal, 12-month, 24 –month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-C30 to the population sample (n= 111), as well as a control sample (n= 100). Comparative study of outcomes: between groups; between different time measurements in MAB patients; and inter-categories/ -intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up). Analysis of health-related quality of life global outcomes (QLQ-C30 + QLQ-PR25). Description of the pharmaceutical expenses in androgen blockade patients. Cost-utility analysis by means of quality-adjusted life years (QALYs) obtained using preference-based weighted index from the EUROQOL 5-D tool.RESULTS: Hot flushes and sexual field worsening as mean expressions related to hormonal suppression. Treated patients had worse subjective perception of health condition and quality of life, in opposition to non-tumoral individuals. Positive bone scan, was a negative-influence factor on quality of life. Most patients undergoing MAB needed cost-utility figures of less than 5000 Euros/ QALY.CONCLUSIONS: There was a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied. The economic impact of this therapy on overall pharmaceutical expenses is relative(AU)

Resultados del uso en cáncer de próstata del bloqueo androgénico completo en área de salud del Hospital de Referencia Tipo 2 (1ª Parte). Calidad de Vida: aplicación del instrumento EORTC QLQ-C30 / Outcomes from the use of maximal androgen blockade in prostate cancer at health area with reference hospital type 2 (1st part). Quality of life: application of EORTC QLQ-C30 instrument

OBJETIVOS: Analizar la influencia que ejerce sobre la calidad de vida el bloqueo androgénico completo (BAC) en los pacientes diagnosticados entre los años 2000-2005 de adenocarcinoma de próstata en el área de salud de Zamora y sometidos a dicha terapia.MÉTODOS: Aplicación basal, al mes 12, mes 24 y mes 36, del instrumento de medición de calidad de vida relacionada con la salud EORTC QLQ-C30 a la muestra poblacional (n= 111) citada, así como a una muestra de sujetos control (n= 100). Estudio comparativo de los resultados entre ambos grupos; entre las diferentes determinaciones temporales para los pacientes con BAC; e inter-categorías/ -intervalos de determinadas variables en pacientes con terapia de deprivación hormonal (tercer año de seguimiento).RESULTADOS: Las esferas cognitiva y sintomática resultaron afectadas de forma temporal puntual en los pacientes con BAC. No se aprecia ninguna esfera que mantenga un deterioro significativamente constante a lo largo del periodo de estudio en los pacientes con deprivación hormonal. Se verifica recuperación en la esfera sociofamiliar. El menor nivel de estudios cursados por los pacientes en tratamiento con BAC, constituye un factor de diferenciación de cara a la obtención de peores resultados en los parámetros de calidad de vida relacionada con la salud aquí analizados.CONCLUSIONES: Repercusión negativa inicial del BAC sobre determinados aspectos calidad de vida, aunque matizable en función de cada esfera estudiada(AU)

OBJECTIVES: To analize the influence that maximal androgen blockade (MAB) exerts on quality of life in patients from the health area of Zamora diagnosed of prostate adenocarcinoma between 2000-2005.METHODS: Basal, 12-month, 24-month and 36-month application of the health-related quality of life measurement instrument EORTC QLQ-PR25 to the population sample (n= 111), as well as a control sample (n= 100). We performed a comparative study of the outcomes between groups; between various time measurements in MAB patients; and inter-categories/ intervals of some variables in patients with hormonal deprivation therapy (third year of follow-up).RESULTS: Cognitive and symptomatic fields were affected in patients with MAB at some specific time points. No field showed a significant constant worsening through the period of study for hormonally deprivated patients. A recovery is seen in the sociofamiliar field.Less academic level in MAB patients represents a distinguishing factor leading to worse outcomes in the health-related quality of life parameters analyzed here.CONCLUSIONS: There is a negative initial repercussion of MAB on quality of life, although tinged according to the different fields studied(AU)

[Mullerianosis of the urinary bladder: a rare entity]. / Mullerianosis vesical: una entidad infrecuente.

OBJECTIVES: To report a new case of bladder mullerianosis. METHODS: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated. RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up. CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its published reports. We support the option of an endoscopic surgery for these patients.

Mullerianosis vesical: una entidad infrecuente / Mullerianosis of the urinary bladder: a rare entity

OBJETIVO: Descripción de un nuevo caso de mullerianosis vesical.MÉTODO: Presentamos el caso de una paciente mujer de 30 años con antecedentes de aborto, que refiere molestias miccionales coincidiendo con las menstruaciones. Una ecografía vaginal demostró la existencia de lesión exofítica vesical, confirmada posteriormente por cistoscopia. Se indicó resección transuretral.RESULTADOS: En el estudio histopatológico de los tejidos obtenidos se objetivó un componente glandular mixto de tipo predominantemente tubárico, con elementos endometriales y endocervicales asociados. No evidencia de recidiva endoscópica tras un año de seguimiento.CONCLUSIONES: Aportamos un nuevo caso de mullerianosis vesical. Destacamos el escaso número de casos publicados. Defendemos la opción quirúrgica endoscópica en estas pacientes(AU)

OBJECTIVES: To report a new case of bladder mullerianosis.METHOD: We present the case of a 30 year old female patient with history of miscarriage, who refers voiding dis-turbances with menstruations. Vaginal ultrasound showed an exophytic bladder lesion, which was confirmed by cistoscopy. Endoscopic resection was indicated.RESULTS: The pathological study of tissues obtained showed mixed glandular structures with predominant tubaric-like type, in association with endometrial- and endocervical-like elements. No evidence of endoscopic relapse after one year of follow-up.CONCLUSIONS: We contribute with a new case of bladder mullerianosis. We emphasize the scarcity of its pu-blished reports. We support the option of an endoscopic surgery for these patients(AU)

[Bladder leiomyosarcoma: case report]. / Leiomiosarcoma vesical: aportacion de un nuevo caso.

OBJECTIVES: To report a new case of bladder leiomyoma in an adult. METHODS: 64-year-old female patient consulting for a four-month hematuria diagnosed of a bladder intraluminal tumor on ultrasound during a routine gynecologic revision. Cystoscopy confirmed the presence of the tumor. Transurethral resection was indicated. RESULTS: Pathology reported a definitive diagnosis of leiomyosarcoma. Anterior pelvic exenteration was subsequently performed. On one year follow-up there is no evidence of disease. CONCLUSIONS: We emphasize the rarity of these neoplasias. We comment on their main characteristics, pointing out the importance of immunohistochemical staining for the definitive histological diagnosis. We refer the therapeutic options described in the literature.

Leiomiosarcoma vesical: aportación de un nuevo caso / Bladder leiomyosarcoma: case report

OBJETIVO: Presentación de un nuevo caso de leiomiosarcoma vesical en adulto.MÉTODO: Describimos el caso de una paciente mujer de 64 años que refiere hematuria de cuatro meses de evolución,y a la que se detecta ecográficamente durante revisiónginecológica rutinaria una neoformación intraluminal vesical. La cistoscopia permitió confirmar la existencia de dicha lesión. Se indicó resección transuretral de la misma.RESULTADOS: El estudio anatomopatológico permitió un diagnóstico definitivo compatible con leiomiosarcoma. Se procedió en un segundo acto quirúrgico a la realización de exanteración pélvica anterior. No evidencia de recidiva tras un año de la cirugía.CONCLUSIONES: Destacamos la infrecuencia de este tipo de neoplasias. Comentamos las principales característicasde las mismas, señalando la importancia de las técnicas de inmunohistoquímica de cara a su diagnóstico histológico definitivo. Hacemos referencia a las posibilidadesterapéuticas descritas en la literatura

OBJECTIVES: To report a new case of bladder leiomyoma in an adult. ;;METHODS: 64-year-old female patient consulting for a four-month hematuria diagnosed of a bladder intraluminal tumor on ultrasound during a routine gynecologic revision. Cystoscopy confirmed the presence of the tumor. Transurethral resection was indicated. ;;RESULTS: Pathology reported a definitive diagnosis of ;;leiomyosarcoma. Anterior pelvic exenteration was subsequently performed. On one year follow-up there is no evidence of disease. ;;CONCLUSIONS: We emphasize the rarity of these ;;neoplasias. We comment on their main characteristics, ;;pointing out the importance of immunohistochemical ;;staining for the definitive histological diagnosis. We refer the therapeutic options described in the literature

[Giant bladder hernia associated with bilateral incipient obstructive uropathy]. / Hernia vesical inguinoescrotal gigante con uropatía obstructiva bilateral incipiente asociada.

OBJECTIVES: To report one case of giant inguinal scrotal bladder hernia associated with incipient bilateral obstructive uropathy. METHODS: We report the case of a 54-year-old male patient presenting with two-time interrupted voiding, with the need of scrotal compression to complete voiding. Physical examination showed a great left inguinal scrotal hernia with significant post void residual before compression. Serum creatinine was 1.7 mg/dl. Voiding cystourethrogram and intravenous urography confirmed the diagnosis of bladder hemia with mild hydronephrosis. Inguinal hernioplasty with bladder hernia reduction was indicated. RESULTS: Morphologically and functionally satisfactory. Clinical and analytical normalization. CONCLUSIONS: We emphasize the rarity of bilateral supravesical obstructive uropathy secondary to bladder hernia. We concur with other authors in the validity of conservative reconstructive surgery in cases such as the one reported.

[Giant retroperitoneal cystic lymphangioma in adults]. / Unfangioma quístico retroperitoneal gigante en adulto.

OBJECTIVES: To report one case of retroperitoneal cystic lymphangioma in an adult patient. METHODS: We describe the case of a 70 year-old female patient who complained of periumbilical pain and progressive increases of abdominal perimeter over a few months. Physical examination showed a great abdominal mass; CT scan confirmed its cystic nature. The indication of surgery was established. RESULTS: complete lesion excision. Pathology report showed the definitive diagnosis of cystic lymphangioma. No evidence of disease after one year. CONCLUSIONS: We emphasize that it is an unfrequent type of retroperitoneal neoplasias in the adult age. We concur with other authors in the importance of complete excision.

Hernia vesical inguinoescrotal gigante con uropatía obstructiva bilateral incipiente asociada / Giant bladder hernia associated with bilateral incipient obstructive uropathy

OBJETIVO: Presentación de un caso de herniavesical ínguinoescrotal con uropatía obstructiva bilateralincipiente asociada.MÉTODO: Describimos el caso de un paciente varón de54 años que refiere micción en dos tiempos, con necesidadde compresión escrotal para completar la misma. Laexploración física evidenció una gran hernia ínguinoescrotalizquierda, con resíduo postmiccional ecográfico significativopre-compresión de la misma. Se objetivó creatininasérica= 1,7 mg/ dL. El diagnóstico de hernia vesicalcon discreta hidronefrosis se confirmó con cistouretrografíamiccional y urografía intravenosa. Se indicó reducción herniariamás hernioplastia inguinal asociada.RESULTADOS: Morfofuncionalmente satisfactorios. Normalizaciónclínica y analítica.CONCLUSIONES: Destacamos la infrecuencia de la uropatíaobstructiva supravesical bilateral secundaria a herniavesical. Coincidimos con otros autores en la validez de lacirugía conservadora reconstructiva para casos como eldescrito

OBJECTIVES: To report one case of giant ;;inguinal scrotal bladder hernia associated with incipient ;;bilateral obstructive uropathy. ;;METHODS: We report the case of a 54-year-old male ;;patient presenting with two-time interrupted voiding, with ;;the need of scrotal compression to complete voiding. ;;Physical examination showed a great left inguinal scrotal ;;hernia with significant post void residual before compression. ;;Serum creatinine was 1.7 mg/dl. Voiding cystourethrogram ;;and intravenous urography confirmed the diagnosis ;;of bladder hernia with mild hydronephrosis. Inguinal ;;hernioplasty with bladder hernia reduction was indicated. ;;RESULTS: Morphologically and functionally satisfactory. ;;Clinical and analytical normalization. ;;CONCLUSIONS: We emphasize the rarity of bilateral ;;supravesical obstructive uropathy secondary to bladder ;;hernia. We concur with other authors in the validity of conservative ;;reconstructive surgery in cases such as the one ;;reported

[Arterial hypertension in associated with congenital unilateral stenosis of the ureteropelvic junction]. / Hipertension arterial asociada a estenosis congenita unilateral de la union pieloureteral.

OBJECTIVES: To report one case of hypertension in association with congenital unilateral stenosis of the ureteropelvic junction (UPJ). METHODS: We describe the case of a 19- year-old male patient without urologic symptoms who was incidentally diagnosed of high blood pressure. Radiological tests showed right hydronephrosis suggestive UPJ stenosis. The insertion of a percutaneous nephrostomy allowed discontinuation of antihypertensive treatment. Dismembered pyeloplasty was indicated. RESULTS: Functional results were satisfactory. Blood pressure normalization without medical treatment was achieved. CONCLUSIONS: We emphasize the physiopathogenic connection between unilateral ureteral obstructive pathology, as the case, described and other entities not strictly urological, such as high blood pressure. We concur with other authors in the validity of conservative reconstructive surgery for these cases.

Hipertensión arterial asociada a estenosis congénita unilateral de la unión pieloureteral / Hypertension in association with congenital unilateral stenosis of the ureteropelvic junction

OBJETIVO: Presentación de un caso dehipertensión arterial asociada a estenosis congénita unilateralde la unión pieloureteral.METODO: Describimos el caso de un paciente varón de19 años, urológicamente asintomático al que se le diagnosticacasualmente hipertensión arterial. Las técnicas deimagen permitieron objetivar una hidronefrosis derechasugestiva de estenosis de la unión pieloureteral. El implantede una nefrostomía percutánea permitió prescindir deltratamiento antihipertensivo. Se indicó pieloplastia desmembrada.RESULTADOS: Funcionalmente satisfactorios. Normalizacióntensional sin tratamiento médico.CONCLUSIONES: Destacamos la conexión fisiopatogénicaentre patología obstructiva ureteral unilateral como ladescrita y otras entidades no estrictamente urológicascomo la hipertensión arterial. Coincidimos con otros autoresen la validez de la cirugía conservadora reconstructivapara casos como el descrito

OBJECTIVES: To report one case of hypertension ;;in association with congenital unilateral stenosis of ;;the ureteropelvic junction (UPJ). ;;METHODS: We describe the case of a 19-year-old male ;;patient without urologic symptoms who was incidentally ;;diagnosed of high blood pressure. Radiological tests showed ;;right hydronephrosis suggestive UPJ stenosis. The insertion ;;of a percutaneous nephrostomy allowed discontinuation of ;;antihypertensive treatment. Dismembered pyeloplasty was ;;indicated. ;;RESULTS: Functional results were satisfactory. Blood ;;pressure normalization without medical treatment was ;;achieved. ;;CONCLUSIONS: We emphasize the physiopathogenic ;;connection between unilateral ureteral obstructive ;;pathology, as the case, described and other entities not ;;strictly urological, such as high blood pressure. We concur ;;with other authors in the validity of conser vative ;;reconstructive surgery for these cases

[Cognitive and behavioural alterations as adverse reaction to tamsulosin not previously described]. / Alteración cognitiva y conductual como reacción adversa no descrita a tamsulosina.

OBJECTIVES: To report one case of adverse reaction to tamsulosin. METHODS: We describe the case of an 80-year-old patient who was started on alpha blocker treatment after acute urinary retention with the aim to perform a voiding test. RESULTS: The patient presented self-limited episodes of disorientation in time and space and abnormal behaviour in coincidence with the first three administrations of the drug. Treatment was stopped. CONCLUSIONS: We report one case of an adverse reaction to tamsulosin not previously described. We make a reference to the drug vigilance mechanisms. We point out the importance of coordination between health-care levels.

[Malignant recurrence of a penile cutaneous horn]. / Recidiva malignizada de cuerno cutáneo peneano.

OBJECTIVES: To report one case of malignant recurrence of a cutaneous horn of the glans penis. METHODS: We report the case of a 66-year-old male patient presenting with penile discomfort over several months. Physical examination showed a corneal lesion in the glans-penis, the biopsy of which was reported as hyperkeratosis on top of pseudoepiteliomatous hyperplasia. Partial penectomy of the glans penis was performed after recurrence three months later. RESULTS: Pathological study of the specimen identified a microinvasive squamous cell carcinoma in the base of the lesion. The patient is disease-free after two years of follow-up. CONCLUSIONS: We emphasize the capacity the penile cutaneous horn has to become malignant. We also point out the need for observation of these lesions after excision.

Recidiva malignizada de cuerno cutáneo peneano / MAlignant recurrence of a penile cutaneous horn

OBJETIVO: Presentación de un caso de recidivamalignizada de cuerno cutáneo localizado en glande.METODO: Describimos el caso de un paciente varón de 66años que refiere molestias peneanas de varios meses de evolución.La exploración física evidenció una lesión córnea cuyabiopsia en cuña demostró hiperqueratosis sobre base dehiperplasia pseudoepiteliomatosa. La recidiva a los tres mesesnos hizo indicar glandectomía.RESULTADOS: El estudio anatomopatológico de la pieza permitióidentificar un carcinoma escamoso microinvasor en labase de implantación del cuerno cutáneo. El paciente seencuentra libre de enfermedad tras dos años de seguimiento.CONCLUSIONES: Destacamos el potencial de malignizacióndel cuerno cutáneo de localización peneana.Señalamos asimismo la necesidad de vigilancia en el tiempode dichas lesiones tras su extirpación

OBJECTIVES: To report one case ofmalignant recurrence of a cutaneous horn of the glanspenis.METHODS: We report the case of a 66-year-old malepatient presenting with penile discomfort over severalmonths. Physical examination showed a corneal lesionin the glans-penis, the biopsy of which was reported ashyperkeratosis on top of pseudoepiteliomatous hyperplasia.Partial penectomy of the glans penis was performedafter recurrence three months later.RESULTS: Pathological study of the specimen identifieda microinvasive squamous cell carcinoma in the base ofthe lesion. The patient is disease-free after two years offollow-up.CONCLUSIONS: We emphasize the capacity thepenile cutaneous horn has to become malignant. Wealso point out the need for observation of these lesionsafter excision

Alteración cognitiva y conductual como reacción adversa no descrita a tamsulosina / Cognitive and behavioural alterations as adverse reaction to tamsulosin not previously described

OBJETIVO: Presentación de un caso de reacciónadversa a la tamsulosina.METODO: Describimos el caso de un paciente varón de 80años al que se instauró tratamiento alfabloqueante tras retenciónaguda de orina, de cara a realizar un posterior intentode retirada de catéter vesical.RESULTADOS: El paciente presentó - coincidiendo con las tresúnicas administraciones del fármaco -, episodios autolimitadosde desorientación témporoespacial y alteración conductual.El tratamiento fue suspendido.CONCLUSIONES: Aportamos un caso de efecto adverso atamsulosina no descrito. Hacemos referencia a los mecanismosde fármacovigilancia. Señalamos la importancia de lacoordinación entre niveles asistenciales

OBJECTIVES: To report one case ofadverse reaction to tamsulosin.METHODS: We describe the case of an 80-year-oldpatient who was started on alpha blocker treatmentafter acute urinary retention with the aim to perform avoiding test .RESULTS: The patient presented self-limited episodes ofdisorientation in time and space and abnormal behaviourin coincidence with the first three administrations of thedrug. Treatment was stopped.RESULTS: We report one case of an adverse reaction totamsulosin not previously described. We make a referenceto the drug vigilance mechanisms. We point out theimportance of coordination between health-care levels

[Infiltrative small cell carcinoma of the bladder. New case report: treatment with radical surgery and chemotherapy]. / Carcinoma vesical infiltrante de celulas pequeñas. Descripcion de un nuevo caso tratado con cirugia radical mas quimioterapia.

OBJECTIVES: To report a new case of infiltrative small cell bladder cancer. METHODS: We describe the case of a 60-year-old male patient who consulted for monosymptomatic hematuria over a few weeks. Cystoscopy showed a neoplasia in the anterior wall of the bladder. Pathological analysis of the TUR chips was compatible with infiltrative small cell tumor. After a negative staging study radical cystectomy plus adjuvant chemotherapy were indicated. RESULTS: Pathological study of the surgical specimen confirmed the diagnosis with involvement of the surrounding fat. There is no evidence of neoplasic involvement after 24 months follow-up. CONCLUSIONS: We point out the validity of a radical surgical approach for this tumor, also emphasizing the importance of adjuvant chemotherapy. We concur with other authors in the need of multicentric studies to outline the most effective surgical option, due to the limited number of cases of this entity.

[Metachronous recurrence of idiopathic high flow priapism]. / Recurrencia metacrónica de priapismo idiopático de alto flujo.

OBJECTIVES: To report one case of metachronous recurrence of idiopathic high flow priapism. METHODS. We describe the case of a 28-year-old male patient who presents with penile partial tumescence which started 10 hours before and history of a similar episode seven years before. Physical examination confirmed the clinical picture, with mild local discomfort on palpation. Blood tests were normal. Cavernous blood gases were compatible with arterial blood O2 saturation levels. The patient had a satisfactory progressive response to oral administration of diazepam. No pathologic findings were seen at the time of arteriography. RESULTS: Complete resolution of the episode. Erectile function was satisfactorily preserved. There was no relapse after one year of follow-up. CONCLUSIONS: We remark the validity of a deferred therapeutic attitude in front of pictures of high flow priapism, as well as the possibility of resolution with conservative measures. We emphasize the peculiarities of this case, mainly its idiopathic character and the metachronous recurrence.