Castleman's disease. A rare cause of isolated retroperitoneal mass.

OBJECTIVES: We describe a case of hyaline vascular type Castleman 's disease with unifocal presentation as retroperitoneal mass. We describe the pathological and radiological findings and present a bibliographic review. METHODS: Castleman's disease is a rare benign disease of unknown etiology characterized by a lymphoproliferative disorder. Two clinical types have been described: localized and multicentric. Isolated retroperitoneal involvement is uncommon. RESULTS: 39-year-old female who complained of back pain. Abdominal CT scan identified a 5 cm retroperitoneal interaortocaval mass. Complete laparoscopic excision was performed. Pathological study showed localized angiofollicular hyperplasia (hyaline vascular type Castleman's disease). CONCLUSIONS: The presentation of Castleman's disease as isolated retroperitonealmass is quite rare and should be distinguished from other retroperitoneal lesions of malignant character. The treatment of choice is surgery, providing a definitive and curative diagnosis. Operative biopsy may be useful.

Enfermedad de Castleman. Una rara causa de masa retroperitoneal solitaria / Castleman's disease. A rare cause of isolated retroperitoneal mass

OBJETIVOS: Describimos un caso de enfermedad de Castleman variante hialino vascular de presentación unifocal como masa retroperitoneal. Se destacan hallazgos radiológicos y anatomopatológicos de esta enfermedad con revisión de la literatura. MÉTODOS: La enfermedad de Castleman es una rara enfermedad benigna de etiología desconocida caracterizada por un desorden linfoproliferativo. Puede presentarse de forma unifocal o multifocal. La afectación retroperitoneal aislada es infrecuente. RESULTADOS: Mujer de 39 años que consulta por lumbalgia. Se realiza TAC abdominal identificándose masa retroperitoneal de 5 cm interaortocava. Es intervenida mediante laparoscopia consiguiéndose la exéresis completa. El estudio anatomopatológico demostró hiperplasia angiofolicular localizada (variante hialino vascular de la enfermedad de Castleman). CONCLUSIONES: La presentación de la enfermedad de Castleman como masa retroperitoneal aislada es bastante infrecuente y debe distinguirse de otras lesiones retroperitoneales de carácter maligno. El tratamiento de elección es quirúrgico, aporta el diagnóstico definitivo, y resulta curativo. La biopsia operatoria puede ser de gran utilidad

OBJECTIVES: We describe a case of hyaline vascular type Castleman’s disease with unifocal presentation as retroperitoneal mass. We describe the pathological and radiological findings and present a bibliographic review. METHODS: Castleman’s disease is a rare benign disease of unknown etiology characterized by a lymphoproliferative disorder. Two clinical types have been described: localized and multicentric. Isolated retroperitoneal involvement is uncommon. RESULTS: 39-year-old female who complained of back pain. Abdominal CT scan identified a 5 cm retroperitoneal interaortocaval mass. Complete laparoscopic excision was performed. Pathological study showed localized angiofollicular hyperplasia (hyaline vascular type Castleman’s disease). CONCLUSIONS: The presentation of Castleman’s disease as isolated retroperitonealmass is quite rare and should be distinguished from other retroperitoneal lesions of malignant character. The treatment of choice is surgery, providing a definitive and curative diagnosis. Operative biopsy may be useful

Ruptura testicular traumática: papel de la exploración quirúrgica / Traumatic testicular rupture: the role of surgical exploration

Se presenta un hombre de 20 años de edad que sufre lesión traumática testicular durante práctica de artes marciales. Se discute el papel de la ecografía y de la exploración quirúrgica.

We present a man 20 years of age that suffered a traumatic testicular injury during the practice of martial arts. The role of echography and surgical exploration are discussed.

[Intraureteral foreign body]. / Cuerpo extraño intraureteral.

OBJECTIVE: We present a rare localization for a foreing body in the urinary system, and review the bibliography to know about it existence, frequency and localization. METHODS: We present the case of a 49 year old woman who referreds she had introduced a metallic objet in her genital area. RESULTS: After the necessary tests, we could see a metallic cylinder. It was 8 cm long and was localized inside the right pelvic ureter. CONCLUSIONS: The presence of strange bodies in the urinary system is a rare urological emergency. Treatment is the key element of the extraction of the least bloody way possible.

Uropatia obstructiva bilateral como forma de presentación de linfoma vesical primario / Bilateral obstructive uropathy as clinical presentation of primary bladder lymphoma

OBJETIVO: Dar a conocer un caso de presentación atípica de linfoma vesical primario tratado en nuestro hospital, así como revisar la bibliografía de este tipo de tumores, que representan el 0.2% de los tumores vesicales, siendo su forma de presentación más frecuente la hematuria macroscópica con coágulos.MÉTODOS: Presentamos el caso de un varón de 83 años, que acudió a Urgencias por oligoanuria de 48h de evolución, en el que se diagnosticó un tumor vesical.RESULTADO: La anatomía patológica resulto ser un linfoma vesical primario de células B.CONCLUSIONES: El linfoma vesical primario es una entidad poco frecuente, que cursa de forma indistinguible a otros tumores vesicales, presentando una buena respuesta al tratamiento con quimioterapia(AU)

OBJECTIVE: We report the event of an atypical presentation of primary bladder lymphoma, treated in our hospital, and review the literature of such tumors, representing 0,2% of bladder tumors, being macroscopic hematuria with clots the most frequent reason for patient consultation.METHODS: We report the case of an 83 years old man who went to the emergency room because of oligoanuria of 48 hours of evolution. He was diagnosed of bladder tumor.RESULTS: The pathology turned out to be a primary bladder lymphoma cell B.CONCLUSIONS: Primary bladder lymphoma is a rare entity that presents a similar behaviour to other bladder tumors, having a good response to treatment with chemotherapy(AU)

Cuerpo extraño intraureteral / Intraureteral foreign body

OBJETIVO: Presentar una localización atípica de cuerpos extraños en el interior del aparato urinario, así como revisar en la bibliografía su existencia, frecuencia y localización.MÉTODOS: Presentamos el caso de una mujer de 49 años, que refiere la introducción de un objeto metálico en el área genital.RESULTADO: Tras la realización de las pruebas complementarias pertinentes, se objetiva un cilindro metálico de 8 cm de longitud, localizado en el interior del uréter pelviano derecho.CONCLUSIÓN: La presencia de cuerpos extraños en el interior del aparato urinario es una rara urgencia urológica, su tratamiento fundamental consiste en la extracción del elemento de la manera menos cruenta posible(AU)

OBJECTIVE: We present a rare localization for a foreing body in the urinary system, and review the bibliography to know about it existence, frequency and lo-calization.METHODS: We present the case of a 49 year old woman who referreds she had introduced a metallic objet in her genital area.RESULTS: After the necessary tests, we could see a metallic cylinder. It was 8 cm long and was localized inside the right pelvic ureter.CONCLUSIONS: The presence of strange bodies in the urinary system is a rare urological emergency. Treatment is the key element of the extraction of the least bloody way possible(AU)

Holmium laser treatment for low grade, low stage, noninvasive bladder cancer with local anesthesia and early instillation of mitomycin C.

PURPOSE: We evaluated the results of laser photocoagulation of recurrent low stage noninvasive bladder cancer. MATERIALS AND METHODS: The study included 36 patients with a recurrent superficial papillary tumor within 1 year of endoscopic resection. Patients underwent laser photocoagulation of the recurrence under local anesthesia and sedation. They received early instillation of 40 mg mitomycin C and were discharged home without a catheter a few hours after the operation. Patients completed a visual analog scale to quantify the perceived level of pain, including 1--no pain to 10--maximum pain. Patients were reviewed after 3, 6 and 12 months to evaluate tumor recurrence. RESULTS: The mean and median visual analog scale score was 3 points (range 1 to 10). No patient had urinary infection or a catheter at hospital discharge. The incidence of recurrence at 12 months was 25%, mainly in the first 15 cases. CONCLUSIONS: Laser photocoagulation with local anesthesia and sedation is easy to perform and well tolerated. There were no complications and the recurrence rate was similar to that of transurethral resection, as calculated using the recurrence calculator of the 2006 guidelines on TaT1 (nonmuscle invasive) bladder cancer from the European Association of Urology.