[Synchronic bilateral testicular seminomas. Ultrasound diagnosis]. / Seminomas testiculares bilaterales sincrónicos. Diagnóstico ecográfico.

OBJECTIVES: To report a new case of bilateral synchronic testicular tumors, and to perform a bibliographic review on the topic, emphasizing the ultrasound characteristics and oddity of these presentation, which accounts for less than 1% of germ cell testicular tumors. METHODS/RESULTS: 29-year-old patient consulting because of an increase of the testicular size over one year. Physical examination and ultrasound revealed a synchronic neoplastic involvement of the testicles, suggesting the radiological diagnosis of bilateral "seminomatous tumor", with "non seminomatous" foci in one of them. Histologically, tumors were in accordance with ultrasound working diagnosis (seminomas, showing one of them anaplastic foci). CONCLUSIONS: Synchronic testicular involvement by neoplasias is an unfrequent fact, scarcely reported in the literature, being most cases germ cell tumors, mainly seminomas, and shows a good correlation between ultrasound and histologic diagnosis.

[Renal pseudoaneurysm and arteriovenous fistula: color doppler study of a post-lithotripsy simple cyst]. / Pseudoaneurisma y fístula arteriovenosa renal estudio mediante doppler color de quiste simple post-litotricia.

OBJECTIVES: To describe the clinical and radiological (color doppler ultrasound, CT scan and arteriography) features of a case of renal arteriovenous malformation type mixed fistula with pseudoaneurysm in a female patient after extracorporeal shock wave lithotripsy. METHODS/RESULTS: We report one case of secondary vascular malformation in a 54-year-old female patient who underwent extracorporeal shockwave lithotripsy, presenting as recurrent hematuria. Ultrasound detected a "cystic" formation newly appeared after lithotripsy, being the diagnostic made by a color doppler study which showed a mixed high speed arteriovenous turbulent flow. The lesion showed intense intravenous contrast uptake on CT scan. Diagnosis was confirmed by arteriography. CONCLUSIONS: External shock wave lithotripsy is, as well as interventional procedures, a known cause of renal vascular complications, so that doppler color studies may be diagnostic in patients with suggestive clinical features, focusing specially on those lesions or morphological abnormalities newly appeared when compared to pre-treatment studies.

Recidiva paratesticular de carcinoma renal / Paratesticular metastasis from renal cell carcinoma

OBJETIVO: Describir las características clínicas e histopatológicas que presenta la recidiva de un carcinoma de células renales en el testículo, ya que la rareza de esta forma de presentación puede suponer dificultades diagnósticas y, consecuentemente, de estadiaje y tratamiento de la enfermedad. MÉTODOS/RESULTADOS: Presentamos un caso de metástasis paratesticular de carcinoma renal en un paciente de 65 años, diagnosticado, tras nefrectomía, 3 años antes. El estudio histológico muestra las típicas características citohistológicas e inmunohistoquímicas de esta neoplasia: nidos de células epiteliales claras con positividad inmunohistoquímica para Vimentina, Citoqueratinas y EMA. CONCLUSIÓN: Aunque el carcinoma de células renales metastatiza raramente al área testicular, el estudio histológico constituye un método fundamental para el diagnóstico definitivo y el planteamiento terapéutico de la enfermedad (AU)