Kidney Transplantation during the First Year of COVID-19 Pandemic in Our Center.

INTRODUCTION: SARS-CoV2 pandemic has altered the normal activity in our day-to-day life. During the most critical moments of the pandemic at the hospital, attendance and programmed activities had to be reduced to a minimum, including kidney transplants. Hospitals with this kind of activity had to suspend or restructure it due to the decrease in the number of donors with a solid organ donation profile, the lack of knowledge as to whether the disease could be transmitted through transplantation or the risk that was believed to be associated with the admission of patients with end-stage chronic kidney disease or immunosuppressive treatment. METHODS: A retrospective review of all patients who had received a kidney transplant at Doctor Peset University Hospital in Valencia was performed from March 2020 to March 2021. The objective was to study the safety of kidney transplantation and the incidence of COVID-19 disease in kidney transplant patients during this pandemic period. RESULTS: 56 cases of kidney transplantation were included, most of them male with an average age of 56 years old, and variable comorbidity such as hypertension, dyslipidemia, an average body mass index of 26 and undergoing renal replacement therapy by hemodialysis. Regarding the organ donors, more than 50% were male patients and the donation was in encephalic death. The average cold ischemia time was 15 hours. Postoperative complications were mostly graded I and II in the Clavien-Dindo classification. 5.4% of the recipients had passed the SARS-CoV2 infection prior to the transplant and 5.4% were infected with COVID-19 after the transplant. CONCLUSION: In our experience, the current kidney transplant program seems viable and safe, even during periods of health emergencies.

Evaluación de la eficacia de fosfomicina trometamol y gentamicina en la profilaxis de la cistoscopia flexible tras el estudio de los patógenos de nuestro entorno / Evaluation of the Efficacy of Fosfomycin Trometamol and Gentamicin in the Prophylaxis of Flexible Cystoscopy after the Study of Microflora in our Environment

Objetivo Optimizar el uso de antibióticos en la profilaxis de la cistoscopia flexible estudiando los patógenos más frecuentes de nuestro entorno y eligiendo el antibiótico según sus antibiogramas. Métodos Desde Enero del 2015 hasta Noviembre del 2015, se analizaron los urinocultivos de nuestra área, se eligió el antibiótico en función a su sensibilidad frente a los patógenos más frecuentes y se comparó con un antibiótico de amplio espectro. Desde Enero del 2016 hasta Diciembre del 2016, se realizaron las cistoscopias agrupando a los pacientes en: Grupo 1: Pacientes sin profilaxis; Grupo 2: Profilaxis con Gentamicina 240 mg; Grupo 3: Profilaxis con antibiótico seleccionado. Como variables principales se definieron la presencia de bacteriuria asintomática e ITU tras la realización de la cistoscopia flexible. Resultados Se analizaron 8.530 urinocultivos y se eligió la Fosfomicina Trometamol 3 gr como profilaxis. Se realizaron 244 cistoscopias distribuidas: Grupo 1: 86 (35%); Grupo 2: 72 (30%); Grupo 3: 86 (35%). Se detectó bacteriuria asintomática postcistoscopia en 6 pacientes (2,5%) en el Grupo 1, 7 pacientes (2,9%) en el grupo 2 y 5 pacientes (2%) en el grupo 3 no presentando diferencias significativas (p 0.120). Desarrollaron ITUs postcistoscopia 1 paciente (0,4%) en el Grupo 1, 5 pacientes (2%) en el Grupo 2 y 2 pacientes (0,8%) en el Grupo 3 sin diferencias significativas (p 0.105). Conclusión La Fosfomicina es tan efectiva como la Gentamicina en la profilaxis de la cistoscopia. Para un uso correcto de los antibióticos, se recomienda el estudio de los patógenos de nuestro entorno.

Objective To optimize the use of antibiotics in the prophylaxis of flexible cystoscopy by studying the most frequent pathogens in our environment and choosing the antibiotic according to its antibiograms. Method Between January 2015 and November 2015, urine cultures were analyzed in our area, the antibiotic was chosen based on its sensitivity to the most frequent pathogens and compared with a broad spectrum antibiotic. From January 2016 to December 2016, cystoscopy was performed by grouping patients into: Group 1 - Patients without prophylaxis, Group 2 - Prophylaxis with 240 mg gentamicin, Group 3 - Selected antibiotic prophylaxis. The main variables were the presence of asymptomatic bacteriuria and UTI after flexible cystoscopy. Results 8530 urine cultures were analyzed and 3 g of fosfomycin trometamol was chosen as the prophylactic. There were 244 cystoscopies: Group 1: 86 (35%); Group 2: 72 (30%); Group 3: 86 (35%). Asymptomatic bacteriuria was detected in 6 patients (2.5%) in Group 1, 7 patients (2.9%) in Group 2 and 5 patients (2%) in Group 3, showing no significant differences (p = 0.120). Post-cystoscopic urinary tract infection developed in 1 patient (0.4%) in Group 1, 5 patients (2%) in Group 2 and 2 patients (0.8%) in Group 3, which showed no significant differences (p 0.105). Conclusion Fosfomycin is as effective as Gentamicin as a prophylactic in cystoscopy. The study of the pathogens in each environment is recommended to correctly prescribe the antibiotic.

Adenocarcinoma de uraco: presentación de dos casos / Urachal adenocarcinoma: report of two cases

OBJETIVOS: Revisión de la literatura del Adenocarcinoma de uraco y presentación de dos casos MÉTODOS/RESULTADOS: Analizamos las características epidemiológicas, clínicas y terapéuticas del Adenocarcinoma de uraco y presentamos dos casos diagnosticados y tratados en nuestro centro CONCLUSIONES: El Adenocarcinoma de uraco es una neoplasia rara, con mal pronóstico y cuyo tratamiento generalmente es la cistectomía parcial o radical con resección en bloque del uraco y el ombligo. Debido a su gravedad, debería tenerse en cuenta a la hora del diagnóstico.AU

OBJECTIVE: Literature review of Urachus adenocarcinoma and report of two cases. METHODS/RESULTS: We analyze epidemiological, clinical and therapeutic features of the Urachus adenocarcinoma and we report two cases diagnosed and treated in our institution. CONCLUSIONS: The Urachus adenocarcinoma is a rare cancer, with poor prognosis and treatment of which usually is radical or partial cystectomy with umbilicotomy and removal of the urachus in bloc. Due to its gravity, you should keep it in mind when you make a diagnosis.AU

Holmium YAG Photocoagulation: Safe and Economical Alternative to Transurethral Resection in Small Nonmuscle-Invasive Bladder Tumors.

OBJECTIVE: To analyze our experience in the treatment of recurrences of bladder tumor using Holmium-YAG (Ho:YAG) laser, assessing recurrence rates, tumor progression, degree of safety, and patient satisfaction, as well as the economic repercussions of the technique. MATERIALS AND METHODS: The study included 109 patients between February 2013 and 2016, who had a superficial recurrence of bladder tumor. Patients were treated by Ho:YAG laser photocoagulation on an outpatient basis and under local anesthetic. Cytology and previous biopsy were collected. The number of tumors, size, time of technique, and any complications were recorded. Subsequently, urine culturing was carried out and we recorded the visual analogue scale, a satisfaction questionnaire, and possible complications. The economic cost of the procedures was calculated. Data were analyzed using a chi-square test for continuous variables and Student's t for independent samples for dichotomous qualitative-quantitative variables. RESULTS: We carried out 139 procedures on 25 women (20%) and 114 men (80%) with a mean age of 67.85 ± 10.41 years and 246 tumors were treated. The consultation time was 21.5 minutes and the photocoagulation time was 7 minutes (1-35). As intraoperative complications, two patients presented monosymptomatic hematuria without requiring treatment and there were no postoperative complications. The total recurrence rate at 6 months was 20%. A value ≤4 on the EVA scale was reported for 94.7% of the patients. The saving per procedure compared with transurethral bladder resection was calculated at €2,007.09. CONCLUSION: The treatment of small recurrences of bladder tumor by photocoagulation with Ho:YAG laser is a well-tolerated technique that offers an acceptable level of cancer control and a lower cost compared with transurethral resection.

Paratesticular rhabdomyosarcoma: a case report.

OBJECTIVE: To report a case of paratesticular rhadomyosarcoma and to perform a bibliographic review. METHODS: We report the case of a 16-year-old male referred to our Department because of a left paratesticular hard tumor with progressive growth. Ultrasound examination showed a paratesticular heterogeneous mass with Internal flow on Doppler. RESULTS: The patient underwent left inguinal orchiectomy, with pathological diagnosis of rhabdomyosarcoma. He refused adjuvant chemotherapy. After being disease-free for 13 months, he presented with left colic pain. Ultrasound and CT examinations showed a left paraaortic retroperitoneal mass causing grade III ureterohydronephrosis, and lung metastases. Despite rescue chemotherapy treatment, there was no response and the abdominal mass progressed. A surgical approach was not possible since patient showed a rapid clinical worsening leading to his death a few weeks later. CONCLUSIONS: Paratesticular sarcomas are very uncommon tumors with poor prognosis.

Radomiosarcoma paratesticular: a propósito de un caso / Paratesticular phabdomyosarcoma: a case report

OBJETIVO: Presentar un caso de radomiosarcoma paratesticular y revisión de la literatura. MÉTODOS: Describimos el caso de un varón de 16 años remitido a nuestro servicio por masa paratesticular izquierda de crecimiento progresivo, con imagen ecográfica de tumoración paratesticular heterogénea con flujo Doppler en su interior. RESULTADOS: Se realizó orquiectomía izquierda, con diagnóstico de rabdomiosarcoma. El paciente rechazó el tratamiento quimioterápico adyuvante. Tras 13 meses libre de enfermedad, reingresó por dolor cólico izquierdo detectándose en ecografía y TC una masa retroperitoneal paraaórtica izquierda que condicionaba uréterohidronefrosis grado III, y metástasis pulmonares. A pesar de instaurarse quimioterapia de rescate, no respondió presentando rápida progresión de la masa abdominal con importante deterioro general que no permitió el abordaje quirúrgico, siendo éxitus a las pocas semanas. CONCLUSIÓN: Los sarcomas paratesticulares son tumores infrecuentes y de mal pronóstico(AU)

OBJECTIVE: To report a case of paratesticular rhadomyosarcoma and to perform a bibliographic review. METHODS: We report the case of a 16-year-old male referred to our Department because of a left paratesticular hard tumor with progressive growth. Ultrasound examination showed a paratesticular heterogeneous mass with Internal flow on Doppler. RESULTS: The patient underwent left inguinal orchiectomy, with pathological diagnosis of rhabdomyosarcoma. He refused adjuvant chemotherapy. After being disease-free for 13 months, he presented with left colic pain. Ultrasound and CT examinations showed a left paraaortic retroperitoneal mass causing grade III ureterohydronephrosis, and lung metastases. Despite rescue chemotherapy treatment, there was no response and the abdominal mass progressed. A surgical approach was not possible since patient showed a rapid clinical worsening leading to his death a few weeks later. CONCLUSIONS: Paratesticular sarcomas are very uncommon tumors with poor prognosis(AU)

[Assymptomatic prostatic infiltration by chronic lymphocytic leukemia]. / Infiltración asintomática de la próstata por leucemia linfática crónica.

OBJECTIVE: Report of a case of leukemic infiltration of the prostate as an incidental CT finding. METHODS: We describe a case of a 60-year-old male suffering from chronic lymphocytic leukemia. A routine-performed CT showed multiple lymphadenopathies and an hypodense area in the left prostatic lobe. The patient was sent to our department to carry out a transrectal ultrasound and prostatic biopsy. He didn't relate any urinary symptoms. RESULTS: By the prostate rectal examination the gland felt hard and with no well defined limits. The transrectal ultrasound showed heterogene parenchyma and several hyperechoic areas by a bad circumscribed prostate. The pathological analysis reported a diffuse infiltration of the gland by chronic lymphocytic leukemia cells. CONCLUSIONS: Although the relapse of hematological tumors to the prostate has been described previously, there is no published case to our knowledge of a leukemic prostate infiltration in an assymptomatic patient as an incidental finding by an imaging procedure.

Infiltración asintomática de la próstata por leucemia linfática crónica / Assymptomatic prostatic infiltration by chronic lymphocytic leukemia

Objetivo: Presentar un caso de infiltración leucémica de la próstata como hallazgo incidental en una prueba de imagen. Métodos: Describimos el caso de un varón de 60 años en seguimiento por una leucemia linfática crónica, al que se realiza un TAC de rutina apreciando adenopatías múltiples y un nódulo hipodenso en el lóbulo prostático izquierdo. El paciente es remitido a nuestro servicio para la realización de ecografía transrectal y biopsias prostáticas. No refiere clínica urinaria. Resultados: Al tacto rectal la próstata está mal delimitada y con aumento difuso de consistencia. La ecografía transrectal muestra una glándula mal delimitada, con parénquima heterogéneo y varias áreas hiperecoicas. El informe anatomopatológico describe la infiltración difusa de la glándula por una leucemia linfática crónica. Conclusiones: Aunque la extensión de tumores hematológicos a la próstata ha sido descrita previamente, no existe en nuestro conocimiento ningún caso publicado de hallazgo incidental en una prueba de imagen de infiltración prostática por leucemia en un paciente asintomático (AU)

Objective: Report of a case of leukemic infiltration of the prostate as an incidental CT finding. Methods: We describe a case of a 60-year-old male suffering from chronic lymphocytic leukemia. A routine-performed CT showed multiple lymphadenopathies and an hypodense area in the left prostatic lobe. The patient was sent to our department to carry out a transrectal ultrasound and prostatic biopsy. He didn’t relate any urinary symptoms. Results: By the prostate rectal examination the gland felt hard and with no well defined limits. The transrectal ultrasound showed heterogene parenchyma and several hyperechoic areas by a bad circumscribed prostate. The pathological analysis reported a diffuse infiltration of the gland by chronic lymphocytic leukemia cells. Conclusions: Although the relapse of hematological tumors to the prostate has been described previously, there is no published case to our knowledge of a leukemic prostate infiltration in an assymptomatic patient as an incidental finding by an imaging procedure (AU)

[Supernumerary spleen simulating a renal tumor. Case report]. / Bazo supernumerario simulando un tumor renal: a propósito de un caso.

OBJECTIVE: Report one case of ectopic spleen simulating a renal tumor. We performed a review of etiopathogenesis, diagnosis and treatment. METHODS: We present the case of a 54-year-old splenectomized female patient with the incidental diagnosis on ultrasound of a left kidney upper pole mass simulating a renal tumor. RESULTS: After the performance of CT scan, and with the suspicion of renal neoplasia, the patient underwent tumorectomy with the pathologic diagnosis of the specimen compatible with supernumerary spleen. CONCLUSIONS: We emphasize the importance of including pseudo masses of splenic origin in the differential diagnosis of left renal, adrenal and retroperitoneal tumors. We emphasize the importance of CT scan as the imaging test of choice, and gammagraphy as a complementary test. We point out conservative attitude as the most suitable in cases of asymptomatic pseudomass of splenic origin.

Bazo supernumerario simulando un tumor renal: a propósito de un caso / Supernumerary spleen simulating a renal tumor. Case report

Objetivo: Presentar un caso de bazo ectópico simulando un tumor renal. Hacemos una revisión de la etiopatogenia, diagnóstico y del tratamiento. Método: Presentamos a una paciente de 54 años esplenectomizada que se le detecta incidentalmente mediante una ecografía una masa en polo superior del riñón izquierdo simulando un tumor renal. Resultados: Tras la realización de un TAC, y bajo la sospecha de neoplasia renal, se le practicó tumorectomía de la lesión observándose en el diagnóstico histológico posterior pieza compatible con bazo supernumerario. Conclusiones: Resaltamos la importancia de incluir las pseudomasas de origen esplénico dentro del diagnóstico diferencial de los tumores renales, suprarrenales y retroperitoneales izquierdos. Destacamos la importancia del TAC como técnica de elección y de la gammagrafía como estudio complementario. Apuntamos la actitud conservadora como la más idónea en los casos de pseudomasa de origen esplénico asintomática tumor (AU)

Objective: Report one case of ectopic spleen simulating a renal tumor. We performed a review of etiopathogenesis, diagnosis and treatment. Methods: We present the case of a 54-year-old splenectomized female patient with the incidental diagnosis on ultrasound of a left kidney upper pole mass simulating a renal tumor. Results: After the performance of CT scan, and with the suspicion of renal neoplasia, the patient underwent tumorectomy with the pathologic diagnosis of the specimen compatible with supernumerary spleen. Conclusions: We emphasize the importance of including pseudo masses of splenic origin in the differential diagnosis of left renal, adrenal and retroperitoneal tumors. We emphasize the importance of CT scan as the imaging test of choice, and gammagraphy as a complementary test. We point out conservative attitude as the most suitable in cases of asymptomatic pseudomass of splenic origin (AU)

[Idiopathic scrotal edema: report of two cases]. / Edema del escroto agudo idiopático: presentación de dos casos.

OBJECTIVE: To report two cases of acute idiopathic scrotal edema. METHODS: We describe the cases of two 12-year-old male patients presenting at the emergency department of our hospital with pain, edema and erythema in one hemiscrotum without history of trauma. RESULTS: On physical examination both patients showed red hemiscrotum skin and increase of the size with normal testicles and epididymis. With the diagnosis of acute scrotum testicular ultrasound were performed and showed heterogeneous edema of the scrotal skin with increased in Doppler flows and normal testicles. CONCLUSIONS: Acute idiopathic scrotal edema is a self-limited pathology which basically affects children before puberty and should be included in the differential diagnosis of acute scrotum to avoid aggressive interventions.

Edema del escroto agudo idiopático: presentación de dos casos / Idiopathic scrotal edema: report of two cases

OBJETIVO: Presentar dos casos de edema de escroto agudo idiopático. MÉTODOS: Describimos los casos de dos varones de 12 años que acudieron al Servicio de Urgencias de nuestro hospital presentando dolor, edema y eritema en un hemiescroto sin recordar antecedente traumático previo. RESULTADOS: A la exploración de ambos pacientes se puede observar los hemiescrotos enrojecidos y aumentados de tamaño pero con testes y epidídimos normales. Con el diagnóstico de escroto agudo se les efectuaron unas ecografías en las que se pudo ver un edema heterogéneo en piel escrotal con flujo Doppler aumentado y testes ecográficamente normales. CONCLUSIONES: El edema de escroto agudo idiopático es una patología autolimitada que afecta básicamente a niños prepúberes que debe ser incluida en el diagnostico diferencial del escroto agudo para evitar intervenciones más agresivas innecesarias

OBJECTIVE: To report two cases of acute idiopathic scrotal edema. METHODS: We describe the cases of two 12-year-old male patients presenting at the emergency department of our hospital with pain, edema and erythema in one hemiscrotum without history of trauma. RESULTS: On physical examination both patients showed red hemiscrotum skin and increase of the size with normal testicles and epididymis. With the diagnosis of acute scrotum testicular ultrasound were performed and showed heterogeneous edema of the scrotal skin with increased in Doppler flows and normal testicles. CONCLUSIONS: Acute idiopathic scrotal edema is a self-limited pathology which basically affects children before puberty and should be included in the differential diagnosis of acute scrotum to avoid aggressive interventions

[Bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci: case report]. / Tumor testicular bilateral sincrónico con focos de neoplasia intratubular de células germinales: presentación de un caso.

OBJECTIVE: To report one case of bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci affecting both testicles. METHODS: We describe the case of a 29-year-old male presenting with a painless tumor in the left testicle for a month. With the suspect of testicular tumor scrotal ultrasound, tumor markers and extension study to rule out metastasis were performed. RESULTS: Ultrasound showed a hypertrophic left testicle with a lesion suspect for neoplasia, and incidental diagnosis of a hypoechoic lesion with augmented Doppler flow within the right testicle. Bilateral orchyectomy was performed with the pathologic diagnosis of classic seminoma with germ cell intratubular neoplasia foci in both testicles. Treatment was completed with two cycles of chemotherapy. CONCLUSIONS: Bilateral synchronic testicular tumors are very rare. The most frequent histological type is classic seminoma. The diagnosis and treatment are similar to unilateral testicular tumors except certain cases in which partial excision of the testicle may be considered.

Tumor testicular bilateral sincrónico con focos de neoplasia intratubular de células germinales: presentación de un caso / Bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci: case report

OBJETIVOS: Presentar un caso de tumor testicular bilateral sincrónico con focos de Neoplasia Intratubular de Células Germinales (NICG) en ambos testículos. METODOS: Describimos el caso de un varón de 29 años que presenta tumoración indolora de un mes de evolución en teste izquierdo. Bajo la sospecha de tumor testicular se le realiza una ecografía escrotal, una determinación de marcadores tumorales y un estudio de extensión tumoral. RESULTADOS: En la ecografía se puede ver un teste izquierdo hipotrófico con lesión sospechosa de neoplasia e, incidentalmente, un testículo derecho con una lesión hipoecoica y aumento de flujo doppler. Se le practicó una orquiectomía bilateral con el diagnóstico de anatomía patológica de seminoma clásico con focos de Neoplasia Intratubular de Células Germinales (NICG) en ambos testículos y se completó el tratamiento con 2 ciclos de quimioterapia. CONCLUSIONES: Los tumores testiculares bilaterales sincrónicos son muy infrecuentes. El tipo histológico más frecuente es el seminoma clásico. El diagnóstico y tratamiento es similar al de los tumores testiculares unilaterales excepto en determinados casos en los que se puede plantear la resección parcial del testículo (AU)

OBJECTIVE: To report one case of bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci affecting both testicles. METHODS: We describe the case of a 29-year-old male presenting with a painless tumor in the left testicle for a month. With the suspect of testicular tumor scrotal ultrasound, tumor markers and extension study to rule out metastasis were performed. RESULTS: Ultrasound showed a hypertrophic left testicle with a lesion suspect for neoplasia, and incidental diagnosis of a hypoechoic lesion with augmented Doppler flow within the right testicle. Bilateral orchyectomy was performed with the pathologic diagnosis of classic seminoma with germ cell intratubular neoplasia foci in both testicles. Treatment was completed with two cycles of chemotherapy. CONCLUSIONS: Bilateral synchronic testicular tumors are very rare. The most frequent histological type is classic seminoma. The diagnosis and treatment are similar to unilateral testicular tumors except certain cases in which partial excision of the testicle may be considered

[Fournier's gangrene]. / Gangrena de Fournier.

OBJECTIVES: We report a retrospective review of the case series of Fournier's gangrene treated in our department from November 1996 to October 2004. METHODS/RESULTS: We studied nine male patients with ages between 21 and 85 years (mean 55 years). 66% of the patients had associated risk factors, and the underlying cause was identified in 56% of the cases. Mean hospital stay was 21 days and two of the patients died from the disease. CONCLUSIONS: Fournier's gangrene is an infection with a very fast evolution, producing necrotizing fascitis of the external genitalia and perineum. It has a high mortality rate, mainly if diagnosis and treatment are deferred. This last includes wide spectrum antibiotic coverage, surgical treatment with debridement and drainage, and, in many cases, a second surgical intervention for reconstructive plasties.

Gangrena de Fournier / No disponible

OBJETIVOS: Presentamos una revisión de los casos de gangrena de Fournier tratados en nuestro servicio desde noviembre de 1996 hasta octubre de 2004. MÉTODO/RESULTADOS: Estudiamos nueve pacientes, todos varones, con edad comprendida entre 21 y 85 años (media 55). En el 66% tenían factores de riesgo y en el 56% de los casos se identificó la causa subyacente. Su estancia media fue de 21 días y destacamos que se produjeron dos defunciones. CONCLUSIÓN: La gangrena de Fournier es una infección de muy rápida evolución que cursa con fascitis necrotizante de los genitales externos y el periné. Tiene una alta mortalidad, sobre todo, si se demora su diag- nóstico y tratamiento. Éste se basa en una cobertura antibiótica agresiva de amplio espectro, en un tratamiento quirúrgico con desbridamiento y drenaje, y, en muchos casos, un segundo tiempo quirúrgico para las plastias correctoras (AU)

OBJECTIVES: We report a retrospective review of the case series of Fournier’s gangrene treated in our department from November 1996 to October 2004. METHODS/RESULTS: We studied nine male patients with ages between 21 and 85 years (mean 55 years). 66% of the patients had associated risk factors, and the underlying cause was identified in 56% of the cases. Mean hospital stay was 21 days and two of the patients died from the disease. CONCLUSIONS: Fournier’s gangrene is an infection with a very fast evolution, producing necrotizing fascitis of the external genitalia and perineum. It has a high mortality rate, mainly if diagnosis and treatment are deferred. This last includes wide spectrum antibiotic coverage, surgical treatment with debridement and drainage, and, in many cases, a second surgical intervention for reconstructive plasties (AU)

[Leydig cell tumor: our experience. Bibliographic review]. / Tumor de células de Leydig: nuestros casos y revisión de la literatura.

OBJECTIVES: To report the case-series of Leydig cell tumors diagnosed at our center, and to perform a bibliographic review on the topic. METHODS: Retrospective review of the clinical records of all patients with the diagnosis of Leydig cell tumor in our center over the last 12 years. We evaluated the clinical, diagnostic and therapeutic features, as well as outcomes. RESULTS: Four patients were diagnosed and treated in our department over this period. Mean patient age of the time of diagnosis was 51 years. Each of our cases have a different presentation. The two patients who underwent sperm analysis had azoospermia. None of the cases showed anomalous hormonal studies. Seventy-five percent of the cases showed ultrasound signs compatible with testicular neoplasia. In all of them surgical treatment was undertaken (inguinal orchyectomy); one of the patients underwent chemotherapy due to metastasis, having a good response. Mean follow-up is 76 months. CONCLUSIONS: It is a rare testicular tumor. Inguinal orchyectomy is the treatment of choice. Its good outcome is remarkable.

Tumor de células de Leyding: nuestros casos y revisión de la literatura / Leydig cell tumor: our experience. Bibliographic review

OBJETIVO: Aportar los casos de tumores de células de Leydig diagnosticados en nuestro Centro, revisando la literatura del tema. MÉTODOS: Estudio retrospectivo de las historias clínicas de los pacientes diagnosticados de tumor de células de Leydig en nuestro Centro en los 12 últimos años. Se valoran los aspectos clínicos, diagnósticos y terapéuticos, así como su evolución. RESULTADOS: Cuatro pacientes fueron diagnosticados y tratados en nuestro Servicio durante este periodo. La edad media de los pacientes en el momento del diagnóstico fue de 51 años. Cada uno de nuestros casos debutó con una manifestación diferente. Los dos casos en los que se realizó espermiograma presentaban azoospermia total. Ningún caso mostró alteraciones en el estudio hormonal. El 75 % presentaba signos ecográficos compatibles con neoplasia testicular. En todos ellos se llevó a cabo tratamiento quirúrgico (orquiectomía vía inguinal), siendo necesario en uno de los pacientes llevar a cabo tratamiento con poliquimioterapia por metástasis, con buena respuesta a la misma. La media de seguimiento ha sido de 76 meses. CONCLUSIONES: Se trata de un tumor testicular poco frecuente. La orquiectomía inguinal es el tratamiento de elección. Destaca su buena evolución

OBJECTIVES: To report the case-series of Leydig cell tumors diagnosed at our center, and to perform a bibliographic review on the topic. METHODS: Retrospective review of the clinical records of all patients with the diagnosis of Leydig cell tumor in our center over the last 12 years. We evaluated the clinical, diagnostic and therapeutic features, as well as outcomes. RESULTS: Four patients were diagnosed and treated in our department over this period. Mean patient age of the time of diagnosis was 51 years. Each of our cases have a different presentation. The two patients who underwent sperm analysis had azoospermia. None of the cases showed anomalous hormonal studies. Seventy-five percent of the cases showed ultrasound signs compatible with testicular neoplasia. In all of them surgical treatment was undertaken (inguinal orchyectomy); one of the patients underwent chemotherapy due to metastasis, having a good response. Mean follow-up is 76 months. CONCLUSIONS: It is a rare testicular tumor. Inguinal orchyectomy is the treatment of choice. Its good outcome is remarkable