[Stage pT0 bladder tumors after radical cystectomy: a review of our series]. / Tumores de vejiga pT0 tras cistectomía radical: análisis de nuestra serie.

OBJECTIVES: To evaluate the data of progression and survival in 43 patients who underwent cystectomy with stage pT0 according to classification TNM-2002. MATERIALS AND METHODS: between 1988 and 2003 in our center had realized 420 cystectomies, 43 patients (10.2%) had not tumor in the cystectomy specimen. RESULTS: In these 43 cases the initial clinical stage (in the transuretral resection of bladder) was T1 in 10 cases (23,3 %), T2 in 31 cases (72%) and T3 in 2 cases. As far as the degree 24 patients presented G2 (55.8%) and 19 (44.2%) were G3. Median time from the transuretral resection to the cistectomy was of 44 days at a median follow-up of 89.3 months. Progression-free survival in the 43 patients was of 180,6 months, but during the follow-up it appeared progression in 7 patients, with disease free survival at 36 months (3-126), since the date of the cistectomia. During the follow up, 5 patients died. When we analyzed the cancer-specific survival according to tumor stage, for the T2 with an average cancer-specific survival is of 180 months, decreasing to 35 months considerably for T3. Similar it happens with the degree of differentiation, significantly diminishing as it advances the degree, with an average of cancer-specific survival for the G3 at 122.6 months. In the same way it happens with pathological positive lymph nodes in the radical cistectomy, with a cancer-specific survival of 188 months when it is N0 and of 54 months if the adenopathy was positive (N+). CONCLUSION: In our experiencie urothelial carcinoma pT0 present a prolonged free period of disease (medium of 180 months). The associated factors of risk to a smaller free period of disease are high degree of differentiation (G3, 116 months), the infiltration of deep layers in the transuretral resection (T3, 32 months) and the ganglionary affectation (pN+ 45 months).

Tumores de vejiga pT0 tras cistectomía radical: análisis de nuestra serie / Stage pT= cystectomy: a review of our serie

Objetivos: Estudiar los datos de progresión y supervivencia en los 43 pacientes cistectomizados y catalogados de pT0 según la clasificación TNM-2002. Material y Métodos: Entre 1988 y 2003 se han realizado en nuestro centro 420 cistectomías, en 43 casos(10,2%) no se halló tumor en la pieza anatomopatológica siendo éstos el núcleo de nuestro análisis. Resultados: En estos 43 casos el estadio clínico inicial (en la resección transuretral de tumor vesical previa a la cistectomía) fue T1 en 10 casos (23,3%), T2 en 31 casos (72%) y T3 en 2 casos. En cuanto al grado 24 pacientes presentaron G2 (55,8%) y 19 (44,2%) fueron G3. La mediana entre la de resección transuretral de tumor vesical diagnóstica (RTU de TM vesical) y la cistectomía fue de 44 días y la mediana del seguimiento fue de 89,3 meses. Progresión. La supervivencia libre de progresión en los 43 pacientes fue de 180,6 meses, pero durante el seguimiento apareció progresión en 7 pacientes con una mediana de supervivencia libre de progresión desde la fecha de la cistectomía de 36 meses (3-126). Supervivencia cáncer-específica (SCE). Durante el seguimiento, 5 enfermos fallecieron, cuatro por la enfermedad y el quinto por un cáncer de pulmón. Si analizamos la SCE, según la anatomía patológica de la RTU de tumor vesical previa, para los T2 la media de SCE es de 180 meses, disminuyendo considerablemente para T3 hasta 35 meses. Similar ocurre con el grado de diferenciación tumoral, disminuyendo significativamente a medida que avanza el grado, con una media de SCE para los G3 de122,6 meses. Del mismo modo ocurre con la afectación ganglionar en la pieza de la cistoprostatectomía radical, con una SCE de 188 meses cuando es N0 y de 54 meses si los ganglios son positivos (N+). Conclusiones: En nuestra experiencia los tumores uroteliales pT0 presentan un periodo libre de enfermedad prolongada (mediana de 180 meses). Los factores de riesgo asociados a un menor periodo libre de enfermedad (PLE) son alto grado de diferenciación (G3, 116 meses), la infiltración de capas profundas en la RTU de tumor vesical(T3, 32 meses) y la afectación ganglionar (pN+) 45 meses

Objectives: To evaluate the data of progression and survival in 43 patients who underwent cystectomy with stage pT0 according to classification TNM-2002. Matherials and methods: between 1988 and 2003 in our center had realized 420 cystectomies, 43 patients (10.2%) had not tumor in the cystectomy specimen. Results: In these 43 cases the initial clinical stage (in the transuretral resection of bladder) was T1 in 10 cases (23,3 %), T2 in 31 cases (72%) and T3 in 2 cases. As far as the degree 24 patients presented G2 (55.8%) and 19 (44.2%) were G3. Median time from the transuretral resection to the cistectomy was of 44 days at a median follow-up of 89.3 months. Progressionfree survival in the 43 patients was of 180,6 months, but during the follow-up it appeared progression in 7 patients, with disease free survival at 36 months (3-126) ,since the date of the cistectomía. During the follow up, 5 patients died. When we analyzed the cancer-specific survival according to tumor stage, for the T2 with an average cancer-specific survival is of 180 months, decreasing to 35 months considerably for T3. Similar it happens with the degree of differentiation, significantly diminishing as it advances the degree, with an average of cancer-specific survival for the G3 at 122.6 months. In the same way it happens with pathological positive lymph nodes in the radical cistectomy , with a cancer- specific survival of 188 months when it is N0 and of 54 months if the adenopathy was positive (N+). Conclusion: In our experiencie urothelial carcinoma pT0 present a prolonged free period of disease (medium of 180 months). The associated factors of risk to a smaller free period of disease are high degree of differentiation (G3, 116 months), the infiltration of deep layers in the transuretral resection(T3, 32 months) and the ganglionary affectation (pN+ 45 months)

[Renal teratoma, case report and review of the literature]. / Teratoma renal, aportación de un caso y revisión de la literatura.

We report a case of intrarenal teratoma in a 39-year-old female patient. The clinical course after three years of follow-up has been satisfactory, finding the patient totally asymptomatic. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from other cystic lesions.

[Primitive neuroectodermal tumor. Ewing's sarcoma]. / Tumor neuroectodérmico primitivo renal/sarcoma de Ewing.

Primitive neuroectodermal tumor is an extraordinarily rare primary tumor in the kidney and can be mistaken for a variety of other round cell tumors. It is important to recognize each of these entities, because each carries unique therapeutic and prognostic implications. However, accurate diagnosis of these tumors is hindered by their significant morphologic overlap and complicated by their rarity. These neplasm are highly aggressive that tend to recurence and to metastatize. Standard therapy combining surgery, chemotherapy, radiation and genetic therapy. We report a case of primitive neuroectodermal tumor of the kidney in a 50 year old female patient.

[Treatment of hemorrhagic cystitis secondary to cyclophosphamide. Literature review with regard to a case]. / Tratamiento de la cistitis hemorrágica por ciclofosfamida. Revisión de la literatura a propósito de un caso.

There are extreme situations in the clinical treatment of intractable hematuria (fortunately not a common disease nowadays), in which even benign process may represent a serious risk to the life of the patient and where certain aggressive procedures like cystectomy have to be considered. Our objective in this paper is to review the different existing therapeutic alternatives for the treatment of an intense type of hematuria which does not yield to continuous saline serum irrigation. This study is partly based on a recent real clinical case in which, after the administration of cyclophosphamide to a young patient with recurrent and intense hematuria, the excretion was controlled through intravesical alum irrigation of thus avoiding cystectomy, a very aggressive surgical procedure with many after-effects.

Teratoma renal, aportación de un caso y revisión de la literatura / Renal teratoma, case report and review of the literature

Objetivo: Reportar un caso inusual de tumor renal. Métodos: Mujer de 42 años que debutó clínicamente con masa lumbar izquierda, se diagnosticó mediante TAC de masa renal, realizándole nefrectomía total. El estudio anatomopatológico confirmó teratoma renal. Resultados: Después de tres años de seguimiento la paciente está asintomática. Conclusión: El teratoma renal es un tumor muy infrecuente pero de buen pronóstico (AU)

We report a case of intrarenal teratoma in a 39-year-old female patient. The clinical course after three years of follow-up has been satisfactory, finding the patient totally asymptomatic. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare;however, it should be distinguished from other cystic lesions (AU)

Tumor neuroectodérmico primitivo renal/Sarcoma de Swing / Primitive neuroectodermal tumor. Ewing´s sarcoma

Los tumores neuroectodérmicos primitivos de riñón son neoplasias extremadamente raras, pudiendo ser confundidas con toda la variedad de tumores de células redondas de riñón. Es importante hacer diagnóstico diferencial entre estas entidades por sus implicaciones terapéuticas y pronosticas, aunque no deja de ser difícil debido a su infrecuencia. Estos tumores son extremadamente agresivos, con tendencia a la recurrencia y a la diseminación temprana a distancia. El tratamiento combina cirugía, quimioterapia y radioterapia, apoyándose en la terapia génica. Aportamos un caso de tumor neuroectodérmico primitivo de riñón en una paciente de 50 años (AU)

Primitive neuroectodermal tumor is an extraordinarily rare primary tumor in the kidney and can be mistaken for a variety of other round cell tumors. It is important to recognize each of these entities, because each carries unique therapeutic and prognostic implications. However, accurate diagnosis of these tumors is hindered by their significant morphologic overlap and complicated by their rarity. These neplasm are highly aggressive that tend to recurence and to metastatize. Standard therapy combining surgery, chemotherapy, radiation and genetic therapy. We report a case of primitive neuroectodermal tumor of the kidney in a 50 year old female patient (AU)

Tratamiento de la cistitis hemorrágica por ciclofosfamida. Revisión de la literatura a propósito de un caso / Treatment of hemorrhagic cystitis secondary to cyclophosphamide. Literature review with regard to a case

Existen situaciones límites en la práctica clínica de hematurias rebeldes a tratamiento, no muy frecuentes hoy en día afortunadamente, en la que por procesos incluso benignos corre serio riesgo la vida del paciente y se plantean actuaciones como la cistectomia. Es nuestro deseo hacer una revisión de las diversas opciones terapéuticas que existen ante una hematuria intensa que no cede con irrigación continua de suero salino. Recientemente se ha precisado el uso de diferentes técnicas en un paciente joven, que tras administración de ciclofosfamida se controlo la hematuria recurrente e intensa mediante irrigación intravesical de alumina, evitando así una cirugía tan agresiva y con tantas secuelas como la cistectomía (AU)

There are extreme situations in the clinical treatment of intractable hematuria (fortunately not a common disease nowadays), in which even benign process may represent a serious risk to the life of the patient and where certain aggressive procedures like cystectomy have to be considered. Our objective in this paper is to review the different existing therapeutic alternatives for the treatment of an intense type of hematuria which does not yield to continuous saline serum irrigation. This study is partly based on a recent real clinical case in which, after the administration of cyclophosphamide to a young patient with recurrent and intense hematuria, the excretion was controlled through intravesical alum irrigation of thus avoiding cystectomy, a very aggressive surgical procedure with many after-effects (AU)

[Pseudotumor renal after partial nephrectomy with the use of surgical gelatin sponge]. / Pseudotumor renal tras el uso de materiales hemostáticos en la nefrectomía parcial.

After renal parenchymal sparing surgery, with the use of surgical gelatin sponge, residual defects may persist on imaging studies at the sites of resection. These "pseudotumors" may lead to confusion as to whether a lesion was removed or has recurred. These lesions usually resolve within a year. We report a case of pseudotumor renal parenchymal sparing surgery in a 69 year old man, with resolution of the lesion 8 months after surgery.

[Pure primary prostate transitional cell carcinoma. A review of our series]. / Carcinoma transicional primario puro de próstata. Revisión de nuestra serie.

Primary prostate transitional cell carcinoma is a very uncommon tumor, that represents about 1% of all prostate tumours. In our institution, only six patients have been diagnosed with pure transitional cell prostate carcinoma until 2002. Bladder origin of the neplasic was ruled out in all cases. We report a study about the progression and survival of prostate transitional cell carcinoma. These prostatic tumours carry a poor prognostic (median survival is 4.6 months) with a strong tendency to metastatic spread. Therefore, we suggest a radical prostatectomy (without cystectomy) when it rules out bladder origin tumour.

Pseudotumor renal tras el uso de materiales hemostáticos en la nefrectomía parcial / Pseudotumor renal after partial nephrectomy with the use of surgical gelatin sponge

Después de una cirugía renal, en la que se usa materiales hemostáticos absorbibles, defectos residuales pueden persistir en los estudios radiológicos en los márgenes de la resección. Estos “pseudotumores” pueden ser confundidos con enfermedad recurrente o residual. Presentamos un caso de pseudotumor renal tras nefrectomía parcial en un varón de 69 años, en el que se decidió actitud expectante, con resolución de la lesión a los 8 meses de la cirugía

After renal parenchymal sparing surgery, with the use of surgical gelatin sponge, residual defects may persist on imaging studies at the sites of resection. These “pseudotumors” may lead to confusion as to whether a lesion was removed or has recurred. These lesions usually resolve within a year. We report a case of pseudotumor renal parenchymal sparing surgery in a 69 year old man, with resolution of the lesion 8 months after surgery

Carcinoma transicional primario puro de próstata / Pure primary prostate transitional cell carcinoma: A review of our serie

El carcinoma transicional primario de próstata es un tumor raro que ocupa alrededor del 1% de los tumores de próstata. Presentamos seis casos diagnosticados en nuestro hospital hasta finales del año 2002. En todos ellos se descartó el origen vesical de la neoplasia. Nuestro objetivo es estudiar los datos de progresión y supervivencia en los carcinomas primarios puros (sin componente de adenocarcinoma) tratados en nuestro centro en los últimos años. En nuestra experiencia se trata de una neoplasia de pronóstico ominoso con una mediana de supervivencia de 4,6 meses. Con tendencia precoz a metastatizar a distancia. Por tanto, sugerimos la realización de cirugía radical prostática (sin cistectomía) en aquellos casos en los cuales no se evidencia enfermedad en la vejiga (AU)

Primary prostate transitional cell carcinoma is a very uncommon tumor, that represents about 1% of all prostate tumours. In our institution, only six patients have been diagnosed with pure transitional cell prostate carcinoma until 2002. Bladder origin of the neplasic was ruled out in all cases. We report a study about the progression and survival of prostate transitional cell carcinoma. These prostatic tumours carry a poor prognostic (median survival is 4.6 months) with a strong tendency to metastatic spread. Therefore, we suggest a radical prostatectomy (without cystectomy) when it rules out bladder origin tumour (AU)

[Idiopathic superinfected giant hematocele]. / Hematocele gigante sobreinfectado idiopático.

A 45 year old male patient is attended for a marked increase in the size of the left hemiscrotum totally painless. The diagnosis was haematocele, but no cause was found for the bleeding. Orchidectomy and complete exeresis of the tunica vaginalis was carried out.

[Kidney transplantation. Technique and complications]. / Transplante renal. Técnica y complicaciones.

We want to make in this article, a deep review of our experience in kidney transplantation since the moment we started the technique in 1986 to the end of the year 2000. We also want to make a compilation of the most important points of the surgical technique, patients selection criteria, and the most common and uncommon complications that can appear in kidney transplantation, analizing our results all along this time.

Transplante renal. Técnica y complicaciones / Kidney transplantation. Technique and complications

En este artículo, queremos llevar a cabo una profunda revisión de nuestra experiencia en el transplante renal desde el momento en el que iniciamos la técnica en el año 1986 hasta finales del año 2000.Asímismo queremos compilar los aspectos más importantes de la técnica quirúrgica, criterios de selección de pacientes y las más frecuentes e infrecuentes complicaciones que pueden aparecer en el transplante renal, analizando nuestros resultados a lo largo de estos años (AU)

Hematocele gigante sobreinfectado idiopático / Infected giant idiopathic haematocele

Varón de 45 años que es atendido por un marcado aumento de tamaño del hemiescroto izquierdo totalmente asintomático. El diagnóstico fue de hematocele aunque no se encontró causa evidente del sangrado. Se llevó a cabo orquiectomía y exéresis completa de la túnica vaginal. (AU)

[Intravesical foreign bodies. Review of the literature]. / Cuerpos extraños intravesicales. Revisión de la literatura.

We want to make a literature review about the bladder foreign bodies. This clinical situation is not an usual emergency, but there are a lot of references in urological articles about it. In this article review we want to make a compilation about the symtoms, the different origins of the foreign bodies, and ways of diagnosis and treatment of this pathology. We also want to add our personal experience in a recent case.