[Are there any differences between the characteristics and the behavior of bladder cancer according to the age of presentation? Our experience]. / Existen diferencias en las caracteristicas y en el comportamiento del tumor vesical según edad de presentación? Nuestra experiencia.

INTRODUCTION: Owing to the different results from the series that evaluate the behavior of the bladder cancer according to the age at the moment of the diagnosis, our objective is based on valuing the characteristics and behaviour according to age of appearance. METHODS: A retrospective study of bladder cancer diagnosed in our area during decade 1993-2003, distributed in 3 intervals of age and some characteristics and behaviour are valued. RESULTS: Elderly patients present greater tumors, non differentiated and with greater rate of progression to infiltrated. Moreover the age, the pathological stage and the tumorlike degree appear as independent significant factors in the multivariant study. CONCLUSIONS: In our experience, the patients greater than 70 years present neoplasms of similar clinical characteristics, although pathologically more aggressive, with greater percentage of progression and worse survival.

¿Existen diferencias en las características y en el comportamiento del tumor vesical según edad de presentación? Nuestra experiencia / Are there any differences between the characteristics and the bahavior of bladder cancer according to the age of presentation? our experience

Objetivo: Dados los diferentes resultados de las series que evalúan el comportamiento de los tumores vesicales según la edad en la que debutan, nuestro objetivo se basa en valorar las características y comportamiento según edad de aparición. Método: Se realiza un estudio retrospectivo de los tumores vesicales de nuevo diagnóstico de nuestra área durante el decenio 1993-2003, distribuidos en 3 intervalos etarios y se evalúan diferentes características y comportamiento. Resultados: Se demuestra que los pacientes de más edad presentan tumores más grandes, indiferenciados y con mayor tasa de progresión hacia infiltrantes. Además aparecen como factores significativos independientes en el estudio multivariante: la edad, el estadio patológico y el grado tumoral. Conclusiones: En nuestra experiencia, los pacientes de edad mayor de 70 años presentan neoplasias de características clínicas similares, aunque patológicamente más agresivas, con mayor porcentaje de progresión y peor supervivencia

Introduction: Owing to the different results from the series that evaluate the behavior of the bladder cancer according to the age at the moment of the diagnosis, our objective is based on valuing the characteristics and behaviour according to age of appearance. Methods: A retrospective study of bladder cancer diagnosed in our area during decade 1993-2003, distributed in 3 intervals of age and some characteristics and behaviour are valued. Results: Elderly patients present greater tumors, non differentiated and with greater rate of progression to infiltrated. Moreover the age, the pathological stage and the tumorlike degree appear as independent significant factors in the multivariant study. Conclusions: In our experience, the patients greater than 70 years present neoplasms of similar clinical characteristics, although pathologically more aggressive, with greater percentage of progression and worse survival

[Consults by scrotum mass: epididymo lesions]. / Consulta por masa escrotal: lesiones epidimarias.

In this review we try to update the knowledge about the tumors of epididymis, describing problems in diagnosis and treatment. We present a case of a 39 years old patient who consults by left testicular mass, before the sonogarphy suspect of tumor was made magnetic resonance imaging , wich aimed towards tumorlike injury. Excision of the injury via inguinal was made and the pathologic diagnosis was of adenomatoid tumor. Owing to the few series that appear in literature, and being the commentaries of these tumors about isolated cases, we expose the characteristics of this illustrated case to value the characteristics in diagnosis and treatment to compare them with other cases.

Consulta por masa escrotal: lesiones epidimarias / Consults by scrotum mass: epididymo lesions

Con esta revisión pretendemos actualizar los conocimientos acerca de los tumores de epidídimo, describiendo problemas en el diagnostico y tratamiento. Presentamos el caso de un paciente de 39 años que consulta por masa testicular izquierda, ante la duda ecográfica de tumor se realizó resonancia nuclear magnética que apuntaba hacia lesión tumoral. Se realizó exéresis de la lesión vía inguinal y el diagnóstico anatomopatológico fue de tumor adenomatoide. Dada las escasas series que aparecen en la literatura, y siendo los comentarios de estos tumores acerca de casos aislados, creemos oportuno exponer las características de este caso ilustrado iconográficamente para valorar las características diagnosticas y actitud terapéutica para poder compararlas con otros casos

In this review we try to update the knowledge about the tumors of epididymis, describing problems in diagnosis and treatment. We present a case of a 39 years old patient who consults by left testicular mass, before the sonogarphy suspect of tumor was made magnetic resonance imaging , wich aimed towards tumorlike injury. Excision of the injury via inguinal was made and the pathologic diagnosis was of adenomatoid tumor. Owing to the few series that appear in literature, and being the commentaries of these tumors about isolated cases, we expose the characteristics of this illustrated case to value the characteristics in diagnosis and treatment to compare them with other cases

[Incidental prostatic cancer: T1a-T1b. Our experience after observation/radical surgery and literature review]. / Cáncer de próstata incidental: T1a-T1b. Nuestra experiencia tras observación/intervención radical y revisión de la literatura.

OBJECTIVES: To analyse the progress of T1a and T1b prostate cancer diagnosed in our hospital. MATERIAL AND METHODS: Retrospective study of 40 patients in T1a-T1b clinical stage diagnosed with prostate adenocarcinoma in our hospital, from 1986 to 1999. A restaging biopsy was performed on the 16 T1a patients after initial diagnosis and control. A radical prostatectomy was performed on the 24 T1b patients. They were all monitored every six months with rectal exam and PSA. We analysed biological and/or clinical progression, time to progression, mortality caused by the tumour and survival. RESULTS: None of the 16 patients with T1a clinical stage presented tumour progression, with a median follow-up of 90 months. 12,5% of the 24 T1b cases presented tumour progression, with a median follow-up of 70 months. Cancer-specific mortality was one patient (4,16 %) in the T1b group. CONCLUSIONS: Observation and follow-up with PSA and rectal exam appears to be a good option for T1a clinical stage, given the good prognosis. Our results show that patients with T1a clinical stage and good prognostic factors could be at a similar risk of suffering from a new prostate cancer as the normal population, although prospective studies are required to validate these results. T1b cases require active treatment and closer monitoring.

[Papillary carcinoma after 13 years of correct function of renal graft]. / Carcinoma papilar hallado en injerto renal tras 13 años de correcto funcionamiento.

It is known the greater probability appearance of malignancy injuries in patients with renal graft due to its inmunosupresión. We expose a case in which after thirteen years of correct operation of the renal transplant a tumor is diagnosed of accidental form by means of ultrasonography of graft's control. It was demonstrated by percutaneous biopsy that it was a carcinoma to papilar and later transplanctectomy was made. We raised a reflection about the novo tumors on renal graft given to the high number of patients with funcionante transplant during long years and the little evidence in Literature, proposing a possible registry of such valuing its behavior and comparing it with the well-known ones on native kidneys without inmunosupresión situation.

[The present time in handling of prostate abscesses: with regard to a case]. / Actualidad en manejo de abcesos prostáticos: a propósito de un caso.

The existence of prostate abscess as bad evolution of an acute protatitis is not very frequent due to the correct handling of the urinary infections by means of suitable antibiotics, in spite of the presence of inmunosupresion situations that can favor their appearance. It is our intention to review the performance in these situations because of a case that by means of minimal invasive therapy by transperineal percutaneous puncture obtained complete improvement.

Cáncer de próstata incidental: T1a-T1b. Nuestra experiencia tras observación/intervención radical y revisión de la literatura / Incidental prostatic cancer: T1a- T1b. Our experience after observational/radical surgery and literature review

Objetivos: Analizar el comportamiento del cáncer de próstata T1a y T1b diagnosticados en nuestro centro. Material y métodos: Estudio retrospectivo de 40 pacientes en estadio clínico T1a-T1b diagnosticados de adenocarcinoma de próstata en nuestro centro, entre los años 1986 y 1999. A los 16 pacientes T1a, se les realizó biopsia de reestadificación tras el diagnóstico inicial y control posterior. A los 24 T1b, se les realizó prostatectomía radical. Todos fueron seguidos mediante tacto rectal y PSA semestral. Analizamos progresión biológica y/o clínica, tiempo hasta la progresión, mortalidad por causa tumoral y supervivencia. Resultados: Ninguno de los 16 pacientes con estadio clínico T1a presentó progresión tumoral, con una mediana de seguimiento de 90 meses. El 12,5% de los 24 casos T1b presentaron progresión tumoral, con una mediana de seguimiento de 70 meses. La mortalidad cáncer específica fue de un paciente (4,16 %) que pertenecía al grupo T1b. Conclusiones: La observación y seguimiento mediante PSA y tacto rectal del estadio clínico T1a parece ser una buena opción dado el buen pronóstico. De nuestros resultados podría deducirse que los pacientes con estadio clínico T1a y buenos factores pronósticos podrían considerarse con un riesgo de padecer un nuevo cáncer de próstata clínico similar al de la población normal, si bien, son necesarios estudios prospectivos que validen estos resultados. Los casos T1b precisan un tratamiento activo y seguimiento más estricto

Objectives: To analyse the progress of T1a and T1b prostate cancer diagnosed in our hospital. Material and methods: Retrospective study of 40 patients in T1a-T1b clinical stage diagnosed with prostate adenocarcinoma in our hospital, from 1986 to 1999. A restaging biopsy was performed on the 16 T1a patients after initial diagnosis and control. A radical prostatectomy was performed on the 24 T1b patients. They were all monitored every six months with rectal exam and PSA. We analysed biological and/or clinical progression, time to progression, mortality caused by the tumour and survival. Results: None of the 16 patients with T1a clinical stage presented tumour progression, with a median follow-up of 90 months. 12,5% of the 24 T1b cases presented tumour progression, with a median follow-up of 70 months. Cancer-specific mortality was one patient (4,16 %) in the T1b group. Conclusions: Observation and follow-up with PSA and rectal exam appears to be a good option for T1a clinical stage, given the good prognosis. Our results show that patients with T1a clinical stage and good prognostic factors could be at a similar risk of suffering from a new prostate cancer as the normal population, although prospective studies are required to validate these results. T1b cases require active treatment and closer monitoring

Carcinoma papilar hallado en injerto renal tras 13 años de correcto funcionamiento / Carcinoma papilar after 13 years of correct function of graft renal

Es conocida la mayor probabilidad de aparición de lesiones malignas en pacientes con trasplante renal debido a su inmunosupresión. Exponemos un caso en el que tras trece años de correcto funcionamiento del trasplante renal se diagnostica de forma casual mediante ecografía de control un tumor sobre el injerto. Mediante punción ecodirigida se evidenció que se trataba de un carcinoma papilar y se realizó trasplantectomía posterior. Planteamos una reflexión acerca de los tumores de novo sobre injerto renal dado el alto número de pacientes con trasplante funcionante durante largos años y la escasa evidencia en la literatura, proponiendo un posible registro de los mismos para valorar su comportamiento y compararlo con los conocidos sobre riñones nativos sin situación de inmunosupresión

It is known the greater probability appearance of malignancy injuries in patients with renal graft due to its inmunosupresión. We expose a case in which after thirteen years of correct operation of the renal transplant a tumor is diagnosed of accidental form by means of ultrasonography of graft´s control. It was demonstrated by percutaneous biopsy that it was a carcinoma to papilar and later transplanctectomy was made. We raised a reflection about the novo tumors on renal graft given to the high number of patients with funcionante transplant during long years and the little evidence in Literature, proposing a possible registry of such valuing its behavior and comparing it with the well-known ones on native kidneys without inmunosupresión situation

Actualidad en manejo de abcesos prostáticos: a propósito de un caso / The present time in handling of prostate abscesses: with regard to case

La existencia de abscesos prostáticos como mala evolución de una prostatitis aguda no es muy frecuente dado al correcto manejo de las infecciones urinarias mediante antibioterapia adecuada, a pesar de ello existen situaciones de inmunosupresión que pueden favorecer su aparición. Es nuestro propósito revisar la actuación en estas situaciones a raíz de un caso que mediante un drenaje percutáneo mínimamente invasivo consiguió completa mejoría

The existence of prostate abscess as bad evolution of an acute protatitis is not very frequent due to the correct handling of the urinary infections by means of suitable antibiotics, in spite of the presence of inmunosupresion situations that can favor their appearance. It is our intention to review the performance in these situations because of a case that by means of minimal invasive therapy by transperineal percutaneous puncture obtained complete improvement

[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.

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)

[Post-traumatic hematoma in pathologic kidney]. / Hematoma postraumático en riñón patológico.

We want to present a case of postraumatic hematoma in a tumoral kidney. The diagnosis of the hematoma was made by abdominal scanner but not the tumor type. It was necessary the chirurgycal review and pathological study to demonstrate an angiomyolipoma as the cause of the kidney hematoma.

Hematoma postraumático en riñón patológico / Postraumatic hematoma in pathological kidney

Presentamos un caso de hematoma postraumático en un riñón tumoral. El diagnóstico del hematoma fue realizado mediante escáner abdominal pero no así el tipo tumoral. Fue necesario la revisión quirúrgica y posterior estudio patológico para demostrar un angiomiolipoma como causante del hematoma renal (AU)