RESUMO
Contribution of a new case of inverted papilloma (IP) of the upper urinary tract (UUT) with the idiosyncrasy of being bilateral and synchronic, a fact not found in the reviewed literature, treated with radical surgery on the left side and conservatively on the right one. Discussion on this pathology is addressed, emphasising its benign biological behaviour, which does not eliminate some cases of malignization. Treatment has to be conservative, and so we stress the relevance of defining a suspicion state to make pre- and peri- operative diagnosis in which endourological methods, that allow both direct visualization and the taking of a biopsy, play a preeminent role. Subsequent strict monitoring is essential due to the likelihood of relapse and malignant changes.
Assuntos
Neoplasias Renais , Pelve Renal , Papiloma , Idoso , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Papiloma/diagnóstico , Papiloma/cirurgiaRESUMO
Seven cases of inverted papilloma (IP), two located at the UUT level and five in the bladder, one associated to transitional cells carcinoma. Treatment was conservative for the whole series, and neither co-adjunctive therapy or chemoprophylaxis was applied, except for the last case; after an average follow-up of 19.8 months they all show complete remission. A discussion of urinary tract IP is suggested, studying the epidemiology, histology, pathogeny, clinical characteristics and diagnostic methods, of which endourological investigations are the most effective for a reliable diagnosis, since they allow direct visualization and biopsy sampling. Regarding the therapeutic options, the paper highlights the need for conservative surgery due to its benign biological behaviour. A strict control of the patients is necessary due to likelihood of recurrence and malignant transformation.
Assuntos
Papiloma/diagnóstico , Papiloma/terapia , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This is a case of a right cervical lump in a 19 years old woman, diagnosed of chondroid Syringoma, by means of Fine Needle Aspiration Cytology, and surgically treated. The AA. analyze clinical, histological, diagnostic and therapeutic aspects of the theme and make a review of the present-day literature.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Neoplasias Parotídeas/patologia , Adenoma de Glândula Sudorípara/cirurgia , Adulto , Biópsia por Agulha , Feminino , Humanos , Neoplasias Parotídeas/cirurgiaRESUMO
We describe an additional case of primary amyloidosis of the bladder whose form of presentation warranted a differential diagnosis from carcinoma of the bladder. The diagnosis was made on the histological findings and the immunohistochemical analyses revealed amyloid fibrils that reacted against the light chain lambda antiserum. The treatment of choice was TUR, which resolves the condition in most of the cases. Conservative surgery, however, does not prevent new deposits and undetected residual lesions may persist, which may warrant other complementary procedures in these patients. After the diagnosis has been made, it is important to discard systemic amyloidosis.