[Latent renal cancer disclosed by a spontaneous subcapsular hematoma].
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Biomedical subjects
Publications and source records attributed to A Kostakopoulos.
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During the last two years, 17 patients with haemorrhage due to radiation cystitis or bladder cancer have been treated by intravesical infusion of 10% Formalin solution. The results were very good in 9 cases, satisfactory in 3, while the remaining 5 cases were disappointing. The control of bleeding by Formalin was safe especially in patients with secondary haemorrhage due to radiation cystitis with no tumour recurrence.
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The authors discuss the radiological signs in 18 patients with an adrenal tumour. 7 of them had a Cushing's syndrome, 10 others a phaechromocytoma and the last had primary hyperaldosteronism. The diagnosis was made from the history, the clinical picture, hormone estimations and pharmacodynamic tests, whilts in the majority of cases the tumour was localised by radiodiagnosis. In all cases, there was hypertension, permanent in tumours of the adrenal cortex, paroxysmal or permanent in the cases of pheochromocytomas. We emphasise the importance of retro-pneumoperitoneum, as the radiological investigation of choice, in the localisation of adrenal tumours, especially pheochromocytomas, and in Cushing's syndrome. In cases of pheochromocytoma, one should follow carefully the blood pressure, during special radiological investigations, in view of the danger of a sudden rise or fall in blood pressure, the first is treated with phentolamine, the second with noradrenaline solution. Finally, a scan using I 131 19-iodocholesterol may be valuable in diagnosis and localisation of adrenal tumours; it has in particular given very encouraging results in the differential diagnosis of adrenal tumours with the clinical presentation of Cushing's disease.
During the period of October 1981 to October 1990, we diagnosed and treated 7 patients (5 males and 2 females) under 25 years old (mean age 21.2) with transitional cell carcinoma of the bladder. The diagnosis and the treatment were the same as in the older age group. The tumors were of low grade and low stage and presented a recurrence rate of 28.5%. The tumors were of favourable prognosis but the follow-up care of these patients should be vigilant and persistent.