Biomedical subjects
Publications and source records attributed to C Cuesta Roca.
Contribution of a case report of diffuse bladder haemangioma developed since childhood, focusing on the diagnosis and management of these tumours and on the pathoanatomical analysis of the lesion. Literature review.
We report the case of a 20-year old male with a right testicular tumor. Bilateral orchidectomy was practised considering the synchronous clinical, ultrasonographical and histological (intraoperative biopsy) findings of the left testis. The definitive pathological report showed a right embryonal carcinoma with wide intratubular germ cell neoplasia (IGCN) of the contralateral testis. IGCN (formerly carcinoma in situ) is present in about 5% of cases in the contralateral gonad of those patients with a testicular neoplasm. More than 50% will develop cancer in that testis. Clinical and physical examination findings are usually unspecific. The diagnosis of IGCN is based on biopsy, although ultrasonography could give some data too, as some authors report. We analyze the therapy options for IGCN: (orchidectomy, chemotherapy, radiotherapy, or "wait and see"). In our case, the first one was made. Chemotherapy was used due to existence of retroperitoneal lymph node metastases, with an excellent follow-up afterwards.
PURPOSE: We reviewed the result of transrectal ultrasound (TRUS)-guided needle biopsies to find the re-biopsy criteria, emphasizing on the Focal Glandular Atypia (FGA) histological changes. MATERIAL AND METHOD: 192 cases were selected, from a total of 1957 patients older than 50, re-biopsied because of high PSA levels and/or abnormal DRE, or because of the histological findings on initial biopsies (high grade PIN and/or FGA). The results are related to the serum PSA levels and DRE characteristics. RESULTS: A 38.83% global positivity for cancer was obtained and 27.08% for re-biopsy. When the first biopsy was negative, the positivity of the re-biopsies was 19.37%; if it was negative for cancer but had high grade PIN and/or FGA changes, the positivity was 65.62%, being higher in FGA changes than in the PIN cases (68.00% vs. 57.14%). The abnormal DRE raised the positivity rate from 17.82% to, 35.75%. CONCLUSIONS: The positivity was especially related to abnormal DRE and/or PSA > or = 10 ng/ml. The tumor rate detected at second and third or successive biopsies was similar (19.28% vs 21.74%). The FGA changes (3.47% globally) had a cancer predictive value of 65.62%. We recommend re-biopsy in all patients with FGA changes.
We present an unusual case of single kidney metastasis from an primary esophageal neoplasm. Its main clinical and diagnostic topics are described. They made us consider him as a good candidate for surgery. The pathological study of the nephrectomy specimen was surprising. The postoperative period was unfortunate, however.
OBJECTIVE: A case of extravesical leiomyoma that had been incidentally discovered in a patient presenting with unspecific pelvic pain is described. METHODS/RESULTS: A 51-year-old male patient consulted for unspecific pelvic pain. Patient evaluation disclosed a well-defined mass. A partial cystectomy was performed. Pathological analysis confirmed the diagnosis of leiomyoma of the bladder. CONCLUSIONS: Mesenchymal tumors of the urinary bladder are rare and account for 1%-5% of all bladder tumors. Leiomyoma is the most common benign non-epithelial tumor. The symptoms caused by this tumor type is varied, unspecific and in most of the cases depends on its location (intravesical, intramural or extramural). Treatment is by surgery, which achieves excellent results.
OBJECTIVES: To analyze the prevalence of vascular risk factors in patients with end-stage renal failure who are candidates to kidney transplantation, determine the efficacy of Doppler ultrasound and to develop a diagnostic vascular algorithm. METHODS: The iliac, femoral, popliteal and posterior tibial arteries of 200 potential kidney graft recipients were evaluated by Doppler US. Patients were assessed for the following risk factors: hypertension, smoking, cholesterol and triglyceride levels, and obesity. Seventy of theses patients subsequently received a kidney allograft. A biopsy of the iliac artery was performed at the level of the arteriotomy. RESULTS: Hypertension (72%), smoking (47%), obesity, hypercholesterolemia and hyperlipidemia (7%) were the most prevalent risk factors. Atherosclerosis was histologically demonstrated in 19.2%: 80% were fibrous plaques. The atherosclerotic arteries showed peak systolic and diastolic flows significantly lower than those of normal arteries (p < 0.05). The resistance index was higher in the atherosclerotic arteries (p < 0.01). The number of cigarettes (R = -0.78) and cholesterol levels (R = -0.43) correlated inversely with the peak flows in the posterior tibial artery. CONCLUSIONS: Vascular evaluation of kidney graft recipients is fundamental. Claudication, hypertension, age > 60 years, asymmetrical pulses and femorobrachial index < 0.7 are indications for performing ultrasound evaluation prior to kidney transplantation.