Biomedical subjects
Publications and source records attributed to C Domínguez Bravo.
The tumour dissemination to brain from renal cell carcinoma is a rare occurrence: generally, it's seen in advanced stages of the disease, such that occurred in our patient that indicated a poor prognosis. A lesion node, the size medle, located in the side left to brain, with of symptoms neurologic associated was found. Histological examination of the resection specimen revealed metastasis from a renal cell carcinoma.
Primary adenocarcinoma of ring cells's bladder is a neoplasm very uncommon and aggressive. Its clinic aspects and diagnosis don't differ too much from the rest of the bladder's neoplasm. It's important the differentiation from a possible primary extravesical origin. Radical surgery is the only treatment with sensitive answer, and the prognosis in awful. We report a case.
We report a case of renal cell adenocarcinoma (T2-G3) metastatic to the stomach in a patient who underwent a left radical nephrectomy and presented hematemesis and melena two weeks postoperatively. We were prompted to report this case because metastasis to the stomach is rare and the literature is scant. Despite treatment by radical surgery, the short disease-free period following nephrectomy, the high histological grade (G3) and the aggressive nature of the tumor have resulted in a short survival.
We report on a 44-year-old patient with Leydig cell tumor of the testis that had been incidentally detected following orchidectomy for a tumor. The clinical, hormonal and histological criteria currently used to distinguish the malignant from the benign form of this tumor and the different therapeutical alternatives are discussed.
Serum prolactin (PRL) levels were measured in 147 males. All patients had no known tumor, endocrine disorder, or symptoms or signs of hyperprolactinemia. All patients denied taking any medication or agents that could alter PRL levels. Semen analyses revealed 34 patients were normospermic, 69 were oligospermic, 26 were azoospermic, and 18 were purely astenzoospermic. PRL levels for the patient groups were not statistically significantly different. PRL values were higher than the normal ranges in 12.2% of the overall study population. A lower incidence (6.19%) was observed for hyperprolactinemia in the normospermics. These findings are comparable to those described elsewhere. Serum testosterone did not drop significantly in the hyperprolactinemics. Similarly, the FSH and LH values did not change significantly. The possible role of PRL in male infertility and the effect of hyperprolactinemia of varying degrees and etiology on sperm count and motility are discussed.
A ureterocele in an adult patient is described. The characteristic clinical features of this condition associated with pyeloureteral duplicity and several secondary disorders make it an unusual case. The clinical features and treatment are described. The etiologic aspects are discussed, highlighting the acquired factors, as well as the diagnostic and therapeutic procedures.
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Presentation of a new case of cyst of the seminal vesicle in one patient with ipsilateral renal agenesis, stressing the frequency of this association. The cyst become evident following confirmation of renal agenesis, and presented an unusual communication to the bladder due to previous surgery (transurethral resection). This diagnosis was only suspected in the computerized tomography and cystoscopy and later confirmed by deferentovesiculography. The relevance of exploring any possible dysplasia of the seminal tract in the presence of renal agenesis is stressed. From an embryological point of view, the close relationship during development of both urinary and reproductive systems appear to explain the coexistence of these two anomalies. The primary symptoms of the condition, including the unspecific ones, as in the present cases, are discussed. Differential diagnosis from other deep pelvic cysts is referred. Following a literature review and based in our personal experience, already published, our views on the different embryological, clinical, diagnostic and therapeutic considerations are established.
Discussion of a retrospective study in our unit of two cases of vesical tumours of mesenchymal origin, in adult patients and with different maturation behaviour. The first patient started with haematuria and after an extensive follow-up period is now free from the disease. The second patient was an accidental finding causing death in the course of the immediate postoperative.
Renal arteriovenous fistulae (AVF) conform a pathology the urologist is not used to see. The basic purpose of this paper is to collect and update the current knowledge of this renal-vascular disorder, quite frequently forgotten when establishing the likely causes of haematuria. The paper describes the etiology of renal AVF and their generation mechanisms, as well as clinical presentations they can have. A most appropriate diagnostic method is still selective renal arteriography, which usually evidences the anomaly through indirect arteriographic signs. However, when the lesion is small it can be difficult to detect it. Finally, a discussion of therapeutical possibilities, both conservative and radical, and a case recently treated in out unit are presented.
A new case of ureter ectopic abouchement in seminal vesicle with cystic dysplasia is presented in one asymptomatic male attending the clinic on an infertility consultation. Suspected diagnosis was based on right kidney absence observed on abdominal echography, associated to severe oligoastenozoospermia seminograms and decrease in ejaculation volume. The computerized axial tomography revealed changes of the ipsilateral seminal vesicle. Diagnosis was confirmed by deferentovesicullography. Malformation embryological and anatomical aspects, as well as accompanying ipsilateral kidney dysplasia are commented. A review of both national and international literature is made supporting the unusual character of the clinical case presented.
Massive polyuria existing in congenital nephrogenic diabetes insipidus can cause a more or less severe dilatation of the urinary tract in absence of obstruction. Clinical and diagnostic aspects of this pathology are presented relating then with other types of diabetes insipidus. One case of bilateral severe dilatation with evolution towards renal atrophia is presented. Mechanical obstruction was discarded. The disease was refractory to urinary concentration tests and therapy to reduce urine volume. The possible etiopathological mechanisms of functional obstruction and surgical alternatives directed to preserve the kidney function are explained and discussed. The current literature is reviewed but the cases reported are few due to the low incidence of urological affectation. Presence of kidney atrophia is exceptional.
We inform of the case of a hymenal membrane imperforation in a 14-year-old patient who consulted for urological symptoms. It is, therefore, a case of an uncommon disorder of a gynecologic origin which, through the occurrence of the menarche and the accumulation of successive menstruations, causes a hematocolpos. This gives rise to a clinical pattern of urinary discomfort as a mechanical effect due to space commitment.