[Epidermoid cyst of the testis].
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Adult↗
Biomedical subjects
C Llorente Abarca
Publications and source records attributed to C Llorente Abarca.
[Yield of ultrasonography-guided transrectal biopsy in the diagnosis of carcinoma of the prostate].
OBJECTIVES: The present study analyzes the combination of digital rectal examination (DRE), prostate specific antigen (PSA), transrectal ultrasound (TRUS) and ultrasound-guided transrectal biopsy in the diagnosis of prostate cancer. METHODS: 115 of 224 patients (51.3%) were biopsied due to a suspicious DRE and/or PSA > 4 ng/ml, and/or DPSA > 0.15, and/or the presence of a hypoechoic lesion on TRUS. RESULTS: Adenocarcinoma of the prostate was diagnosed in 28 (24.3%) of these 115 patients. The positive predictive value (PPV) for carcinoma of the prostate was 4.76% if PSA was < 4 ng/ml, 5.12% if PSA was 4.1 to 10 ng/ml, and 48% if PSA was > 10 ng/ml. If DPSA is considered, the PPV is 7.4% if PSA is 4.1 to 10 ng/ml and 51.02% if PSA is > 10 ng/ml. If DRE is suspicious, the PPV is 43.6%, with a sensitivity of 85.7% and a specificity of 63.9%. The PPV for carcinoma of the prostate was 34% for a hypoechoic lesion on TRUS, 50% if DRE is suspicious, 53.5% is PSA is > 10 ng/ml and 65% if DRE is suspicious and PSA > 10 ng/ml. CONCLUSIONS: The detection rate of carcinoma of the prostate is increased when DRE, PSA, TRUS and US-guided transrectal biopsy are used in combination.
Adenocarcinoma↗
[Conservative treatment of muscle-infiltrating bladder tumors with TUR].
OBJECTIVES: The absence of tumor in up to 10% of cystectomy specimens of patients with invasive bladder cancer justify the search for non aggressive therapies. The present study attempts to establish the safety and curative capacity of TUR alone for patients with superficial muscle-infiltrating bladder cancer. METHODS: Over a period of 18 months, 12 patients with superficial muscle-infiltrating bladder cancer (T2) were diagnosed at our department, TUR was repeated in 9 of the 12 patients. The extension study was negative in all 9 patients. RESULTS: The mean follow up was 12.8 months (range 7-70 months). Local recurrence was found in 4 patients (44.4%) who were submitted to another TUR; 3 were superficial and 1 invasive (with the same muscle involvement as at the initial diagnosis). The tumor-free survival rate was 9.3 months. No patient showed tumor progression. CONCLUSION: The percentage and nature of local recurrence, tumor-free survival and the progression rate (which was not observed during the short follow up period) indicate that TUR is a treatment option that must be taken into account in selected patients with invasive bladder cancer.
Aged↗
[Ureteral resection of ureteral inflammatory polyp associated with lithiasis].
We report on a fibroepithelial polyp case with inflammatory characteristics located in the pelvian ureter, and related with an ureteral calculus, which was treated in a conservative way with ureteroscopic resection, after the pincer extraction of the stone. Our team found two fibroepithelial polyp cases in the bibliography reviewed treated with ureteroscopic resection. We consider that the polyp's reactive inflammatory nature is due to the urothelial chronic irritation caused by the calculus.
Aged↗
[Effect of cell differentiation in prostatic cancer on basal PSA].
The effect of cell differentiation on PSA production in patients with prostate cancer has been evaluated. With this intention 70 patients were included and were analyzed for age, T stage, cell differentiation, bone scan involvement and PSA level prior to therapy. In well-differentiated tumours mcan PSA was 31.3 ng/mL, 56.6 in those with moderate differentiation and 31.6 in poorly differentiated ones (p > 0.05). Multivariate analysis shows no significant differences between both variables, but and inverse relationship between cell differentiation and PSA production (r = -0.27, p > 0.05) can be seen. The most influential variable on PSA levels was de extent of bone scan involvement. Cell differentiation as confusion variable to interpret PSA values in poorly differentiated tumours deserves further study to know the exact role of this protein as a treatment response criterion in prostate cancer.
Aged↗
[Usefulness of ultrasonography in the assessment of acute pyelonephritis].
OBJECTIVE: The diagnosis of acute pyelonephritis (APN) is based fundamentally on the clinical and bacteriological findings. Radiology is useful in ruling out obstructive causes that often require surgical management. The present study analyzed the role of renal ultrasonography (US) in patients with clinical symptoms, signs and history compatible with APN that have normal plain abdominal x-rays. METHODS: 87 patients who consulted our emergency services with symptoms and signs compatible with APN were reviewed. Patients who referred renal colic and those with a previous history of urological disease other than uncomplicated recurrent urinary tract infection were excluded. Patients with a plain abdominal x-ray compatible with lithiasis were excluded. Renal US evaluation was performed by the urologist to rule out hydronephrosis. RESULTS: 37 (42.5%) of the 87 patients had an abnormal US scan. These patients were evaluated again by US or IVP, or both (one case). Obstructive uropathy was demonstrated in only 5 cases (5.8%). These foregoing 5 patients were treated by surgery. CONCLUSIONS: In our series, renal US evaluation indicated surgical treatment in 5.8% of patients with clinical features of APN and a plain abdominal x-ray with no evidence of lithiasis. This incidence is likely to be lower in the outpatient setting. It is difficult to propose a standard approach in the management of these patients. It may therefore be more reasonable to utilize US and IVP in those patients who do not respond to antibiotic therapy.
Acute Disease↗
[Abscessed primary retroperitoneal leiomyoma].
OBJECTIVE: To describe a case of primary retroperitoneal leiomyoma presenting as pelvic abscess. METHODS/RESULTS: A patient who had consulted for fever and hypogastric and perineal pain is described. The diagnostic imaging techniques disclosed a heterogeneous pelvic mass compatible with an abscess, which was drained. After the purulent material had been drained, the mass was removed surgically. The pathological analysis of the surgical specimen disclosed a retroperitoneal leiomyoma. CONCLUSION: An abscessed primary retroperitoneal leiomyoma is a very uncommon tumor.
Abscess↗
[Systemic lupus erythematosus and pyeloureteral obstruction. Description of a case].
OBJECTIVE: To discuss the clinical implications of systemic lupus erythematosus (SLE) as a complication of a urological condition. METHODS: Herein we describe a patient who presented with acute pyelonephritis due to ureteropelvic juntion stenosis, and a superimposed activation of SLE that had not been previously detected. RESULTS: This form of presentation led to a delay in making the diagnosis since it was focused urologically. The diagnosis of SLE was based on the clinical features, determination of antinuclear antibodies (ANA) and a decrease in serum complement. CONCLUSION: When a patient consults with fever arising from a urological condition that is refractory to conventional therapy, it is mandatory to make the differential diagnosis from other disease entities, as shown in this case.
Adult↗