Biomedical subjects
Publications and source records attributed to D Pesqueira.
We report the appearance of three cases of Leydig cell tumours on MRI. This imaging method showed well-defined and peripheral intratesticular tumours displaying marked and homogeneous enhancement when contrast medium was used. This latter finding was only observed in Leydig cell tumours when they were compared in a series of 104 patients with different scrotal pathologies.
Contribution of one case of prostate cancer presenting with a large abdominal mass associated to anaemia and weight loss. Serum PSA level was greater than 10,000 ng/mL. Imaging studies showed large retroperitoneal mass that led to other differential diagnoses. Biopsy revealed findings suggestive of adenocarcinoma with a distinct immunohistochemical pattern. No metastasis was evidenced in bone scan. Complete hormonal blockade resulted in significant decreased PSA levels and almost complete involution of adenopathies, as well as overall improvement.
OBJECTIVE: Transurethral resection (TUR) is the elective procedure in the treatment of superficial bladder tumor. The association of intravesical chemotherapy has no influence on survival and cause specific survival. This study was carried out to determine the evolution of T1 GIII bladder carcinoma treated with TUR only. PATIENTS AND METHODS: We retrospectively reviewed the records of 42 consecutive patients with T1 GIII bladder carcinoma. Follow-up was available for 34 patients. No patient received either adjuvant or neoadjuvant therapy. All the patients were treated with TUR only and followed for a median of 40 months. They were followed by cystoscopy, urinary cytology and intravenous urography. RESULTS: Forty-seven percent of patients had a solitary tumor while 53% had multiple tumors. Tumor recurrence occurred in 50% with a disease-free interval until the first relapse of 9.6 months. Progression of the primary tumor was observed in 23.5% of patients. The overall survival rate was 73.6% and the cancer-specific survival estimate was 88.2% at mean 36 months of follow-up. CONCLUSIONS: T1 GIII bladder carcinoma may be treated initially with transurethral resection only with acceptable recurrence and progression rates. This would avoid costs and complications of the adjuvant/neoadjuvant therapies.
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Between November 1992 and March 1993 our Service conducted a campaign for early detection of prostate disease among the male population of Vigo. The study focused in the relationship of PSA with the age, rectal examination and prostate symptomatology score. In view of the results obtained it has been concluded that PSA levels increase gradually as a function of age, volume and prostate symptomatology score.
Case report of a 49-year old male patient who presented with signs and symptoms in agreement with Cushing's Syndrome, the etiology of which was shown to be an ACTH-independent macronodular hyperplasia. In such cases, the therapeutical choice is bilateral adrenalectomy which was adopted by us using a posterior approach. The relevance of the clinical diagnosis and therapeutical aspects of this condition are reviewed.
Contribution of two cases of congenital adrenal hyperplasia by blockade in the 21-hydroxylase enzyme synthesis. Diagnosis was reached from the clinical signs and symptoms (virilization syndrome), and was confirmed by radiological and laboratory tests. Hormone treatment was done with hydrocortisone and fludrocortisone, but surgical correction of external genitalia was required to improve cosmetic appearance.
Emergence of multiple bilateral renal cysts observed in patients undergoing periodic haemodialysis is 40%. The pathology, known as Acquired Cystic Renal Disease (A.C.R.D.) presents a high association to renal cancer. Two cases of A.C.R.D. and their association with hypernephroma, one resulting in secondary retroperitoneal haemorrhage and the other in intracystic haemorrhage, are presented. Forms and diagnosis are analyzed, insisting upon the need of monitoring the patients in haemodialysis from the point of view of tumour emergence.
Finding an adenocarcinoma at the vesicle suggests three possible diagnosis: Intestinal adenocarcinoma with vesical location. Adenocarcinoma of the urachus. Vesical primitive adenocarcinoma. Presentation of one case of intestinal adenocarcinoma, revealed by its mictional symptomatology, with the endoscopic appearance of being a single vesical tumour, later shown to be a vesical adenocarcinoma, on which extended surgery of the gut and partial surgery of the bladder was performed.
We present a case of Leydig's cell tumour in a young adult, with endocrinal manifestation. The relative rarity of these neoplasias. The opposition of their clinical manifestations, virilizing in the child and feminizing in the adult. Its always benign evolution in infancy and its occasional malignity in the adult (20%) are commented on and reviewed.
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An asymptomatic case of cystic renal carcinoma is presented. The only diagnosis of certainty was given by a marked increase in L.D.H. levels in the fluid of the tumor after puncture. The pros and cons of imaging studies, and the relative lack of value of aspiration cytology when negative results are encountered are discussed. The pathological anatomical findings of the nephrectomy sample certified the diagnosis, showing the presence of a pseudocystic adenocarcinoma due to intratumor necrosis.
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Retrospective study in 51 patient with locally advanced prostate cancer (34 pT3 and 17 N+) selected from 88 radical prostatectomies performed between February 1985 and December 1993. An evaluation is made of the clinical/pathological stage correlation and the effectiveness of the different diagnostic methods (61% of understaging). The possibility to rescue locally spread tumours is analyzed, 7/51 (13.72%) patients receiving pre-operative neoadjuvant hormonal therapy. Estimated survival at 8 years was 82.6% of all patients treated with radical surgery and, at the end of the study, the situation of 30/46 (65.2%) patients assessed by digital rectal examination, quality of life index, PSA follow-up, abdominal ultrasound and/or CT, bone scan and chest X-ray, was an estimated 8-year disease-free evolution. It is observed that radical surgery and the post-surgical hormonal approach permit good survival in locally advanced prostate cancer and that the use of a neoadjuvant hormonal approach permit good survival in locally advanced prostate cancer and that the use of a neoadjuvant hormonal approach allows in many cases the rescue of patients for radical surgery.