Biomedical subjects
Publications and source records attributed to F García Víctor.
Ureteral obstruction can be secondary to a lot of reason. We present a uncommon case report of ureteral obstruction to Rosai-Dorfman disease. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management.
We present an uncommon case of retroperitoneal malignant schwannoma diagnosed accidentally. The clinical, diagnostic and therapeutic features are discussed.
Inverted papilloma of the upper urinary tract is a rare tumor and generally considered to be a benign. We present two cases of benign ureteral inverted papilloma. They were discovered after to study a upper urinary infection and a gross hematuria respectively. Both cases appear to be associated with asynchronous and synchronous bladder carcinoma, so it is very important a strict follow-up.
Case report of a retroperitoneal liposarcoma pleomorfico with calcification in diagnosed in our hospital. We comment on its clinical characteristics, diagnostic methods and treatment. We likewise comment the possible differential diagnoses.
A case report of kidney polycystic and horseshoe kidney coincidence in the same patient. They are two congenital associated renal diseases uncommon for urologists. The form of clinic presentation is described, the diagnostic methods used and the therapeutic management.
OBJECTIVE: To describe a case of inverted carcinoma of the right renal pelvis associated with transitional cell carcinoma of the bladder. The unusual nature of this condition and the incidence of tumor recurrence in some patients with bladder cancer and, at least initially, no histopathological evidence of infiltrating tumor prompted us to report this case. METHODS/RESULTS: A 65-year-old male consulted for prostatism. Several months earlier he had had an episode of hematuria. The difficulty in making the diagnosis is underscored and the possibility of conservative surgical management is discussed. Tumor recurrence at two sites distinct from that of the bladder tumor warranted TUR. Two years after the first surgical procedure the patient is disease-free. CONCLUSION: Like most authors, we usually perform radical surgery in these cases. However, in the case described herein, the difficulty in making the diagnosis prompted us to use a conservative approach which, at the present time, appears to have been effective for the renal tumor. New treatment options, like endourological surgery, may have an important place in the management of this tumor type in carefully selected cases.
OBJECTIVE: To describe an additional case of Sertoli cell testicular tumor. Although more cases have been reported in the world literature, only one case with bilateral involvement has been described in the Spanish literature over the last 18 years. METHODS: A 34-year-old male consulted for a testicular mass which he had detected a few weeks earlier. US and CT evaluation disclosed a tumor in the right testis and no evidence of metastasis. The patient underwent right radical orchidectomy via the inguinal approach and insertion of a testicular prosthesis. RESULTS: Histopathological analysis of the surgical specimen disclosed a Sertoli cell testicular tumor. Patient control follow-up at 3 and 9 months postoperatively showed no changes in tumor markers or CT findings. CONCLUSION: The benign or malignant nature of Sertoli cell testicular tumor is currently defined by the presence or absence of metastasis, although there are histopathological criteria that might indicate a certain degree of aggressiveness.
We evaluated the results and complications of 85 ureteroneocystostomies performed from 1978 to 1987. These varied according to the etiology of the disorder; the success rate was 100% for malformations, 87.5% for gynecologic ureters, and 80% for stenosis of the end of the ureter. Several surgical techniques were employed. The Politano-Leadbetter procedure was the most widely-used (40% of cases), and the Cohen technique achieved the best results (100% success rate). All the failures (7.1% of the cases) were due to stenosis of the reimplanted ureter.
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Urothelial inverted papilloma is usually a solitary lesion with rare recurrences. Its behaviour is unclear, its potential for recurrence or progression is not well-known. We present a case of inverted papilloma of the bladder with recurrence in prostatic urethra after four years of follow-up. We review etiology, clinical presentation, diagnose, treatment and the present discussion about its malignancy ability.
OBJECTIVE: To report an additional case of small cell (oat cell) carcinoma of the bladder. METHODS/RESULTS: A 78-year-old patient who consulted for hematuria is described. A TUR biopsy demonstrated small cell undifferentiated carcinoma. The patient received neoadjuvant chemotherapy and subsequently underwent surgery, but died 6 months postoperatively. CONCLUSIONS: Regardless of the treatment utilized, this tumor type maintains its aggressive behaviour and can be associated with other carcinomatous components (papillary transitional cell carcinoma and carcinoma in situ). However, after treatment with CDDP + VP-16 and partial cystectomy, our patient was asymptomatic for 5 months.
Following Labrie's idea, during the last three and a half years about 35 stage D patients were treated with Total Androgenic Blockade, while Radiotherapy and adjuvant TAB was used in 7 stage C patients. Subjective response rate in stage D was 86%. In 46% of the cases there was some sort of objective response (either partial or complete). After 43 months the actual survival rate is 34%. These results show no improvement from other series, but the inclusion of patients with little life expectancy should be taken into account. Results obtained in stage C, though very few patients were included in the series, were good, and patients currently alive remain free from local and metastatic illness. Since the number of patients was reduced, no conclusion can be drawn. In view of the disease progression, Estracyt was used as a second line therapy. Results have been poor showing some subjective, but no objective, response usually of short duration, in all patients (5 cases) undergoing such therapeutic procedure.
OBJECTIVES: We reviewed our series of vesicovaginal fistula that had been treated by the abdominal-transvesical approach, which we have also utilized in complex relapsed fistulas of the posterior aspect of the bladder in all but one case of triple fistula associated with lithiasis of the bladder. METHODS: 6 patients with vesicovaginal fistula secondary to pelviogynecological surgery were treated by the abdominal-transvesical approach. One patient had been referred to our hospital for a triple fistula that had relapsed for the fifth time. This patient was submitted to cystolithotomy during the same session. Another patient with urinary incontinence and cystocele prior to the fistula underwent unrethrocervicopexy following the Marshall-Marchetti-Krantz technique after fistula repair. All the cases were treated by the same surgeon without omental interposition. RESULTS: Excellent results were achieved in all 6 cases, with no fistula relapse. The urinary infection disappeared in those patients with this complication prior to fistula repair. Patient control evaluation was performed 6-12 months postoperatively and at 4 years. All 6 patients are currently urologically asymptomatic and continent. CONCLUSIONS: In our view, vesicovaginal fistula repair can be done via the vaginal, abdominal or combined approach. We do not believe that one technique is superior over the other. Although the 6 cases described herein are not significant statistically, the abdominal-transvecial approach has been successful in these 6 cases, despite the difficulty that is always encountered in some cases of vesicovaginal fistula, regardless of the technique utilized. Omental interposition may be useful in those cases with a large fistulous defect. Some advocate fistulectomy in all cases. The time to surgical correction following diagnosis was always more than three months. The crossed or x-shaped suture achieves minimal superpositioning. Postoperative bladder drainage should not lie on the suture of the bladder mucosa to prevent decubitus through placement of a cystostomy tube. The foregoing points are essential in this procedure.