Biomedical subjects
F J Regadera Sejas
Publications and source records attributed to F J Regadera Sejas.
[Multiple urethral lithiasis. Report of a case].
OBJECTIVE: To report a case of multiple urethral calculi, an uncommon urological condition in our setting. The clinical, radiological and therapeutic aspects are discussed and the literature is briefly reviewed. METHODS/RESULTS: A 77-year-old male consulted at the emergency services of our hospital for dysuria, pollakiuria and difficulty in voiding. The patient also referred and indurated area in the penile ventral aspect. Radiological examination disclosed three calculi in the penile urethra with were successfully removed by meatotomty and urethrolithotomy. The patient is currently asymptomatic. CONCLUSIONS: Urethral calculus is uncommon in developed countries. "Milking" is not advocated due to the high incidence of urethral injury. Treatment is by simple urethrolithotomy in combination with other techniques (urethroplasty, diverticulectomy, etc.), if required.
[Renal cell carcinoma. Clinical onset with peritoneal carcinomatosis. Report of a case].
Renal carcinoma accounts for 2-3% of malignant tumours in the adult, with high tendency for metastasis basically in liver, lymph nodes, lungs and bones. Intraperitoneal, gut, mesentery and omentum involvement is extremely rare affecting only 1% of patients with metastasis at post-mortem. Contribution of one case of renal carcinoma with initial presentation as intraperitoneal metastasis.
[Castleman's disease in the retroperitoneal region].
OBJECTIVE: To describe a case of Castleman's disease presenting as a retroperitoneal mass, with special reference to the differential diagnosis from other retroperitoneal lesions. The histological features, variants, clinical manifestations, etiopathogenesis and treatment of Castleman's disease are reviewed. METHODS: A 64-year-old male presented with voiding symptoms and hypogastric pain. An ultrasound scan showed a 5 x 6 cm mass located behind the bladder and above the prostate, which was confirmed by an abdomino-pelvic CT scan. RESULTS: Retroperitoneal sarcoma was suspected and the mass was resected. The histopathological analysis showed giant lymphoid hyperplasia (vascular hyaline variant of Castleman's disease). CONCLUSIONS: Retroperitoneal Castleman's disease is a lymphoproliferative disorder with two well-defined histological types and a mixed variant. Although this lesion is frequently localized to the mediastinum (71%), extrathoracic lesions have been described. Definitive diagnosis is based on the postoperative pathological findings.
[Synchronous bilateral renal adenocarcinoma. Our experience with conservative kidney surgery].
OBJECTIVE: To present our experience with synchronous bilateral renal adenocarcinoma. The indications for conservative surgery, the different types and the controversies are discussed. METHODS: 5 patients with bilateral renal adenocarcinoma from our series of 320 renal adenocarcinomas were analyzed for gender, age at presentation, tumor location, size, presenting features and type of surgery performed. RESULTS: Bilateral renal adenocarcinoma accounted for 1.56% in our series. Mean age at presentation was 57.8 years (range 43-69 years). All 5 patients were male. All patients underwent conservative surgery by tumor excision or partial nephrectomy of the side with less involvement followed by delayed radical surgery of the contralateral side. Follow-up ranged from 19 months to 14 years. To date all patients are disease-free and only one is on dialysis 14 years postoperatively. CONCLUSIONS: Bilateral renal adenocarcinoma has been reported to account for 1.4%-5% of all renal masses. The incidence in our series was 1.56%. Conservative renal surgery is indicated in patients like those described herein to prevent the need for dialysis. In our view, conservative renal surgery is a good therapeutic option that carries a small risk of tumor multicentricity and future recurrence.
[Pelvic lipomatosis: cause of extrinsic ureteral obstruction. Report of a case].
Contribution of one case of pelvic lipomatosis, suspected through diagnostic imaging (CAT) and diagnosed by exploratory laparotomy, leading to severe unilateral ureterohydronephrosis and contralateral distal ureteral ectasia. The features of the disease, presentation form, diagnosis and treatment are discussed.
[Bilateral abscess of cavernous bodies].
Report of a rare case of abscess in both cavernous bodies. Its peculiarity is based on the location, the bilateral nature and the absence of a clear causative factor, although it was probably related of a local septic focus (rectal or prostatic). Diagnosis was established with CAT because of the primarily posterior location and the significant peripheral inflammatory reaction. The patient was treated successful with a vigorous antibiotic therapy and open drainage from both cavernous bodies with no development of sequelae such as fibrosis and penial incurvation or impotence.
[Posttraumatic hematuria associated with pelvic arteriovenous fistula].
OBJECTIVE: To describe a patient with severe hematuria of late onset and pelvic arteriovenous fistula secondary to pelvic trauma. METHODS/RESULTS: A patient with multiple fracture of the pelvis and sacrum from a road traffic accident presented severe posttraumatic hematuria associated with pelvic arteriovenous fistula. The fistula was resolved by selective embolization and the hematuria immediately ceased. CONCLUSION: Patients with severe or long-lasting hematuria after pelvic trauma and no injuries to the urinary system, warrant arteriographic evaluation to discard vascular lesions. If present, these lesions are generally easily resolved by selective embolization.
[Polycystic renal dysplasia. Casual diagnosis in adult age].
OBJECTIVE: Multicystic renal dysplasia is the most frequent type of cystic renal disease and also one of the most common causes of abdominal mass in childhood. Herein we describe a case of multicystic renal dysplasia that was incidentally discovered in an asymptomatic adult patient. METHODS/RESULTS: A kidney abnormality was incidentally detected during physical examination in a young woman who had consulted for unspecific digestive symptoms. The findings of the imaging techniques, which were fundamental in making the diagnosis, are presented. The most important congenital and cystic renal abnormalities and their differential diagnosis are reviewed. CONCLUSIONS: The main features of multicystic renal dysplasia and its differential diagnosis are underscored.
[Penile incarceration at its base with metallic object].
Herein we describe a case of penile incarceration due to a nut at the base of the penis which was resolved by cutting the metallic object. The literature on penile strangulation describes different foreign bodies and methods of management of constrictive penile band injury.
[Renal autotransplantation in a case of idiopathic retroperitoneal fibrosis refractory to other treatments].
We report a case of renal autotransplantation in a patient with right retroperitoneal fibrosis that had been previously treated by ureterolysis with intraperitonization and corticoid therapy without success. The literature is briefly reviewed and the therapeutic possibilities in refractory retroperitoneal fibrosis are discussed, with special reference to renal autotransplantation.
[A new case of ectopic ureteral outlet into the seminal vesicle].
We report an additional case of ectopic ureter opening into the seminal vesicle in a patient who had consulted for nephric colic from calculus in dysplastic kidney and urinary tract infection. The clinical features, the diagnostic and therapeutic aspects of this rare malformation are briefly reviewed.
[Renal adenocarcinomas associated with other malignant neoplasms].
The renal adenocarcinoma is not a frequent tumour within the scope of multiple neoplasias, at least in the clinical series. Conversely, it appears at a higher relative rate in the post-mortem series. This paper submits a review of renal adenocarcinoma associated in life to other malignant neoplasias, enumerating their major clinical and epidemiological data. Also, it reviews the literature with regard to frequency and etiology, applying the data to our series. The paper concludes that hypernephroma is not a tumour frequently associated with others in life, given its tendency to be secondary to other primary ones, therefore its development depending on survival to the initial tumour. It also emphasizes the need for adequate anamnesis aimed to detect multi-cancer syndromes and the etiology of multiple neoplasias. Further studies are needed to understand the scope of multiple neoplasias and their relative risk.
[Vesico-uterine fistula: report of 2 new cases].
Presentation of two new cases of vesico-uterine fistulae secondary to cesarean operation. In one case our route for surgical approach is explained as a novelty; also, the time-frame within which it was performed, one month, since it is usual to recommend a minimum of three months. In the second case an in-dwelling vesical catheter was sufficient to achieve closure. The article also reviews the existing literature on the different aspects: signs, symptoms and therapy, of this infrequent pathology.
[Ureteral metastasis of renal adenocarcinoma: review of the literature and contribution of a new case].
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[Testicular feminization syndrome].
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[Primary abscess of the psoas muscle. Report of a new case].
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[Malacoplakia of the prostate: contribution of 2 cases].
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