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Biomedical subjects

J A Valero Puerta

Publications and source records attributed to J A Valero Puerta.

At least 19 recordsLinked to original sources
PubMed2001

[Mucinous adenocarcinoma of the prostate].

OBJECTIVE: To describe a case of mucinous adenocarcinoma of the prostate. METHODS: A 77-year-old patient presented with urinary complaints. Patient evaluation showed an enlarged prostate and increased PSA levels. RESULTS: A prostate biopsy showed a glandular neoplasm with extensive mucinous differentiation and abundant lacunae of PAS positive mucus (mucinous adenocarcinoma). The patient remains well one year after the diagnosis. CONCLUSIONS: Mucinous adenocarcinoma of the prostate is a rare variant that should be recognized and does not necessarily imply a worse prognosis than other carcinomas of the prostate.

Adenocarcinoma, Mucinous↗
PubMed2001

[Bladder adenocarcinoma with glandular cystitis areas].

OBJECTIVE: To describe a case of adenocarcinoma of the urinary bladder. METHODS: A 63-year-old patient consulted for gross hematuria. Ultrasound evaluation showed a bladder neoplasm and CT demonstrated extensive infiltration of adjacent structures. RESULTS: Histological analysis of the TUR specimen confirmed a muscle infiltrating glandular neoplasm (adenocarcinoma) with diffuse areas of cystitis glandularis. Patient evolution has been poor and he is now in the end stage of the disease. CONCLUSIONS: The morphology is not unlike that of colorectal carcinoma, which should be distinguished. The association of areas of cystitis glandularis indicates a possible relationship.

Adenocarcinoma↗
PubMed2000

[Differential diagnosis of intrascrotal calcification: lithiasis attached to hydrocele wall].

OBJECTIVE: To report a case of scrotal calculus in a hydrocele, attached to the parietal portion of the tunica vaginalis, complicating the differential diagnosis. METHODS: A 54-year-old patient with a clinical diagnosis of hydrocele is described. Ultrasound confirmed the diagnosis and demonstrated a calcified structure in the hydrocele fluid, attached to the parietal portion of the tunica vaginalis. A calculus of 1.7 cm diameter was found during the surgical procedure. CONCLUSION: The presence of calculus in a hydrocele does not change the prognosis or treatment of this condition, although some doubts may arise during sonographic assessment if it is attached to the parietal portion of the tunica vaginalis.

Calcinosis↗
PubMed2000

[Non-specific granulomatous epididymitis].

OBJECTIVE: A case of granulomatous epididymitis is presented. METHODS: A 23-year-old patient consulted for nonspecific pain in the left supratesticular region. Physical examination showed a hard, indolent, enlarged epididymis. An ultrasound scan revealed normal testes with small bilateral hydrocele and left epididymal enlargement with calcifications. Resection was performed via the inguinal approach. RESULTS: The histopathological analysis demonstrated intense granulomatous reaction with multinucleated giant cells and foci of spermatozoal remnants. Staining for fungi and acid-fast bacilli were negative. CONCLUSION: The condition was diagnosed as nonspecific granulomatous epididymitis.

Adult↗
PubMed2000

[Pacinian neurofibroma of the vulva].

OBJECTIVE: To report on a rare case of Pacinian neurofibroma of the vulva. METHODS: A 27-year-old patient who presented with a vulvar tumor is described. Patient evaluation showed no other remarkable findings. RESULTS: The nodule was resected without difficulty. The histopathological analysis-demonstrated Pacinian neurofibroma with abundant concentric laminar structures. The immunohistochemical (CD34+), ultrastructural and histological analyses showed perineural cells. No signs of neurofibromatosis were found. CONCLUSIONS: Pacinian neurofibroma may present in the vulva and could probably arise from the so-called perineural fibroblasts.

Adult↗
PubMed2000

[Atypical stromal hyperplasia of the prostate (stromal proliferation of uncertain malignant potential)].

OBJECTIVE: To describe a case of atypical stromal hyperplasia of the prostate. METHODS: A 62-year-old patient presented with prostatic syndrome. Physical examination disclosed an indurated prostate and PSA determination showed increased levels. A prostate biopsy was performed. RESULTS: The histological analysis showed atypical stromal proliferation with elongated nuclei and immunohistochemical expression for vimentine, smooth muscle actin and CD34 with glandular hyperplasia. The diagnosis was that of atypical stromal hyperplasia of the prostate (prostatic stromal proliferation of uncertain malignant potential). CONCLUSIONS: A careful histological study is necessary to make the correct diagnosis of prostatic stromal proliferation of uncertain malignant potential. CD34 expression is a characteristic finding. As its name indicates, its evolution is uncertain.

Cell Division↗
PubMed2000

[Bladder metastasis of signet-ring cell adenocarcinoma from the stomach].

OBJECTIVE: To describe an additional case of metastatic bladder tumor from gastric signet-ring cell adenocarcinoma. METHODS/RESULTS: Local recurrence was demonstrated by gastrointestinal endoscopy and biopsy in a 52-year-old female who underwent total gastrectomy for signet-ring cell gastric adenocarcinoma two years earlier. A CT scan showed bilateral hydronephrosis and diffuse thickening of the bladder wall. Bladder biopsy demonstrated signet-ring cell adenocarcinoma. Palliative treatment with ureteral catheterization was instituted. CONCLUSIONS: Signet-ring cell adenocarcinoma of the bladder is usually a primary tumor. Metastatic signet-ring cell adenocarcinoma to the urinary bladder is uncommon.

Carcinoma, Signet Ring Cell↗
PubMed1999

[Relapse in brucella orchiepididymitis].

This paper describes a case of systemic brucellosis accompanied by brucellar orchitis that resolved favourably. There was however a relapse at the testicular level inappropriately treated that triggered a new episode of systemic brucellosis.

Adult↗
PubMed1999

[Rupture of kidney pelvis in retroperitoneal fibrosis].

OBJECTIVE: To present a case of rupture of the renal pelvis in a patient with idiopathic retroperitoneal fibrosis and no previous dilatation of the left excretory system. METHODS/RESULTS: A patient with retroperitoneal fibrosis underwent surgery for ureterolysis and intraperitonealization of the right ureter. The control IVP was unremarkable. One week later, however, rupture of the left renal pelvis was observed, which was resolved by placement of a ureteral catheter. CONCLUSIONS: In the case described, rupture of the renal pelvis without previous obstruction could be due to ureteral akinesia associated with the retroperitoneal fibrosis.

Humans↗
PubMed1999

[Bilateral hydronephrosis with papillary polypoid cystitis].

OBJECTIVE: A case of papillary polypoid cystitis with bilateral hydronephrosis and an intravesical mass is presented. METHODS/RESULTS: A routine ultrasound evaluation performed in a 64-year-old diabetic female revealed an intravesical mass and bilateral hydronephrosis. There was extensive bladder involvement and the ureteral orifices could not be visualized during endoscopy. Transurethral resection of the lesion was performed. The histological examination showed papillary polypoid cystitis. The urinary cultures were positive, antibiotic therapy was instituted and the hydronephrosis, disappeared. CONCLUSIONS: Papillary polypoid cystitis, although a benign and superficial lesion, can be diffuse, involve both ureteral orifices and cause hydronephrosis.

Abdomen↗
PubMed1999

[The bilateral ureteral metastasis of a medullary carcinoma of the thyroid].

OBJECTIVE: To describe a case of bilateral hydronephrosis arising from a medullary thyroid carcinoma that had metastasized to both ureters. METHODS/RESULTS: A case of bilateral hydronephrosis in an asthmatic 54-year-old female patient who consulted for recurrent bilateral nephric colic is described. The patient presented with severe impairment of renal function. Patient evaluation with imaging techniques could not identify the cause of the hydronephrosis. Bilateral ureteral catheterization improved renal function. The patient died from an episode of bronchospasm. Autopsy revealed a medullary carcinoma of the thyroid that had metastasized to several organs, including both ureters, causing hydronephrosis. CONCLUSIONS: In a patient presenting with bilateral hydronephrosis without a diagnosis of a primary tumor, it is difficult to suspect an underlying metastasis to the ureter. The imaging techniques are unable to detect small metastatic lesions.

Carcinoma, Medullary↗
PubMed1999

[Results of ambulatory major surgery in urology, within an integrated unit].

OBJECTIVE: To contribute our experience in the performance of ambulatory major surgery, through the creation of an integrated unit. Such units take advantage of existing resources both in terms of space and materials, as well as personnel, without the need to open separate ambulatory major surgery units that would involve greater resources expenditure. MATERIAL AND METHODS: 48 patients undergoing ambulatory major urology surgery were analyzed. The patients were admitted the same morning of the procedure and then, after leaving the operating theatre, they were moved to the reanimation room and later to the urology ward, where they were evaluated by the urologist on duty and discharged. A few days later the patients returned to the outpatient's clinic for re-evaluation. RESULTS: 48 patients underwent surgery, 44 male and 4 female. Mean age of patients was 34 (3-86) years. The procedures most frequently performed were: hydrocelectomy, vaginal peritoneum duct closure, orchiopexy, ureterorenoscopy due to ureteral lithiasis, internal urethrotomy, varicocelectomy, vesical tumor resection and circumcision in children. Only in two cases, hospital stay was longer than 12 hours and there was only one re-admission. CONCLUSIONS: Ambulatory major surgery integrated units may allow to perform this type of surgery in small units, with little resources and with a volume of patients not sufficient to create an independent unit.

Adolescent↗
PubMed1999

[A simple renal cyst, the origin of Wunderlich's syndrome].

OBJECTIVE: An additional case of Wunderlich syndrome arising from a ruptured simple renal cyst is presented. METHODS/RESULTS: A 50-year-old female presented with pain, a mass in the left renal fossa and hypovolemia that could not be managed conservatively. The imaging techniques disclosed a large collection of blood in the left perirenal area. Surgical drainage of the hematoma and nephrectomy were performed. A simple cyst containing blood was found in the lower pole of the kidney. Its wall had been ruptured and had caused the hemorrhage. CONCLUSIONS: If surgical management of hemorrhage is decided in a patient with Wunderlich's syndrome, a conservative procedure should be performed and nephrectomy avoided if the underlying condition is benign.

Female↗
PubMed1999

[Erythrocytosis and hydronephrosis in a horseshoe kidney].

OBJECTIVE: To report a case of erythrocytosis in a patient with a hydronephrotic horseshoe kidney and normal erythropoietin values. METHODS/RESULTS: A hydronephrotic horseshoe kidney was discovered during evaluation to determine the etiology of the erythrocytosis in a 23-year-old male with normal erythropietin values. Blood parameters returned to normal following heminephrectomy. The hydronephrosis had been caused by stenois of the pyeloureteric junction. CONCLUSIONS: Although erythropoietin values may be normal, hydronephrosis can cause secondary erythrocytosis.

Adult↗
PubMed1999

[Giant renal lithiasis].

OBJECTIVE: To describe a case of giant renal calculus. METHODS/RESULTS: A 57-year-old female with a previous history of left renal calculus 30 years earlier, consulted for episodes of gross hematuria. The imaging studies showed a giant, spherical calculus, 9 cm in diameter, in the left renal pelvis with hydronephrosis and remaining renal parenchyma functioning. The patient refused surgery. CONCLUSION: Giant renal calculi may progress slowly, without symptoms and without abolishing renal function.

Aged↗
PubMed1998

[Reduction of hospital stay, because of the early removal of the bladder catheter in transurethral resection of the prostate].

OBJECTIVE: To analyze the effects of removal of the bladder catheter 48 hours following transurethral resection of the prostate for benign prostatic hyperplasia in relation to the length of hospital stay and the incidence of important postoperative complications. METHODS: A study was conducted on 117 patients who had undergone TURP at our hospital over a period of one year. They were divided into two groups: group I comprised 55 patients in whom the bladder catheter had been systematically removed 48 hours following the procedure and had been discharged from hospital once they had attained a satisfactory micturition; group II comprised 62 patients in whom the bladder catheter was removed following conventional practice. RESULTS: The mean length of hospital stay for the early catheter removal group was 2.02 days versus 3.85 days for group II. The postoperative complication rate was similar for both groups. CONCLUSIONS: Early removal of the bladder catheter following TURP does not increase the complication rate. It shortens the length of hospital stay and reduces the cost of the procedure.

Aged↗