Biomedical subjects

M Rebassa Llull

Publications and source records attributed to M Rebassa Llull.

10 recordsLinked to original sources

PubMed2000

[Bilateral germ tumors of the testis. Report of 5 cases and review of the literature].

OBJECTIVE: To know the prevalence of the bilateral germ cell tumours of testis diagnosed in our Department and to review the literature. MATERIAL AND METHODS: 64 patients diagnosed of a germ cell tumour of the testis were followed during an average period of 51.4 months (1-168 months). RESULTS: 5 (7.8%) patients developed a second germ cell testicular tumour. In one patient the tumours were synchronous while in the remaining four were metachronous, occurring in an average interval of 59 months. One patient with a metachronous tumour died as consequence of the second tumour. In two of the five patients risk factors were identified, one presented testicular atrophy and the second referred history of undescended testis. DISCUSSION: The probability of developing a germinal testis tumour between the patients with history of a previous germ cell tumour of the testis is sensibly greater than between the general population. The prevalence of the bilateral tumours of the testis oscillates between 1-5% and approximately 75% will be metachronous. The principal factor that can predict the appearance of a second testicular tumour is the presence of the carcinoma in situ (Cis) in the contralateral testicular biopsy. Except in cases of testicular atrophy or previous history of undescended testis we do not recommend routine biopsy of the other testis.

Adolescent↗

PubMed2000

[Low-flow priapism associated with systemic lupus erythematosus and nephrotic syndrome].

OBJECTIVE: To present a case of priapism associated with systemic lupus erythematosus and nephrotic syndrome. METHODS: A 29-year-old male patient with a history of multiple pathologies consulted at the emergency services with painful priapism of 12 hours' duration. The intracavernosal aspirated blood had a venous appearance. Among the risk factors analyzed, systemic lupus erythematosus and nephrotic syndrome are recognized to cause hypercoagulability, a condition that can lead to low flow priapism. RESULTS: There was no response to lavage-aspiration or intracorporeal administration of an alpha-adrenergic agonist. The high surgical risk of the patient advised against surgery. The priapism gradually diminished until complete remission on the sixth day. The patient has remained without spontaneous erection. CONCLUSION: Systemic lupus erythematosus and nephrotic syndrome can cause low flow priapism. The best treatment is by prevention with adequate antithrombotic prophylaxis.

Adult↗

PubMed1999

[Upper urinary tract tumors: results of treatment and follow-up].

OBJECTIVE: To present the results of treatment and follow-up of 105 patients with tumor of the upper urinary tract. METHODS: A retrospective study was conducted on 105 patients (88 male and 17 female; mean age 68.3 years) with tumor of the upper urinary tract that had been treated from 1975 to 1997. In total 114 functional units were treated, including recurrences and bilateral tumors. The sites of involvement were: ureter (49.9%), pelvis (41.2%) and the entire upper urinary tract (8.7%). Ninety-six percent were transitional cell carcinomas: 4.8% were well differentiated (GI), 68% moderately differentiated (G2) and 26.8% poorly differentiated (G3); 58.6% were superficial, while 41.3% showed tumor invasion into or beyond the muscle layer. Ninety-two of the 105 patients were followed. The SPSS program was employed for the statistical analysis. The survival was calculated by the Kaplan-Meier method and the differences by the log rank test. Multivariance analysis was performed using the Cox regression method. RESULTS TREATMENT: 58% underwent radical nephroureterectomy, 30% were treated conservatively and 11.6% underwent partial resection of the upper urinary tract. Recurrence: 8.7% of the patients showed tumor recurrence. The recurrence rate after conservative surgery was 13.6% and was as high as 80% in the remaining ureter. Metastasis: 22.8% of the patients presented metastasis to the retroperitoneal lymph nodes, bone, liver and lungs. Survival: In the univariate analysis tumor stage, age, radical and conservative surgery were found to influence survival, while stage and surgery (radical or conservative) were found to be statistically important by multivariate analysis. CONCLUSIONS: The treatment of choice for high grade and stage transitional cell carcinoma is by radical surgery, whereas for the superficial and well differentiated tumors, conservative management can achieve similar survival rates while preserving the renal unit and upper urinary tract.

Adult↗

PubMed1999

[Expression of protein p53 in superficial transitional carcinoma of the bladder with differing course].

OBJECTIVE: To determine the prognostic value of p53 protein expression in relation to progression of superficial bladder cancer. METHODS: A retrospective study was conducted in which p53 protein was determined in TUR fragments of 18 patients with superficial transitional cell carcinoma of the bladder with no evidence of tumor progression in the last 6 years and in 13 patients with superficial tumors that had become invasive. DO-7 monoclonal antibody was utilized (+if stained nuclei were more than 25%). RESULTS: Expression of p53 protein was found in 9 patients (50%) with bladder tumors that had not progressed and in 6 patients (46.1%) with bladder tumors that had become invasive (p = 0.83). CONCLUSION: Determination of p53 protein was not related with cancer progression in this series.

Aged↗

PubMed1998

[Rectorrhage as an unusual extrarenal complication after ESWL].

We report a case of rectorrhage due to an hematoma of sigmoid colon post ESWL in a patient with chronic hepatopathy and right ureteral calculus. We comment the clinic and endoscopical study, as well as the review of literature.

Gastrointestinal Hemorrhage↗

PubMed1998

[Asymptomatic renal carcinoma diagnosed based on synchronous metastasis in the thyroid gland].

Secondary tumors of the thyroid are very rare, being the kidney the most frequent place of the primary tumor. The majority of these metastases appear months or years after the primary renal tumor. We report the case of an asymptomatic renal carcinoma discovered after the histological analysis of a thyroidectomy piece. The treatment of the primary renal tumor was radical nephrectomy. Three years after diagnosis and treatment the patient is free of relapse.

Carcinoma, Renal Cell↗

PubMed1998

[Prostatic rhabdomyosarcoma in adults].

OBJECTIVE: To report on two adult patients with prostatic embryonal rhabdomyosarcoma. The literature is briefly reviewed and the clinical, diagnostic and therapeutic aspects of this unusual variety of prostate cancer are discussed. METHODS: Two patients, aged 27 and 34 years, with prostatic embryonal rhabdomyosarcoma are presented. Both cases showed tumor dissemination at the time of diagnosis. Both patients received chemotherapy. RESULTS: A 60% reduction in tumor volume was achieved in one patient, who subsequently underwent rescue surgery and, in spite of a recurrence, is still alive 3 years after the diagnosis. The other patient showed no response to chemotherapy. He refused rescue surgery and was lost to follow-up. CONCLUSION: Embryonal rhabdomyosarcoma of the prostate in the adult is an unusual and aggressive tumor, of rapid growth and progression. Early diagnosis and treatment without delay by radical surgery and chemotherapy are essential to improve the prognosis of this disease.

Adult↗

PubMed1998

[Tumors of the upper urinary tract: epidemiology, clinical, and diagnosis].

OBJECTIVE: To review the epidemiological, clinical and diagnostic aspects of upper urinary tract tumors (UUTT). METHODS: The clinical records of 105 patients with UUTT were reviewed. There were 114 functioning units in total. Data on distribution according to sex, age at presentation, involved side, focality, localization, association with bladder tumor, risk factors, clinical features, radiological and histological findings were analyzed. Descriptive statistical analysis was performed and the means and frequency rates were estimated. RESULTS: Of the 105 patients, 88 (83.8%) were male and 17 (16.1%) were female, accounting for a male to female ratio of 5.1:1. The mean age was 68.3 +/- 10.5 years (range 24-88). The tumor involved the left side in 52 cases (49.5%), the right side in 49 cases (46.6%) and 4 cases (3.8%) had bilateral involvement; 84 (80%) were unifocal and 21 (20%) were multifocal. The pyelocaliceal region was compromised in 41.2% (47/114) of the functioning units, the lumbar ureter in 14% (16/114), the sacral ureter in 7% (8/114), the pelvic ureter in 28.9% (33/114) and the entire upper urinary tract in 8.7% (10/114). UUTT was associated with a bladder tumor in 60.9%. The bladder tumor and UUTT presented simultaneously in 26 cases (29.8%). The bladder tumor presented before the UUTT in 35 cases (40.2%) and in 26 cases (29.8%) it presented after. Smoking was found to be the most important risk factor. Hematuria was the most common reason for consultation (67.6%), followed by flank pain (23.8%), and 13.3% were asymptomatic. The most common urographic finding was a filling defect (46.4%), followed by loss of function (36.8%) and hydronephrosis (20.1%). Loss of renal function was observed in 66% of the cases with metastasis. Histologically, 99% were transitional cell carcinoma, basically moderately differentiated (68.8% grade II) and non infiltrating (58.6% pTa-pT1). CONCLUSIONS: Our findings are largely in agreement with the data published in the literature, although we have found a very high incidence of UUTT associated with bladder tumor in our series.

Adult↗

PubMedDate not supplied

[Hand-assisted laparoscopic nephrectomy].

INTRODUCTION AND OBJECTIVES: To present the number of cases of hand-assisted laparoscopic nephrectomy. This study evaluates our results and difficulties of starting a progresive programme of laparoscopy. MATERIAL AND METHOD: Between november 2003 and november 2005, 35 hand-assisted laparoscopic nephrectomies were carried out, of a total of 45 laparoscopic nephrectomies. 22 radical nephrectomies, 3 simple nephrectomies and 10 nephroureterectomies. The average age of patients was 66 years (47-89). On average, they were overweight (IMC 28,3), with approximately 38% being obese. ASA 2.3 (1-4). The tumors measured 4.8cm on average, and 80% of these were T1. In 28.6% of the cases, they had previously undergone abdominal surgery. RESULTS: One was undertaken in 2003, 17 in 2004, and 17 in 2005. The surgery time was 140 minutes, 130 minutes (80-210) in radical nephrectomies, 135 minutes (120-150) in simple nephrectomies and 163 minutes (80-240) in the nephroureterectomy. Patients began an oral diet 1.7 days later, and were able to get up 1.7 days later. In the case of obese patients, they began an oral diet 2.3 days later and were able to get up (2.4 days) later than those non obese cases. (1.5 and 1.4 days respectively). The average stay has been 5.8 days (3-15). The average stay of the cases without complications was 4.2 days and those that encountered complications 9.7 days. In no cases was there a need for a blood transfusion. In 11.4% we had major complications with an average stay of 11.7 days. In 5.7% of cases there were reconversions, and 5.7% of cases were reoperated. 17.1% had minor complications, with an average stay of 8.8 days CONCLUSIONS: The advantage of hand-assisted nephrectomy is that it allows one to begin a laparoscopy, with a reduced learning time, and with satisfactory results, allowing the incorporation of laparoscopy surgery in hospitals with a reduced annual volume.

Aged↗

PubMedDate not supplied

[Renal leiomyosarcoma. Apropos a case].

OBJECTIVE: To describe an additional case of leiomyosarcoma of the kidney in a patient that presented with nonspecific abdominal pain and a palpable mass. The clinical features, diagnosis and therapeutic aspects, as well as the prognostic factors of this tumor type are reviewed. METHODS: Patient evaluation included US, CT and MRI. The patient underwent a left radical nephrectomy and received adjuvant external radiotherapy. RESULTS: The patient is asymptomatic and has no local recurrence or metastasis 15 months postoperatively. CONCLUSIONS: Leiomyosarcoma of the kidney is an uncommon malignant mesenchymal tumor. To our knowledge, less than 100 cases have been reported in the literature. Its clinical features and the US, CT and MRI findings are not unlike those of renal adenocarcinoma. The treatment of choice is by radical nephrectomy.

Adult↗