Biomedical subjects
Publications and source records attributed to O Bielsa.
We report on a 52-year-old patient with spontaneous intraperitoneal rupture of pyonephrosis. The diagnostic features, preoperative findings and treatment are discussed and the literature reviewed.
Presence of retroperitoneal or mediastinal mature teratomas secondary to metastatic testicle germinal tumours which have not responded to multiple chemotherapy constitute the so called Growing Teratoma. They can either represent the metastasis of a mature teratoma site in the original testicle tumour or the evolution from a non-differentiated lesion during therapy. The first two cases of Growing Teratoma Syndrome published in the national literature are presented here. Both cases had a retroperitoneal growth of the mature teratoma following successful achievement of normalization of serum tumoral markers through chemotherapy with CDDP, Bleomycin, and VP-16 in one case (Hospital Clínico) and with BOMP/EPI (Belomycin, Metrothexate, Vincristine, Cisplatin/Vo-16, Cisplatin, Iphosphamide) in the second one (Hospital del Mar) of a non-seminomatose testicle tumour. After a follow-up of 14 and 9 months respectively the good prognosis of these mature teratomas was verified in both cases, so as in the rest of the literature. We coincide with regard to performing a retroperitoneal lymphadenectomy with exeresis of tumoral masses as the most adequate attitude, both to prevent growth of the mature teratoma and to allow us to discard the presence of residual immature lesions.
A case of testicular malacoplakia and epididymis in a 62 year old man is presented. A literature review is made (only 6 cases describing epididymal malacoplakia have been reported), commenting on the clinical, diagnostic, anatomopathological, pathogenic and therapeutic aspects of malacoplakia.
Secondary vesical amyloidosis is an uncommon pathology and few cases are described in the literature. A suddenly appearing hematuria resistant to treatment in a patient with a diagnosis of systemic amyloidosis is usually the initial sign that guides us to its diagnosis. We present a case of vesical amyloidosis in a patient with systemic amyloidosis secondary to a Rheumatoid Arthritis of length evolution, and which was diagnosed as a result of a pattern of massive incoercible hematuria.
This paper presents one case of cholesteatoma of the left renal pelvis of a horseshoe kidney. This is quite an unusual process presenting an uncertain etiology and originated from a escamour metaplasia of the urothelium. Diagnosis can be made by X-rays and unlike leukoplasia it is not considered to be a pre-malignant condition. Probable etiologies, diagnosis and treatment are commented.
We consider the presence of calcifications in a series of 107 renal masses by means of simple X-ray, echography and CAT, in which 23 cases (21.4%) were found. The most effective exploration for revealing them was CAT (in 13% of the cases, the only one). We found a relative higher frequency of calcification in the benign masses (31%) than in the neoplastic ones (17%). In the latter we found no differences in survival as compared with the non-calcified ones. No pattern of calcification proved characteristic of benignity or of neoplasia. The variety of malignant renal mass most often calcified was the papillary hypernephroma (57.1%).
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Small cell carcinoma of the bladder ("oat cell") is a very uncommon tumor. Its sudden onset, rapid progression to an often fatal outcome and early metastatic spread are the main clinical features of this tumor. Immunohistochemical staining for neuroendocrine markers is positive in a large number of cases. A case of small cell carcinoma of the bladder is described. The clinical course of the patient, as well as the histopathological and immunohistochemical findings are presented.
A retrospective study was conducted in 206 renal carcinomas (RC) that underwent surgery between 1983 and 1992, evaluating those that were diagnosed incidentally. Among this series, 74 cases (35.9%) were incidental renal carcinomas (IRC). The complementary examination that allowed to reach a diagnosis was ultrasound in 58 (78.4%) patients, computerized axial tomography (CT) in 23 (17.6%) and intravenous urography (IVU) in 3 (4%). An evaluation is made of the main prognostic factors (nuclear differentiation grade and pathological stage) and the survival in these patients. The results obtained allow to conclude that IRC display an earlier pathological stage and lower nuclear differentiation grade than the other RC, the difference being statistically significant (p < 0.05). Also, the probability of survival in IRC-diagnosed patients is higher than in those diagnosed with non-incidental RC, the difference being statistically significant (p < 0.05).