Biomedical subjects

Oscar Rodríguez Faba

Publications and source records attributed to Oscar Rodríguez Faba.

At least 19 recordsLinked to original sources

PubMed2006

[Determination of P53 in infiltrative primary bladder tumors as a prognostic factor for understaging].

OBJECTIVES: To determine if p53 expression in patients with infiltrative bladder cancer is a prognostic factor on clinical staging and cancer specific survival. METHODS: Immunohistochemical analysis of p53 in 34 patients (33 males and 1 female) undergoing radical cystectomy for infiltrative bladder cancer, with a mean follow-up of 16 months. RESULTS: p53 overexpression was detected in 18 patients (64%). In the p53 positive group two patients were stage T1G3, 18 patients T2, 1 patient T3, and 2 patients T4. In the negative group a better correspondence between TUR and cystectomy stage was found, with stage worsening only in 3 patients. On follow-up, p53 positive patients showed worse outcomes due to their worse stages, although no statistical differences were found (p = 0.24). In the group of patients following a bladder sparing protocol (n = 6), p53 negative patients had complete remission of the disease. CONCLUSIONS: We see significant differences on understaging/more aggressive local outcome in p53 positive patients, with no greater mortality in this group. P53 expression does not contraindicate the inclusion of a patient in a bladder sparing protocol, although larger studies would be necessary to confirm these results.

Aged↗

PubMed2006

[Neurosyphilis and bladder dysfunction].

OBJECTIVES: Syphilis is a systemic disease the course of which follows successive clinical stages. Central nervous system and spinal cord involvement on late phases may lead to bladder dysfunction. We report one case of neurosyphilis with associated bladder hyperreflexia. METHODS/RESULTS: 51-year-old male with the diagnosis of neurosyphilis consulting for voiding disorders with evidence of detrusor hyperactivity of neurogenic etiology on the urodynamic study. CONCLUSIONS: The differential diagnosis of neurogenic bladder in patients with psychiatric or neurological symptoms should include neurosyphilis. Etiologic diagnosis is obtained by cerebrospinal fluid examination, and the diagnosis of bladder dysfunction by urodynamic study.

Humans↗

PubMed2006

[Solitary pararenal fibrous tumor].

OBJECTIVES: To report a rare clinical case of solitary pararenal fibrous tumor, analyzing its pathological characteristics and prognosis by a bibliographic review. METHODS/RESULTS: We present the case of a 36-year-old male consulting for right flank colic pain, which was diagnosed of a solid mass in the lower pole of the right kidney and underwent right radical nephrectomy. Pathological study of the surgical specimen showed the presence of a solitary pararenal fibrous tumor. CONCLUSIONS: Solitary fibrous tumor is a rare neoplasia, being its pararenal localization even rarer. It is a tumor with benign behavior in up to 90% of the cases. The immunohistochemical study is the key to diagnosis.

Adult↗

PubMed2005

[Relationship between LUTS (lower urinary tract symptoms) and quality of life].

OBJECTIVES: To evaluate the impact of the lower urinary tract symptoms (LUTS) included in the IPSS on the quality of life and to determine the relationship between quality of life or total IPSS score and treatment. METHODS: Retrospective review of the IPSS questionnaire in 125 male patients who had consulted for LUTS between January 2001 and December 2003. Results were included in an Access database. Statistical analyses were done with the SPSS 11.0 software. RESULTS: 17% of the patients showed severe symptoms in accordance to the IPSS score. In the quality of life evaluation grouped into two categories, 88% referred good or indifferent quality of life. In the evaluation of the association between IPSS individual questions and quality of life there was a significant association for all questions. Patients reporting worse quality of life had a 6 times higher risk of receiving treatment. With a mean follow-up of two years, 91% of patients who were not on treatment continued without it. CONCLUSIONS: The most severe symptoms are, the worse the quality of life. The independent parameters that most influenced decision to start treatment were quality of life and total IPSS. Frequency, weak stream and hesitation may explain quality of life on each patient.

Adult↗

PubMed2005

[The treatment of urinary incontinence by injectables. Analysis of our series].

OBJECTIVES: To determine the efficacy of endoscopical injections for the treatment of stress urinary incontinence (SUI), evaluating its low invasiveness and positive impact on quality of life. METHODS/RESULTS: Belween 1997--2003 30 procedures of periurethral injection of various substances for urinary incontinence were performed at our department in women between 47-80 years. All patients were evaluated before surgery, clinically and urodynamically, in accordance to international standardized parameters (filling pressure/flow studies, maximum urethral closure pressure, LPP-leak point pressure). The kind of material employed for injection, surgical technique and satisfaction degree were also evaluated. RESULTS: The indication for surgery was SUI in 17 cases (56.6%), and mixed urinary incontinence in 73 cases (43.3%). 16 cases (53.3%) had history of previous surgery for SUI. Regarding urodynamic parameters, 19 patients (63.3%) have a maximum urethral closure pressure below 25 H2O cm, and 22 patients (73.3%) had a leak point pressure below 60 H2O cm. Collagen was employed in six cases (20%) and macroplastic in 24 (80%) (14 of them with the MIS system). 22 patients had three injection sites (73.3%). Mean follow-up was 38 months. Continence outcomes were evaluated in relation to complete continence (12 cases, 40%), mild incontinence and patient satisfaction (11 cases, 36.6%), and severe incontinence (7 cases, 23.3%). CONCLUSIONS: 1-To achieve acceptable results it is mandatory to do the best possible indication (Mc Guire type III SUI). 2.-There is an excellent relationship between minimal invasiveness and good results.

Aged↗

PubMed2005

[Spontaneous regression of venous thrombus in a case of renal carcinoma].

OBJECTIVES: To report the first case of spontaneous regression of renal vein and inferior vena cava thrombus in a patient with renal clear cell carcinoma. METHODS/RESULTS: We describe the case of a woman with the diagnosis of renal mass with venous thrombus of the renal vein and inferior vena cava. Extension studies before radical nephrectomy showed regression of the thrombus which was confirmed during nephrectomy. CONCLUSIONS: Spontaneous regression of clear cell renal carcinoma metastases is estimated below 1 % of the cases. This is the first case report of regression of a tumoral thrombus of the renal vein and inferior vena cava.

Aged↗

PubMed2004

[Renal cell carcinoma with late lung and ocular metastases].

OBJECTIVES: We report one case of ocular and lung metastases seven years after radical nephrectomy for renal cell carcinoma. METHODS: The case of a 45-year-old male patient who underwent radical nephrectomy for a localized renal cell carcinoma (T2N0M0) in 1995 was found in a review of malignant renal neoplastic pathology. RESULTS: Seven years later he presented with a lung metastasis requiring neumonectomy, and an ocular metastasis requiring enucleation. He is currently receiving systemic treatment with interferon and interleukin. CONCLUSIONS: Clinical presentation and evolution of metastasic renal carcinoma is very variable, a difference with other neoplasias. Ocular localization is exceptional and may appear long time after primary tumor; clinically, it may be asymptomatic or present with sudden sight loss. MRI, CT scan and retinal examination are the diagnostic methods employed, and treatment may be surgery, brachytherapy or radiotherapy depending on location and size of the lesion.

Carcinoma, Renal Cell↗

PubMed2004

[Treatment of a cavernous hemangioma of the bladder by endoscopical resection].

OBJECTIVES: We report three cases of bladder hemangioma. METHODS: Three cases of cavernous hemangioma of the bladder with pathologic confirmation treated by endoscopical resection. RESULTS: There is no evidence of recurrence in either patient after resection. CONCLUSIONS: The endoscopical treatment of small bladder hemangiomas is an effective treatment.

Adult↗

PubMed2004

[Urinary stone in a Bricker's ileal conduit].

OBJECTIVES: To report one case of urinary stone as a relatively frequent complications of urinary diversion using bowel loops. METHODS: We perform a short bibliographic review using the case report format. RESULTS: Stone formation in Bricker's type urinary diversion is secondary to various factors such as urinary stasis, bacteriuria, presence of intestinal mucus, metallic sutures, metabolic disturbances, etc. CONCLUSIONS: Periodic control by radiological studies is recommended due to the high frequency of this complication in patients with urinary diversion. Treatment is usually conservative or minimally invasive, being surgery reserved for those cases in which stone extraction is not safe using other methods.

Humans↗

PubMed2004

[Obstructive urethral angioleiomyoma].

OBJECTIVES: To report one case of urethral angioleiomyoma because of the rare site, and to review its main characteristics. METHODS: We report one case of male urethra angioleiomyoma presenting with obstructive symptoms. RESULTS: We performed excision and end to end anastomosis of a small bulbar urethra stenosis. Pathology reported angioleiomyoma. CONCLUSIONS: Angioleiomyoma is a benign tumor arising from smooth muscle within blood vessel walls. It is extremely rare in the urethra. It is more common in females. Recurrence and metastasis are exceptional. It shows scarce or moderate cellularity with predominance of fusiform cells. They may express smooth muscle vimentin, desmin, and actin. The best therapeutic option is resection.

Aged↗

PubMed2003

[Utility of computerized tomography in determining the extent of infiltrating bladder tumors: our experience].

OBJECTIVES: To evaluate the reliability of bladder transitional cell carcinoma (TCC) staging, comparing findings on computerized tomography (CT) with pathologic results after radical cystectomy. METHODS: We retrospectively review 115 consecutive patients with bladder TCC undergoing radical cystectomy. Preoperative CT findings were compared with pathology results obtained after cystectomy and lymphadenectomy. RESULTS: We found that as a whole CT showed a tendency to local overstaging of 27.8% for tumours infiltrating bladder wall only, and understaging of 36.5% Regarding lymph nodes involvement, CT overstaged 4.6% of patients and understaged 23.8%. CT was capable to detect only 7.15% pN positive cases. CT was unable to detect the only patient with intra-abdominal metastatic involvement. CONCLUSIONS: Abdomino-pelvic CT has real limitations to detect extra vesical extension and lymph node metastasis in patients with bladder TCC.

Abdominal Neoplasms↗

PubMed2003

[Extra adrenal pheochromocytoma. Report of two cases].

OBJECTIVES: To review two cases of extra adrenal pheochromocytoma. METHODS: We present two cases: a 75-year-old patient with history of high blood pressure and intravesical tumor compatible with urinary bladder paraganglioma, and a 59-year-old patient with a retroperitoneal tumor arising from para-aortic ganglia. RESULTS: Diagnosis was made by CT scan and transurethral resection in the first case, all posterior extension studies were negative; in the second case retroperitoneal exeresis surgery was performed after CT scan. CONCLUSIONS: Extra adrenal pheochromocytomas are catecholamine producing tumours, which determines their clinical features; treatment should be surgical. A bibliographic review about this disease is performed.

Adrenal Gland Neoplasms↗

PubMed2003

[Assessment of the Gleason score in biopsies and specimens of radical prostatectomy].

OBJECTIVES: To evaluate the similarity between Gleason grade on prostate biopsies and their final result after radical prostatectomy. METHODS: We retrospectively review the medical records of 129 patients who underwent radical prostatectomy. Mean PSA value was 10.7 ng/ml. The relationships between pathological reports of biopsies and radical prostatectomy specimens, and other variables such as PSA were established. RESULTS: Globally, 72 cases (55.8%) were in the same risk group by grade on biopsy and surgical specimen. Biopsy result was understaged in 48 cases (37.2%) and overstaged in 9 cases (7%). We found biopsy understaging in 42 cases (60%) in the low grade group, 6 cases (10.9%) in the intermediate grade group, and 50% in the high grade group, although in this latter the number of cases was very low. CONCLUSIONS: Overall biopsy understaging was 37.2%, being much more evident in low grade tumors (60%). It seems that understaging was greater when PSA > 10 ng/ml, although differences were not significant.

Biopsy↗

PubMed2003

[Giant bladder diverticulum presenting as inferior vena cava syndrome].

OBJECTIVES: To report the case of a giant bladder diverticulum clinically presenting with symptoms of inferior vena cava compression. METHODS: Patient under study because of inferior limbs edema who underwent ultrasound that found a giant bladder diverticulum. RESULTS: Diverticulectomy plus adenomectomy were performed. CONCLUSIONS: Acquired giant bladder diverticula are very rare; they should be treated surgically to avoid possible complications.

Aged↗

PubMed2003

[A new case of bladder endometriosis in a patient with a history of Cesarean section].

OBJECTIVES: To report one new case of endometriosis in a patient with history of caesarean section. METHODS: It is the case of a female patient presenting with voiding symptoms and hematuria, with a bladder tumor on ultrasound. RESULTS: After TUR of a retro trigonal tumor pathology report showed bladder endometriosis. Treatment was completed with hormone therapy, being the patient relapse free at one year follow-up. CONCLUSIONS: History of caesarean section is one of the possible etiologies of bladder endometriosis.

Adult↗

PubMed2003

[Non-obstructive azoospermia: 2 new cases of Sertoli cell only syndrome].

OBJECTIVES: We report 2 cases of Sertoli cell only syndrome and perform a bibliographic review. METHODS: Clinical and pathologic study of 2 male patients 33 and 37-year-old respectively who presented with infertility. RESULTS: Testicular biopsy, the most important diagnostic test in the study of infertile men, showed bilateral Sertoli cell only syndrome. CONCLUSIONS: The Sertoli cell only syndrome is an entity in which seminiferous tubules show a total absence of germ cells with Sertoli cells alone. Etiology is unknown in most cases. Testicular biopsy is performed in these azoospermic men to rule out tubular obstruction or abnormalities of the spermatogenesis. Assisted reproduction techniques are a therapeutic option, making genetic counselling necessary due to the risk of transmission of the genetic defects that cause male infertility.

Adult↗

PubMed2003

[A chicken bone as cause of Fournier gangrene].

OBJECTIVES: Fournier's gangrene is a synergistic infective necrotizing fascitis, which involves perianal, perineal and genital regions, with rapid evolution and severe prognosis. We perform a literature review and report a recent case. METHODS: We report the case of a male patient who presented with scrotal pain and history of excretion of a chicken bone in a bowel movement. RESULTS: Despite aggressive surgery and wide spectrum antibiotic, the prognosis severe and the mortality is high. CONCLUSIONS: Rapid and accurate diagnosis remains the key to achieving a successful outcome. Early, wide and repeated debridement procedures reduce the mortality.

Foreign-Body Migration↗

PubMed2002

[Clinical presentation of testicular germinal cancer].

OBJECTIVE: To review the clinical features in our series of patients of germ-cell testicular cancer. METHODS: The charts of 73 patients with diagnosis of germ-cell testicular tumours were reviewed. Age, history of cryptorchism, time to diagnosis, main symptoms, and serum markers values (alpha- fetoprotein and beta-HCG) were analysed. All cases underwent orchiectomy and extension study with abdominal CT-scan and either chest X-ray or Thoracic CT-scan. We follow the AJCC-UICC 1997 stage classification. Histological cell line, size, and clinical stage at presentation (local, regional and distance) have been analysed also. RESULTS: Among 73 germ-cell testicular tumours 34 were seminomas (46.6%) and 39 were non-seminomatous (54.4%). Clinically, 58.9% of the patients had localised stage I tumours. On presentation 85.7% seminomas were stage I compared to 35.9% non-seminomatous tumours. The remaining tumours were diagnosed in advanced phases (stages II and III). Inguinal orchiectomy was performed in all patients except 5 in whom tumours were incidentally diagnosed (atrophic testis orchiectomy, hydrocoelectomy, trauma) and needed a second operation including ipsilateral scrotal excision. When size, cell line and primary tumour T category were reviewed we found that 32.3% seminomas and 20.5% non seminomas were smaller than 4 cm. 50% seminomas and 49.7% non seminomas were pT1; 41.2% seminomas and 28.2 non seminomas were pT2; finally 8.8% seminomas were pT3 compared to 23.1% non seminomas. Vascular infiltration, also evaluated in this chapter, was present in 38.2% seminomas compared to 38.5% non seminomas. Elements of embryonal carcinoma were found in 37 non seminomatous tumours, either isolated (14) or associated with other components. Teratoma appeared in 18 non seminomatous tumours, 16 of them associated to embryonal carcinoma alone or together with other components. Elements of choriocarcinoma and endodermal sinus were evident in 5 and 4 cases respectively, always associated with other elements. CONCLUSIONS: Seminomas clinical presentation substantially differs from that of non seminomatous testicular tumours in age, clinical features, stage and histological aggressiveness.

Adolescent↗