[Epididymal adenomatoid tumors. 2 new cases]

OBJECTIVE

To review the different aspects of epididymal tumors, with special reference to adenomatoid tumor of the epididymis (mesothelial neoplasm). Two such cases are reported herein.

METHODS

Two cases of adenomatoid tumor of the epididymis are described. The clinical features, diagnosis and treatment are discussed, within the context of the algorithm recently presented by Pellicé and co-workers.

RESULTS/CONCLUSION

Most of the epididymal tumors are benign and treatment using a scrotal approach will suffice. However, inguinotomy should be performed when the benign nature of the tumor cannot be established unequivocally.

[Gynecomastia and Leydig cell tumor, clinically occult]

OBJECTIVES

An uncommon case of clinically occult Leydig cell tumor of the testis is described. The literature is reviewed with special reference to the difficulty encountered in making the diagnosis.

METHODS/RESULTS

The clinical data of a patient with occult Leydig cell tumor of the testis, whose only remarkable feature was a long history of gynecomastia, are presented.

CONCLUSIONS

A hormonal study and scrotal ultrasound evaluation are essential in the diagnosis of this tumor type and should be performed even in the absence of testicular anomalies on palpation.

[Fibrous pseudotumor of the epididymis]

Presentation of one case of fibrous pseudotumor of epididymis in a 33 year-old patient. Final diagnosis was achieved after surgical exeresis and its pathoanatomical examination. Etiopathogeny, clinic presentation and therapeutical approach are reviewed. Considering, in general, the clinical inespecificity of intrascrotal processes, we believe it is important to know this entity in order to be in a position to address differential diagnosis with truly neoplastic processes.

[Urinary tract involvement as the first clinical manifestation of adenocarcinoma of the colon]

A patient with a previous history of left renal colic and no evidence of passing calculi was admitted to hospital for exacerbation of the urinary condition. The IVP and US evaluation revealed a ureteral stop which appeared to be extrinsic on retrograde uretero-pyelography. Surgery disclosed a large urinoma in the lumbar fossa. The compromised ureteral segment was removed and the pathological analysis of the surgical specimen revealed infiltration from adenocarcinoma. A primary tumor was sought early postoperatively due to irregular constipation referred by the patient. Finally, adenocarcinoma of the sigmoid colon was found. Only 8 similar cases of urinoma from extravasation due to ureteral obstruction secondary to a tumor have been reported in the literature up to 1982.

[Acquired cystic renal disease, bilateral spontaneous renal hemorrhage, and functional renal transplantation. Review of the literature and report of a case]

Presentation of one case of bilateral, retroperitoneal, intracystic and spontaneous renal haematoma in a patient with acquired renal cystic disease (ARCD) and renal transplantation with functioning graft. A literature review is made with regard to the association of ARCD and spontaneous renal haematoma in dialysed patients; also an analysis of the etiopathogenic factors, as well as diagnostic and therapeutical approaches to the above association. No reference has been found in the literature of concomitant ARCD, bilateral spontaneous renal haemorrhage and renal transplantation with functioning graft.

[Nephrectomy following treatment with ESWL of staghorn lithiasis complicated with urinoma]

We report on a female patient that had undergone extracorporeal shock wave lithotripsy for a staghorn stone. We describe the endourological maneuvers that were performed, but had failed to avoid nephrectomy due to renal fistula with urinoma.

[Pulmonary fibrosis secondary to nitrofurantoin]

Herein we report a case of pulmonary fibrosis secondary to chronic administration of nitrofurantoin following radical surgery for a bladder tumor and urinary intestinal diversion. The patient developed pulmonary superinfection and acute respiratory failure. She initially responded to treatment, but relapsed after two weeks. She died from the underlying disease.

[Leiomyoma of the renal capsule. Presentation of a case and review of the literature]

Leiomyoma of the renal capsule is rare and very difficult to diagnose preoperatively. We report on a patient in whom a solid renal mass had been incidentally detected during ultrasound evaluation for a gastroenterological condition. A CT scan confirmed the presence of a solid mass. The intraoperative biopsy showed it was a benign tumor and conservative surgery was performed. According to the literature, this tumor type has, as yet, not been diagnosed preoperatively. However, some angiographic features may indicate the presence of this condition. This is the fourth case of leiomyoma of the renal capsule reported in the literature and the second case treated by conservative surgery.

[Review of 45 cases of renal oncocytomas published in our country, and presentation of 2 new cases]

A review is made on the characteristics presented by the 45 cases of renal oncocytomas published in the specialized literature in our country, which are compared to major publications on the subject in the international literature in which a recent review reports 200 cases. Also, two new cases are presented. These tumours are included within the 17 benign renal tumours accumulated in our centre (11.7%) accounting for 2.27% of all renal tumours diagnosed by our group. The renal oncocytoma opens a significant controversy with regard to its definitive identity and, therefore, with regard to its possible therapy whether radical or conservative.

[Pulmonary fibrosis secondary to nitrofurantoin]

We report a case of pulmonary fibrosis from long-term furantoin therapy after radical surgery for a bladder tumor and urinary intestinal diversion. The patient developed pulmonary superinfection and acute respiratory failure. She initially responded to treatment, but relapsed two weeks later. The underlying pathological condition led to the patient's death.

[Paratesticular rhabdomyosarcoma. Report of 2 cases]

Reporting 2 cases of paratesticular embryonal rhabdomyosarcoma with different locations, one epididymal and one in the testicle tunic vaginalis. In both cases a retroperitoneal disease was present at the time of diagnosis. Although the treatment was similar the clinical evolution has been very different. One patient died 3 years after diagnosis with pulmonary metastasis, the other one is still disease-free 7 years after diagnosis. Discussion of the clinical presentation, differential diagnosis and most important the multidisciplinary therapy used in this type of tumours.

[Solitary contralateral, asynchronous adrenal metastasis of renal adenocarcinoma. Review of the literature]

A case of solitary, contralateral, asynchronous adrenal metastasis that appeared 5 years following nephrectomy is described herein. To our knowledge, ours is the fifth case reported in the world literature.