[Intravesical therapy: Influence on superficial bladder cancer recurrence]

OBJECTIVES

To review the influence of various intravesical treatments on superficial bladder cancer recurrence.

METHODS

We retrospectively reviewed 473 superficial bladder neoplasias. Based on diagnosis and transurethral resection of bladder tumor (TUR BT), and depending on pathology, we proposed different adjuvant treatment and follow-up schemes.

RESULTS

The following factors were independent risk factors for a longer recurrence-free time: intravesical instillations, high dose BCG, and maintenance therapy in comparison to induction.

CONCLUSIONS

The use of intravesical instillations independently increases the time to recurrence. It was demonstrated that recurrence was significantly later when high dose BCG and maintenance therapy were employed.

[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.

[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.

[Cystic hamartoma of the renal pelvis: unfrequent finding]

OBJECTIVES

This cystic hamartoma of the renal pelvis is a very unfrequent benign tumor. We report one case emphasizing its histology and performed a bibliographic review.

METHODS

Mid age female patient with the incidental diagnosis of a renal mass taking up the pelvis.

RESULTS

A radical nephrectomy was performed with the pathologic report of cystic hamartoma of the renal pelvis.

CONCLUSIONS

It is a cystic renal tumor with well-defined histologic and immunohistochemical criteria, and it probably does not involve any danger for the patient's live.

[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.

[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.

[Clinical course of epidermoid carcinoma of the penis in our series]

OBJECTIVES

To study the evolution of 49 patients with squamous cell carcinoma of the penis.

METHODS

49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases.

RESULTS

There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis.

CONCLUSIONS

Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.