ABSTRACT: Adenocarcinomas of the upper urinary tract are very rare malignancies often related to primary genitourinary and extraurinary tumours. Primary adenocarcinomas are even rarer. There are no clinical guidelines for the management of primary ureteral adenocarcinoma. Our objective is to propose a management algoritm of this sort of tumours.
We report a case of adenocarcinoma affecting a ureteral stump in a patient who previously underwent a nephrectomy. A review of literature is performed.
After the ureterectomy the pathologist diagnosed a ureteral adenocarcinoma. We performed an extension study in order to discard an extraurinary origin.
Adenocarcinoma of the ureteral stump is a very rare malignancy. About the clinic and pathologic characterization, there is no an established reference due to the short number of previous reports. Clinical presentation may include previous nephrectomy, flank pain, dysuria, urgency and/or gross hematuria. It seem necessary the complete resection of the urinary tract when a nephrectomy is performed. Adjuvant chemotherapy can be employed with uncertain results.
Actas urologicas españolas 07/2009; 33(6):691-5. · 0.46 Impact Factor
Actas urologicas españolas 05/2009; 33(4):453. · 0.46 Impact Factor
ABSTRACT: Stab wounds of the kidney have traditionally been managed by open surgery. Nowadays the conservative management of stab wounds injuries is extended in order to avoid unnecessaries nephrectomies and laparotomies without increasing morbidity and mortality. Although there is no a strong evidence to recommend when to operate or what sort of follow up we must do.
We present two new cases of stab wounds injuries managed conservatively. We performed a systematic review of the literature.
Both patients evolved favorably although one of them presented hematuria 7 days after the traumatism and we performed an embolization of an arteriovenous fistula. Most of the articles are based on series of cases or retrosprospective studies.
The diagnosis and staging of stab wounds of the kidney must be done with clinic and CT scan. Conservative management is required when the patient is not hemodinamically unstable and injuries do not require inmediate repair. These patients require a long-term follow up to prevent the appearance of complications. Randomized prospective multicenter trials are needed to support the optimum management for each kidney injury degree.
Actas urologicas españolas 33(7):830-4. · 0.46 Impact Factor