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ABSTRACT: To report two new cases of Ewing's sarcoma/primitive neuroectodermal tumor of the kidney, one of them with tumor thrombus in cava.
Characterization of two new cases and literature review by PubMed search.
We report the cases of two men diagnosed with primary renal Ewing's sarcoma, who have been treated with nephrectomy and adjuvant chemotherapy, being in complete remission to date.
Ewing's sarcoma / primitive neuroectodermal tumor of the kidney is a rare condition that mainly affects young adults. The natural history of these tumors is the evolution towards metastatic disease and death. Treatment is multimodal, combining surgery and chemotherapy. The role of radiotherapy is not well established.
Archivos españoles de urología 09/2011; 64(7):636-9.
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European journal of obstetrics, gynecology, and reproductive biology 06/2011; 158(2):368-9. · 1.97 Impact Factor
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ABSTRACT: To review the unusual localizations of metastasic prostate cancer with the contribution of a clinical case of prostatic adenocarcinoma metastasis in the thyroid cartilage.
49-year-old-male admitted with history of 48 hour hematuria associated with lumbar pain radiating to the lower extremities and cervical tumour for 3 months.
CT scan of the thorax, abdomen and pelvis was performed showing an insufflating lesion on the left thyroid cartilage lamina suggesting chondrosarcoma, a 4 cm tumour on the posterior side of the bladder, and metastases on L4-S1 vertebral bodies and left iliac bone. Cystoscopy revealed an image on the posterior vesical wall suggesting prostatic infiltration by a tumoral process without evidence of urothelial tumors. PSA was 617 ng/ml. Digital rectal examination: Prostate with augmented consistency. Due to these results an ultrasound-guided transrectal prostatic biopsy was performed with the pathological result of Gleason 8 prostatic adenocarcinoma involving boths lobes. Complete androgen blockade with Bicalutamide and Goserelin was started with good response lowering the PSA level down to 29 ng/ml. Regarding the cervical mass suggestive of thyroid chondrosarcoma a left vertical partial laryngectomy was performed with replacement of the thyroid cartilage by septal cartilage. Pathological study of the piece revealed the presence of prostatic adenocarcinoma.
Metastatic prostate cancer in the thyroid cartilage is exceptional, there being only five cases described in the literature. This fact, linked to the scant frequency of tumours lying in this cartilage and diagnosis by means of radiological suspicion, makes it very difficult to include metastatic prostate cancer in the routine differential diagnosis of cervical masses.
Archivos españoles de urología 03/2011; 64(2):132-5.
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ABSTRACT: To determine whether a 10-core prostate biopsy scheme is superior to the sextant scheme in diagnosing prostate cancer in patients programmed for a first biopsy, with negative rectal digital examination and PSA between 3.5-20 ng/ml.
A randomized prospective study was performed comparing two prostate biopsy schemes, with randomization stratification according to prostate volume (< or = 50 ml and > 50 ml). Sample size predetermination yielded a minimum of 304 patients in order to achieve the primary objective. Statistical analysis was carried out on an intent-to-treat basis, using the chi-squared test and uni- and multivariate analysis via logistic regression.
Cancer was detected in 27.3% of the cases. A significant association was observed between cancer diagnosis and age (p=0.03), prostate volume (p=0.0001) and ultrasound nodule identification (p=0.0001). No correlation was observed with the total number of cores in the series (p=0.37) or with prostate volume < or = 50 ml (p=0.87) or > 50 ml (p=0.09). In the multivariate analysis, age > 70 years (p=0.005), prostate volume < or = 50 ml (p=0.001), and ultrasound nodule identification (p=0.003) were identified as independent variables associated to cancer diagnosis.
No statistically significant differences were found between the two prostate biopsy schemes. In glands over 50 ml in size, the sextant scheme may prove to be insufficient.
Archivos españoles de urología 03/2010; 63(2):107-16.
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ABSTRACT: We review the presentation, diagnosis and treatment of Mondor's disease of the penis, with the contribution of a new clinical case.
A 43-year-old male reported to the emergency room with preputial inflammation and edema associated to swelling of the dorsal region of the penis for the previous three weeks.
Doppler ultrasound revealed thrombosis of the superficial dorsal vein of the penis, associated to candidiasic balanitis. Treatment was provided in the form of nonsteroidal antiinflammatory drugs and antibiotic and antifungal agents. The symptoms disappeared after 7 days of treatment, followed by the development of punctate phimosis that required circumcision.
Mondor's syndrome is an infrequent condition usually caused by trauma, though it is important to consider the possibility of associated coagulation problems, infections and neoplastic processes. Doppler ultrasound is the technique of choice for confirming the diagnosis and resolution of the condition. Treatment is based on nonsteroidal antiinflammatory medication, antibiotherapy and sexual abstinence. The use of anticoagulation is controversial, but may prove useful in patients with coagulation disorders.
Archivos españoles de urología 06/2009; 62(4):317-9.
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ABSTRACT: To analyze safety and efficacy of KTP green laser photovaporization for the treatment of lower urinary tract obstruction caused by benign prostatic hyperplasia based on data from the medical literature.
Most articles consulted emphasize its low complication rate, efficacy, and short learning curve. They have the limitation that most papers are not comparative, the number of patients included is low, and follow-up in many of them short.
Prostatic vaporization with KTP laser is today an alternative to TUR, more in patients with comorbidities, due to its low complication rate. Nevertheless, we accept it is an expensive technology and more follow-up is required to confirm the results remain.
Archivos españoles de urología 12/2008; 61(9):1023-7.
