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Testicular tumors are usually managed by radical orchiectomy because of the high incidence of malignant lesions. Epidermoid cyst of the testis is a rare benign tumor, and its differential diagnosis from malignant testicular tumors is difficult.The clinical records of seven patients who attended our hospital with testicular epidermoid cysts were reviewed. Preoperative evaluation consisted of testicular ultrasonography in 6 patients, and magnetic resonance imaging in 4 patients. A peroperative biopsy was performed in four patients.Ultrasonographic appearance was specific for diagnosis of epidermoid cyst in 80% of patients. Pathological diagnosis was made in all biopsies taken during surgery. Conservative management was (tumorectomy or partial orquidectomy) performed in 6 patients (85%).Preoperative imaging findings, gross characteristics of the lesion, and peroperative biopsy results provide adequate information to attempt testis-sparing surgery instead of radical orchiectomy.

Previous studies have shown ocular haemorrhages in choline-deficient rats. The aim of this paper is to study further the relationship between ocular and renal lesions and biochemical alterations in rats fed a choline-deficient diet. Fifty one weanling male Wistar rats, were divided into two groups. Thirty one of them were fed a choline-deficient diet and the rest was fed a choline-supplemented diet ad libitum. Animals from both groups were killed between the fifth and the eighth day. Urea, creatinine and homocysteine concentrations in blood were determined. Eyes were used for light microscopy study; high resolution light microscopy and the study of the retina as "rétine a plat". Kidneys were studied by light microscopy. Choline-supplemented rats did not show ocular or renal lesion. Choline-deficient rats that showed renal lesions, tubular or cortical necrosis, did not always have ocular changes. There were no ocular changes in the only choline-deficient rat without renal lesion. The ocular changes consisted mainly in haemorrhage in both cameras and ciliary and vitreous bodies. Correlations between ocular and renal lesion (r = 0.72, p0.0001, CI 95%: 0.48-0.86); ocular lesion and creatinine (r = 0.86, p0.0001, Cl 95%: 0.72-0.93) and ocular lesion and urea (r = 0.70, p0.0001, Cl 95%: 0.44-0.85) were positive. Choline-deficiency induces ocular haemorrhagic lesions after the development of renal necrosis. The ocular pathology could be due to the immaturity of the ocular vasculature at this age. The hyaloid, choroid and retinal system are involved.

The aim of this study is to value the hearing results obtained in our department following stapedectomy and the reasons of primary failures.We present a retrospective study of 95 stapedectomies in 82 patients, performed from January 1997 to September 2002 at Hospital Xeral-Cies of Vigo (Pontevedra).Medium presurgical audiometric threshold was 65.71 and postsurgical 26.68. Good results were obtained in 84.21% of cases (air-bone gap closure difference under 20 dB), 10.52% had not change in air threshold and the rest deteriorated.We compare our results with other authors and we consider that stapedectomy is a safe surgical technique, but it has important complications and they have to be bear in mind to prevent them.

Tympanoplasty is the surgical technique used to restore the anatomy and function of the middle ear. The tympanoplasty type I or myringoplasty is performed when the ear only has a perforation of the tympanic membrane without any ossicular damage. We present a retrospective study started in 1997 and finished in 2000 with a total of 118 cases who had undergone a myringoplasty along this period of time. The percentage of closure was 85.59% (n = 101). The techniques used were underlay in a 60.16% of the patients (n = 71), overlay in 34.74% (n = 41) and sandwich in 5.08% (n = 6). In the paediatric patients (under 14 years of age) the percentage of a successful graft following surgery was 88% and in the adults 83.87%. More than fifty years have passed. Since Zöllner and Wullstein described for the first time this type of surgery important because of its good results.

Contribution of one case of prostate cancer presenting with a large abdominal mass associated to anaemia and weight loss. Serum PSA level was greater than 10,000 ng/mL. Imaging studies showed large retroperitoneal mass that led to other differential diagnoses. Biopsy revealed findings suggestive of adenocarcinoma with a distinct immunohistochemical pattern. No metastasis was evidenced in bone scan. Complete hormonal blockade resulted in significant decreased PSA levels and almost complete involution of adenopathies, as well as overall improvement.

We report on the case of a 19-year-old man with post-traumatic high-flow priapism that appeared after riding on a mountain bike. Laboratory test (cavernous blood gas measurement) and image studies (color flow Doppler ultrasound and arteriography of the internal pudendal artery) that confirmed the diagnosis are depicted. He was successfully treated with selective percutaneous arterial embolization with autologous blood clot, recovering a normal erectile function.

The endoscopically-guided lateral discharge laser (VLAP) has been considered an alternative in the management of benign prostate hyperplasia (BPH). The purpose of this paper is to describe the technique, results obtained in 20 treated patients, and pathoanatomical findings in those later treated with prostate transurethral resection. Four patients were carriers of an indwelling catheter, while IPSS/QL mean values in the other 16 patients were 23/4. Mean maximum flow was 7.01 mL/s. Assessment after one and two years shows a fall of mean IPSS/QL to 5/1 and mean maximum flow to 15.2 mL/s and 21 mL/s, respectively, but the difference is not significant. This paper also describes the morbidity affecting 65% patients, which is comparable to the retreatment rate (15%) obtained in other series published. The results are similar to those described in the literature although, in our view, the high rate of complications undermines this choice as an alternative in BPH management.

For the last two years we have been testing a protocol for early diagnosis of acoustic schwannoma. We analyzed the results obtained in outpatients of the ENT clinic for ten months. Using the protocol described 10.7% accurate diagnoses, were obtained although in only one diagnosis was made in the intracanalicular stadium that was susceptible to ENT surgery.

A case of malignant priapism is described in a 58-year-old patient with metastatic carcinoma of the bladder. The diagnostic methods and the possibilities of palliative treatment are discussed.

The Authors present a case of giant cystic craniopharyngioma in a child; the tumor, diagnosed by CT scan, was completely removed. The Authors consider this cyst as the biggest one reported in the literature of the last ten years.