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Objectives: International TNM Staging System for renal cell carcinoma (RCC) classifies as T3b when "tumor grossly extends into the renal vein or its segmental branches, or vena cava below the diaphragm". The finding of microscopic invasion of the vein wall is not taken into account for TNM staging. We analyse its prognostic significance in localized and locally advanced RCC., Methods: From January 1989 to July 2002, 257 RCC were surgically excised. Excluding Von Hippel-Lindau patients and stage IV (TNM 2002), 241 cases were studied in retrospect, with a median follow up of 50.96 months. Histopathological data from the renal vein were available in 216 specimens. There was renal vein wall invasion in 22. We compare the outcomes in this group vs. the group without microscopic involvement of the renal vein wall (n: 194)., Results: Mean age for the group with renal vein invasion (RVI) was 65.02 years. Mean tumour size in the same group was 9 cm, larger than in control group (p<0,001). Thrombus was found in 72.7% vs. 6.2% in the control group. Clear cell carcinoma (77.3%) was the predominant histological subtype. Nuclear grade 2 according to Fuhrman's Classification System accounts for 42.9% of the cases. Metastatic progression risk (HR: 4,86) and death risk (HR: 6,49) are significantly higher in RVI group. When renal vein thrombosis is found, progression and death risks are still higher (HR: 7.22 and 8.38, respectively)., Conclusions: Microscopic invasion of the renal vein wall is a dependent prognostic factor for disease progression and death for RCC. Macroscopic renal vein involvement is an independent prognostic factor. When both factors are found together, disease outcome is worse.

Objectives: Atypical lymphatic spread of germ cell tumors to inguinal lymph nodes has been reported mostly related to prior surgical involvement of the inguinoscrotal region, as in orchiopexy., Methods: A patient with cryptorchidism and failed orchiopexy in his childhood was diagnosed with a testicular neoplasm. Inguinal orchiectomy was performed., Results: Pathological analysis showed classical seminoma spreading into a subcutaneous adjacent lymph node. Further metastatic disease was not found. Patient was treated with adjuvant chemotherapy., Conclusions: We emphasize the need for accurate staging and a multidisciplinary approach when dealing with onco-urological patients presenting with atypical disease.

Testicular plasmacytoma is a very unfrequent plasma cells neoplasm. It is usually an incidental autopsy finding devoid of clinical expression, but it presents sometimes as part of a multiple myeloma and is exceptionally its only location. Bilateral involvement is extremely unfrequent. We report the case of a 58-years-old man diagnosed with multiple myeloma in complete remission who complains about progressive enlargement of both testicles. After ultrasonography and PAAF, bilateral testicular plasmacytoma is diagnosed. Treatment includes surgery (orchiectomy), radiotherapy and chemotherapy. Prognostic is worse when multiple myeloma is associated.

Objective: To report one case of myofibroblastic bladder tumor., Methods/results: We report the case of a 30-year-old woman with recurrent urinary tract infections and incidental finding of a bladder mass after abdominal ultrasound. After TUR, inflammatory myofibroblastic tumor of the bladder was diagnosed., Conclusion: Myofibroblastic tumor (also known as inflammatory pseudotumor or pseudosarcoma) is a benign tumor with mesenchymal origin. Bladder location is very uncommon. It must not be misdiagnosed as a malignant neoplasm. Optimal treatment when arising in the bladder is TUR, with excellent long-term prognosis.

Objective: Solitary fibrous tumours (SFTs) are rare neoplasias that were first reported in pleura, but can occur in different sites. Inguinal location is extremely rare., Methods/results: We report one case of a 74 year old man with a right inguinoscrotal mass with 50 years of evolution. After surgical extirpation, solitary fibrous tumour was diagnosed., Conclusions: The vast majority of solitary fibrous tumours (SFTs) have a benign course. Only a few cases have aggressive behaviour, with local recurrence and metastasis. Treatment is surgical, but we must do a long-term follow up in all cases.

Objective: Tumors of the epididymis are rare. They are unusually benign and adenomatoid tumors are the most frequent. Report of two cases of this kind of tumor of the epididymis., Methods/results: We report two cases of adenomatoid tumor of the epididymis diagnosed at our hospital during last year. Two males, 35 and 54 years old respectively asked for urology consultation about a palpable scrotal mass. They didn't have any other symptoms. Imaging techniques revealed a solid epididymal mass. Epididymectomy was performed. Pathological diagnosis was adenomatoid tumor., Conclusions: The majority of epididymal tumors follow a benign course. In the finding of an epididymal mass, after palpation and imaging tests, organ sparing surgery (epididymectomy) is recommended. We will avoid unnecessary orchiectomies.

Objectives: Bladder leiomyoma is an uncommon mesenchymal benign tumor. It is generally asymptomatic and incidentally detected., Methods: We report a new case managed with transurethral resection without evidence of relapse. A bibliographic search was performed to evaluate the diagnostic techniques, clinical features and treatment options of this rare disease., Conclusions: Bladder leiomyoma is a benign mesenchymal tumor originating from smooth muscle. Biopsy and histological study are required for definitive diagnosis. Surgery is the treatment of choice, and it has an excellent prognosis if resection is complete.

We describe here in a case of genitourinary tuberculosis presenting with a haematuria and a bladder tubercle. Though imaging studies made genitourinary tuberculosis diagnostic feasible, the clinical presentation made runing out malignancy mandatory. Bladder tubercle was endoscopicary removed and histopathological analysis performed.

Objectives: Rupture of the corpora cavernosum is an uncommon pathology requiring immediate treatment. We performed a bibliographic search, and analyzed different diagnostic and therapeutic methods., Methods/results: Two cases of traumatic rupture of the corpus cavernosum are described. The clinical features, penile ultrasound findings and immediate surgical treatment are discussed., Conclusions: Penile fracture is an uncommon pathology. Generally, history and physical examination are enough to establish the diagnosis. Penile ultrasound can help in case of doubt. Most urologists deem immediate surgery the standard therapy.

Amyloidosis of the seminal vesicles is a common finding in autopsies, with increased incidence in older population. It is usually asymptomatic. We report a case of symptomatic localized amyloidosis of the seminal vesicles, with hemospermia and suprapubic pain. Diagnosis was achieved through ultrasound-guided transrectal biopsy. Systemic amyloidosis must be ruled out through proper evaluation. Seminal vesicle enlargement secondary to amyloid deposit may be misdiagnosed as carcinomatous invasion.

Bladder hernia is present in an important number of cases of inguinal hernias. Massive inguinoscrotal bladder hernias are rarer. The association of massive bladder hernia and bilateral ureterohydronephrosis is not often found. According to our knowledge, there have been only seven cases documented in the last ten years. Therefore, we will present a case of renal failure secondary to inguinoscrotal bladder hernia with bilateral obstructive uropathy. Once we have analyzed a clinical case, we will give the diagnosis and treatment for those hernias.

We report a case of small cell carcinoma of the urinary bladder in 71-year-old male patient. Oat cell of the urinary bladder is extremely uncommon, and up to date only 135 cases have been reported in word literature. Histologic, microscopic, and immunohistochemical characteristics are similar to oat cell carcinoma of the lung and other extrapulmonary oat cell carcinomas. We conclude this report with immunohistochemical study with PGP 9.5, neuron-specific enolase a synaptophisine.

Diagnosis of tumours during pregnancy is quite unusual, considering the low frequency of neoplasias in this period (1/1000 pregnancies) as well as the low incidence of bladder cancer in patients under 30, which makes the coincidence of both phenomena quite uncommon. The paper contributes the case of a 28-year old female diagnosed with bladder cancer during her pregnancy.

Urothelial inverted papilloma account for 2.2% of all urothelial tumours. The preferred location is the bladder; they occur singly and are generally benign, although the majority of authors agrees in treating this entity as a tumour of low aggressiveness. The report contributes four cases of inverted papilloma, three in male patients and the fourth in a female. One was located in the renal pelvis. A revision is made of the etiology, clinical signs and symptoms, diagnosis and treatment, as well as their relationship to surface carcinoma, as it occurs asynchronously in one of the cases described.

Objective: This study was conducted to determine the efficacy of our BCG dose and schedule for prophylactic therapy in superficial bladder tumors., Methods: Following complete TUR, 81 mg intravesical BCG were administered weekly for six weeks and for nightly another six times. The patients were evaluated every three months by cytology, cystoscopy and routine analysis., Results: 21/25 patients completed the treatment. At 15.5 months median follow-up, 18/21 (85.7%) were disease-free, 2/21 (9.5%) had recurrence and 1/21 (4.7%) showed disease progression., Conclusions: BCG is the most effective prophylactic therapy for superficial bladder tumors currently available. The ideal dose, treatment schedule and its mechanism of action are as yet unknown.

The essence of self-transfusion is the extraction of a patient's own blood for subsequent infusion to the same patient. The practice of this strategy has become particularly important from the moment the likelihood of AIDS virus transmission through transfusion with homologous blood products became known. This article presents our experience in both open and endoscopic BPH surgery over the period ranging from January 93 to December 94, and analyzes the health care and socioeconomic aspects of that experience.

Endometrial Carcinoma is an uncommon intraductal prostatic tumour, the origin (either from prostatic epithelium or Müellerian) and management (traditional hormonal therapy vs. progestagens) of which has been the subject of vigorous debate. Currently and with the help of the immunohistochemical techniques its origin has finally been confirmed as being prostatic, thus justifying the use of the traditional hormonal therapy applied in prostate acinous carcinoma. The paper contributes one case of Endometrial Carcinoma confirmed by immunohistochemical techniques, as well as a review of the main landmarks in the study of these tumours.

Aztreonam is a monobactam antibiotic with a very specific spectrum of action for gram-negative aerobic bacteria. Since these bacteria are responsible for most of the urinary tract infections, we conducted a study to determine its efficacy in the prophylaxis and treatment of infections in prostate surgery, one of the most common procedures performed in our field. Thirty-two patients received 1 gm Aztreonam at the time of anesthetic induction and q 8 h thereafter to a total dose of 3 gm. Cultures were performed before and 72 h after surgery. Twenty-eight patients had no complications and a sterile urine culture or less than 10,000 colonies, 2 developed wound infection from Staph, aureus and 1 had more than 100,000 colonies of Enterococci in urine. The foregoing findings indicate that Aztreonam is useful for prophylaxis and treatment of urinary tract infections in prostate surgery.

Renal oncocytoma is an uncommon, generally benign tumor of the renal parenchyma arising from tubular cells with typical gross, microscopic and ultrastructural features. We report another case of renal oncocytoma that had been treated conservatively on the basis of the pre- and intraoperative findings. The present case provides further insight into the biological behaviour of this tumor type. Its origin, pathological features, diagnostic and therapeutic difficulties, and prognosis are discussed.