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Objective: To present a case of giant adrenal carcinoma associated with renal vein and inferior vena cava (IVC) thrombus. Up to now, there is no similar case reported in the national literature., Methods: 75 year old woman with signs of virilization. CT-scan showed an 18 cm adrenal mass with venous thrombus and possible pulmonary metastases. The working diagnosis was primary suprarenal carcinoma., Result: Due to elderly age and advanced stage, including metastasis, we decided to not perform surgery, and initiate chemotherapy., Conclusions: Adrenal Cancer is an infrequent and very aggressive tumor. Surgery is the only curative treatment. In advanced stages chemotherapy is recommended, but with poor results.

Summary Objectives: Case report of a mature cystic teratoma (dermoid cyst), pseudopilomatrixoma like variant., Method: 53-year old patient with a left testicular mass, diagnosed as mature cystic teratoma of the testis(dermoid cyst), the pilomatrixoma-like variant, after radical orchiectomy. Tumoral markers were negative and no extension was observed. The patient is disease-free after 6 months follow-up., Results: Testicular teratoma is a tumour composed of cells derived from the three embryonic layers (ectoderm, endoderm and mesoderm). They can appear at any age, but they are much more prevalent in childhood. They appear at any age, but are much more common in childhood, where they comprise up to 30% of all tumours. They are much less prevalent in adults,representing only 7% of all testicular germ cell tumours, Conclusions: Prepubertal cases are invariably benign in nature, regardless of their histology. However, cases which appear after puberty are potentially malignant, even if histologically pure. Mature cystic teratoma (dermoid cyst) is the only exception to this rule, as no malignant degeneration of these types of tumours has been published.

Objectives: Transitional cell carcinomas (TCC) of the bladder are usually aggressive and may produce bone metastases that infiltrate the bone marrow. Most of these cases present with bone symptoms and metastases and are detected with imaging tests. It is extremely rare for asymptomatic patients with a normal bone scan to have bone marrow involvement (anaemia and thrombocytopenia) due to tumour infiltration. We aim to examine that state with a case report., Methods: We present the case of a 41-year old male with infiltrating TCC of the bladder, who presented with isolated, unexplained anaemia and thrombocytopenia after radical cystoprostatectomy. A bone marrow puncture was required, in which metastatic infiltration was revealed. We performed a literature search of similar cases., Results: There are very few cases of TCC with bone marrow infiltration which become apparent only through haematological changes and have normal imaging tests., Conclusions: Patients with infiltrating carcinoma of the bladder with isolated haematological changes and a negative extension study should be assessed by bone marrow puncture for correct staging and to be able to offer the best treatment.

Objectives: To report the case of a 47-years-old woman with several small stones located inside a calyceal diverticulum of the right kidney and to highlight the importance of minimally invasive endourological treatment in these cases., Methods: Owing to the presence of diverticular calculi and clinical symptoms of recurrent infection, we decided to perform percutaneous nephrolithotomy (PNL). After Holmium-YAG laser calculi fragmentation and removal of all stone material, we fulgurated the diverticular lining and infundibulum with a resectoscope and a rollerball electrode., Results: The patient is free of symptoms after 6 months follow-up. The disappearance of the calculi and diverticulum is confirmed with excretory urogram., Conclusions: Endourological approach for diverticular calculi, such as percutaneous nephrolithotomy (PNL), is a minimally invasive treatment with excellent results and low morbidity. Using this procedure we are able to perform stone removal and cavity fulguration. According to this, we think that endourological techniques, and specially PNL could be the first option for treatment in selected cases of this pathology.

Objectives: Lithiasic pathology continues being very prevalent in our environment. There are multiple approaches and treatments to solve it in current urology. Lately, endourological techniques have suffered a spectacular advance which has permitted to increase their success rates, diminishing also their comorbidity very much. Nevertheless, despite all improvements we still face a series of complications that may reduce the success of the procedure. Among all of them, we emphasize stone retropulsion during endoscopic lithotripsy, because it appears in an important number of procedures and, it does not only diminish the range of stone free patients, but also is associated with a longer surgical time, and occasionally will make necessary the employment of additional procedures that increase cost and treatment morbidity. To reduce the incidence of this retropulsion classical manoeuvres have been employed: antitrendelenburg, decrease of the intensity of the irrigaton flow, modification of laser parameters, or pneumatic balloons. Currently, we have other more effective mechanisms to combat it, among them: the devices that occlude the ureteral lumen, and nitinol baskets/forceps. Adequate selection of the stone extraction device may be definitive for completion of the ureterorenoscopic procedure with success, and in the programmed time. The election of an inadequate device may make the procedure impossible or cause iatrogenic damage to the urinary tract. For all it, specific instruments to entrap and extract stones (baskets and ureteral lumen occlusion devices) is an armamentarium that every endourologist should be familiar with.

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: 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.

Objective: To state the scarce incidence of this prostatic pathology and the relative confusion with terminology applied to the presence of intraprostatic melanin pigments., Methods/results: 66-year-old patient with elevated serum PSA with the diagnosis of prostatic blue nevus after biopsy., Conclusions: This diagnostic finding has not clinical or prognostic significance. They are benign lesions that must not be confused with other similar more aggressive lesions.

Objectives: The treatment of patients with a great burden of stones is very difficult and often requires complex treatments including different kinds of surgery, associated in some cases with ureteral stents., Methods: We present the case of a patient with complex renoureteral stone disease in whom we used the stone sweeper stent before SWL. The catheter is a 6.5 Fr radial expanding stent with small baskets, a special structure designed to extract small stones < 5mm., Results: The placement and retrieval of bilateral stents were performed without complications, extracting several small stones inside the baskets., Conclusions: The Stone Sweeper stent may play an important role in the treatment of patients with great stone burden; by dilating the ureter and helping the passage of stones and capturing small residual fragments it may decrease the need of new treatments. Currently, more clinic and research tests with this stent are necessary to determine proper indications and associated complications.

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.