D efinimos endometriosis como la presencia de tejido endometrial fuera de la cavidad uterina. Es una patología que aparece con mayor frecuencia en mujeres jóvenes, siendo la media de edad en el momento del diagnóstico entre 25-29 años 1 .La endometriosis se localiza principalmente en los ovarios, ligamentos útero-sacros, peritoneo pél-vico, trompas de Falopio, cuello cervical, vagina y fondo de saco de Douglas. En el aparato urinario es infrecuente (1,2% de los casos descritos, siendo la vejiga el órgano más afecto -84%-) 2,3 .Presentamos dos casos de endometriosis vesical en 2 mujeres, 1 de ellas sin antecedentes de ningún procedimiento o intervención ginecológi-ca. Realizamos además una revisión de la clínica, diagnóstico y tratamiento de esta excepcional patología urológica. CASOS CLÍNICOSCaso 1: Paciente mujer de 30 años con antecedentes de gastritis que acude a nuestra consulta por referir síndrome miccional irritativo que se acentúa en el periodo menstrual. A la exploración RESUMEN ENDOMETRIOSIS VESICAL: DOS NUEVOS CASOS La endometriosis en el aparato urinario es una patología infrecuente, siendo la vejiga el órgano afecto en la mayoría de las ocasiones. Se manifiesta clínicamente con urgencia, frecuencia, dolor hipogástrico y en ocasiones con hematuria. La cistoscopia es la prueba diagnóstica más fiable aunque el diagnóstico de confirmación es histológico.Presentamos 2 casos de endometriosis vesical en 2 mujeres jóvenes, una con antecedentes de manipulación ginecológica, en las que el tratamiento quirúrgico fue satisfactorio. Tras 1 y 3 años de seguimiento las pacientes permanecen asintomáticas.PALABRAS CLAVE: Endometriosis. Vejiga. Cistitis. ABSTRACTVESICAL ENDOMETRIOSIS: REPORT OF TWO CASES Endometriosis affecting the urinary tract is very rare and the most common site of involvement is urinary bladder. The clinical features are urgency and frequency, hipogastric pain and hematuria. Cistoscopic examination is the most valuable diagnostic test but definitive diagnosis requires histologic confirmation.We report 2 cases of endometriosis in 2 young women, one with previously cesarean section, in which surgical treatment was effective. After 1 and 3 years of follow-up respectively the patients remain assymptomatic.
Renal leiomyoma is a rare benign mesenchymal tumor that should be taken into consideration for the differential diagnosis of renal masses, because it would be an indication for nephron-sparing surgery; nevertheless, due to the difficulties to differentiate it from renal cell carcinoma it is not rare that the diagnosis is achieved after histological study of the nephrectomy specimen.
The patient is disease free 18 months after surgery. We emphasize the importance of adjuvant treatment in the posterior evolution of the tumoral disease.
Approximately 15% of cases of renal cell carcinoma present cystic configuration on radiologic and pathologic examination. These lesions are often difficult to differentiate from the multiloculated renal cyst or other benign cystic lesions such as hemorrhagic cyst and so on. We report a case of multilocular cyst of the right kidney complicated with clear cell type renal cell carcinoma in which MRI suggested benign cyst. The diagnosis of complicated benign cyst must be proposed very cautiously and the persistence of doubtful images justifies surgical exploration.
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