Retroperitoneal space is called sometimes no man�s land�and for a good reason: this is disputed anatomical territory for many surgical and medical specialties. Their wide histological diversity and unspecific clinical presentation make them a challenge for the surgeon. In order to improve their detection immunohistochemistry seems to show promising results. Methods of detection have evolved over time to identify as much as possible the histological type of tumor. Because of this extreme variability immunohistochemistry through its various markers is the one that often sets the definitive diagnosis, the simple histopathological examination being insufficient. This paper aims to highlight the main markers used in retroperitoneal tumors. As it can be seen there is a huge histologic areal for these tumors. Some have proven some of them still not. Given the fact that there is a tendency toward personalized therapy it is imperative to identify the histological type of tumor as soon as possible.
The retroperitoneum can host a wide variety of pathologies, including benign and malignant tumors. Primary retroperitoneal tumors are rare, usually large in size, more than half of them being larger than 20 cm at the time of diagnosis, due to their silent growth. They often present several therapeutic challenges because of their rarity, relatively late presentation and anatomical location, often in close relationship with several important structures in the retroperitoneal space. Extensive surgery is often required because of the intimate relationships with vital organs in the retroperitoneum. Retroperitoneal sarcomas frequently involve major vessels, originating from them or secondarily encase or invade them, requiring major vascular resections, with increasing morbidity. The main intervention that can increase the survival of patients with retroperitoneal tumors is radical resection. The involvement of large retroperitoneal vessels often makes impossible a radical intervention, usually because of the lack of an adequate material for ample and laborious vascular reconstruction. In this paper, a thorough search of the PubMed database was performed, to bring into the light the implications of vascular involvement in primary retroperitoneal tumors and the need of a strong cooperation between the urological or general surgeon and the vascular surgeon.
Even if today�s standard procedure for diagnosis of prostate cancer is transrectal ultrasound guided prostate biopsy ( TRB), transperineal ultrasound -guided template biopsy (TPTB) is a safe procedure because the infectious complication have been increasing, with a detection ratio even better than TRB. We consider that TPTB can be the gold standard biopsy. To assess the efficiency and safety of transperineal ultrasound-guided template biopsy of prostate (TPTB). We studied prospectively a number of 405 patients who underwent TPTB of prostate as first means of diagnosis from September 2015 to August 2017.The procedure was performed in the surgery room, in lithotomy positon, under local anesthesia, by means of standard freehand method sampling of at least 12 fragments,based on predetermined mapping. The data base included the age of the patient, the PSA level, the prostatic volume, the presence of clinical suspicion at digital rectal examination, the histopathological data and immediate and late post-surgery complications. Prostate cancer was diagnosed in 68.6 % of men ( median PSA level was 11 ng/mL). A higher detection ratio within patients with prostate volume [ 60 mL can be noticed.The average Gleason score was of 7.6. No patient developed any feverish symptom or urosepsis. Given the increasing trend of sepsis ratio as a result of transrectal biopsy of prostate, as well as the increased ratio of antibiotic resistance, we appreciate that the benefit of transperineal approach is important enough in order to perform TPTB as first means as well as routine for all patients. In this report we looked to assess the efficiency and the safety of TPTB as first mean of diagnosis. None of the patients had a previous biopsy by transrectal or transperineal method.
Cystoscopy is the most common assessment method for the lower urinary tract, with the primary goal of establishing pathology management that can occur at this level. The most used method of performing cystoscopy is with white light, but it can lead to omission of lesions, especially when considering millimetric tumor formations. New light source technologies are under development, such as narrow-band cystoscopy. Overall, we examined a total of 416 patients, known with tumoral lesions, in WLI followed by reassessment in NBI at the same time and transurethral resection of tumor biopsy specimens. In 37.5% of the cases, NBI highlighted 1 to 3 tumors in addition to WLI. In 178 cases, tumor formations were newly discovered, and in 238 patients these were recurrent. Histopathological diagnosis indicated the pTa stage in 67.3% of cases, in 27.64% patients presented with pT1 stage and in 5.04% of cases CIS was identified. In terms of grading, G1 was identified in 205 of the cases, 124 patients presenting G2 and G3 occurred in 87 of the cases.
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