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lunes, 9 de noviembre de 2009

Cancer Vesical

Paciente masculino con Cancer de Prostata ( operado hace unos dos años ) , ya visto por nosotros hace unos meses atras , por lesion producida en procedimiento de instalacion de sonda Foley de forma inadecuada ( ver iatrogenia-instrumental .)
En la actualidad tiene re-ingreso con diagnostico de Insuficiencia Renal Cronica ( IRC ), Anemia Normocitica Normocromica, Cardiopatia Isquemica, Hipertension Arterial, Infeccion Vias Urinarias.

Analitica

Globulos Blancos 10,200
Hemoglobina 8.7
Hematocrito 27.1
Creatinina 4.1
Urea 98
Examen Orina con mas de 100 leucocitos por campo
Hematies en orina 8-10 por campo

Al examen fisico destaca masa de consistencia petrea en hipogastrio, no movilizable, no dolorosa

En la sonografia encontramos

Dilatacion Hidronefrotica bilateral de ambos riñones ( fotos 5-6-7-8 )
Signos sonograficos de Insuficiencia Renal Cronica ( fotos 5-6-7-8 )

Masa solida ,ecogena, infiltrante, localizada en base y pared lateral derecha de vejiga, con bordes libres irregulares, mide 10,6 X 6,9 X 7,3 cms. El contenido de orina es escaso porque la masa ocupa ¾ parte de la luz vesical ( el paciente no tiene sonda vesical, orina por rebosamiento ).
Nuestro criterio es que se trata de Cancer Vesical por metastasis de vecindad del Cancer Prostatico ( fotos 1-2-3-4 ).


Bladder Cancer


Male patient with Prostate Cancer (already operated for about two years), as seen by us some months ago, for injury sustained in installation procedure of Foley inappropriately (see iatrogenic-instrumental )
Currently it has re-admission with a diagnosis of chronic renal failure (CRF), normochromic normocytic anemia, ischemic heart disease, Hypertension, Urinary Tract Infection.

Analitica

White blood cells 10.200
Hemoglobin 8.7
Hematocrit 27.1
Creatinine 4.1
Urea 98
Urine Test with more than 100 leukocytes per field
Red cells in urine 8-10 per field


On physical examination mass of stony consistency stands in hypogastrium not mobilized, not painful

In the sonography are

Bilateral hydronephrotic dilatation of both kidneys (photos 5-6-7-8)
Sonographic signs of chronic renal failure (photos 5-6-7-8)

Solid echogenic mass, infiltrating, located on base and right lateral bladder wall, with irregular free edges, it measures 10.6 X 6.9 X 7.3 cms. The content of urine is limited because the mass occupies ¾ of the bladder lumen (the patient has no urinary catheter, urine overflow).
Our view is that this is for Bladder Cancer metastasis of prostate cancer Neighborhood (photos 1-2-3-4)





























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