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Intravesical protrusion of retropubic osteophyte mimicking a urinary bladder tumour
Protrusión intravesical de osteofito retropúbico que simula un tumor de la vejiga urinaria
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Fluorocholine accumulated in the left ilium (C). This lesion was not observed on scintigraphy (A) or CT (B), but was confirmed by bone MRI (D).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Oelstrom, R. Núñez, P. Sanchez, E. Sanchez-Saugar, L. Garcia-Cañamaque, I. Duran" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Oelstrom" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Núñez" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sanchez" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Sanchez-Saugar" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "Garcia-Cañamaque" ] 5 => array:2 [ "nombre" => "I." "apellidos" => "Duran" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480612001179" "doi" => "10.1016/j.acuro.2011.11.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480612001179?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578612001801?idApp=UINPBA00004N" "url" => "/21735786/0000003600000007/v1_201304251927/S2173578612001801/v1_201304251927/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Intravesical protrusion of retropubic osteophyte mimicking a urinary bladder tumour" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor</span>:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "446" "paginaFinal" => "447" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "B. di Pierro-Giovanni, H. Danuser, A. Mattei" "autores" => array:3 [ 0 => array:3 [ "nombre" => "B." "apellidos" => "di Pierro-Giovanni" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "H." "apellidos" => "Danuser" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "nombre" => "A." "apellidos" => "Mattei" "email" => array:1 [ 0 => "agomat@gmx.ch" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Scienze Ginecologico-Ostetriche e Scienze Urologiche, Universidad Sapienza, Roma, Italy" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Klinik für Urologie, Luzerner Kantonsspital, Lucerna, Switzerland" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Protrusión intravesical de osteofito retropúbico que simula un tumor de la vejiga urinaria" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 792 "Ancho" => 952 "Tamanyo" => 95358 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT-scan of abdomen-pelvis showing a filling defect on the anterior bladder wall due to the symphyseal osteophyte.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The term osteoarthritis describes a common, age-related, heterogeneous group of disorders characterized by focal areas of loss of articular cartilage in synovial joints, associated with varying degrees of osteophyte formation, subchondral bone changes and synovitis. Joint damages are caused by a mixture of systemic factors (genetic inheritance, age, etc.) that predispose to the disease and local mechanism (cartilage lost, bone remodeling, osteophyte formation, etc.) that dictate its distribution and severity. Various genetic abnormalities have been described, but most sporadic osteoarthritis probably depends on minor contributions from several genetic loci. Osteoarthritic joint damages may be associated with clinical symptoms, but the severity of joint disease is only weakly related to that of the clinical problems.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We recently observed a 66-year-old man presenting to our department with a history of macrohaematuria, which occurred intermittently during the previous 2 months in absence of any other sign or symptom. The patient denied recent genitourinary traumas, surgery, infections, previous bladder cancer history or anticoagulant therapy. He underwent retropubic radical prostatectomy 9 years earlier and the actual PSA value was <0.01<span class="elsevierStyleHsp" style=""></span>ng/ml. Physical examination was negative. On urinary cytology, no malignant urothelial cells were identified and the urine culture revealed only erythrocytes and leucocytes, without evidence of infection. Pelvic ultrasonography showed a 3.2<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2.0<span class="elsevierStyleHsp" style=""></span>cm large endoluminal mass located on the anterior bladder wall. Subsequent cystoscopy confirmed this bulge projecting into the vesical lumen, and CT scan of abdomen-pelvis showed a filling defect of the anterior bladder wall due to posterior symphyseal osteophyte secondly involving the urinary bladder (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No treatment was necessary, no further investigation was performed, and the patient was healthy with no signs or symptoms after a 10-month follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In fact, haematuria is the most common finding in bladder tumours. Usually, diagnostic tools include urine cytology, ultrasonography, and cystoscopy with description of the tumour (site, size, number and appearance) and further mucosal abnormalities. Intravenous urography (IVU) or CT of abdomen and pelvis is also performed in selected cases (tumours located in the trigone). However, a transurethral resection of the bladder tumours is essential to make a correct diagnosis and remove all visible lesions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Differential diagnosis between primary bladder tumours and further diseases can be required: in the literature, benign or malignant entities, such as gastronintestinal carcinoma<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> or focal infolding of normal mucosa,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> secondly involving the bladder or mimicking a bladder neoplasm, are already described.</p><p id="par0025" class="elsevierStylePara elsevierViewall">To our knowledge, this is the first report describing an osteophyte from the pubic symphysis presenting as a mass causing vesical impression and mimicking a bladder tumour. Therefore, osteophyte of the pubic symphysis has to be considered also when performing the abovementioned differential diagnosis. In fact, several pathologic processes can involve the symphysis, including infectious, congenital, metabolic, inflammatory, traumatic, and degenerative diseases. The most frequently occurring symptoms are pain and discomfort, and treatment is most often conservative.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In our case, the only sign complained by the patient was the macroscopic haematuria. On the other hand, in presence of macroscopic haematuria, the finding of an intraluminal vesical mass usually leads to perform cystoscopy and a TUR or at least a biopsy, but, in our experience, recognizing the non-neoplastic nature of the lesion enabled us to avoid not required surgical procedures. This suggests that sometimes imaging examinations can be decisive to exclude primary/secondary vesical neoplasms or distinguish between malignant and benign disorders involving the bladder, in order to avoid further unnecessary procedures.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: di Pierro-Giovanni B, Danuser H, et al. Protrusión intravesical de osteofito retropúbico que simula un tumor de la vejiga urinaria. Actas Urol Esp. 2012;36:446–7.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 792 "Ancho" => 952 "Tamanyo" => 95358 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT-scan of abdomen-pelvis showing a filling defect on the anterior bladder wall due to the symphyseal osteophyte.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenesis and management of pain in osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.A. 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Civantos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Urology" "fecha" => "2000" "volumen" => "55" "paginaInicial" => "949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10840481" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudomass of the bladder neck after prostatectomy: report of two cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.J. Halpern" 1 => "L.G. Gomella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2263020255" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2003" "volumen" => "226" "paginaInicial" => "833" "paginaFinal" => "835" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12601184" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000003600000007/v1_201304251927/S2173578612001813/v1_201304251927/en/main.assets" "Apartado" => array:4 [ "identificador" => "6306" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000003600000007/v1_201304251927/S2173578612001813/v1_201304251927/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578612001813?idApp=UINPBA00004N" ]
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