Spermatocytic seminoma: a case report

An 81-year-old man with a painless enlargement of the right testis which developed 11 years ago was treated with right orchiectomy without any combined therapy in 1981. This tumor pathologically proved to be spermatocytic seminoma. The patient has been well and has shown no evidence of recurrence for the past 5 years.     

Traumatic dislocation of the testis: report of five cases

Five cases of traumatic dislocation of the testis are described. Dislocation of the testis is a rare injury, with only 93 cases having been reported in Japan. Recent reports have revealed an increased number of motor cycle accidents involving teenage patients. Early surgical management is required, since closed reduction is difficult. We discuss its classification, diagnosis and treatment.     

Parathyroid carcinoma. A report of five cases

Parathyroid carcinoma, although rare, represents 0.5-4.0 per cent of the cases of hyperparathyroidism. The authors have encountered five cases of parathyroid carcinoma in their experience treating 445 patients with primary hyperparathyroidism (1.1%) since 1965. All five patients were women, ranging in age fro 29 to 60 years, and had marked hypercalcemia at the time of presentation, with values up to 26 mg/dl in one case. All the tumors were locally adherent to surrounding structures at the time of parathyroidectomy. Pathologically they were characteristic with a dense sclerotic reaction and fibrous bands criss-crossing islands of parathyroid cells. Three patients with local as well as distant metastases have died as a result of recurrent parathyroid carcinoma (follow-up: 2, 3, and 6 years). The remaining two patients became normocalcemic following resection, and have been asymptomatic for 1 and 7 years, respectively. The overall survival and clinical course, in our limited experience with five parathyroid carcinoma cases demonstrates that the morbidity and mortality in these patients is mainly due to local recurrence with the resultant metabolic disturbances, as has been previously noted in the literature.     

Positive hydrocele cytology accompanying testis seminoma.

Accurate palpation of the testis may be obscured by the presence of a hydrocele. Analysis of hydrocele fluid is seldom reported. We describe the cytologic demonstration of malignant cells within a hydrocele accompanying testicular seminoma. Although this connection is not unexpected, it is only rarely documented.     

Giant seminoma of the left testis: a case report]

A 66-year-old man visited our hospital with a history of a slowly growing left scrotal contents for the past 5 years. Serum beta-human chorionic gonadotropin and lactate dehydrogenase was greatly elevated. The resected mass was 26 cm x 16 cm x 13 cm in size, 2,258 g in weight. It arose from left testis and grew to the left inguinal region. Histologically it was pure seminoma.     

Rotator cuff repair with carbon filament. A preliminary report of five cases

Carbon filament-polylactic acid (CPA) is useful in closing large and massive tears of the rotator cuff. CPA was not used to fill a large gap between the cuff edge and raw bone. In the small number of shoulders (five) repaired with CPA, the best results were obtained in first-time operations. In two patients who had total acromionectomies, the functional results were poor, as expected. CPA-assisted cuff repairs have not yet been shown to be significantly better than repairs with conventional techniques.     

Cervical spinal epidural abscesses. A report on five cases.

The authors report a series of five cases of non tuberculous cervical spinal epidural abscesses. There were neither patients suffering from immunodeficiency syndromes nor drug addicts; all the patients were in their seventh decade; two patients were affected by diabetes mellitus refractory to medical treatment. Retropharyngeal abscess was the main etiological risk factor (two cases); Staphylococcus aureus was cultured in two cases. Gadolinium MRI was necessary for a preoperative diagnosis, planning surgical approach and postoperative prognosis. Surgical debridement was performed via an anterior approach in those cases where the collection was located lower than C4 and did not span more than three vertebral segments; posterior approach, via a laminectomy, was performed in a case of C1-C2 location of the lesion and in a case of involvement of the whole cervical spine. Surgical results were poor in those patients affected by diabetes mellitus, a lesion involving the high cervical segments (higher than C4) or a lesion spanning more than three levels. Medical treatment with MRI follow-up was not undertaken in any of the patients and we opted for surgical drainage in all the cases due to the possibility of a sudden neurological deterioration, caused both by spinal cord mechanical compression and vascular compromission.     

Neuropathic arthropathy of the elbow. A report of five cases.

BACKGROUND: Neuropathic arthropathy of the elbow is rare and characterized by a painless but unstable articulation. The functional capacity of patients with this condition has not been reviewed in detail. METHODS: Five male patients, with an average age of fifty-one years, were treated for neuropathic arthropathy of the elbow. The underlying conditions associated with the arthropathy included syringomyelia, insulin-dependent diabetes mellitus, end-stage renal failure, and two cases of polyneuropathy of unknown cause. Four patients sought medical attention after a specific traumatic event. Peripheral sensory and motor dysfunction was present in each patient. Radiographs of the elbow revealed dislocation, fracture fragmentation, and heterotopic ossification. Our management of the neuropathic elbows centered on maintenance of a functional arc of motion through physical therapy aimed at regaining muscle strength and the use of orthoses for support. Operative treatment was performed for an associated ulnar or radial nerve compression syndrome in three patients, and an open reduction and internal fixation of an unstable proximal ulnar nonunion associated with loose implants was performed in one. RESULTS: The patients were followed for an average of nineteen months, with a range of twelve to thirty-six months. All patients had a pain-free elbow with a functional range of motion at the most recent follow-up examination, and none wished to have further treatment. The operatively treated ulnar nonunion united successfully. All three patients treated surgically for an associated nerve compression syndrome had recovery of nerve function. CONCLUSION: In the face of instability and gross distortion of the joint, the patients in this series demonstrated remarkably good function.     

Compartment syndrome in burn patients. A report of five cases

Compartment syndrome has been observed in five burn patients. In all five patients the diagnosis was delayed and muscle necrosis occurred. Three limbs in two patients required amputation because of complete muscle necrosis, and the function of limbs in the three other patients was affected to different degrees. It is suggested that early limb escharotomies or fasciotomies in patients with full-thickness burns is necessary. Dressing should not be very tightly wound in limbs that have been grafted and the sensory and motor function of fingers or toes must be monitored carefully as well as distal circulation in limbs after operation.     

Spontaneous pneumomediastinum: A report of five cases

Conclusion SPM is a self-limiting disease in which symptoms subside with conservative management in most cases. However, drainage of mediastinal air may be inevitable when vital structures of the mediastinum are severely compromised. In the presence of symptoms which are highly suggestive of SPM, obtaining a CT of the chest will confirm the diagnosis. If not suspected clinically, more invasive diagnostic tools such as oesophagoscopy and/or bronchoscopy may not be warranted in order to rule out perforation of an air containing mediastinal organ.