Tunica albuginea cyst associated with hydrocele testis: report of a case]

The patient is a 54-year-old male presenting with a chief complaint of a right intrascrotal mass. Ultrasonographic image of the right testis demonstrated a marginally located cyst, 5 mm in diameter, with hydrocele fluid. Partial orchiectomy and hydrocelectomy with Bergmann's method were performed without any morbidity. Histopathological diagnosis was tunica albuginea cyst. To date, this case is the sixth reported case in Japan.     

Tunica albuginea cyst: Rare testicular mass

A case of a benign tunica albuginea cyst as a possible testicular malignancy is presented.     

Adenomatoid tumor of testicular tunica albuginea: a case report]

Adenomatoid tumors are uncommon neoplasms of the paratesticular tissues. We report a case of an adenomatoid tumor of the testicular tunica albuginea. A 54-year-old man presented with a painless right intrascrotal mass. Serum levels of HCG-beta and AFP were within normal limits. Scrotal ultrasonography showed an oval-shaped low echoic lesion located on the surface of the testis. The patient underwent right partial orchiectomy. Histological examination revealed adenomatoid tumor of the tunica alubuginea testis. Adenomatoid tumors of the testicular tunica alubuginea are rare. Examination of tumor markers, ultrasound studies and diagnoses of frozen sections can prevent needless orchiectomy.     

Solitary infected renal cyst: a case report]

A 48-year-old man was admitted to our hospital because of high fever and left flank pain. Laboratory findings revealed a high white blood cell count, high C-reactive protein level, and severe pyuria. Sonographic examination revealed an enlargement of the cyst at the upper pole of the left kidney that had already been detected. Percutaneous drainage was performed for the cyst and 60 ml of purulent fluid was obtained. Bacterial culture of the fluid was positive for Propionibacterium acnes and gamma-Streptococcus. The drainage and administration of povidone-iodine was continued for 7 days. The size of the cyst was reduced with disappearance of symptoms.     

Adenomatoid tumor of the tunica albuginea: a case report

A case of male adenomatoid tumor of tunica albuginea of the testis is reported. A 45-year-old man referred to our hospital because of intrascrotal mass on the right side. The mass increased in size for eight months. Then we excised the tumor, and spared the right testis. The tumor was arising from the tunica albuginea of the testis with a pedicle. The histological diagnosis was adenomatoid tumor. Adenomatoid tumor is a rare benign tumor. A total of 97 cases of adenomatoid tumor of epididymis have been reported in males, but only 23 cases of adenomatoid tumor of the testis have been reported in Japan. Herein, 24 cases of adenomatoid tumor of testis including our case are discussed and reviewed.     

Tunica albuginea tissue analysis after electromotive drug administration

PURPOSE: To minimize patient discomfort electromotive drug administration has been used as noninvasive transdermal therapy for Peyronie's disease. We directly measured the tissue concentration of verapamil after electromotive drug administration to investigate whether this treatment modality is an effective drug delivery system. MATERIALS AND METHODS: A total of 19 tunica albuginea samples from 16 men undergoing surgical treatment for Peyronie's disease were used for analysis. Of these 16 men 14 underwent electromotive drug administration, including 12 with 10 mg. verapamil and 2 with 10 mg. verapamil plus 0.05 mg. epinephrine. In 2 men partial plaque excision was performed and the tunica albuginea samples were directly injected with verapamil. Another 3 men who served as controls had no exposure to verapamil. Electromotive drug administration was performed at an output of 2 mA. for 20 minutes. Tissue analysis was done using liquid chromatography-tandem mass spectrometry. RESULTS: Control tunica albuginea samples showed a verapamil level that was undetectable up to 109 ng./gm. The 14 verapamil electromotive drug administration treated specimens demonstrated undetectable to 37,510 ng./gm. verapamil. Overall 10 of the 14 electromotive drug administration treated tunica albuginea specimens (71.5%) contained measurable levels of verapamil. Adding epinephrine to the drug solution did not appear to enhance drug delivery. The concentration of verapamil in the 2 direct verapamil injection tunica albuginea samples was 166,898 and 118,411 ng./gm., respectively. There were no surgery or electromotive drug administration related complications. CONCLUSIONS: Electromotive drug administration is a safe and noninvasive treatment modality. Verapamil was detected in 71.5% of tunica albuginea specimens after electromotive drug administration with a wide range of verapamil levels. To our knowledge whether these levels affect change in Peyronie's disease plaque, resulting in improvement in penile deformity, is unknown and requires further placebo controlled trials.     

Tunica albuginea overlapping: a novel technique for the treatment of erectile dysfunction

Tunica albuginea (TA) in venogenic erectile dysfunction (VED) was found subluxated and flabby because of degeneration and atrophy of its collagen fibres. This had apparently led to derangement of TA veno-occlusive mechanism. We investigated the hypothesis that overlapping of the subluxated and flabby TA would achieve a competent veno-occlusive mechanism during erection. Tunical overlapping was performed in nine VED patients (age 35.6 +/- 1.6 years). Intracorporal pressure (ICP) was measured pre- and postoperatively. After penile degloving, TA on lateral penile aspect was divided along whole length of corpus cavernosum (CC) and tunical double-breasting for 1-1 1/2 cm was performed. A biopsy was taken from TA and stained with haematoxylin and eosin and Masson's trichrome. Clinical efficiency of the operation was evaluated after 6 months. ICP increased (P < 0.01) postoperatively in the nine patients. The increase was maintained during follow-up period in eight patients and decreased to preoperative level in one. Six months after operation, the eight patients had significantly (P < 0.01) improved scores for the erectile function domain over the preoperative scores. Microscopic examination of TA biopsies showed atrophy of the collagen fibres. Tunical overlapping aims at correction of TA flabbiness, corporal tissue support and improving of veno-occlusive mechanism.     

Giant epidermoid cyst of the scrotum: a case report]

A 74-year-old male with the chief complaint of painless enlargement of a mass in the scrotum was diagnosed as having a giant epidermoid cyst on July 8, 1991. He had no past history of injury or pain of the scrotum. Magnetic resonance imaging (MRI) of the scrotum demonstrated a well-circumscribed homogeneous mass, and was distinguished from both normal testes. Under the diagnosis of intrascrotal epidermoid cyst, the mass was resected surgically. The mass measured 23 x 15 x 15 cm, and it contained liquids. The pathological diagnosis was epidermoid cyst of the scrotum.     

Giant müllerian duct cyst: a case report]

A case of giant müllerian duct cyst is reported. The patient was a 27-year-old male, complaining of microscopic hematuria. A giant cystic abdominal mass was palpable. After screening examination including ultrasound tomography, intravenous pyelography, computed tomography and magnetic resonance-imaging, müllerian duct cyst was suspected. Operation for this cyst was performed with median incision. The cyst measured 25 x 21 x 14 cm. The surface as smooth and consistency was soft. Included fluid was slightly turbid and yellowish measuring 2,200 ml. This was considered to be the largest müllerian duct cyst case reported in the Japanese literature.     

Benign cystic lesion of the tunica albuginea: a case report

We describe a patient whose testicular parenchyma was displaced by a cyst. Histologic findings suggested that the cyst was a dilated efferent ductule passing through the tunica albuginea. Such a cyst is an important and benign consideration in the differential diagnosis of testicular masses. Although orchiectomy was performed in this case, early consideration and confirmation of benign lesions may permit testicular preservation.     

Tunica albuginea urethroplasty for anterior urethral strictures: A urethroscopic analysis

Objective:   To assess the efficacy of tunica albuginea urethroplasty (TAU) for anterior urethral strictures.
Methods:   We assessed 206 patients with anterior urethral strictures who underwent TAU. The procedure involves mobilization of strictured urethra and laying it open with a dorsal slit. Edges of the slit-open urethra are sutured to edges of the urethral groove with a silicon catheter in situ . Thus in neourethra, the roof is formed by tunica albuginea of the urethral groove. Results were assessed at 6, 12, 24 and 36 months by comparative analysis of patient satisfaction along with retrograde urethrogram, urethrosonogram, uroflowmetry, and were categorized as good, fair and poor. Good and fair results were considered as successful. Thirty patients were taken for postoperative urethroscopic analysis to allow better understanding of both successful and failed cases.
Results:   Postoperative evaluation at 6 months showed a 96.6% success rate, which decreased to 94.7% at 1 year, 93.2% at 2 years and over 90% at the end of 3 years. The overall failure rate was 9.2%, which required revision surgery. Urethroscopic visualization of the reconstruction site showed wide, patent and distensible neourethra uniformly lined by urothelium over roof formed by tunica albuginea of the corpora cavernosa in successful cases. Failure cases showed diffuse fibrotic narrowing or circumferential scarring.
Conclusion:   Tunica albuginea is a locally available distensible tissue, sufficient to maintain the patency of the neourethra, without any graft or flap. TAU is easier and useful when patients have unhealthy oral mucosa due to tobacco chewing.     

Tunica albuginea plication for the correction of penile curvature

OBJECTIVE: To evaluate the efficacy of tunica albuginea plication (TAP) in the correction of congenital and acquired penile curvatures and determine key points for a successful outcome of this procedure. MATERIALS AND METHODS: From December 1995 to January 2001, 40 patients with penile curvature (10 congenital and 30 secondary to Peyronie's disease) underwent surgical correction by TAP. Indications were difficult or impossible penetration, normal erectile function, stable disease. For TAP we used non-absorbable inverted stitches tied with the assistant pushing down the tunica albuginea with a mosquito clamp to create an adequate groove for the knot. The results were evaluated subjectively and objectively. RESULTS: At mean follow-up of 30 months, full subjective and objective success (straight penis, mild shortening, normal erection, penetration and sensation) was achieved in 37 (92.5%) patients. Objective but not subjective success was achieved in 2 patients (5%), 1 complaining of psychogenic erectile dysfunction and the other of excessive penile shortening. There was only one failure, namely persistent glans numbness due to damage of the non-mobilized neurovascular bundle. CONCLUSIONS: TAP is a simple and effective method for the correction of congenital and acquired penile curvatures. Key points for successful outcome are adequate preoperative evaluation and counselling, careful preparation of tunica albuginea, mobilization of urethra or neurovascular bundle when needed, use of inverted stitches carefully buried, objective postoperative evaluation with a pharmacological erection test.     

A case report of a paraesophageal bronchogenic cyst and an esophageal cyst]

There are relatively few paraesophageal bronchogenic and esophageal cysts in mediastinal tumors. It is often difficult to distinguish between these cysts. Case 1: 11 year old, male with no symptoms. An abnormal tumor shadow was revealed by chest roentgenogram. Before operating, CT, MRI and other laboratory tests were suggested that the tumor was neurogenic. A cyst with a pedicle connected to the esophageal muscle layer was found during the operation. Pathological examination confirmed a bronchogenic cyst lined with cartilage. Case 2: 38 year old female with epigastralgia. Upper gastrointestinal series revealed that the thoracic esophagus was smoothly compressed from the outside. CT and MRI showed a well-defined cystic mass in the posterior mediastinum. The cyst bordered the esophagus, but there was no direct communication between them. The pathological findings showed the presence of a double layer of smooth muscle without cartilage which was diagnosed as an esophageal cyst.     

Postauricular dermoid cyst: a case report

A rare localization of dermoid cyst in the postauricular region is presented.     

Parotid duct cyst: a case report

Salivary gland cysts can be benign or malignant. Salivary duct cysts are benign tumours that occur mainly in the parotid gland and represent 10% of all salivary gland cysts. We report the case of a 48-year-old man who presented with a painless preauricular mass on the right side. Superficial parotidectomy was performed based on magnetic resonance imaging (MRI). Histopathologic examination of the specimen revealed a parotid duct cyst. Here we report clinical features, diagnosis, and treatment of the case as well as a review of the literature.     

Parathyroid cyst: a rare case report

Parathyroid cysts are rare lesions arising in the neck and anterior mediastinum. Fewer than 250 cases have been pub lished in the literature. Parathyroid cysts constitute only 0.6% of all thyroid and parathyroid lesions, but should be considered in the differential diagnosis of anterior neck masses, particularly in the presence of hypercalcaemia.     

Adrenal cyst: report of a case

This is a case report of an adrenal cyst which developed in a 36-year-old man. The patient experienced sudden abdominal pain, accompanied by sweating. The diagnosis was established by ultrasound-sonography and CT-scan. The adrenal cyst was removed surgically; it measured 20 X 10 X 10 cm and contained 1,900 ml of a white, cloudy fluid. Histological examination showed that the cyst wall was lined with mesothelial cells and was of congenital origin. The cyst was endocrinologically non-functioning, for all the endocrinological data were within normal limits. After surgery, however, hypertension has persisted and has been diagnosed as being essential in origin. This is the 63rd case reported in the Japanese literature.     

Congenital esophageal cyst: a case report

Congenital oesophageal cysts are extremely rare findings in the context of masses developing in the mediastinum. The embryogenetic and physiopathological aspects of these lesions have yet to be fully clarified. Preoperative diagnostic investigations may be only partly successful in indicating the correct diagnosis. Surgical excision is always indicated, via either the thoracoscopic or thoracotomic routes. We report here on case of a duplication oesophageal cyst which we diagnosed and treated successfully in our department. The clinical and therapeutic aspects of these lesions are discussed and compared with other cases reported in the literature.