Case report: MRI in the diagnosis of testicular Leydig cell tumour

We report the appearance of three cases of Leydig cell tumours on MRI. This imaging method showed well-defined and peripheral intratesticular tumours displaying marked and homogeneous enhancement when contrast medium was used. This latter finding was only observed in Leydig cell tumours when they were compared in a series of 104 patients with different scrotal pathologies.     

Unusual appearance of retroperitoneal fibrosis simulating a tumour

Retroperitoneal fibrosis (RPF) is an uncommon entity that usually presents as a fibrous plaque-like lesion that encases the aorta and inferior vena cava below the level of the renal arteries. We present an unusual mass-like appearance of this disease simulating a tumour, with foci of calcification, seen in a young girl.     

Multiple hyperechoic testicular lesions are a common finding on ultrasound in Cowden disease and represent lipomatosis of the testis

Cowden disease (CD) is a genetic disease associated with multiple hamartomas and malignant neoplasms. During investigations for possible subnormal fertility, a series of eight males with CD underwent ultrasound scanning of their testes. Our findings detail the seven adult patients that were found to have multiple and bilateral testicular lesions on ultrasound. These lesions in Cowden's patients represent a newly described testicular pathology - lipomatosis of the testis. Here we detail the radiological findings. Ultrasound findings showed multiple (estimated 40+) discreet lesions randomly scattered thoughout the parenchyma of each affected testis. The lesions themselves had heterogeneous echo texture, but all being hyperechoic and with a variable size from 1 mm to 6 mm. One patient underwent MR examination of the lesions in which a high T(1) signal was seen, but no useful characteristic features were identifiable.     

A sonographic appearance of testicular lymphoma

The sonographic findings in two cases of testicular lymphoma are presented. Both show hypoechoic striations radiating out from a hypoechoic mediastinum testis. This appearance has not previously been described and may represent infiltration along the lymphatics within the testis.     

Imaging appearance of giant cell tumour of the spine above the sacrum

Giant cell tumour (GCT) of the spine is rarely encountered in daily clinical practice. Most of the tumours occur at the sacrum instead of at the spine above the sacrum, which has been reported to account for 1.3–9.3% of all spine GCTs. This article is a review of our radiological experience of the diagnosis of spine GCT above the sacrum based on 34 patients at a single institution. The purpose of this pictorial review is to highlight the imaging findings of GCT and to provide clues that may distinguish it from other, more common neoplasms.Giant cell tumour (GCT) of the spine is rarely encountered in the daily clinical practice. Most of the tumours occur at the sacrum instead of at the spine above the sacrum, which has been reported to account for 1.3–9.3% of all spine GCTs.¹ There are only a few published reports focusing on GCT of the spine above the sacrum in the literature.^2,3 This article was a review of our radiological experience of the diagnosis of spine GCT above the sacrum based on 34 patients at a single institution. The purpose of this pictorial review is to highlight the imaging findings of GCT and to provide clues that may distinguish it from other, more common neoplasms.     

Granular cell tumour of the oesophagus: endoscopic ultrasound appearances

A case of granular cell tumour of the oesophagus in a middle-aged woman is reported. The pathological features and appearances on endoscopic ultrasound (EUS) are described, and the role of EUS in the characterization of intramural oesophageal tumours is discussed.     

Acute segmental testicular infarction: differentiation from tumour using high frequency colour Doppler ultrasound.

Segmental testicular infarction is rare, of variable aetiology but usually idiopathic. B-mode ultrasound may demonstrate a focal mass indistinguishable from a testicular tumour, with confirmation only achieved following surgery. We report a case of segmental testicular infarction presenting as a heterogeneous mass on B-mode ultrasound, confidently diagnosed as an area of infarction on high frequency colour Doppler ultrasound and proven on histology. The pre-operative differentiation of tumour from segmental infarction allows testis-sparing surgery.     

Unusual appearance of a cisternal hydatid cyst

We herein describe a case of an isolated multilocular hydatid cyst occurring in the basilar cisterns, with nondependent levels of different signal intensities shown on MR images. Three portions were visualized on T1-weighted images: the hyperintense inferior aspect, the isointense central part, and the superior aspect of lower signal intensity. The inferior portion was hypointense on T2-weighted images. This unusual appearance was caused by layering of hydatid sand and may represent a characteristic feature of hydatid disease.     

An unusual presentation of metastatic testicular tumour

We report a unique case of metastatic malignant teratoma from an undescended testis which presented with acute pulmonary embolism. After chemotherapy, the undescended right testicle was resected along with a cord of non- obstructing inferior venal caval tumour which extended into the right atrium with tumour floating free within the atrium at the end of the cord of tumour. The presentation, diagnosis and treatment of testicular tumours is described and the literature pertaining to testicular tumours in military personnel reviewed.