Cystadénome Papillaire de L’épididyme: Un Nouveau Cas

Papillary cystadenoma of the epididymis is a rare benign neoplasm that arises from the efferent duct epithelium. It may show as a unilateral or bilateral epididymal mass and its association with von Hippel-Lindau syndrome is very high, particularly in bilateral lesions. A 36-year-old male presented with a left-side scrotal mass of one year duration. On local examination, a painless irregular and hard testicular mass. Ultrasonography of the scrotum revealed a left strong hypoechoic, homogeneous, well limited testicular mass of 30×25×22mm diameter. The tumorous scorers were normal (beta HCG and AFP). The testicular mass was explored through a left inguinal incision. In palpation, it is a hard testicular tumor. Left Orchidectomy is carried out. The pathologic examination reveals a serous papillary cystadenoma borderline paratesticular without sign of invasion. We propose guidelines from literature for diagnosis, histogenesis and treatment of this rare tumor.     

Cavernous hemangioma of the testis: a case report and review of the literature

A 73-year-old man consulted our hospital with a painless intra-scrotal mass in the left testis. Serum levels of human beta-chorionic gonadotropin and alpha-fetoprotein were normal. Scrotal ultrasonography demonstrated left testis with a heterogeneous texture. A diagnosis of probable testicular malignancy was made, and a left radical orchiectomy was performed. The histopathological diagnosis was testicular cavernous hemangioma. To our knowledge, only 19 cases of cavernous hemangioma of the testis have been reported in the literature so far. Although this is a rare tumor, it should be considered in the differential diagnosis of testicular tumor.     

Relapse of brucellosis simulating testis tumor

We report on a case of a 32-year-old man referred for evaluation of a painless left testicular mass suggesting a testicular tumor. Previous history was uneventful except for a 3-year history of systemic brucellosis without epididymo-orchitis. Radical inguinal orchidectomy was performed. Clinical and histopathological findings indicated a brucellar abscess of the left testis. Even in the absence of systemic symptoms, the possible relapse of brucellosis as an abscess formation in the testis should be considered as a rare cause of testicular mass in patients who live in endemic regions.     

Inguinal lymph node metastasis of seminoma 18 years after initial treatment: a case report

Late relapse of testicular tumor is rare. We report a case of recurrence of seminoma at left inguinal lymph node 18 years after initial treatment. A 63-year-old man had a left orchiectomy for left testicular tumor (T1N0M0) in February 1985, with no past history of scrotal or inguinal surgery. Histological examination revealed seminoma (pT1), and prophylactic radiotherapy (34.2 Gy) to para-aortic and left hemi-pelvic regions was perfomed. In November 2003, the patient presented with left inguinal swelling, and was referred to our hospital with suspicion of metastasis to left inguinal lymph nodes. Serum markers (AFP, hCG, hCGbeta and LDH) were normal. Computerized tomography (CT) showed three masses in the left inguinal region, but no other abnormal mass was detected at chest, abdomen or pelvis. Lymphoidectomy of the left inguinal region was perfomed in January 2004, and the mass revealed to be metastasis of seminoma by histological examination.     

Epidermoid cyst of the testis difficult to make a preoperative diagnosis on the echoic examination: a case report

A case of epidermoid cyst of the testis is presented. The patient was a 64-year-old man who complained of a painless mass in the left scrotum. Physical examination revealed a hen-egg sized enlargement of the left scrotal contents. The ultrasonographic appearance did not show a hyperechoic partition, which is called echogenic rim, a characteristic of this tumor on the echoic examination, and was homogeneous, almost similar to that of a normal testis. Because malignant testicular tumors could not be excluded preoperatively, excisional biopsy of the left testis was performed first. Histological diagnosis was an epidermoid cyst of the testis. As the left testis was almost completely occupied by the tumor and no normal testicular tissue was recognized, we performed orchiectomy additionally. Epidermoid cyst of the testis is a rare benign tumor that accounts for about 1 percent of all testicular tumors. It clinically resembles malignant testicular tumors, and orchiectomy is often performed for treatment. About 154 cases of testicular epidermoid cyst have been reported in the Japanese literature and are reviewed briefly here.     

Prostatic carcinoma with metastasis to the testicle: a case report

A 63-year-old man was admitted with the complaints of macrohematuria, sense of residual urine and urinary frequency. Physical examination revealed an enlarged hard prostate and left scrotal mass. The pathological diagnosis of the needle biopsy specimen of the prostate showed undifferentiated adenocarcinoma. The patient underwent bilateral orchiectomy for hormone therapy of prostatic carcinoma and treatment of suspected left testicular tumor. The histology of testicular tumor revealed metastasis from carcinoma of the prostate. Metastasis of the testis from prostatic carcinoma is rare in spite of the high incidence of the primary tumor. Clinical findings on testicular metastasis from carcinoma of the prostate obtained in 62 cases reported in available literature are reviewed and discussed in detail.     

睾丸混合性生殖细胞瘤的诊治

目的 探讨睾丸混合性生殖细胞瘤的临床特征及治疗策略.方法 回顾性分析1例睾丸混合性生殖细胞瘤患者病史资料并结合相关文献讨论睾丸混合性生殖细胞瘤的生物学行为、治疗及随访策略.患者为22岁青年男性,发现左侧睾丸肿物2个月余,AFP 200.43ng/mL、β-HCG 554.17 mlU/mL,阴囊彩超及CT提示左侧睾丸实...     

Testicular papillary cystadenomatous tumor of low malignant potential: a case report and discussion of the literature

We report the fifth case of a rare testicular serous papillary cystadenomatous tumor of low malignant potential. All patients presented with a testicular mass. Histologically, the tumor can be differentiated from testicular papillary cystadenocarcinoma. The natural history of this rare tumor is yet to be determined.     

Malignant fibrous histiocytoma of the spermatic cord. Presentation of one case and literature revision

We present a case of malignant fibrous histiocytoma (MFH) of the spermatic cord. An 80-years-old man was admitted to the hospital with a left scrotal mass, related to a genital traumatism several months ago. Under the suspicion of a testicular tumor, left radical orchiectomy was performed. Histological examination of the tumoral mass revealed a malignant fibrous histiocytoma. The tumor was firmly adhered to the spermatic cord. MFH is an extremely rare, highly malignant connective tissue tumor, which may, occasionally, affect the male genital tract. There are no agreed treatment principles. The overall prognosis is poor.     

Splenogonadal fusion in adults: presentation of three cases and review of the literature

Splenogonadal fusion (SGF) is a rare congenital anomaly in boys and girls. It commonly presents as a testicular mass treated with an unnecessary orchiectomy. We present 3 cases of SGF diagnosed in adulthood and discuss the published literature focusing on several aspects of this rarity. These cases of SGF of both types presented with the usual complaints. In our first case, orchiectomy was performed since the left testis was hypoplastic and testicular neoplasm could not be ruled out. The testicles could be preserved in the latter 2 cases. The second case is the continuous-type SGF associated with contralateral testicular aplasia and, to our knowledge, this is the first reported case of continuous SGF associated with testicular aplasia. Knowledge of this entity may help prevent unnecessary orchiectomy.     

Wilms' tumor with metastasis to the left testis

Wilms' tumors account for the vast majority of renal neoplasms in infants and children. Common areas for metastases include the lung, liver, and contralateral kidney. Less common sites include the bone, skin, brain, and orbit. We report a case of Wilms' tumor in a 13-month-old boy who, after radical left nephrectomy, developed a left testicular mass that turned out to be metastatic Wilms' tumor. The epidemiology, case history, review of the literature, and possible etiology of this rare site of metastatic Wilms' tumor are discussed.     

Metachronous bilateral testicular tumors in a case of male infertility

A 42-year-old man referred to our hospital with the chief complaint of a solid mass of right scrotal contents. As ultrasonography revealed a right testicular tumor, right high orchiectomy was performed and the pathlogical diagnosis was testicular seminoma. At the age of 35-year-old, he was admitted to another hospital for male infertility due to azoospermia. Because left testicular tumor was found, left high orchiectomy was performed, with right testicular biopsy and testicular sperm extraction of the right testis at the same time. Pathological diagnosis revealed left testicular seminoma and no malignancy of the right testicular biopsy specimen. After the second operation, he has been receiving androgen replacement therapy, with no evidence of tumor recurrence.     

Liposarcoma of the spermatic cord in the left scrotum and inguinal region: a case report

We report a rare case of liposarcoma of the spermatic cord in the left scrotum and inguinal region. The patient was a 75 year old male, who visited our hospital with the complaint of painless left scrotal swelling and inguinal mass which had been noticed for 3 to 4 years. Ultrasonography and computed tomography (CT) showed a heterogenous mass in the left inguinal region and intrascrotum. We suspected a left testicular tumor and removed it by high inguinal orchiectomy. Histological examination revealed a well-differentiated liposarcoma of sclerosing type. Tumor local recurrence was not recognized at 8 months after operation. This is the 43rd case of liposarcoma of the spermatic cord in the Japanese literature.     

A case report of epididymo-testicular bilharziasis in a child]

The disease was revealed by a tumor of the left testis. Ultrasound showed an enlargement of testis and epididymis with some hypoechogenic areas resembling epididymo-orchitis or tumor. The location of bilharzial lesions in the testis is very rare. The main sign of urogenital bilharziosis, hematuria, was present. Orchidectomy is the treatment of choice when the testis is destroyed and only histological study is able to confirm the nature of testicular mass.     

Xanthogranulomatous orchitis with scrotal fistulas

Xanthogranulomatous orchitis is an extremely rare inflammatory change of testis which is difficult to distinguish from testicular tumor. We report on a 21-year-old man who presented with left testicular swelling and pyogenic discharge from the scrotum. Testicular tumor markers were normal. Scrotal ultrasonography showed a testicular tumor in the left testis. Because of severe adhesion between the scrotum and intrascrotal structures, radical orchiectomy combined with hemiscrotectomy was performed to exclude possible malignancy. Histopathological findings showed xanthogranulomatous orchitis.     

Mature teratoma arising from an intraabdominal testis in a 2-month-old boy: case report and review of intraabdominal testicular tumors in children

Tumors arising in an undescended testis are rare in infants. We report a mature teratoma in an intraabdominal testis of a 2-month-old boy. He presented with a large left-sided abdominal mass and nonpalpable left testis. Abdominal ultrasound and computed tomography showed a well-defined, sizable cystic tumor with focal calcification in the lower abdomen. Tumor markers were all within normal limits. Surgical resection revealed a large tumor arising from an intraabdominal left testis, and histologic analysis identified a mature teratoma. The tumor was completely removed, and there was no recurrence at follow-up 3 years later. The histologic condition of prepubertal intraabdominal testicular (IAT) tumors is quite different from that of testicular tumors in childhood descended testes and postpubertal IAT tumors. A total of 30 cases of IAT tumors in children, including our case, were reviewed to elucidate this issue.     

A case of testicular tumor in an elderly man

Testicular tumor is seen exclusively in men from 30 to 50 years old. In elderly men, the incidence of testicular tumors is rarer than that of other malignant tumors. Herein we report a case of an elderly patient with a testicular tumor comprised solely of seminoma. A 60-year-old man was seen at the urologic clinic of Osaka Kita Municipal Citizen's Hospital because of painless swelling of the left scrotal contents. At the time of clinical visit, physical examinations and scrotal sonography showed a fist-sized mass with solid echo pattern in the left scrotum. He was hospitalized for the exploration of the suspected testicular tumor. The testicular mass was removed surgically through the left inguinal incision. Histopathological examinations of the resected tumor revealed pure seminoma. Chest film, computerized axial tomography, retroperitoneal ultrasound study and specific tumor markers were all negative which indicated stage 1 testicular tumor confined to the scrotal region according to Dixon and Moore's staging. He received adjuvant irradiation at the level of mediastinal lymph node after the operation. Postoperatively, he recovered well without any evidence of recurrence. In this report, the prognosis of non-bulky pure seminoma in elderly men are briefly reviewed in association with a conventional therapy to this disease in elderly patients described in the literature.     

Primary carcinoid tumor of the bilateral testis associated with carcinoid syndrome

Carcinoid tumors derived from neuroendocrine cells can release serotonin and other vasoactive substances into the systemic circulation, resulting in carcinoid syndrome. Testicular carcinoid, a rare disease accounting for less than 1% of all testicular neoplasms, rarely manifests symptoms of carcinoid syndrome. We describe a case of carcinoid syndrome arising from a primary testicular carcinoid tumor. A 21-year-old male patient presented with facial flushing and diarrhea for 5 years. He had an enlarged left testis and a 1-cm, ill-defined, hard, non-tender mass in his right testis. His 24 h urinary excretion of 5-hydroxyindoleacetic acid was elevated (16.1 mg/day). Somatostatin receptor scintigraphy correlated with carcinoid tumor in both testes. Following bilateral orchiectomy, the patient's facial flushing and diarrhea disappeared.     

Leydig cell tumor of the testis presenting male infertility: a case report

A 33-year-old male was referred to our hospital for male infertility with painless swelling of the left scrotal content. Left high orchiectomy was performed under the diagnosis of left testicular tumor. Histologically, this testicular mass was a Leydig cell tumor. We reviewed 55 cases of Leydig cell tumor of the testis previously reported in Japan, and reported the hormonal profile in our case before and after surgery.     

Burned-out testicular tumor: a case report

A 29-year-old man was referred to our hospital with loss of appetite and a left lower abdominal mass. A small nodule was palpable in his left testis and ultrasonographic examination demonstrated that the nodule was low echoic. Computed tomography showed a large mass in his left retroperitoneal space. We thought the mass was a metastatic lesion from a testicular tumor. Left orchiectomy was done and microscopic examination revealed no viable tumor cells. Only fibrous tissue, small calcified areas, and hyaline bodies were found. As tumor markers were normalized after 3 courses of chemotherapy with bleomycin, etoposide, and cisplatine, the retroperitoneal mass was removed with the left kidney. It consisted of embryonal carcinoma, mature teratoma, and yolk sac tumor. One course of adjuvant chemotherapy was done and the patient has since been free from recurrence. We suppose that the tumor was a so-called 'burned-out' testicular tumor.