1/14. Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient.STUDY DESIGN: A case report of xanthogranulomatous funiculitis and epididymo-orchitis. Xanthogranulomatous inflammation is an uncommon, non-neoplastic process characterised by destruction of tissue, which is replaced by a striking cellular infiltrate of lipid-laden macrophages. CASE REPORT: A 21-year male sustained complete tetraplegia at C-6 level, after a fall in 1998. The neuropathic bladder was managed with an indwelling urethral catheter. He had many unsuccessful trials of micturition. Sixteen months after the cervical injury, he noticed swelling of the left side of the scrotum following removal of a blocked catheter. He was prescribed antibacterial therapy. Four weeks later, physical examination revealed a hard and irregular swelling encompassing the testis, epididymis and spermatic cord. The clinical diagnosis was epididymo-orchitis progressing to pyocele. Through a scrotal incision, the swollen testis, epididymis and diseased segment of the spermatic cord were removed en masse. Histopathology showed extensive areas of necrosis, with xanthogranulomatous inflammation in the spermatic cord and to a lesser extent in the testis/epididymis. CONCLUSION: Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding, and subsequent interstitial extravasation of urine together with chronic, low-grade, suppurative infection possibly led to development of xanthogranulomatous inflammation in the testis and the epididymis. Since tissue destruction is a feature of xanthogranulomatous inflammation, the definite and curative treatment is either complete (or, where applicable, partial) excision of the affected organ in most of the cases.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/14. Post-transplant epididymitis and orchitis following listeria monocytogenes septicaemia.We report the occurrence of epididymitis and orchitis 1 week after the onset of listeriosis in an 11-month-old boy receiving an orthotopic liver transplantation for biliary atresia. Immunologic implications of listeria monocytogenes-induced testicular inflammation are discussed, and the potential role of immunosuppression with tacrolimus is also discussed.- - - - - - - - - - ranking = 0.25keywords = inflammation (Clic here for more details about this article) |
3/14. leiomyosarcoma complicating chronic inflammation of the testis.OBJECTIVE: To report on a case of leiomyosarcoma of the testis that appeared to have arisen from a background of chronic testicular inflammation. CLINICAL PRESENTATION: A 65-year-old man with a 15-year history of diabetes mellitus and low-grade discomfort and swelling in the right testis presented as an emergency with exacerbation of the pain and swelling of the testis. Repeated ultrasound examination of the testis in the past 5 years had suggested a chronic testicular inflammatory disorder. Ultrasound during the current emergency case admission revealed a normal left testis, but a large heterogeneous solid mass with a moderate intratesticular calcification in the right testis and the presence of a moderate hydrocele. serum alpha-fetoprotein and beta-human chorionic gonadotropin were normal. A right radical orchidectomy was performed. Histopathology and immunohistochemistry revealed primary leiomyosarcoma of the right testis. There was no spermatic cord or venous involvement. One year after orchidectomy there was no sign of metastasis. CONCLUSION: Radical orchidectomy followed by surveillance appears to be the treatment of choice for this testicular leiomyosarcoma, which seemed to have run an indolent course compared to other testicular tumours.- - - - - - - - - - ranking = 1.25keywords = inflammation (Clic here for more details about this article) |
4/14. Xanthogranulomatous orchitis.Xanthogranulomatous inflammation is an uncommon process that is usually associated with severe renal infection. We report a case of a 64-year-old man with xanthogranulomatous inflammation in the testis who presented with contralateral epididymoorchitis and a painless testicular mass. Only two prior cases of xanthogranulomatous orchitis have been reported. This case highlights the need for a broad differential diagnosis when approaching testicular masses, particularly in the setting of coincident infection.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
5/14. Metastatic appendiceal adenocarcinoma presenting late as epididymo-orchitis: a case report and review of literature.BACKGROUND: Whereas testicular metastases are in themselves a rare entity, testicular secondaries from an appendiceal carcinoma have not yet been described. The case also illustrates the diagnostic dilemma of a tumour presenting as epididymo-orchitis. CASE PRESENTATION: The authors present a case of an appendiceal carcinoma that, two years after radical therapy, manifested as a secondary in the testis. It was misdiagnosed as an epididymo-orchitis and was only revealed through histology. CONCLUSIONS: Practitioners need to remember that long-standing testicular inflammation may result form secondary tumours. Even "exotic" primary tumours in the medical history of the patient must give rise to an increased suspicion threshold.- - - - - - - - - - ranking = 0.25keywords = inflammation (Clic here for more details about this article) |
6/14. Addisonian crisis and tuberculous epididymo-orchitis.OBJECTIVE: To describe a case of acute primary adrenal insufficiency in which tuberculosis was subsequently detected as the etiologic factor when the patient presented with tuberculous epididymo-orchitis. methods: A case of acute primary adrenal insufficiency associated with bilaterally enlarged adrenal glands is reported, along with the subsequent finding of a scrotal mass diagnosed as tuberculous epididymo-orchitis. diagnosis, adrenal function, and results of imaging studies after institution of antituberculous treatment are discussed. RESULTS: A 41-year-old Egyptian man, who had immigrated to the united states 5 years previously, had acute psychosis and addisonian crisis. A substantially increased early morning level of plasma adrenocorticotropic hormone and a low level of serum cortisol confirmed the diagnosis of primary adrenal insufficiency. Both adrenal glands were enlarged but without calcification on computed tomography. A previous bacille Calmette-Guerin vaccination complicated the interpretation of a positive tuberculin skin test result. Both lungs were clear on chest radiography and computed tomography. Seven months later, the patient had a left scrotal mass and underwent radical orchiectomy. Examination of the pathology specimen showed caseous granulomatous inflammation and necrosis, and acid-fast bacilli were identified. culture was positive for mycobacterium tuberculosis. CONCLUSION: In a patient from a country where tuberculosis is endemic, tuberculosis should be considered in the differential diagnosis when primary adrenal insufficiency is detected, especially in association with enlarged or calcified adrenal glands. Extra-adrenal tuberculous involvement should be actively sought because it may provide indirect microbiologic or histologic clues. Other than the lungs, special attention should be paid to the genitourinary system.- - - - - - - - - - ranking = 0.25keywords = inflammation (Clic here for more details about this article) |
7/14. Xanthogranulomatous funiculitis and orchiepididymitis: report of 2 cases with immunohistochemical study and literature review.Two patients with xanthogranulomatous inflammation are described, one with involvement of the spermatic cord and the other with 1 testicle and epididymis affected. To our knowledge, only 12 cases of xanthogranulomatous orchiepididymitis have been reported previously, one of which also presented a xanthogranulomatous funiculitis. Clinically, our patients presented with spermatic cord enlargement (case 1) and chronic orchitis that did not respond to treatment with antibiotics (case 2). Histopathologically, both cases showed extensive xanthogranulomatous inflammation with numerous foamy macrophages that were associated with colonies of microorganisms suggestive of actinomyces in case 1. Additionally, escherichia coli was cultured from the surgical specimen of case 2. The possible underlying pathology may be diabetes in case 1 and phlebitis associated with chronic orchitis in case 2. Differential diagnoses with other lesions that are rich in macrophages, such as malakoplakia, and those testicular neoplasms without serologic tumor markers are discussed.- - - - - - - - - - ranking = 0.5keywords = inflammation (Clic here for more details about this article) |
8/14. Late occurrence of bilateral tuberculous-like epididymo-orchitis after intravesical bacille Calmette-Guerin therapy for superficial bladder carcinoma.We report a case of bilateral tuberculous-like epididymo-orchitis occurring 3 years after intravesical bacille Calmette-Guerin instillation therapy in an 83-year-old patient with proven superficial bladder carcinoma. The patient had no previous history of tuberculosis. Because of persistent inflammation and painful swelling of the epididymides and testes, the patient underwent bilateral orchiectomy. This case demonstrates the late adverse effects that can occur after intravesical BCG therapy, which in our patient ended in surgical removal of both gonads.- - - - - - - - - - ranking = 0.25keywords = inflammation (Clic here for more details about this article) |
9/14. Testicular swelling with pneumonia and septicaemia: a rare presentation of right-sided endocarditis.As far as we are aware, right-sided bacterial endocarditis has not previously been described as presenting with systemic illness and testicular swelling. We report a teenager who presented with this unusual combination as a consequence of right-sided endocarditis. He presented with high fever, with chills and rigor, along with painful enlargement of the left testicle, a productive cough with progressive breathlessness, and joint pains. His blood culture was positive for staphylococcus aureus, and a computerised tomographic scan of the chest revealed multiple pulmonary emboluses. Ultrasound of the testicles showed features of inflammation, and an echocardiogram revealed a vegetation on the tricuspid valve.- - - - - - - - - - ranking = 0.25keywords = inflammation (Clic here for more details about this article) |
10/14. Epididymo-orchitis caused by intravesically instillated bacillus Calmette-Guerin: genetically proven using a multiplex polymerase chain reaction method.The intravesical instillation of bacillus Calmette-Guerin (BCG) is a standard therapy for superficial bladder carcinoma. Tuberculosis-like inflammation in the genitourinary tract is a serious complication of BCG. It can occur after a long interval from the cessation of the intravesical BCG therapy. If inflammation occurs, it is necessary to test whether the BCG strain has caused it or another mycobacterium species has. However, there has never been a report that proves BCG causes the inflammation, because BCG is difficult to differentiate from other strains of mycobacterium bovis and other members of the mycobacterium tuberculosis complex by conventional tests, including regular polymerase chain reaction (PCR). We first present a case of epididymo-orchitis, which developed 31 months after the cessation of BCG therapy, detected using a multiplex PCR method as having been caused by BCG. Our report illustrates the efficacy of this method to detect the responsible microbe that is thought to be transmitted from the instillated BCG strain.- - - - - - - - - - ranking = 0.75keywords = inflammation (Clic here for more details about this article) |
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