1/140. Tuberculous orchitis co-existing with tuberculosis of the sternum--case report. The sternum and testis are infrequent localisations for extra pulmonary tuberculosis. The initial response to a co-existing lesion, as this case depicted is, to implicate a malignant process of some sort. A high index of suspicion is needed to overcome this diagnostic riddle. biopsy of the lesion and bacteriological work-up are essential ingredients of management. ( info) |
2/140. Malignant large cell calcifying sertoli cell tumor of the testis (LCCSCTT). Report of a case in an elderly man and review of the literature. Malignant Large Cell Calcifying sertoli cell tumor of the testis (LCCSCTT) is a rare histological variant of sex cordstromal tumors. It usually arises in young males, sometimes is associated with endocrine abnormalities and has a benign course. It is exceptional in elderly men and the outcome is rarely fatal. We report a case of LCCSCTT in a 73 year-old man with fatal outcome. The tumor involved the right testis and several areas of the tunica albuginea were grossly invaded. serum levels of HCG, LH and testosterone were normal. Lymphoangiography performed after orchiectomy showed an involvement of the iliac and preaortic lymph nodes. X-ray of the chest showed no lung metastases. A thorough study of the light microscopic, immunohistochemical and ultrastructural appearances was performed. immunohistochemistry revealed positivity to vimentin, S-100 and NSE. Our observations confirm the previous findings concerning malignant LCCSCTT and point out the histogenesis of the tumor from sertoli cells. ( info) |
3/140. Synchronous torsion of testicular appendages: a rare mechanical cause of bilateral scrotal pain. We describe a case of synchronous torsion of testicular appendages, a previously unreported cause of bilateral scrotal pain. Exploration and excision was curative. ( info) |
4/140. Ectopic ureter associated with renal dysplasia. Two patients, aged 22 and 68, were admitted for recurrent orchi-epididymitis and septicemia respectively. On digital rectal examination, a right pararectal mass was palpated. CT showed in both patients unilateral renal agenesia with a dilated blind ectopic ureter and an enlarged pseudocystic seminal vesicle. MRI obtained in one patient demonstrated a hyperintense content of the blind ureter and the seminal vesicle. Cross section imaging findings were in agreement with deferentography. histology confirmed the diagnosis of renal dysplasia, with a blind ectopic ureter, opening in the seminal vesicle. ( info) |
5/140. Epididymo-orchitis following intravesical bacillus Calmette-Guerin therapy. OBJECTIVE: To describe a case of epididymo-orchitis that developed four years after treatment with intravesical bacillus Calmette-Guerin (BCG) and to review the incidence of this adverse effect. DATA SOURCES: Information about the patient was obtained from the medical chart. A medline search of English-language literature (from January 1976 to April 1999) was conducted. STUDY SELECTION: All case reports of BCG-related epididymo-orchitis were evaluated. review articles describing complications of BCG therapy for bladder cancer and the prevention and treatment of these complications were reviewed. DATA EXTRACTION: Studies were evaluated for reports of BCG-related epididymo-orchitis and its treatment. DATA SYNTHESIS: Our case report is compared with others reported in the literature. The incidence of BCG-associated epididymoorchitis is rare. CONCLUSIONS: Epididymo-orchitis should be considered as a late complication of BCG therapy for bladder cancer. Proper patient selection may help decrease the risk of complications from BCG therapy. ( info) |
| We report a case of invasive group A streptococcus infection of the scrotum that presented as epididymoorchitis and rapidly progressed to streptococcal toxic shock syndrome. The presentation, pathophysiology, and management of invasive group A streptococcus and streptococcal toxic shock syndrome are reviewed. Rapid recognition is necessary to avoid the significant morbidity and mortality associated with these invasive infections. ( info) |
7/140. 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. ( info) |
| We report 3 patients with acute epididymo-orchitis with abscess formation due to pseudomonas aeruginosa, which is relatively unusual and difficult to treat. All patients presented with swollen testicles, pain and high fever. First, they were treated empirically with several antibiotics. After several weeks of antibiotics therapy, the swelling of scrotum still persisted. In one patient, dark yellow pus drained from a fistula of the scrotum. Finally, an orchiectomy was performed on all patients. During the operation, an abscess was found in each testis. Each culture of the pus yielded P. aeruginosa, which is susceptible to many antibiotics. ( info) |
| meconium periorchitis (MPO) is an uncommon entity associated with healed meconium peritonitis. The typical presentation is soft hydrocele at birth which becomes harder in weeks as the meconium calcifies. It mimics a scrotal mass, and, without knowledge of this rare disease, this may lead to unnecessary surgery. Both the masses and the calcifications have the tendency to resolve spontaneously without compromising the testicle. Sonographic features together with an abdominal plain film are diagnostic, and visualization of the normal testicle may be helpful in differentiating this tumor-like lesion from scrotal tumors. A case of a meconium periorchitis is reported on and the radiological and histological features are discussed with a literature review on the subject. ( info) |
| 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. ( info) |