1/77. Clinics in diagnostic imaging (33). Missed testicular torsion.A 13-year-old boy presented with a painful scrotal swelling. On examination, the left testis was enlarged and tender. Ultrasound scan showed diffuse hypoechogenicity, with absent intra-testicular but increased peri-testicular blood flow. The diagnosis of missed testicular torsion was confirmed at surgery. The role of imaging in differentiating among other causes of painful scrotal swelling, such as infection, trauma and tumour, are discussed.- - - - - - - - - - ranking = 1keywords = testis (Clic here for more details about this article) |
2/77. Metachronous bilateral torsion of the testicular appendices.BACKGROUND: Torsion of the appendix testis is a common cause of scrotal pain in children and a common cause for surgical exploration of the pediatric scrotum. The first case of metachronous bilateral torsion of the testicular appendices managed by a non-operative approach is reported. methods/RESULTS: A case report and a computer-assisted review of the literature are presented. Physical findings of a tender, mobile mass over the anterior surface of the testis characterize the presentation. Doppler findings of normal blood flow to the testes with increased flow to the adjacent appendix testis can be utilized as an adjunct to diagnosis. Ultrasonographic findings of a pedunculated mass with a central hypoechoic area at the superior aspect of the testis support the diagnosis. Accurate non-operative diagnosis of torsion of the appendix testis permits successful conservative management with non-steroidal anti-inflammatory agents. CONCLUSIONS: Improvements in ultrasonographic and Doppler imaging of torsion of the appendix testis have facilitated the diagnosis of this entity and decreased the need for surgical exploration of the scrotum.- - - - - - - - - - ranking = 6keywords = testis (Clic here for more details about this article) |
3/77. Mullerian-type epithelial tumor arising within a torsed appendix testis.Because it is a remnant of the mullerian duct system, the appendix testis contains mullerian epithelium that theoretically may produce epithelial tumors similar to those that occur in the female genital tract. Few reports of tumors of mullerian origin arising in the testis exist, and rarely are neoplasms arising from the appendix testis identified. We present a case of a serous cystic neoplasm of low malignant potential derived from mullerian-type epithelium that was located in the torsed appendix testis of a young, otherwise healthy, boy.- - - - - - - - - - ranking = 8keywords = testis (Clic here for more details about this article) |
4/77. A rare simultaneous presentation of testicular mixed germ cell tumor with a contralateral testis torsion.We report a rare case of a 27-year-old man presenting with an acute scrotum with simultaneous occurrence of testicular tumor and contralateral torsion. Preoperative imaging demonstrated the testicular missed torsion, yet findings were equivocal with regard to the testicular tumor. On scrotal exploration the left testis was found to be ischemic due to threefold rotation. The right testis was not identifiable, being composed of numerous necrotic lesions. Frozen section suggested malignancy, hence high right orchiectomy was performed. Histologic examination of the right testis showed mixed germ cell tumor, containing all the subtypes. To our knowledge no similar case has been reported.- - - - - - - - - - ranking = 7keywords = testis (Clic here for more details about this article) |
5/77. Bilateral asynchronous perinatal testicular torsion: a case report.Bilateral perinatal testicular torsion (PTT) is an extremely rare condition. A baby boy at the postnatal 28th hour presented with right scrotal erythema and swelling, and left hydrocele were detected. There were no systemic symptoms. Right hydrocele had been detected during prenatal ultrasonography at the 34th week of gestation. Emergency technetium Tc 99m pertechnetate scintigraphy showed hypoperfusion in both sides suggesting testicular torsion. The patient underwent surgery immediately. Right necrotic testis was removed, left testis was judged as viable, and thus was treated with detorsion. Bilateral PTT in the neonate is a true emergency because of the risk of anorchia. Controversy still exists regarding the treatment of unilateral PTT. Some investigators suggest delayed operation regarding the anesthetic risk imposed on the neonate and the reality that operative salvage of the prenatally torsed testicle is a remote possibility. However, although asynchronous bilateral PTT is rare, the patient with unilateral PTT is at risk of contralateral testicular torsion in the waiting period of delayed operation. Therefore, the authors recommend early surgical intervention.- - - - - - - - - - ranking = 2keywords = testis (Clic here for more details about this article) |
6/77. sertoli cell tumor in a prepubertal boy mimicking testicular torsion.A 9-year-old boy presented with left, intermittent testicular pain that was present for 3 days. On physical examination, left testis was grossly enlarged and firm but mildly tender. serum alpha-fetoprotein and beta-human chorionic gonadotropin levels were within normal range. color doppler ultrasonography which was performed to rule out testicular torsion revealed an intratesticular mass located at the upper pole of left testis and left radical orchiectomy was performed. The histopathological diagnosis was sertoli cell tumor.- - - - - - - - - - ranking = 2keywords = testis (Clic here for more details about this article) |
7/77. Emergency laparoscopic orchidectomy for torsion of intra-abdominal testis: a case report.Torsion of an intraabdominal testis is a rare cause of acute abdominal pain. With a history of undescended testis, it is difficult to establish the diagnosis and to exclude other emergency abdominal conditions without a laparotomy. The following case report illustrates the usefulness of laparoscopy as a diagnostic as well as a therapeutic tool in such a condition.- - - - - - - - - - ranking = 6keywords = testis (Clic here for more details about this article) |
8/77. Perinatal torsion of spermatic cord.A case of torsion of the testis in the newborn is presented. A review of the literature indicates that this condition tends to occur in babies weighing over 3,000 Gm., born of primigravida; the involved testicle is usually nontender, and frequently there is adhesion of the skin to the mass. Controversies in regard to methods of treatment are discussed.- - - - - - - - - - ranking = 1keywords = testis (Clic here for more details about this article) |
9/77. Prenatal testicular torsion: sonographic appearance in the newborn infant.The prenatal diagnosis of spermatic cord torsion is often really difficult and the diagnosis is usually retrospective. Herein, we report a case of a male newborn baby who presented at delivery with an enlarged, swollen and tender scrotum. US showed an enlarged right testis, with dishomogeneous texture, fluid collection between the testis and the tunica vaginalis and large hydrocele. Differential diagnosis included hydrocele complicated by infection or hemorrhage, testicular tumor or postnatal testicular torsion. color and power Doppler did not reveal any flow signal, and the diagnosis of antenatal torsion with initial necrosis was made. The role of color Doppler US is emphasized in directing the patient to emergency surgical exploration, when testicular salvage may be possible. Delayed surgical treatment can be proposed, when the diagnosis of antenatal torsion has a high degree of certainty. However, the Doppler examination of a newborn baby's testis is a very difficult challenge even for an experienced radiologist.- - - - - - - - - - ranking = 3keywords = testis (Clic here for more details about this article) |
10/77. Torsion of a benign cyst arising from the tunica vaginalis testis.We describe a rare case of torsion of a benign cyst originating from the parietal layer of tunica vaginalis. This case presented with acute scrotum. Surgical exploration revealed a cyst arising from the parietal layer of tunica vaginalis of which the pedicle was twisted. When a cystic mass is detected in the scrotum of boys with acute scrotum, torsion of a cyst in the cavum tunica vaginalis testis should be considered.- - - - - - - - - - ranking = 5keywords = testis (Clic here for more details about this article) |
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