1/17. systemic vasculitis presenting as a tumorlike lesion. Four case reports and an analysis of 79 reported cases.systemic vasculitis might present as a tumorlike lesion that initially could misdirect the correct diagnosis and the appropriate medical treatment. The aim of the present study is to summarize all reported cases of tumorlike presentation in systemic vasculitides, in order to have comprehensive data on the characteristics of this unusual phenomenon. We report 4 cases of systemic vasculitis presenting as a tumorlike lesion. In addition, we performed a medline search of all English-language papers published from 1966 to 1999, looking for vasculitis presenting as tumorlike lesion. Details were included concerning vasculitis classification, specific characteristics, location of the "tumor," the presence or absence of systemic involvement, and whether surgery was performed before diagnosis. Seventy-nine cases of vasculitis presenting as a tumorlike lesion were found in the literature, in addition to the 4 new cases described. The average age of the reported cases was 50.5 /- 15.8 years, and 51% were female. In 82% of the cases the "tumor" was associated with constitutional symptoms and elevated erythrocyte sedimentation rate (ESR). The most common vasculitis categories with tumorlike presentation were wegener granulomatosis (WG; 28 cases) and giant cell arteritis (GCA; 17 cases). In almost half the patients, surgery was performed before diagnosis. All patients with GCA presented with either a breast or an ovarian tumor. The most common location of a tumorlike lesion was the breast (22%), followed by central nervous system lesions (16%). Other frequent locations were the ovary (10%), caused exclusively by GCA and polyarteritis nodosa (PAN), and the male genitourinary system, almost all caused by PAN. Including vasculitis in the differential diagnosis of a tumorlike lesion might lead to an earlier diagnosis and consequently to prompt and appropriate treatment, avoiding needless operations. Constitutional symptoms and elevated ESR should alert clinicians to the possible diagnosis of vasculitis rather than a tumor. The association of GCA with ovarian pseudotumor is distinct and has not been emphasized before. We therefore suggest that GCA should be included in the list of differential diagnosis of an ovarian or breast tumor in an elderly woman, particularly when systemic symptoms and parameters of inflammation are present.- - - - - - - - - - ranking = 1keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
2/17. giant cell arteritis mimicking a testicular tumour.giant cell arteritis involving the testis was identified incidentally upon orchidectomy of a right testicular mass. The mass looked like a malignant process on ultrasound. The patient also had generalised disease and was treated appropriately. giant cell arteritis involving the bladder, prostate, uterus, and adnexa have been described before. To our knowledge, this is the first described case of giant cell arteritis affecting the testis.- - - - - - - - - - ranking = 0.0029471221270745keywords = arteritis (Clic here for more details about this article) |
3/17. Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach.BACKGROUND: polyarteritis nodosa (PAN) is a multisystem necrotising small and medium sized vasculitis that when left untreated carries a grave prognosis, with a five year survival of 10-15%. Prolonged immunosuppressive treatment with cyclophosphamide and steroids leads to high remission rates while carrying the risk of life threatening complications. The diagnostic and therapeutic approach for patients with isolated genital tract PAN is not well defined. OBJECTIVE: To present the management and follow up of two patients with limited PAN localised to the male and female reproductive system. case reports: A 26 year old man presented with an "acute scrotum". He was afebrile and had no other sign or symptom. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, liver and renal function tests, C reactive protein, antinuclear antibody, cryoglobulins, complement levels, antineutrophil cytoplasmic antibodies, and hepatitis B surface antigen, were all normal. His left testis was excised. Histopathology disclosed PAN of medium sized arteries with testicular infarction but no signs of torsion or infection. The other patient was a 51 year old woman who had had a total hysterectomy for a uterine myoma; incidentally PAN of the uterus and fallopian tubes was discovered. Neither patient received any immunosuppressive treatment after surgical removal of the affected organ. On prolonged follow up (clinical and laboratory evaluation) both patients are healthy with no sign of local recurrence or systemic PAN.- - - - - - - - - - ranking = 4.0913997096801keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
4/17. Isolated testicular polyarteritis nodosa mimicking testicular neoplasm-long-term follow-up.polyarteritis nodosa is a systemic vasculitis characterized by segmental necrotizing lesions of medium and small-size arteries. Rarely, the inflammatory process is isolated and involves a single organ without systemic manifestations. We describe a patient with isolated polyarteritis nodosa of the testis who presented with a testicular mass mimicking primary testicular tumor. The postoperative laboratory evaluation was negative. Long-term follow-up, without systemic treatment, showed no evidence of recurrence in the remainder of the testis or development of systemic vasculitis.- - - - - - - - - - ranking = 5.0913158800994keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis, necrotizing (Clic here for more details about this article) |
5/17. Isolated polyarteritis nodosa of the male reproductive system.polyarteritis nodosa (PAN) frequently affects the testis and epididymis. We describe a 29-year-old man with isolated PAN of the testis and review reported cases of isolated PAN of the testis or epididymis. Our patient underwent orchiectomy and at followup 17 months later was without evidence of recurrence or development of systemic PAN.- - - - - - - - - - ranking = 4.0913997096801keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
6/17. Wegener's granulomatosis diagnosed by testicular biopsy.Urogenital involvement, other than the kidneys, is extremely rare in Wegener's granulomatosis (WG) and occurs in less than 1% of the cases. When encountered it is confined to prostate, bladder, urethra, cervix, and vagina. Granulomatous infiltration of the testis from WG has not been cited in the medical literature. We report a case of WG in a Hispanic male who presented with sensorineural hearing loss and hemoptysis. He had a pulmonary lesion and a painless right testicular mass, which was found to have necrotizing granulomas on excisional biopsy. This may be the first reported case of WG diagnosed by testicular biopsy as testicular involvement is rare in WG. We believe that the actual incidence of testicular involvement in WG may be higher as genital examination may be ignored during routine physical examinations.- - - - - - - - - - ranking = 0.00033718786598763keywords = necrotizing (Clic here for more details about this article) |
7/17. Sonographic appearance of isolated necrotizing vasculitis of the testis.The presentation of necrotizing vasculitis of the testis is variable and may mimic a testicular tumor. Necrotizing vasculitis of the testis is characterized by fibrinoid necrosis of the walls of small and medium-sized testicular arteries. We report a patient with isolated necrotizing vasculitis of the testis who presented with clinical imaging findings suspicious for testicular neoplasm. We describe the clinical course and sonographic characteristics of evolving necrotizing vasculitis of the testis, briefly review the literature, and discuss the implications for the diagnosis and management of this condition.- - - - - - - - - - ranking = 0.0023603150619134keywords = necrotizing (Clic here for more details about this article) |
8/17. polyarteritis nodosa of the epididymis in a patient with Whipple's disease.The case of a 55-year-old white male who developed necrotizing arteritis localized to the superior pole of the epididymis is presented. He had a history of Whipple's disease and euthyroid Graves' disease. Histopathologic section of an extratesticular mass showed a necrotizing vasculitis with giant cells; periodic acid Schiff stain for Whipple "bacilli" was negative. The combination of rare diseases in our patient suggests the possibility of a common infectious or immune etiology, perhaps mediated via circulating immune complexes.- - - - - - - - - - ranking = 0.37343051104681keywords = nodosa, arteritis, necrotizing (Clic here for more details about this article) |
9/17. Symptomatic urogenital manifestations of polyarteritis nodosa and Churg-Strauss angiitis: analysis of 8 of 165 patients.To establish the clinical features and evolution of ureteral and testicular manifestations of polyarteritis nodosa, 8 cases among a group of 165 patients were reviewed. Urogenital manifestations are rare and were related to hepatitis b virus markers in 5 of the 8 patients. Malignant hypertension was present in 6 of 8 patients and renal insufficiency related to renal infarctions was noted in 5. prognosis is good and regression generally is obtained with steroid therapy or with plasma exchange and vidarabine when polyarteritis is related to hepatitis B virus. In some cases ureteral stenosis may require an operation in association with steroids and/or immunosuppressive treatments.- - - - - - - - - - ranking = 5.5554991977211keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis (Clic here for more details about this article) |
10/17. Testicular vasculitis: implications for systemic disease.Nine cases of testicular vasculitis were identified from the surgical pathology and autopsy files of the Johns Hopkins Hospital. In three cases this was the initial manifestation of polyarteritis nodosa. Two of these men presented with recurrent testicular pain and fever, with orchiectomy samples showing focal infarcts and necrotizing vasculitis. The third man presented with epididymitis, with his biopsy specimen showing vasculitis. In two cases, men presented with systemic and testicular signs of polyarteritis nodosa, and the diagnosis was made on testicular biopsy and later studied at autopsy. In another case, the testicular lesions were seen with Goodpasture's syndrome; the patient was thoroughly studied at autopsy, and no evidence of polyarteritis nodosa was found. In the remaining three cases, testicular vasculitis was identified incidentally without diseases associated with vasculitis, one at orchiectomy for prostate adenocarcinoma and the other two at autopsy. polyarteritis nodosa is the most common cause of necrotizing vasculitis of the testes, and pathologists should recognize the rare testicular presentation of this disease. However, testicular vasculitis also may be seen with other systemic diseases associated with vasculitis. Three of our cases were seen without systemic vasculitis, suggesting that testicular vasculitis may occur as an isolated finding without being a manifestation of systemic disease.- - - - - - - - - - ranking = 3.0924951028588keywords = polyarteritis, polyarteritis nodosa, nodosa, arteritis, necrotizing (Clic here for more details about this article) |
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