1/2277. Primary carcinoid of testis. A patient with primary solid carcinoid of the testis is described and 8 previous cases are reviewed. Ultrastructural study of our case disclosed pleomorphic granules, typical of the insular type carcinoid of the intestine of midgut derivation. Primary solid testicular carcinoid appears to behave as a benign neoplasms. None of these patients had evidence of metastases or the carcinoid syndrome for periods ranging from 20 months to 25 years. ( info) |
2/2277. Mixed testicular tumor in immunosuppressed patient: case report. A 30-year-old man who was maintained on immunosuppressants following renal transplantation had seminoma with teratoma of the right testis 3 months postoperatively. The temporal relationship in the development of the tumor in the presence of immunosuppressants strongly suggests the importance of the immunodefense mechanism in the control, development or growth of the neoplasm. ( info) |
3/2277. Fine needle biopsy of metastases at retrograde pyelography, directed by fluoroscopy. Report of a case with malignant teratoma of the testis. Percutaneous fine needle aspiration biopsy was performed at retrograde pyelography in order to differentiate between metastatic and scarry involvement of a strictured ureter in a patient earlier operated upon because of malignant teratoma. The method is recommended in patients with malignant diseases where the differential diagnosis is impossible to establish at retrograde pyelography or urography. ( info) |
4/2277. life-threatening germ cell tumor arising in cryptorchidism: a case report. We report a case of life-threatening germ cell tumor in abdominal cryptorchidism. A 32-year-old man presented with a three-month history of dyspnea, loss of appetite, general weakness and a large abdominal mass. physical examination revealed vacancy of the right scrotal contents. Chest radiograph showed massive left pleural effusion. Abdominal ultrasound revealed ascites, right hydronephrosis and the presence of an 18 x 15-cm heterogeneous echogenic mass in the upper abdomen and right iliac fossa. Abdominal computerized tomography (CT) revealed the presence of a large heterogeneous tumor and an enlarged (4 x 4-cm) retroperitoneal lymph node. Sonoguided needle biopsy of the abdominal mass demonstrated malignant cells of an uncertain type and origin. serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) concentrations were elevated. Under the diagnosis of metastatic nonseminomatous germ cell tumor in abdominal cryptorchidism, the patient received three cycles of cisplatin-based combination chemotherapy followed by resection of the abdominal residual cryptorchid tumor. Histologically, the tumor showed marked necrosis without viable cancer. The patient had remained free of disease for seven months following surgery. ( info) |
5/2277. Neuro-ophthalmologic manifestations of a paraneoplastic syndrome and testicular carcinoma. The authors report two patients with testicular cancer who exhibited supranuclear gaze disorders as a manifestation of a paraneoplastic brainstem encephalomyelitis. In the first patient, neuro-ophthalmic dysfunction was accompanied by a prominent limbic encephalitis whereas in the second patient, an unusual, mixed pendular and jerk nystagmus was manifested. neuroimaging revealed an enhancing hypothalamic mass in the first patient and was negative in the second. blood from both patients contained an antibody previously reported in a patient with limbic encephalitis and testicular cancer. ( info) |
6/2277. Ossified intratesticular mucinous tumor. We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 x 4.8 x 4-cm, predominantly solid, and partially cystic mass completely replaced the testis with no extension to tunica albuginea and epididymis. The multiloculated area was mostly covered by a single layer of bland mucinous epithelium with few areas of epithelial tufting, stratification, and nuclear atypia. The solid areas consisted of mature bone and fibrous stroma with cholesterol clefts, some multinucleated giant cells, moderate infiltration of lymphocytes, and foamy vacuolated macrophages. The bone showed occasional rimming of osteoblasts and rare osteoclasts. Rare foci of mature bone were found in the nonfibrosed wall and lumen cysts. The patient is alive and well 3 years after right orchiectomy with spermatic cord resection. ( info) |
7/2277. Late recurrence with malignant degeneration of testicular teratoma. Case report. Radical orchiectomy was performed on a 25-year-old man for benign mature teratoma. A synchronous without change 3 cm retroperitoneal mass was followed for five years. The mass enlarged and became symptomatic twelve years after orchiectomy. Excision of the mass revealed a non-seminomatous germ cell tumor. Possible explanation is malignant degeneration of the teratomatous elements. Testicular teratomas should be treated as potentially malignant non-seminomatous tumor. ( info) |
8/2277. Surgical management of chylous fistula after retroperitoneal lymph node dissection. Conservative treatment with low-fat diet, medium-chain triglyceride or total parenteral nutrition, depending on the general condition of the patient, is the mainstay in the treatment of chylous ascites. In patients with persistent chylous fistula direct surgical closure is a valid treatment option. ( info) |
9/2277. Primary carcinoid tumor of the testis: immunohistochemical, ultrastructural and dna flow cytometric study of two cases. Primary testicular carcinoid tumor, occupying 0.23% of testicular neoplasm, is a rare and indolent neoplasm with the potential for distant metastasis. We present two cases of primary pure carcinoid tumor of the testis. Both patients were 36 years old. physical examination revealed testicular mass with and without tenderness. The preoperative serum levels of beta-human chorionic gonadotropin and alpha-fetoprotein were normal and neither patient had carcinoid syndrome. The tumors measured 7.5x6x4 cm and 5.5x5x4 cm in size. Histologically, immunohistochemically and ultrastructurally, the tumors showed typical features of the carcinoid tumor. Case 1 showed extensive tumor necrosis and vascular invasion. dna flow cytometric analysis showed aneuploidy with dna index of 1.47 and S G2M of 14.0% in case 1 and tetraploidy with dna index of 1.96 and S G2M of 22.1% in case 2. Both patients have been well without any signs of metastasis after operation for 24 months in case 1 and for 16 months in case 2. ( info) |
10/2277. Primary follicular lymphoma of the testis in childhood. BACKGROUND: Follicular lymphoma in childhood is rare. The authors present four unusual primary follicular lymphomas of the testis in children. methods: Tumor tissue was evaluated using light microscopy, immunohistochemistry, flow cytometry, and polymerase chain reaction (PCR) for immunoglobulin heavy chain (IgH) and bcl-2 gene rearrangements. Southern blot and immunohistochemical analyses were used to detect bcl-6 gene rearrangements and protein expression, respectively. RESULTS: Four young boys ranging in age from 3 to 10 years were diagnosed with Stage IE follicular large cell lymphoma (Grade 3). A B-cell phenotype was documented in all four cases; monoclonality was confirmed in three cases by demonstration of light chain restriction or clonal IgH gene rearrangement. None of the lymphomas expressed Bcl-2 or p53 protein, and bcl-2 gene rearrangements were not found in the three lymphomas studied. In contrast, Bcl-6 protein was expressed by all three lymphomas studied, and a bcl-6 gene rearrangement was detected in the one case analyzed by Southern blot. All four boys were treated by orchiectomy and combination chemotherapy and are alive with no evidence of disease 18-44 months following their initial diagnoses. CONCLUSIONS: Follicular lymphomas may rarely occur as primary testicular tumors in prepubertal boys and, when localized, appear to be associated with a favorable prognosis. In contrast to follicular lymphoma in adults, pediatric follicular lymphomas of the testis are usually of large cell type (Grade 3) and lack bcl-2 or p53 abnormalities. The identification, in one case, of a bcl-6 gene rearrangement suggests an alternate molecular pathogenesis for pediatric follicular lymphoma. ( info) |