Cases reported "Cryptorchidism"

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1/36. Transverse testicular ectopia: preoperative diagnosis by ultrasonography.

    Transverse testicular ectopia (TTE) is a rare anomaly. We report the first case of TTE described in taiwan. The physical examination, ultrasonography (US), and laparoscopy revealed both testes in the left hemiscrotum, and surgical correction was performed. This case was diagnosed preoperatively by US, which can offer an easy, safe, and convenient alternative in the preoperative diagnosis of TTE. The possible mechanism for this anomaly and the literature are reviewed.
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2/36. Congenital spigelian hernia and cryptorchidism: cause or coincidence?

    Congenital spigelian hernia (SH) is very rare in the pediatric age group. This is a report of two cases of SH in 1-week and 3-month-old male infants. A review of the literature revealed only 35 cases of SH in children younger than 17 years of age, bringing the total including our 2 cases to 37. There were 25 males and 12 females, a ratio of 2.1:1. Their ages ranged from 6 days to 17 years (mean 4.52 years). The hernia was situated on the right side in 13, the left side in 19, and was bilateral in 4. In one case the side of the hernia was not mentioned. In 29 cases the hernia was spontaneous while in 5 it was caused by trauma. In 3 children the hernia developed postoperatively, in 2 following repair of a congenital diaphragmatic hernia and in 1 following excision of a mediastinal neuroblastoma. Two children presented with a strangulated SH. Eleven of the 35 previously reported children had associated conditions; in 5 there was an ipsilateral undescended testis (UDT). Our two infants with SH also had an ipsilateral UDT. The significance of this association is discussed.
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3/36. Noonan's syndrome and seminoma of undescended testicle.

    A 26-year-old white man with Noonan's syndrome and a history of lifetime lymphedema had had bilateral orchiopexy for undescended testicles at the age of 12. He noticed increased swelling of the right testicle confirmed by ultrasonography as a solid mass. Computed tomography of the abdomen and pelvis showed multiple enlarged mesenteric and retroperitoneal lymph nodes. At right inguinal orchiectomy, pathologic findings were consistent with seminoma of the right testicle. Postoperatively, he was treated with four cycles of cisplatin and etoposide. A case of nonseminoma in Noonan's syndrome has been reported previously, but this is first case report of seminoma in a patient with Noonan's syndrome.
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4/36. Bidirectional Glenn shunt in an infant with prune-belly syndrome.

    The prune-belly syndrome (PBS) usually is described as a deficiency of the anterior abdominal muscle involving bilateral cryptorchidism and urinary tract malformations. In this report, we will present an eleven-month-old boy with PBS associated with a complex cardiac anomaly. A bilateral bidirectional Glenn shunt was performed with the diagnosis of isolated dextrocardia, single ventricle, pulmonary atresia, incomplete A-V septal defect, hemiazygos continuity, persistent right superior vena cava, patent ductus arteriosus-dependent pulmonary blood flow. The patient required special consideration for postoperative pulmonary care.
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5/36. Transverse testicular ectopia detected by MR imaging and MR venography.

    Crossed testicular ectopia is a rare anomaly, characterised by migration of one testis towards the opposite inguinal canal. In most reported cases, the correct diagnosis was not made pre-operatively. We report a case of transverse testicular ectopia diagnosed pre-operatively with MRI. MRI and MR venography demonstrated unilateral location of both testes in the right inguinal canal, which was confirmed by surgery. We provide a brief literature review of transverse testicular ectopia and the imaging of undescended testis.
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6/36. Postoperative hepatic laceration in a child with type 3 von Willebrand disease.

    We report an unusual postoperative complication (hepatic laceration) in a child with type 3 vWD, who has not received any prophylaxis.
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7/36. Bilateral cryptorchidism with bilateral inguinal hernia and retrovesical mass in an infertile man: single-stage laparoscopic management.

    A 30-year-old married man presented with the complaint of inability to procreate. Examination revealed bilateral nonpalpable testes and bilateral inguinal hernia. ultrasonography of the abdomen could not locate the testis; instead, a hypoechoic 5 x 5-cm mass was found behind the bladder. A CT scan of the abdomen revealed the right testis near the right inguinal canal. The left testis could not be identified beside the soft tissue mass. The patient was taken for diagnostic as well as therapeutic laparoscopy. The testis on the right was found just proximal to the internal inguinal ring, and right orchidopexy was done. The left testis was small and rudimentary; hence, orchidectomy was done. Bilateral laparoscopic herniorrhaphy was carried out with polypropylene mesh by fixing it intracorporeally to the pubic bone, Cooper's ligament, inguinal ligament, and conjoint tendon. Subsequently, the retrovesical mass was excised and retrieved by dilating the umbilical port site. The operative time was 3.5 hours with minimal blood loss. The postoperative period was uneventful, and the patient was discharged after 24 hours. The histopathology examination of the retrovesical mass showed an extragonadal germ cell tumor compatible with seminoma.
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8/36. Mature teratoma arising in intraabdominal undescended testis in an infant with previous inguinal exploration: case report and review of intraabdominal testicular tumors in children.

    The authors report the youngest case of postoperative intraabdominal mature testicular teratoma in a 5-year-old boy after previous exploration for impalpable testis. A total of 26 cases of intraabdominal testicular tumor in children including our case were reviewed and discussed from both the English- and the Japanese-language literature. The average age was 2.5 years, and, in the 13 children younger than 1 year there were no malignant teratomas, although there was one immature teratoma. Four of these had undergone previous inguinal exploration in which 3 patients except our patient were more than 10 years old. This case report confirms the importance of finding an intraabdominal testis at operation for impalpable testis. Early detection of the testicular location near the internal inguinal ring in these patients supports the hypothesis that the intraabdominal testicular teratoma itself may have been the primary cause of the undescended testis. Furthermore, it is suspected that many of the intraabdominal testicular malignant teratomas in adults may have arisen from these mature testicular teratomas in infants.
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9/36. seminoma in an intra-abdominal testis misdiagnosed as a kidney tumor and associated with ipsilateral renal agenesis.

    We present a case of seminoma found in an intra-abdominal testis and associated with ipsilateral renal agenesis and absence of the ipsilateral seminal vesicle. Although malignant tumor degeneration in an undescended intra-abdominal testis is rare, understanding its radiologic appearance is important in order to confirm the diagnosis preoperatively and detect possible malformations of other organs.
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10/36. Laparoscopic orchiectomy and contralateral vasectomy in a patient with an abdominal testicle: a case report.

    We present a case of a 38-year-old man with a unilateral intra-abdominal testicle and undesired fertility in whom orchiectomy and contralateral vasectomy were performed laparoscopically. Urologists have been using diagnostic laparoscopy in patients with nonpalpable testes to plan the definitive procedure when the testicle is present, and to avoid laparotomy in cases of testicular absence. This case of laparoscopic orchiectomy and vasectomy demonstrates that operative laparoscopy allows another subset of patients with cryptorchidism to avoid open laparotomy.
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