Cases reported "Cryptorchidism"

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11/36. Juvenile granulosa cell tumor of an intraabdominal testis.

    Juvenile granulosa cell tumor of the testis is a distinct form of sex cord-stromal tumor of neonates and infants [1]. This tumor comprises a significant percentage of testicular tumors in baby boys. We present a patient who had preoperative imaging studies.
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ranking = 1
keywords = operative
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12/36. Laparoscopic management of persistent mullerian duct syndrome.

    Between 1993-2002 we used both diagnostic and operative laparoscopy in the management of five cases of persistent mullerian duct syndrome (BMDS). Two siblings from two different families accounted for four of the cases. They presented with cryptorchidism and inguinal hernias. The diagnosis was established during diagnostic laparoscopy. The impalpable testes were on the left in three, on the right in one and bilateral in one. The latter case had been managed previously in another hospital by an open technique, and the diagnosis was missed. Transverse testicular ectopia was present in two unrelated boys. All the cases were managed by splitting the uterus in the midline and then bringing the testis with the vas and attached uterine tissue into the scrotum. Three of the five cases were managed laparoscopically. Follow-up of 6 months to 10 years showed satisfactory results in four of the five cases.
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keywords = operative
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13/36. Lost and found testes: the importance of the hCG stimulation test and other testicular markers to confirm a surgical declaration of anorchia.

    BACKGROUND: In patients with impalpable testes,laparoscopy or open surgery is considered conclusive in establishing the absence of testicular tissue. methods: Retrospective chart review. RESULTS: Over a 22-year period, 4 out of 82 patients with a diagnosis of bilateral anorchia by laparoscopy or laparotomy had persistent testicular tissue suggested by endocrine evaluations. The clue to the presence of testicular tissue was: (1) a pubertal rise in plasma testosterone (2 patients); (2) the presence of possible Mullerian structures and of a detectable plasma anti-mullerian hormone (1 patient), and (3) the fact that one of the gonads had not been seen at surgery (1 patient who still had a testosterone response to hCG postoperatively). Testes were localized by venography (3 patients) and laparotomy (1 patient). CONCLUSION: A surgical diagnosis of bilateral anorchia needs to be confirmed by hCG stimulation, gonadotropin levels, or other markers of testicular function.
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ranking = 1
keywords = operative
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14/36. Cystic dysplasia of the rete testis associated to cryptorchidism: a case report.

    A case of cystic dysplasia of the rete testis (CDRT) is reported. Nine months after right orchidopexy, a 10-year-old boy presented a palpable mass in the ipsilateral hemi-scrotum. Preoperative ultrasound showed a cystic lesion involving almost the whole testis. Radical orchidectomy was performed and at gross examination a hilar multiloculated cystic lesion was confirmed; microscopic examination showed cystic spaces lined by benign appearing monostratified epithelium with atrophy of the surrounding testicular parenchyma. These findings were consistent with the diagnosis of cystic dysplasia of the rete testis. Immunohistochemical investigation evidenced a pattern similar to that of a normal rete testis. Renal ultrasound and DTPA scintigraphy performed after pathological diagnosis documented the absence of the ipsilateral kidney. CDRT is a rare cause of scrotal swelling in the pediatric patient. When diagnosis is suspected, based on clinical and sonographic findings, conservative surgery may be considered.
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ranking = 1
keywords = operative
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15/36. A case of immature teratoma originating in intra-abdominal undescended testis in a 3-month-old infant.

    Teratomas in an undescended testis are rare in infants. This report was the youngest case of immature teratoma originating in intra-abdominal undescended testis. A 3-month-old infant with cryptorchism was seen because of an asymptomatic palpable mass in the right abdomen. ultrasonography and computed tomography revealed a multicystic large tumor with focal calcifications in the right side and serum tumor markers within normal limits. Complete resection of the tumor was performed and the histopathological diagnosis was made as immature teratoma of the right testis. Because retroperitoneal lymph nodes metastasis was observed in 3-month follow-up postoperatively, retroperitoneal lymphadenectomy and chemotherapy including bleomycin, etoposide, and cisplatin were performed. Presently, the infant has been free of recurrence for 3 years. We suggest that nonpalpable testis should undergo a careful evaluation and prompt resolution and that the subsequent finding of an intra-abdominal mass should make us think on the possibility of intra-abdominal testicular germ cell tumor. Postoperative adjuvant chemotherapy in combination with complete resection of the tumor is necessary for pediatric immature teratomas originating in intra-abdominal undescended testis.
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ranking = 2
keywords = operative
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16/36. Preoperative multidetector computed tomography diagnosis of a seminoma originating from an undescended testis by "testicular vascular pedicle" sign.

    We report a 65-year-old man with a palpable right lower quadrant mass who underwent multidetector computed tomography (MDCT) examination. Preoperative diagnosis of seminoma was possible by demonstration of "testicular vascular pedicle" sign by MDCT. We describe CT findings of the "testicular vascular pedicle" sign in this report.
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ranking = 5
keywords = operative
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17/36. Torsion of an intraabdominal testis tumor presenting as an acute abdomen.

    Torsion of an intraabdominal testicular tumor is a rare preoperative diagnosis. An increased diagnostic yield is dependent on an expedient and comprehensive preoperative evaluation. This consists of a detailed past surgical history, a thorough physical examination, and close inspection of the preoperative abdominal films. An illustrated case report is presented.
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ranking = 3
keywords = operative
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18/36. CT and MR imaging of malignant germ cell tumor of the undescended testis.

    Preoperative localization of the impalpable undescended testis is necessary to facilitate proper surgical planning. There is an increased incidence of malignant change in the undescended testis; demonstration of malignancy before surgery will significantly alter the treatment. We describe the computed tomographic (CT) and magnetic resonance (MR) findings in 2 patients with malignant change in an intraabdominal testis. The CT scan revealed lesions with areas of low density, 1 of which had focal calcifications; MR revealed lesions of predominantly low or intermediate signal intensity on both long and short TR/TE images, with some areas of very high signal on both sequences. After initial management with chemotherapy, the residual tumor was surgically resected. In neither instance was residual normal testis demonstrated. Both CT and MR are ideal methods of examining malignant transformation of the undescended testis, because of their ability to characterize the internal structure of the organ and, in the case of MR, its capacity for multiplanar imaging. They are almost of equal value except for the ability of CT to identify calcification and of MR to diagnose hemorrhage.
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ranking = 1
keywords = operative
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19/36. Bilateral trifid ureters associated with fused kidney, ureterovesical stenosis, left cryptorchidism and angioma of the bladder.

    The first case of bilateral trifid ureters associated with fused kidney, ureterovesical stenosis, a left undescended testicle and angioma of the bladder is reported. Bilateral ureteroneocystostomy and left orchiopexy were done. The patient is well 3 months postoperatively with no urinary tract infection and stable renal function.
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ranking = 1
keywords = operative
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20/36. Purported absence of the testis following surgical exploration: the need for further investigation.

    Two cases of purported absence of the testes following extensive surgical exploration are reported. On subsequent investigation both boys were found to have testes. It is recommended that when confronted with a patient with a similar history the operative record should be studied and the original surgeon should be contacted to ascertain that either a testis was removed or bind-ending internal spermatic vessels were found. If proper documentation is not available, further evaluation should be done.
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ranking = 1
keywords = operative
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