Cases reported "Testicular Diseases"

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1/20. Case of mediastinal seminoma with testicular microlithiasis.

    Testicular microlithiasis is a rare condition in which calcified concretions fill the lumina of the seminiferous tubules. We report the case of a 19-year-old Japanese man with mediastinal seminoma, normal testicular physical findings and bilateral testicular microlithiasis seen on ultrasonography. Testicular needle biopsy demonstrated multiple laminated calcifications within the seminiferous tubules without any signals of a viable germ cell tumor. To our knowledge, this is only the sixth reported case of extragonadal germ cell tumor with testicular microlithiasis.
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ranking = 1
keywords = germ
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2/20. The association of germ cell tumours of the testis with sarcoid-like processes.

    Sarcoid-type pulmonary lymphadenopathy associated with testicular cancer is a rare condition which has been previously reported in only 14 cases. Earlier case reports have failed to distinguish between generalized sarcoidosis as opposed to a local granulomatous reaction to tumour. We describe a further 8 cases of the association and provide strong supportive evidence for systemic sarcoidosis in 5 of our patients. In 3 of our patients with systemic sarcoidosis there was coexisting testicular cancer requiring additional treatment. We therefore advise caution in the interpretation of the clinical and histological findings in these patients, and recommend thorough investigation of all such cases.
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ranking = 2
keywords = germ
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3/20. yolk sac tumor and testicular microlithiasis.

    yolk sac tumor (YST) of prepubertal testis is a peculiar neoplasm with overall good prognosis. There are no known conditions associated with the development of this tumor. The case of a 2-year-old boy with testicular YST and presence of testicular microlithiasis (TM) in the adjacent-still-recognizable testicular tissue is reported. Concentrically laminated microliths were clearly extratubular structures. Ultrasound of the remaining testis revealed microlithiasis. Bilateral TM is being recognized with increasing frequency due to the extensive use of ultrasound. The exact meaning of its finding has not been definitively elucidated, but the association of TM with cryptorchidism, intratubular germ cell neoplasia and germ cell tumors either of the testis or mediastinum is on record. The combination of prepubertal YST and bilateral TM has not been reported previously. Finding of TM at this early age suggests a congenital deranged Sertoli cell function and/or an abnormal gonadal embryogenesis in its pathogenesis.
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4/20. Bilateral testicular microlithiasis with a unilateral testicular germ cell tumor: a case report.

    There is an important association between testicular microlithiasis and germ cell tumors. Ultrasound findings of 1-3 mm echogenic foci within the testicular parenchyma may be noted. Testicular microlithiasis in the general population without germ cell tumors or cryptorchidism has been estimated between 0.05 and 0.6%. However, findings of microlithiasis in concordance with germ cell tumors can be as high as 40%. We present the case report of a man with bilateral testicular microlithiasis and a unilateral germ cell tumor. Discussion of the relationship between these two conditions is also reviewed.
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ranking = 4
keywords = germ
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5/20. Macro-orchidism: light and electron microscopic study of four cases.

    A hormonal and quantitative light microscopy study of one man with macro-orchidism associated with mental retardation and fragile x chromosome (case no. 1) and three men with idiopathic macro-orchidism (cases no. 2 to 4) is reported. Hormonal study revealed slightly increased follicle-stimulating hormone serum levels in cases no. 1 to 3. The testes from cases no. 1 (orchidoepididymoectomy specimen) and 2 (testicular biopsy) presented interstitial edema and three different tubular patterns that were arranged in a mosaic-like manner. Type I tubules had an increased diameter (less than 220 microns), dilated lumen, and thin seminiferous epithelium usually consisting of sertoli cells, spermatogonia, primary spermatocytes, and sometimes a few spermatids. Type II tubules had a normal diameter (180 to 220 microns) and germ cell development varied between complete spermatogenesis and Sertoli-cell-only tubules. Type III tubules had decreased diameter (less than 180 microns), atrophic seminiferous epithelium, and thickened tunica propria. The appearance of the nuclei of the sertoli cells in the three types of tubules could be either mature or immature. Some of the mature sertoli cells presented a granular cytoplasm. A few of these granular cells grouped together, forming nests that protruded into the tubular lumen. The testicular biopsies from cases no. 3 and 4 only presented type II tubules that contained both mature and immature sertoli cells. Quantitative study revealed that the large testicular size was principally due to an increased tubular length in all four cases. Although the seminiferous tubule lesions and interstitial edema suggest an obstructive process, the testicular excretory ducts (studied in case no. 1) appeared normal or only slightly dilated. It is possible that the seminiferous tubule lesions (dilated lumen and germ cell depletion) might be secondary to the Sertoli cell lesions (granular cytoplasm and nuclear immature-like pattern.
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ranking = 1
keywords = germ
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6/20. Testicular microlithiasis heralding mixed germ cell tumor of the testis in a boy.

    The clinical implications of the association between testicular microlithiasis (TM) and germ cell tumor (GCT) of the testis are still debated since the natural history of incidentally discovered TM has not been defined. Therefore, it is questionable whether TM can be considered as a precursor of malignancy. We are reporting the case of a 9-yr-old boy with a mixed GCT who had presented 3 yr earlier with TM and hydrocele. This evolution suggests that testicular GCT may develop some years later in a boy with pre-existing and incidentally discovered TM. Our case history and other reports of the literature might suggest a strong association between both conditions, thus vindicating the view that individuals with TM should have clinical and ultrasound follow-up. Longitudinal evaluation may be particularly indicated in the patients with additional testicular dysgenetic features, apart from TM.
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ranking = 2.5
keywords = germ
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7/20. Ultrasonographic findings of testicular microlithiasis associated with intratubular germ cell neoplasia.

    Testicular microlithiasis is an uncommon condition in which calcified concretions fill the lumina of seminiferous tubules. We report the case of a twenty-three-year-old white man with a metastatic germ cell tumor and normal findings on testicular physical examination, but abnormal ultrasonography of the right testis. orchiectomy revealed intratubular germ cell neoplasia with testicular microlithiasis. Multiple circular echogenic foci on ultrasound correlated with the histologic finding of testicular microlithiasis. Further studies are indicated for assessing ultrasonography as an adjunct for screening the population at risk for intratubular germ cell neoplasia.
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ranking = 3.5
keywords = germ
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8/20. sarcoidosis and testicular germ cell tumor. Case report.

    The authors describe the case of a patient with stage II non seminomatous germinal cell tumor of the testis with a generalized sarcoidosis. They review the existing literature and discuss the problem of diagnosis.
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ranking = 2.5
keywords = germ
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9/20. Congenital testicular lymphangiectasis in children with otherwise normal testes.

    Two cases of testicular lymphangiectasis are reported, occurring in stillborns. The disease is a congenital malformation consisting of an abnormal expansive development of lymphatic vessels in both testes. autopsy study revealed the absence of pulmonary, intestinal or systemic lymphangiectasis. The testes showed normal tubular development with normal germ cell numbers and also normal Leydig cell numbers. The epididymis and spermatic cord appeared normal. In contrast with the two previously reported cases of testicular lymphangiectasis, the present cases were not associated with cryptorchidism or other malformations.
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keywords = germ
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10/20. Epidermoid cyst of the testis.

    An epidermoid cyst of the testis is a rare benign lesion, representing about 1% of all testicular tumors. Most of the lesions occur between the age of 20 and 40 and present as a painless enlargement of the testis, or are found as a nodule on routine examination. Histopathologic findings consist of a cyst filled with keratin and lined by a squamous epithelium. There is evidence that this tumor is of germ-cell origin and represents monoepidermal differentiation of a benign teratoma. There is some discussion about treatment, but most authors perform radical orchiectomy.
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