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American Family Physician Feb 1998Family physicians often must evaluate patients with testicular pain or masses. The incidental finding of a scrotal mass may also require evaluation. Patients may seek... (Review)
Review
Family physicians often must evaluate patients with testicular pain or masses. The incidental finding of a scrotal mass may also require evaluation. Patients may seek evaluation of a scrotal mass as an incidental finding. An accurate history combined with a complete examination of the male external genitalia will help indicate a preliminary diagnosis and proper treatment. Family physicians must keep in mind the emergency or "must not miss" diagnoses associated with testicular masses, including testicular torsion, epididymitis, acute orchitis, strangulated hernia and testicular cancer. Referral to a urologist should be made immediately if one of these diagnoses is suspected. Benign causes of scrotal masses, including hydrocele, varicocele and spermatocele, may be diagnosed and managed easily in the primary care office.
Topics: Diagnosis, Differential; Epididymitis; Genital Diseases, Male; Hernia, Inguinal; Humans; Male; Orchitis; Spermatic Cord Torsion; Spermatocele; Testicular Diseases; Testicular Hydrocele; Testicular Neoplasms; Varicocele
PubMed: 9490992
DOI: No ID Found -
Urology May 1998High resolution ultrasound has increased our awareness of benign testicular cysts that appear to arise from the intratesticular sperm conduit system of the...
High resolution ultrasound has increased our awareness of benign testicular cysts that appear to arise from the intratesticular sperm conduit system of the intratesticular ducts of the mediastinum and rete testis. The location of these benign cysts in the area of the mediastinum and rete testis and the absence of signs of a germ cell tumor may permit testicle preservation. These benign cysts may contain sperm. We present a case of a benign sperm-containing cyst with visible communication to the rete testis, designated an intratesticular spermatocele and managed with testicle preservation.
Topics: Adult; Humans; Male; Spermatocele; Testis
PubMed: 9610575
DOI: 10.1016/s0090-4295(98)00087-9 -
The Turkish Journal of Pediatrics 2022Placental transmogrification of the lung (PTL) is a clinical spectrum varying from asymptomatic to severe pulmonary impairment; such as recurrent pneumothorax,...
BACKGROUND
Placental transmogrification of the lung (PTL) is a clinical spectrum varying from asymptomatic to severe pulmonary impairment; such as recurrent pneumothorax, bronchopneumonia, respiratory distress syndrome and chronic obstructive airway disease. PTL usually presents as a bullous lesion, and rarely can appear in nodule or cyst formation on chest imaging. PTL with giant bullous emphysema has a male preference, is more commonly unilateral and mostly affects one lobe, but can rarely involve more than one lobe.
CASE
Here we report a 13-year-old boy presenting with bullous emphysema and coexisting with a borderline testicular tumor. He had no complaints of cough, sputum, or shortness of breath. He had a past medical history of pneumonia five years ago. In order to elucidate the underlying lung pathology, a wedge lung biopsy was performed and the patient was diagnosed with PTL. Scrotum ultrasonography was performed because of hydrocele in both testes, and bilateral epididymal cysts with papillary solid projections were reported. Pathological examination of the epididymal tumor revealed a `Mullerian type borderline epithelial neoplasm` which is an analogue of the ovarian serous borderline tumor.
CONCLUSIONS
In conclusion, we reported the youngest PTL case in the literature, a rare disease with unknown pathophysiology, presenting as bullous emphysema and coincidental Mullerian type borderline epithelial neoplasm. It is important to diagnose placental transmogrification of the lung in a child with bullous emphysema because compared to other cystic lung diseases it is a benign disease and if no additional malignity exists, lobectomy or pneumonectomy is the cure for the disease.
Topics: Child; Male; Female; Humans; Pregnancy; Adolescent; Placenta; Pulmonary Emphysema; Lung; Emphysema; Neoplasms, Glandular and Epithelial
PubMed: 36305451
DOI: 10.24953/turkjped.2021.5515 -
Clinical Case Reports Dec 2020Bilateral epididymal cysts are infrequent particularly in children. They commonly arise from the epididymal head. Cysts arising from the epididymal tails are very rare....
Bilateral epididymal cysts are infrequent particularly in children. They commonly arise from the epididymal head. Cysts arising from the epididymal tails are very rare. Spontaneous resolution may occur with no need for surgical excision of cysts and can take up to 50 months.
PubMed: 33363806
DOI: 10.1002/ccr3.3199 -
Annals of Surgery Oct 1920
PubMed: 17864356
DOI: 10.1097/00000658-192010000-00009 -
American Journal of Men's Health May 2018Scrotal sonography is commonly used for evaluation of the infertile male. While epididymal cysts are frequently observed during sonographic assessment, their presence...
Scrotal sonography is commonly used for evaluation of the infertile male. While epididymal cysts are frequently observed during sonographic assessment, their presence has uncertain import. This study is a retrospective case-control sonographic and chart review comparison of infertile men and fertile volunteers to clarify the possible association of epididymal cysts and infertility. The study included 91 consecutively recruited patients from January 2012 to December 2014. The infertile group consisted patients with male factor infertility who underwent scrotal sonography ( n = 67). The fertile group consisted of men requesting vasectomy who were recruited for study involvement and consented to undergo scrotal sonography ( n = 24). The main outcome measure was infertility. The existence of epididymal cysts on scrotal sonography was the main risk factor. Predictably, the only sonographic findings associated with infertility were small testes (right: t = -2.52; left: t = -2.28, both p = .01) and the presence of a varicocele, χ = 5.766 with p = .02. The infertile men were also younger and more likely to use alcohol. Of the 91 men studied, 71% demonstrated epididymal cysts (73% of infertile and 67% of fertile men). Epididymal cysts were not be associated with infertility, χ = 0.362 with p = .55. This occurrence of epididymal cysts is the highest ever reported (71% of all men). While the occurrence of epididymal cysts in this cohort is unexplained, our observation that these cysts are not associated with infertility will be useful for those clinicians counseling patients observed to have these structures.
Topics: Adult; Humans; Infertility, Male; Male; Medical Audit; Michigan; Middle Aged; Retrospective Studies; Scrotum; Spermatocele; Ultrasonography; Young Adult
PubMed: 27118455
DOI: 10.1177/1557988316644976 -
Cureus May 2022Bilateral multilocular huge epididymal cysts are a rare entity with few reports in the literature. Epididymal cysts are mostly found in middle-aged men with or without...
Bilateral multilocular huge epididymal cysts are a rare entity with few reports in the literature. Epididymal cysts are mostly found in middle-aged men with or without symptoms. We present the case of a 45-year-old man with asymptomatic bilateral scrotal swelling, which was clinically diagnosed as a right epididymal cyst with left hydrocele. However, an ultrasound of the scrotum revealed bilateral epididymal cysts with normal testes. Intraoperatively, it demonstrated bilateral huge epididymal cysts for which the patient underwent excision of bilateral epididymal cysts. Postoperatively, the patient is doing well on follow-up. Thus, it is concluded that when the epididymal cyst is larger than 10 mm or 1 cm and does not involute with time, surgery is indicated. In comparison, epididymal cysts smaller than 10 mm or 1 cm are managed conservatively.
PubMed: 35677005
DOI: 10.7759/cureus.24722 -
Diagnostic and Interventional Radiology... Mar 2011The use of high-frequency ultrasound is increasing for the treatment of cystic, vascular, and solid non-neoplastic intratesticular masses. Cystic lesions examined... (Comparative Study)
Comparative Study Review
The use of high-frequency ultrasound is increasing for the treatment of cystic, vascular, and solid non-neoplastic intratesticular masses. Cystic lesions examined include simple testicular cysts, tunica albuginea cysts, epidermoid cysts, tubular ectasia of rete testis, and intratesticular abscesses. Vascular lesions examined include intratesticular varicocele and intratesticular arteriovenous malformations. Solid lesions examined include fibrous pseudotumor of the testis, focal or segmental testicular infarct, fibrosis of the testis, testicular hematoma, congenital testicular adrenal rests, tuberculoma, and sarcoidosis. Gray-scale and color-flow Doppler sonography facilitate the visualization of the benign characteristics of the lesions. Magnetic resonance imaging can also help as a problem-solving modality in some cases.
Topics: Adult; Aged; Biopsy, Needle; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Rete Testis; Risk Assessment; Sensitivity and Specificity; Spermatocele; Testicular Diseases; Testicular Neoplasms; Ultrasonography, Doppler, Color; Varicocele
PubMed: 20677130
DOI: 10.4261/1305-3825.DIR.3116-09.0 -
Hinyokika Kiyo. Acta Urologica Japonica Aug 1963
Topics: Adolescent; Appendix; Child; Cysts; Diagnosis, Differential; Embryology; Epididymis; Geriatrics; Humans; Infant; Infant, Newborn; Male; Spermatocele; Testis
PubMed: 14051176
DOI: No ID Found -
Cureus Dec 2023Torsion of an epididymal cyst is one of the rare and least-known causes of acute scrotal pain. Epididymal cysts, when large, can undergo occasional complications like...
Torsion of an epididymal cyst is one of the rare and least-known causes of acute scrotal pain. Epididymal cysts, when large, can undergo occasional complications like infection or, rarely they might undergo torsion, needing emergency surgery. We present a case of a 37-year-old gentleman with acute scrotal pain to the scrotum. Testicular torsion was suspected clinically, but sonography revealed a normal-appearing testis and a large left-sided epididymal cyst with internal echoes and dependent debris. A diagnosis of epididymal cyst torsion was suspected based on sonographic findings. Exploratory surgery showed a reddish, inflamed epididymal cyst that had undergone torsion on its pedicle. The cyst was excised leading to symptomatic relief to the patient. Due to the rarity of this condition, such cases are often misdiagnosed clinically as testicular torsion. Ultrasonography helps in aiding the correct diagnosis and the radiologist needs to be familiar with the radiological aspects of diagnosing torsion of epididymal cysts.
PubMed: 38283501
DOI: 10.7759/cureus.51158