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Minerva Anestesiologica Mar 2021
Topics: Humans; Male; Nerve Block; Pain, Postoperative; Pudendal Nerve; Spermatic Cord
PubMed: 33300329
DOI: 10.23736/S0375-9393.20.15061-2 -
World Journal of Clinical Cases Jan 2021Tumors of the spermatic cord are rare, and approximately 25% are malignant neoplasms. Metastatic spermatic cord tumors are even rarer. Several studies have revealed that...
BACKGROUND
Tumors of the spermatic cord are rare, and approximately 25% are malignant neoplasms. Metastatic spermatic cord tumors are even rarer. Several studies have revealed that the most frequent primary tumors metastasizing to the spermatic cord and peritesticular tissues are neoplasms of the stomach and prostate. Furthermore, metastasis to the spermatic cord or epididymis may occur retrograde lymphatic and hematic routes. We present the case of a man with gastric cancer that metastasized to the spermatic cord and epididymis, with concomitant ipsilateral hydronephrosis after surgical resection and chemotherapy for his primary tumor.
CASE SUMMARY
A 71-year-old man underwent total gastrectomy for pT4aN2 poorly differentiated gastric adenocarcinoma in December 2016. Two months after surgery, he received adjuvant chemotherapy with TS-1 from February 2017 to February 2018. Surveillance computed tomography (CT) was performed in June 2018, which did not reveal any sign of tumor recurrence. In November 2019, he presented with left lower quadrant abdominal pain and a palpable left inguinal-scrotal mass. CT revealed left mild hydronephrosis and a left scrotal mass measuring 4.0 cm × 1.7 cm. Tumor biomarkers, including alpha-fetoprotein (AFP), lactate dehydrogenase (LDH), beta-human chorionic gonadotropin (βHCG), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) were all normal. Renal and testicular echography showed left hydronephrosis and a left peritesticular soft tissue lesion with blood flow. Diagnostic ureteroscopy showed left lower ureter narrowing without an intraluminal lesion. A biopsy was obtained for the indurated spermatic cord and epididymis, which showed poorly differentiated adenocarcinoma. Immunohistochemical staining demonstrated that the tumor was diffusely and strongly positive for homeobox protein CDX2. The features were consistent with metastatic adenocarcinoma of a primary gastric tumor.
CONCLUSION
In patients with a history of primary cancer, an inguinal mass of unknown cause with accompanying ipsilateral hydronephrosis may be a sign of distant metastasis from a primary tumor, especially of gastrointestinal origin.
PubMed: 33511197
DOI: 10.12998/wjcc.v9.i1.278 -
Deutsches Arzteblatt International Jan 2013
Topics: Epididymitis; Humans; Male; Scrotum; Spermatic Cord Torsion; Ultrasonography
PubMed: 23413385
DOI: 10.3238/arztebl.2013.0042 -
Minerva Urology and Nephrology Oct 2022Chronic scrotal pain (CSP) may be due to an identifiable cause, may be multifactorial, or may be idiopathic. Successful treatment often requires multimodal therapy with... (Review)
Review
Chronic scrotal pain (CSP) may be due to an identifiable cause, may be multifactorial, or may be idiopathic. Successful treatment often requires multimodal therapy with a multidisciplinary approach. Conservative options may be offered initially, but if symptoms fail to improve with conservative interventions, more invasive therapies may be required. A nerve block may be attempted and patients who experience improvement in pain following nerve blocks may be good candidates for surgical denervation of the spermatic cord. Alternative surgical treatment options including proximal nerve blocks, neuromodulation, cryoablation, vasectomy reversal, varicocelectomy, and even orchiectomy have been described. The aim of this review is to discuss the treatment options for CSP with a focus on surgical treatment options.
Topics: Chronic Pain; Genital Diseases, Male; Humans; Male; Pelvic Pain; Scrotum; Spermatic Cord; Vasovasostomy
PubMed: 35274901
DOI: 10.23736/S2724-6051.21.04529-8 -
International Surgery 2014We report a case of giant spermatic cord liposarcoma (SCL) in an 81-year-old patient, presenting with a huge scrotal mass that reached up to the knee joint. SCL is a...
We report a case of giant spermatic cord liposarcoma (SCL) in an 81-year-old patient, presenting with a huge scrotal mass that reached up to the knee joint. SCL is a rare tumor, and about 200 cases have been reported in the literature so far. Although 20% of liposarcomas arise in the retroperitoneum, only 0.1% present as incidental inguinal hernias. The occasional presence of myxoid stroma in well-differentiated liposarcomas can lead to confusion with myxoid sarcoma subtypes. Correct diagnosis is critical and reflects remarkable differences in behavior and therapeutic choices.
Topics: Aged, 80 and over; Contrast Media; Genital Neoplasms, Male; Humans; Liposarcoma; Male; Orchiectomy; Spermatic Cord; Tomography, X-Ray Computed
PubMed: 25058774
DOI: 10.9738/INTSURG-D-13-00072.1 -
Cancer Genomics & Proteomics 2021Benign smooth-muscle tumors, leiomyomas, occur in nearly every organ but are most common in the uterus. Whereas much is known about the genetics of uterine leiomyomas,...
BACKGROUND/AIM
Benign smooth-muscle tumors, leiomyomas, occur in nearly every organ but are most common in the uterus. Whereas much is known about the genetics of uterine leiomyomas, little genetic information exists about leiomyomas of other organs. Here, we report and discuss the genetic findings in a para-testicular leiomyoma.
MATERIALS AND METHODS
Cytogenetic, array comparative genomic hybridization (aCGH) RNA sequencing, reverse-transcription polymerase chain reaction (RT- PCR), and Sanger sequencing analyses were performed on a leiomyoma of the spermatic cord removed from a 61-year-old man.
RESULTS
The karyotype was 48~50,XY,add(3) (p21),+4,+7,+8,+9,add(21)(q22)[cp9]/46,XY[2]. aCGH confirmed the trisomies and also detected multiple gains and losses from 3p and 21q. RNA sequencing detected the chimeras ARHGEF3-CACNA2D2, TRAK1-TIMP4, ITPR1- DT-NR2C2, CLASP2-IL17RD, ZNF621-LARS2, CNTN4- RHOA, and NR2C2-CFAP410. All chimeras were confirmed by RT-PCR and Sanger sequencing.
CONCLUSION
Our data, together with those previously published, indicate that a group of leiomyomas may be cytogenetically characterized by aberrations of 3p and the formation of fusion genes.
Topics: Chromosomes, Human, Pair 21; Chromosomes, Human, Pair 3; Comparative Genomic Hybridization; Genital Neoplasms, Male; Humans; Karyotyping; Leiomyoma; Male; Middle Aged; Mutant Chimeric Proteins; Spermatic Cord; Trisomy
PubMed: 34183386
DOI: 10.21873/cgp.20278 -
Deutsches Arzteblatt International Jun 2012The acute scrotum in childhood or adolescence is a medical emergency. Inadequate evaluation and delays in diagnosis and treatment can result in irreversible harm, up to... (Review)
Review
BACKGROUND
The acute scrotum in childhood or adolescence is a medical emergency. Inadequate evaluation and delays in diagnosis and treatment can result in irreversible harm, up to and including loss of a testis. Various diseases can produce this clinical picture. The testis is ischemic in only about 20% of cases.
METHODS
This review is based on a selective literature search, the existing clinical guideline, and the authors' experience.
RESULTS
The clinical approach to the acute scrotum must begin with a standardized, rapidly performed diagnostic evaluation. Dopper ultrasonography currently plays a central role. Its main use is to demonstrate the central arterial blood supply and venous drainage of the testis. The resistance index of the testicular vessels should also be determined.
CONCLUSION
Physical examination and properly performed Doppler ultrasonography enable adequate evaluation of the acute scrotum in childhood and adolescence. In the rare cases of diagnostic uncertainty, immediate surgical exposure of the testis remains the treatment of choice.
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Epididymitis; Humans; Infant, Newborn; Male; Scrotum; Spermatic Cord Torsion; Ultrasonography
PubMed: 22787516
DOI: 10.3238/arztebl.2012.0449 -
Anticancer Research 2007Primary osteosarcoma of the spermatic cord is a rare tumour with few mentions in the literature. A 59-year-old man presented with a large painless left inguinal and... (Review)
Review
Primary osteosarcoma of the spermatic cord is a rare tumour with few mentions in the literature. A 59-year-old man presented with a large painless left inguinal and scrotal mass. The patient underwent excision of the mass, which arose from the spermatic cord. A left high dissection of the spermatic cord and radical orchiectomy due to associated atrophy of the left testicle were performed. Pathological findings were suggestive of spermatic cord osteosarcoma. The patient died eleven years later of metastatic lung disease. Spermatic cord osteosarcoma is an uncommon neoplasm and its preoperative diagnosis is very difficult. Any palpable suspicious mass of the cord should be investigated with ultrasonography before excision; CT scan and magnetic resonance imaging may be helpful in defining preoperative diagnosis and the extension of the mass into the neighbouring tissues. Surgical treatment of spermatic cord sarcomas in adults is via a radical orchiectomy with high dissection of the spermatic cord and en bloc excision of involved neighbouring tissues; overall 5- and 10-year survival rates are reported in the literature to be 75% and 55%, respectively.
Topics: Bone Neoplasms; Fatal Outcome; Humans; Lung Neoplasms; Male; Middle Aged; Orchiectomy; Osteosarcoma; Spermatic Cord; Testicular Neoplasms
PubMed: 17595783
DOI: No ID Found -
Minerva Pediatrics Jun 2023
Topics: Infant, Newborn; Male; Humans; Spermatic Cord Torsion; Testis; Orchiectomy
PubMed: 36757016
DOI: 10.23736/S2724-5276.23.07168-9 -
La Tunisie MedicaleSplenogonadal fusion is a rare congenital anomaly. The aim of this study was to report a case of splenogonadal fusion mimicking a spermatic cord cyst, and discuss...
INTRODUCTION
Splenogonadal fusion is a rare congenital anomaly. The aim of this study was to report a case of splenogonadal fusion mimicking a spermatic cord cyst, and discuss therapeutic management of this rare congenital malformation.
OBSERVATION
An eight-years old patient was presented with an asymptomatic three-centimeter oval scrotal mass mistaken for a spermatic cord cyst. Surgical exploration has revealed tow purple-red, firm encapsulated masses. The first mass was two cm long and adherent to the upper pole of the left testis with a cleavage plane. The second mass was four cm long, attached to the first by a fibrous cord and drawn on its superior pole by a serpiginous vascular structure that extended inside the abdomen. The spermatic cord was individualized. Extemporaneous anatomopathological examination of the first mass, totally excised, has concluded to benign lesion. Therefore, the peritoneum was opened, and the superior mass was excised as high as it could be reached without orchiectomy. Definitive Anatomopathological examination concluded to an ectopic splenic tissue. The final diagnosis was a continuous splenogonadal fusion.
CONCLUSION
This case highlights the clinical characteristics of this condition, with a special focus on the signs and findings that might help prevent unnecessary orchiectomy. Consequently, it is essential to include this malformation in the differential diagnosis of scrotal masses in children.
Topics: Male; Child; Humans; Testicular Diseases; Spleen; Spermatic Cord; Digestive System Abnormalities; Diagnostic Errors; Cysts
PubMed: 36571759
DOI: No ID Found