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Cancer Sep 2021Acute lymphoblastic leukemia (ALL) in children and adolescents can involve the testes at diagnosis or upon relapse. The testes were long considered pharmacologic... (Review)
Review
Acute lymphoblastic leukemia (ALL) in children and adolescents can involve the testes at diagnosis or upon relapse. The testes were long considered pharmacologic sanctuary sites, presumably because of the blood-testis barrier, which prevents the entry of large-molecular-weight compounds into the seminiferous tubule. Patients with testicular involvement were historically treated with testicular irradiation or orchiectomy. With the advent of contemporary intensive chemotherapy, including high-dose methotrexate, vincristine/glucocorticoid pulses, and cyclophosphamide, testicular leukemia present at diagnosis can be eradicated, with the risk of testicular relapse being 2% or lower. However, the management of testicular leukemia is not well described in the recent literature and remains relevant in low- and middle-income countries where testicular relapse is still experienced. Chemotherapy can effectively treat late, isolated testicular B-cell ALL relapses without the need for irradiation or orchiectomy in patients with an early response and thereby preserve testicular function. For refractory or early-relapse testicular leukemia, newer treatment approaches such as chimeric antigen receptor-modified T (CAR-T) cell therapy are under investigation. The control of testicular relapse with CAR-T cells and their penetration of the blood-testis barrier have been reported. The outcome of pediatric ALL has been improved remarkably by controlling the disease in the bone marrow, central nervous system, and testes, and such success should be extended globally. LAY SUMMARY: Acute lymphoblastic leukemia (ALL) in children and adolescents can involve the testes at diagnosis or upon relapse. Modern intensive chemotherapy has largely eradicated testicular relapse in high-income countries. Consequently, most current clinicians are not familiar with how to manage it if it does occur, and testicular relapse continues to be a significant problem in low- and middle-income countries that have not had access to modern intensive chemotherapy. The authors review the historical progress made in eradicating testicular ALL and use the lessons learned to make recommendations for treatment.
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Biology; Combined Modality Therapy; Cyclophosphamide; Humans; Male; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Recurrence; Testicular Neoplasms; Vincristine
PubMed: 34031876
DOI: 10.1002/cncr.33609 -
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 -
American Family Physician May 1999Although testicular cancer accounts for only 1 percent of all tumors in males, it is the most common malignancy in males between 15 and 34 years of age. Cryptorchidism... (Review)
Review
Although testicular cancer accounts for only 1 percent of all tumors in males, it is the most common malignancy in males between 15 and 34 years of age. Cryptorchidism is the most significant risk factor for testicular cancer, increasing the risk up to 11-fold. A painless testicular mass is the classic presentation for testicular cancer, although a number of patients present with diffuse pain or swelling. Ultrasonography may be helpful in confirming the presence of a scrotal mass within the testicle. Intratesticular masses are considered malignant until proved otherwise. Radical orchiectomy is the treatment for the primary tumor. Staging of disease is based on tumor histology, serum tumor markers and presence of lymph-node or other metastatic disease. Depending on the stage of disease, further treatment may include observation, radiotherapy, chemotherapy or surgery. Survival rates in patients with testicular cancer have improved dramatically in the past 20 years and now exceed 90 percent overall.
Topics: Biomarkers, Tumor; Humans; Incidence; Male; Mass Screening; Neoplasm Staging; Patient Education as Topic; Prognosis; Survival Rate; Teaching Materials; Testicular Neoplasms; United States
PubMed: 10323360
DOI: No ID Found -
Current Urology Apr 2017The purpose of this study is to study the main epidemiological, clinical, para clinical, pathological, therapeutic, and evolutionary features of patients with testicular... (Review)
Review
PURPOSE
The purpose of this study is to study the main epidemiological, clinical, para clinical, pathological, therapeutic, and evolutionary features of patients with testicular neuroendocrine tumors (TNET).
MATERIALS AND METHODS
Nine case series and sixteen case reports were identified by searching PubMed database and qualified for inclusion in this study. We added the data of one case treated in the department of urology in Habib Bourguiba Hospital in Sfax, to the published cases.
RESULTS
A total of 132 cases were collected. Median age at diagnosis was 39 years old (range 10- 83 years). The most common presenting symptom was either a testicular mass or a swelling in 38.46% of cases. Carcinoid syndrome was documented in 10.60% of patients. The clinical examination revealed a palpable mass in 44.70% of patients. This mass was painless and firm in most cases. Serum tumor markers (β-gonadotrophine chorionique humaine, α-feto protein, and lactate dehydrogenase) were within normal limits in all patients except in one case. Most testicular neuroendocrine tumors (76.52%) were primary and pure. The tumors were positive for chromogranin (100%), synaptophysin (100%) and cytokeratin (93.10%). Metastases were detected at time of diagnosis in eight cases (6.06%). The main treatment was radical orchiectomy performed in 127 patients (96.21%). The 5-year overall survival rate was 78.70% and the 5-year specific survival rate was 84.30%.
CONCLUSION
The diagnosis of testicular carcinoids is based on the immunohistochemistry study. The treatment of choice for these tumors is radical orchiectomy. Somatostatin analogues were reported to be effective in patients with carcinoid syndrome.
PubMed: 28559773
DOI: 10.1159/000447146 -
Life (Basel, Switzerland) Mar 2022A growing need is emerging worldwide for new molecular markers which could enhance the accuracy of diagnostic and therapeutic methods for detecting urogenital cancers.... (Review)
Review
A growing need is emerging worldwide for new molecular markers which could enhance the accuracy of diagnostic and therapeutic methods for detecting urogenital cancers. Mass spectrometry imaging (MSI) is a very promising tool in this regard. In this review, we attempt to provide a subjective summary of the latest publications on potential biomarkers of renal, bladder, prostate, and testicular malignancies detected with MSI through the eyes of a clinical urologist.
PubMed: 35330118
DOI: 10.3390/life12030366 -
Testicular tumours in children: an approach to diagnosis and management with pathologic correlation.Insights Into Imaging May 2020Testicular tumours are rare in children. Painless scrotal mass is the most frequent clinical presentation. Tumoural markers (alpha-fetoprotein, beta-human gonadotropin... (Review)
Review
Testicular tumours are rare in children. Painless scrotal mass is the most frequent clinical presentation. Tumoural markers (alpha-fetoprotein, beta-human gonadotropin chorionic) and hormone levels (testosterone) contribute to the diagnosis and management of a testicular mass in boys. Ultrasonography is the best imaging modality to study testicular tumours. A benign tumour is suggested when ultrasonography shows a mainly cystic component, well-defined borders, echogenic rim or normal to increased echogenicity lesion when compared to the healthy testicular parenchyma. Malignant tumour is suspected when ultrasonography shows inhomogeneous, hypoechoic, not well-circumscribed or diffuse infiltration lesion. However, these ultrasonographic findings may overlap. Colour Doppler, power Doppler, elastography and contrast-enhanced ultrasonography are useful complementary methods to characterise the focal testicular lesions. Chest computerised tomography and abdominopelvic magnetic resonance are necessary to establish the extension in case of malignant proved tumours.Benign tumours are more frequent in prepuberal boys and malignant tumours in pubertal boys. Mature teratoma prepubertal-type is the most common histologic type. Testicular sparing surgery is the choice in benign tumours. Radical inguinal orchiectomy is indicated in malignant tumours. Prognostic is excellent.The purpose of our study is to show an approach to the diagnosis and management of the most frequent testicular tumours in children according to clinical manifestations, imaging findings and tumour markers levels based on histologically confirmed tumours in our hospital.
PubMed: 32462465
DOI: 10.1186/s13244-020-00867-6 -
Central European Journal of Urology 2021Widespread use of scrotal ultrasonography has led to the detection of incidental, non-palpable small testicular masses (STMs). Historically, all intratesticular masses... (Review)
Review
INTRODUCTION
Widespread use of scrotal ultrasonography has led to the detection of incidental, non-palpable small testicular masses (STMs). Historically, all intratesticular masses were treated radically, however more conservative strategies are now being applied with growing evidence that up to 80% of STMs are benign lesions. Testis-sparing surgery is deemed a gold standard in STMs. However, the high probability of the benign nature of STMs and the excellent cure rate of localized testicular cancer has led to emerging attempts to use an active surveillance (AS) strategy for selected groups of patients.
MATERIAL AND METHODS
We conducted a non-systematic review of the literature in the PubMed and Embase databases for articles associated with AS strategy in STMs.
RESULTS
The main inclusion criteria for AS in patients with STMs were lack of risk factors of testicular cancer, no features of disseminated disease, negative tumor markers, non-palpable lesion that did not exceed 10 mm. Mean follow-up time of AS across the studies ranged from 9.6 to 29.6 months. Surveillance protocols were based on regular physical examination, scrotal ultrasonography and measurement of tumor markers. The change rate to active treatment ranged from 0% to 8% without reported deterioration of oncological outcomes. Patients have proceeded to surgical treatment based on their preference, lesion growth, change in echogenicity, tumor marker growth and the need for testicular exploration for other reasons.
CONCLUSIONS
Active surveillance is a reasonable conservative strategy in the management of STMs in selected groups of patients with minimal risk of deteriorating impact on oncological outcomes.
PubMed: 33976910
DOI: 10.5173/ceju.2021.0268 -
Animal Reproduction Feb 2020The current upsurge in intensive farming practices of greater cane rat has not only lead to higher growth rate but is accompanied by increased fat deposition especially...
The current upsurge in intensive farming practices of greater cane rat has not only lead to higher growth rate but is accompanied by increased fat deposition especially in the males. This study attempts to characterize one of the most commonly used fat estimation parameter, the body mass index (BMI) as well as evaluates its relationship with testicular and hormonal parameters in seventy-two sexually active male cane rats over a period of one year. Six animals, kidded and raised in a farm, with known ages were used each month. The experimental protocols entail body measurements of weight, height and length; histology; orchidometry; and hormonal immunoassay of testosterone, estradiol, progesterone, LH and FSH using their various kits. The mean values of the body mass (BMI) and Lee (LI) indices of male greater cane rats were 1.18±0.20g/cm and 0.30±0.02g/cm respectively with the testicular histology indicating normal spermatogenesis. BMI/LI, both of which followed the same pattern, neither correlate with testicular parameters nor with serum testosterone, progesterone, LH and FSH concentrations but had low correlations with serum estradiol concentration (r = 0. 2; 0.0023). So, these relationships may provide clue on obesity and its effect on reproductive performance and strengthened the possibility of the characterized BMI/LI as obesity marker for breeding selection in male cane rat.
PubMed: 32368277
DOI: 10.21451/1984-3143-AR2019-0026 -
Indian Journal of Medical and... Jan 2011Testicular tumor in prepubertal age group is uncommon. Most of the testicular tumors are benign in this age group and present as painless, hard testicular mass. We...
Testicular tumor in prepubertal age group is uncommon. Most of the testicular tumors are benign in this age group and present as painless, hard testicular mass. We present a case where a 7 year male child presented to us with painless scrotal swelling, which was cystic and transilluminating, clinically mimicking as hydrocele. On ultrasonography, the mass was solid. Orchidectomy was performed and histopathology revealed mature cystic teratoma.
PubMed: 21731217
DOI: 10.4103/0971-5851.81891