[Computer tomography in deciding on the operability of a testicular neoplasm metastasis in the retroperitoneum].
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Adult↗
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Results for “TESTICULAR NEOPLASMS”
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Prepubertal male and testicular neoplasms: diagnosis and treatment.
Prepubescent testicular tumors are far more likely to be benign than adult tumors. However, malignant yolk sac tumors are still the most commonly reported testicular neoplasms in the literature. Teratomas are benign in the pediatric population and constitute the second most commonly reported tumors and, in some series, they are the most common. The remaining tumors are far more rare and often benign. Regardless of tumor type, with prompt diagnosis and treatment long-term survival is excellent. This article contains concise reviews of the various tumors, their diagnoses and management options.
Child↗
[Bilateral testicular neoplasms].
Three cases of bilateral testicular neoplasms were found in 112 patients treated in the last 7 years. In two patients bilateral seminoma developed at various time periods. In one case seminoma coexisted with germinal carcinoma.
Adult↗
Familial occurrence of testicular neoplasms (in cousins).
Testicular malignancies in closely related family members rarely occur. Only 18 cases have been reported in the literature. Our cases concern two families with testicular tumors occurring in cousins. This is the first such incidence reported. The need for a thorough checkup of other family members is reiterated.
Adolescent↗
[Prevention and early diagnosis of testicular neoplasms].
Aetiology of testicular cancer is still poorly characterized, so the prevention is unlikely to achieve. A fundamental issue is early detection as delay in presentation is a common feature in patients affected by this disease. Moreover there is much evidence suggesting a significant association between delay in diagnosis and clinical stage at presentation particularly for nonseminomas. 176 valuable patients with non seminomatous germ cell tumors of the testis had a clearly identifiable interval from first symptoms until diagnosis; mean delay was 13.9 weeks, and there was a correlation between difference in delay of I clinical stage patients (mean: 10.0 weeks) and III stage patients (mean: 18.6 weeks) ANOVA: p < 0.035. These data suggest that encouraging programmes in order to provide more informations on testicular cancer and testicular self examination (TSE) may contribute to reduce the number of young men requiring toxic treatment and major surgery and even may reduce mortality.
Humans↗
Endocrinology of testicular neoplasms.
The hypothalamic-pituitary-testicular axis finely regulates levels of circulating sex steroids--especially testosterone and estradiol--and spermatogenesis. Testosterone, directly as an androgen and as a prehormone for estradiol, regulates LH secretion at both hypothalamic and pituitary levels. Leydig cells, principally under the control of LH, produce testosterone. Sertoli cells, under the control of FSH, and sensitive to intratesticular levels of testosterone, produce estradiol. This locally produced estrogen seems to be necessary for maturation of the germ cells. An abnormality in this sensitive control system, leading to elevations in gonadotrophins or steroid levels, may be etiologically important in both germ cell and nongerm cell neoplasia. Testicular cancers are associated frequently with endocrinologic manifestations, which may be more disabling to the patient than the malignant potential of the tumor, especially with childhood Leydig cell tumors. Estrogen dominance with an elevated estrogen/testosterone ratio can be seen in any testicular neoplasm and may result in gynecomastia. It may be due to a decrease in circulating testosterone or to an increase in estrogens. Virilization is seen frequently in Leydig cell tumors of adolescents. Further elucidation of hormonal interrelationships should lead to better understanding of the genesis of testicular neoplasia and to more effective therapy.
Animals↗
Malignant testicular neoplasms in immunosuppressed patients.
PURPOSE: Testicular cancers were studied in patients on immunosuppression. MATERIALS AND METHODS: A retrospective analysis was done of testicular cancer in patients on immunosuppression reported on between 1975 and 1995. RESULTS: The management schemes adopted in the immunosuppressed population followed the generally accepted management concepts. No patient with low stage (A to B1) disease died of testis cancer. Only 4 of 66 patients (6.1%) with the acquired immunodeficiency syndrome died of testis cancer compared to 5 of 20 (25%) after transplantation, implying significantly higher cause specific mortality in post-transplant patients (Fisher's exact test, p < 0.01). The incidence of adverse effect of therapy did not differ from the expected incidence in other patients. CONCLUSIONS: Patients on immunosuppression with testicular neoplasms should be treated in the standard fashion as indicated by tumor histology and stage of disease, since most will tolerate therapy and benefit from the standard treatment protocols.
Acquired Immunodeficiency Syndrome↗
[Unusual presentation form of testicular neoplasms. Report of 5 cases].
Testicular tumors have a typical form of presentation, but there are also unusual forms that must always be considered. We report on 5 cases of testicular tumors that had an uncommon form of presentation: 3 seminomas (1 anaplastic), 1 teratocarcinoma and 1 carcinoma in situ. All testicular changes, particularly in the young male, must be suspected as being a testicular neoplasm and a complete work up must be performed until the exact diagnosis can be made. Currently, evaluation of the testes by ultrasound is a necessary procedure in the diagnosis of this pathological condition. Because it is non-invasive, simple and low-cost, it is the ideal method of evaluation.
Adolescent↗
[Usefulness of fine needle aspiration puncture in the diagnosis of testicular neoplasms and in the study of testicular physiopathology].
OBJECTIVE: To review the current use of fine needle aspiration in the diagnosis of intratubular germ cell tumor and other testicular pathology. METHODS: The Medline database was accessed to review the literature on fine needle aspiration. Journal articles, monographs and books on the subject were also reviewed. RESULTS: The cytological findings on fine needle aspiration were not found to be conclusive in the diagnosis of intratubular germ cell tumor. CONCLUSIONS: Surgical testicular biopsy is currently considered to be the only reliable diagnostic method for intratubular germ cell tumor and in the determination of the pathogenesis of male infertility. However, conventional open surgical biopsy and thru-cut biopsy are not atraumatic procedures and cause injury to the testis. The sensitivity of fine needle aspiration as a diagnostic procedure has not yet been established, probably due to the lack of information or consensus on the characteristic findings on which to establish the diagnosis of intratubular germ cell tumor, or for application in the diagnosis and follow-up of testicular tumors and the study of testicular physiopathology.
Biopsy, Needle↗
Cortical cerebellar degeneration with testicular neoplasm.
Cortical cerebellar degeneration was found in a 28-year-old man with testicular neoplasm. The patient, who had undergone a left orchidectomy for the testicular tumor, developed progressive cerebellar symptoms with mental changes 7 months later. The autopsy revealed the spread of a malignant germ cell tumor of the testis, and cortical cerebellar degeneration in the central nervous system (CNS) which was characterized by almost complete loss of Purkinje cells and degeneration of the both dentate nuclei and superior cerebellar peduncles. The present case is the first of cortical cerebellar degeneration combined with testicular neoplasms.
Adult↗
Abnormal testis at US in patients after orchiectomy for testicular neoplasm.
PURPOSE: To categorize ultrasonographic (US) intratesticular abnormalities in patients after orchiectomy for testicular neoplasm and to correlate US, clinical, and histopathologic findings. MATERIALS AND METHODS: Two hundred thirty-five testicular US examinations were performed in 171 patients who previously underwent orchiectomy for testicular neoplasm. Abnormalities were identified in 28 patients. The abnormalities were described as masses, heterogeneous changes, or macrocalcification. US findings were correlated with histopathologic findings in specimens obtained at surgery in 18 patients; follow-up to determine clinical outcome was obtained from the review of medical records in the remaining 10 patients. RESULTS: Testicular US revealed intratesticular mass in 15, heterogeneous changes in 11, and macrocalcification in two patients. Eighteen patients had histopathologic correlation; 13 had testicular cancer. At US, 10 of the 15 (67%) patients with a mass and only three of the 11 (27%) with heterogeneous changes had cancer. All 10 patients without surgical correlation had clinical follow-up of 2(1/2)-7 years (mean, 3.95 years), with no evidence of disease. CONCLUSION: Intratesticular mass always is a concern, and heterogeneous changes are less worrisome, but in all patients, rigorous follow-up is recommended to rule out malignancy.
Adult↗
Leydig cell hyperplasia mimicking testicular neoplasm.
Patients with extragonadal seminoma are at high risk of developing a primary testicular neoplasm many years after the initial diagnosis and therapy. Therefore, long-term follow-up is critical in the proper management of these patients. We present the first case of Leydig cell hyperplasia, mimicking a testicular neoplasm, 21 years after diagnosis and treatment of extragonadal seminoma.
Adult↗
Inhibin-alpha CD99, HEA125, PLAP, and chromogranin immunoreactivity in testicular neoplasms and the androgen insensitivity syndrome.
We investigated 115 testicular and 3 epididymal tumors and 6 cases of the complete androgen insensitivity syndrome (AIS) for the expression of inhibin-alpha, CD99, HEA125, PLAP, and chromogranin, using monoclonal antibodies and standard immunhistochemical techniques. Ihibin-alpha was detected in the neoplastic cells in 27 of 27 primary Leydig cell tumors (LCTs), 1 of 1 metastatic LCT, 6 of 20 Sertoli cell tumors (SCTs), 4 of 5 juvenile granulosa cell tumors (GCTs), and 2 of 5 unclassified sex cord-stromal tumors (USCSTs). Except for 2 choriocarcinomas, the choriocarcinomatous component of 1 mixed germ cell tumor, and a small focus of inhibin-positive syncytiotrophoblast in 1 embryonal carcinoma, inhibin-a immunoreactivity was not present in the neoplastic cells of the 38 remaining testicular germ cell tumors; 11 B-cell and 1 T-cell lymphomas; 1 granulocytic sarcoma; and 1 rhabdomyosarcoma of the testis; 1 adenoma of the rete testis, and 3 adenomatoid tumors of the epididymis. Inhibin-alpha immunoreactivity was present in the Sertoli cells and Leydig cells in 5 testicular hamartomas and in 1 Sertoli cell adenoma in 6 cases of AIS; both Sertoli and Leydig cells were also positive in the extranodular testicular parenchyma present in 2 of these cases. CD99 was detected in 10 of 15 primary LCTs, 1 of 7 SCTs, 3 of 5 JGCTs, and in 1 of 5 USCSTs but was not found in any tumor outside the sex cord-stromal category. HEA125 immunostaining was not detected in sex cord-stromal tumors; however, 3 of 12 seminomas, 3 of 12 embryonal carcinomas, 6 of 8 yolk sac tumors, and 1 of 2 teratomas were HEA125 positive. PLAP was not detected in sex cord-stromal tumors except for 4 of 15 primary LCTs but was present in most germ cell tumors. Chromogranin immunostaining was present in the sex cord-like element in 1 of 5 USCSTs, 1 of 8 YSTs, 1 of 2 teratomas, and in 1 of 1 rete adenoma, and in normal adjacent rete testis. In conclusion, although inhibin-alpha and PLAP, and, to a somewhat lesser extent, CD99 and HEA125 immunostaining are helpful in the differential diagnosis of certain testicular neoplasms that are difficult to distinguish on morphologic grounds, chromogranin is far less helpful in this context.
12E7 Antigen↗
Isolated testicular vasculitis mimicking a testicular neoplasm.
A 19 year old man presented with unilateral testicular swelling and pain. An initial diagnosis of epididymo-orchitis was modified to a presumed testicular neoplasm following ultrasonography. The final diagnosis of isolated testicular vasculitis was established following histological examination of the orchidectomy specimen. Staining for antineutrophil cytoplasmic antibodies was negative. Despite immunosuppressive treatment, the patient developed further symptoms affecting the remaining testis one year later. He responded well to an increase in immunosuppressive therapy and has remained asymptomatic 18 months from diagnosis. Symptomatic vasculitis confined to the testis is extremely rare, but must be considered in the differential diagnosis of testicular swelling and may be the presenting feature of a systemic vasculitis such as polyarteritis nodosa. The risk of progression to systemic disease in such cases is unknown. Immunosuppressive therapy must be considered carefully and long term follow up is important.
Adult↗
Histologically similar testicular neoplasms occurring in brothers.
Testicular malignancies occur rarely in closely related family members. Two young adult brothers are described who had histologically similar seminomas in the right testis. To my knowledge this is the tenth set of testicular tumors and the third set of histologically similar cell type seminomas reported in non-twin brothers.
Adult↗
Value of fine needle aspiration cytology in the diagnosis of testicular neoplasms.
In 403 patients with a clinical suspicion of a testicular neoplasm, fine needle aspiration (FNA) was performed on the scrotal mass in 380 cases and on an extrascrotal swelling in 23 cases. There were 109 unsatisfactory aspirates. Fluid was aspirated in 50 cases, and only normal testicular elements were obtained in 82 cases. The aspirate showed an inflammatory lesion in 104 cases. A diagnosis of malignancy or suspicious for malignancy was given in 52 and 6 cases, respectively. Histopathologic confirmation of malignancy was available for 30 cases, for which the aspirate had been reported as malignant in 23, suspicious for malignancy in 3, unsatisfactory in 2 and negative for malignancy in 2. There were no false-positive FNA cytodiagnoses. No local seeding of tumor by the FNA procedure was observed. Typing of the testicular tumors on the aspirates showed a problem in classifying teratocarcinomas.
Biopsy, Needle↗
[TESTICULAR NEOPLASMS IN INFANTS].
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Child↗
Testicular neoplasms: 29 tumors studied by high-resolution US.
High-resolution (10-MHz) ultrasonography produces extremely detailed anatomic images of the testis. The sonographic features most helpful in detecting tumors are mass, bright echogenic foci, and diffuse parenchymal texture change. Of 29 patients with testicular neoplasms, 21 (72%) had one or more masses, 19 (66%) had one or more echogenic foci, and nine (31%) had a diffuse parenchymal texture change. Bright echogenic foci were present in six (86%) of seven testes that had a regressed germ-cell tumor. In an attempt to define the histologic features of bright echogenic foci, we performed needle localization under real-time guidance on four operative specimens. We observed immature bone and cartilage, calcification, tubular atrophy and fibrosis, and focal noncalcific scarring. Discovery of occult testicular neoplasms was common (9/29); four patients were thought to have had "extragonadal" germ-cell tumors before abnormalities were found on the sonograms.
Adolescent↗