SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We review 3 cases of spermatic cord liposarcoma that have been followed for 12 months to 5 years after diagnosis. Inguinal orchiectomy rendered adequate treatment. Preoperative diagnosis of liposarcoma of the spermatic cord is unusual although gray scale sonography may be of some assistance. A review of the literature reveals that adjunctive medical or surgical treatment appears to be superfluous.
We present a case of spermatic cord cavernous hemangioma. A 32-year-old man presented with a circumscribed, painless mass in the left side of the spermatic cord. An orchiectomy of the left testicle was performed. A 3 x 3 x 2.5-cm mass was present in the spermatic cord area. Histologic examination and immunohistochemical study showed a benign vascular tumor composed of vascular spaces of varying size. Although cavernous hemangioma can occur in any location, the spermatic cord is an extremely rare site, and, to our knowledge, only a few cases have been previously reported.
Malignant fibrous histiocytoma (MFH) of the spermatic cord represents an uncommon location for the most common soft-tissue tumor in adults. MFH of the spermatic cord is such a rare entity that only 28 case reports have been described in the literature to date. The rarity of MFH of the spermatic cord has made diagnosis, staging, and treatment difficult. Solutions to such questions will only be answered as our database continues to expand. Therefore, this case report is presented in hopes of lending statistical power to future analysis of the correct treatment planning, mortality rates, and prognostic indications of a relatively unknown subset of a common disease.
This study evaluated the long term effects of unilateral torsion of the spermatic cord on the contralateral testis of guinea pigs, employing both fine structural and quantitative studies. Young, adult Hartley strain guinea pigs were divided into six experimental groups (12 animals per group). The first three groups consisted of 36 animals in which unilateral torsion was surgically induced. In group I (torsion maintained), unilateral torsion of the spermatic cord was maintained until the day of sacrifice; in group II (torsion and untwist), torsion of the spermatic cord was maintained for 8 to 12 hours, then the spermatic cord was untwisted and the testis was retained until the day of sacrifice. In group III (torsion and orchiectomy), testes were removed after 8 to 12 hours of spermatic cord torsion. The second three groups consisted of 36 animals: group IV (unilateral orchiectomy), group V (unilateral sham operation), and group VI (pentobarbital injection alone), which served as controls. One half of the animals from each group were killed after 4 months and the other half were killed after 8 months. The most frequently observed histologic changes in the contralateral testes of the experimental animals were focal disorganization and exfoliation of immature germ cells into the lumen. Severe damage, with almost complete absence of germ cells, was noted only in an occasional tubule. Quantitative evaluation of the germ cells of the contralateral testis revealed significant loss of germ cells in groups I, II, and III after 4 months, and in groups I and II after 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Unilateral spermatic cord torsion causes damage to the contralateral testis in humans and animals models. It is now known, however, at what age an animal's reproductive capacity is most susceptible to this type of trauma. To determine if the animal's age is a factor in its susceptibility to reproductive damage, rats at 30 to 70 days of age were subjected to unilateral spermatic cord torsion. Rats of the same ages underwent sham surgery and served as controls. The animals were allowed to recover from the surgery and to attain puberty before a period of fertility testing. Fertility, serum testosterone, organ weight, and testicular histologic data were obtained after the breeding period. Our data indicate that animals undergoing torsion at the youngest (30 days) and oldest (70 days) ages exhibited no change in the parameters studied. Animals between the ages of 35 and 50 days are highly susceptible to reproductive damage due to unilateral spermatic cord torsion, and the 35-day-old animals exhibit the most susceptibility. The stages of testicular development occurring during this period are such that damage to one testicle will result in degeneration of both organs. However, once the animal is older than 50 days, its reproductive capacity is not affected by spermatic cord torsion. The specific period of susceptibility in the development of human testes is yet to be defined.
It is not uncommon to find testicular germ-cell tumors in the spermatic cord. This may represent contamination or true involvement (vascular invasion or direct tumoral extension into the cord). A correct identification of the process has important clinical implications. In a review of 326 testicular germ-cell tumors, 79 (24.2%) revealed tumor in the spermatic cord. Of these 79, contamination was found in 57 (72.1%), true involvement in 15 (19%), and true involvement and contamination in 7 (8.9%). Spermatic cord contamination was seen most frequently with seminomas: 34 (24.1%) of 141 seminomas and 20 (15.4%) of 130 mixed germ-cell tumors. Eighteen of the 20 mixed germ-cell tumors contained an embryonal carcinoma component. True involvement was seen most frequently in embryonal carcinoma. Six (15.4%) of 39 pure embryonal carcinomas demonstrated true cord involvement. Six mixed germ-cell tumors with true cord involvement contained an embryonal carcinoma component. Distinguishing between true involvement of the spermatic cord and contamination can occasionally be problematic. Because true involvement, especially at the spermatic cord resection margin, identifies patients at a high risk for relapse, the problem of contamination caused by inadequate precautionary measures can be avoided by meticulous handling and processing of the specimens.
Spermatic cord hematoma is a rare diagnosis. The etiology may be idiopathic, traumatic, secondary to anticoagulation therapy, or as an extension of a retroperitoneal hemorrhage. It has been misdiagnosed as an incarcerated inguinal hernia, a testicular torsion, or a tumor. A review of the English literature is presented. An additional case is presented here as a complication of anticoagulation therapy after aortic valve replacement. Risk factors for a spermatic cord hematoma may warrant an ultrasound examination.
A semi-quantitative study of the extra-parenchymal Leydig cells in the tunica albuginea testis and spermatic cord was performed on histological sections immunostained with anti-testosterone antibodies in the testes and spermatic cords obtained from human foetuses, adults and elderly men without testicular or related diseases (autopsy specimens), as well as from adult men with cryptorchidism (surgical specimens). The albugineal Leydig cells appeared in small groups in the vicinity of blood vessels. The Leydig cells of the spermatic cord usually appeared inside or around nerve trunks. The percentages of testes and spermatic cords with extra-parenchymal Leydig cells were higher in the cryptorchid testis group than in the normal male groups. The number of Leydig cells per mm2 in the tunica albuginea testis was higher in normal adult males than in foetuses. This number decreased in elderly men and increased markedly in cryptorchidism. The number of Leydig cells per mm2 in the spermatic cord was also higher in normal adults than in foetuses and it did not change with either advancing age or cryptorchidism. In foetuses, the percentage of cells intensely immunostained by anti-testosterone antibodies in the tunica albuginea and spermatic cord did not differ significantly from that found in the testicular parenchyma, whereas in the other three groups (adult, elderly, and cryptorchid men) the percentages of these cells in the tunica albuginea and spermatic cord were significantly lower than in the testicular parenchyma.
OBJECTIVE: To report an additional case of lipoma of the spermatic cord, an uncommon, silent tumor. METHODS: A case of lipoma of the spermatic cord is described. The patient had presented with an enlarged scrotum with no symptoms. The literature on lipoma of the spermatic cord is briefly reviewed, with special reference to its diagnosis, forms of presentation and treatment. RESULTS: US evaluation demonstrated a mass adhered to the epididymis. An epididymal tumor was suspected and surgical exploration by the inguinal approach was performed. CONCLUSIONS: Lipoma is the most common tumor of the spermatic cord. Its etiology is unknown. It frequently appears in the fourth and fifth decades of life and usually involves the left hemiscrotum. It is silent and is detected by enlargement of the scrotum. The diagnosis is histological supported by US, which offers a reliability of 80%-100%. Treatment is by surgery in all cases.
A case of rhabdomyosarcoma of the spermatic cord in a 6-year-old boy is reported. On February 26, 1986, he visited Nakamura Hospital with the chief complaint of enlargement of the left scrotal content. The contralateral scrotum was normal. The left scrotal content was a hard thumb-head-sized tumor. The left testis and epididymis were not distinguishable from the tumor. On the same day, left high inguinal orchiectomy was performed. The tumor was 3.5 by 2.5 by 2.5 cm in size and was distinguishable from the testis, epididymis and tunica vaginalis. Histopathological findings were embryonal rhabdomyosarcoma and it appeared to have originated from the spermatic cord. Two years after operation, the boy is living without metastasis. Including our experience, 101 cases of the paratesticular rhabdomyosarcoma found in Japanese literature are reviewed and briefly discussed.
We report a case of solitary neurofibroma of the spermatic cord. Such benign tumors arise from perineural and Schwann cells and may be located in various parts of the body, but are rarely observed in the spermatic cord. No clinical or laboratorial manifestations of von Recklinghausen disease (Neurofibromatosis) were identified. Distinct criteria have been established for a diagnosis of von Recklinghausen disease, so that a solitary neurofibroma may not represent this complex. Only a little number of solitary neurofibromas of the spermatic cord are reported in the literature.
We studied 25 patients with spermatic cord torsion occurring after puberty. The elapsed time between the onset of symptoms and observation varied from 6 months to 7 years. We evaluated the semen of these patients and found that the number of spermatozoa was lower in patients with an atrophic testis (13 patients) than in those with a normal testis or, in those with torsion treated by orchidectomy. Moreover, the number of spermatozoa was lower in patients who had torsion for more than 2 years before being checked (12 patients) than in patients who had a more recent torsion (13 patients). Agglutinating antibodies were present in 20% of the patients but, they are not correlated fertility or sterility. Immunofluorescent antibodies also were not correlated with the changes found by semen analysis. They are not present in patients with a normal testis at the time of observation. On the other hand, immobilizing antibodies were significantly correlated with sterility and, particularly with changes of motility. These data suggest that sterility after spermatic cord torsion is correlated with an autoimmune mechanism. It may occur particularly in those patients with atrophic testes and has a slow onset taking more than 2 years to evolve completely.
Semen quality and endocrine parameters after spermatic cord torsion were investigated. Of 24 patients evaluated following spermatic cord torsion 12 were treated with bilateral orchiopexy (orchiopexy group), and 12 were treated with ipsilateral orchiectomy and contralateral orchiopexy (orchiectomy group). The average sperm density and the average total sperm count in the orchiectomy group were significantly lower than those in the orchiopexy group (p < 0.05, p < 0.05, respectively). The mean serum follicle stimulating hormone level in the orchiectomy group was significantly higher than that in the orchiopexy group (p < 0.05). These findings suggest a significant decrease in testicular function in the orchiectomy group. All the patients in the orchiopexy group demonstrated a normal semen quality and endocrine parameters during followup. Four of the 8 patients in the orchiectomy group whose duration of followup was more than two years still demonstrated oligozoospermia (< 20 x 10(6)/ml, one of 4 was azoospermia). The average age at operation of these four patients with abnormal semen quality was significantly higher than that of the other 4 patients with normal semen quality (p < 0.05), whereas no significant difference in duration of torsion preceding surgical therapy was observed between these two groups. These findings suggest that subsequent semen quality is likely to remain within normal limits with early surgical treatment by bilateral orchiopexy. Ipsilateral orchiectomy in the younger generation seems to result in less damage of the contralateral testis than in the older generation.
Tumors of the spermatic cord are indeed rare and 91% are of mesenchymal origin. Nearly all epithelial tumors are metastases with the primary tumor located in the gastrointestinal tract, prostate, kidney. In 9.5% of cases, initial symptoms are localized to the metastatic site prior to the discovery of the primary tumor. When a diagnosis of epithelial malignant tumor of the spermatic cord is made an investigation for the primary site must be performed. We report a case of metastatic tumor of the right spermatic cord occurring as first clinical manifestation of a silent adenocarcinoma of the sigmoid colon.
We present 2 cases of spontaneous idiopathic spermatic cord hematoma and review the literature. These hematomas predominately occur in untraumatized young adults after physically stressful exercise. Surgical exploration was performed in 4 previously reported cases and our own. In each case the preoperative diagnosis was incorrect. Since this clinical entity cannot clearly be distinguished from other causes of an acute scrotum surgical exploration seems warranted. Possible etiologies of spontaneous idiopathic spermatic cord hematoma are spermatic cord vein rupture and tear in the cremasteric muscle.
Primary lymphomas of the spermatic cord (LSC) are rare and have only been described in 10 cases in the literature. The present study is a review of the clinicopathological features of LSC described in the cases reported in the literature and presents a new case. LSC is a tumour affecting middle-aged men and is frequently misdiagnosed as an inguino-scrotal hernia. It is often of high malignancy grade. Stage I LSC has a poor prognosis when treated only locally.
Torsion of the spermatic cord constitutes a surgical emergency. Morphologically and functionally, the fate of the compromised testis largely depends on the time elapsed between the acute episode and surgical intervention. Patients who had been treated for testicular torsion by our group from 1976 to 1989 were requested to return for outpatient evaluation. These patient were divided into two groups according to the time elapsed between the diagnosis and surgical intervention. We observed that surgical correction within 12 hours following presentation permitted testicular salvage. Testicular volume was generally preserved and remained normal or slightly diminished. However, when the time elapsed was over 12 hours, testicular atrophy was observed in 46% of the patients. We can conclude, therefore, that detorsion must be performed as soon as possible. Vaginalis testis eversion will generally achieve stable and lasting fixation.
We report a case of neuroblastoma in a patient who had no involvement of the spermatic cord at diagnosis but who developed spermatic cord metastasis 2 months later. The metastasis appeared on sonography as a hypoechoic, highly vascular, fusiform, hard, 14x10x7 mm mass located in the right inguinal canal and extending into the scrotum. The diagnosis of spermatic cord metastasis was confirmed by resection and histopathologic examination. We recommend that the scrotum and spermatic cord be evaluated by high-resolution sonography in children with neuroblastoma, both at the time of diagnosis and during follow-up.