The shrinking seminoma--fact or fiction?

We report 2 cases of testicular seminoma with unusual but dissimilar clinical presentations, which may represent different stages of spontaneous regression of a primary testicular seminoma, the so-called 'shrinking seminoma'. The aetiology of this phenomenon is discussed. These cases also illustrate that, like enlargement, reduction in the size of a testicle warrants investigation for malignancy.

Prostatic infarction/infection in acute urinary retention secondary to benign prostatic hyperplasia.

PURPOSE: We assess the role of acute prostatic infarction and prostatic inflammation in causing acute urinary retention in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A prospective controlled clinicopathological study was undertaken comparing 35 patients who presented with acute urinary retention secondary to BPH with another 35 patients with symptomatic BPH. All 70 patients were treated with transurethral resection. The prostatic chips in each group were examined by 1 histopathologist, who was unaware of the clinical presentation of the patient, for changes of infarction, acute and chronic inflammation, and predominant histological pattern. RESULTS: There was a higher incidence of glandular pattern in the retention group compared to a stromal pattern in the control group, which was statistically significantly different (p < 0.001). A 5-fold higher incidence of prostatic carcinoma was noted in the acute retention group, which was also statistically significant (p < 0.05). CONCLUSIONS: Prostatic infarction and inflammation had no role in the etiology of acute urinary retention due to BPH.

Benign polyps with prostatic-type epithelium of the urethra and the urinary bladder.

The clinico-pathological features of nine urethral and urinary bladder polyps with prostate-type epithelium are described. The average age of the patients was 46 years. Three patients previously had cystoscopy and the lesion was not noticed on the initial examination. The commonest presentation in this series was haematuria, dysuria and frequency of micturition. One patient presented with postmicturition dribble and another with haemospermia. The polyps contained acini and papillae lined by prostate-type epithelium which was confirmed by immunohistochemical tests for prostate specific antigen and prostate acid phosphatase. In this series no age versus location relationship could be established. Symptoms resolved following resection or initial biopsy followed by fulguration. Recurrence is extremely rare.

Malignant mesothelioma of the tunica vaginalis testis diagnosed by aspiration cytology--a case report with review of literature.

A case of malignant mesothelioma of the tunica vaginalis testis diagnosed by preoperative cytology of hydrocele fluid is reported. In our view this is only the second case diagnosed by preoperative cytology. The unique feature of this case, the characteristic ultrasound appearance, was recognized and confirmation by aspiration cytology led directly to radical orchiectomy, thus avoiding hydrocelectomy, hemiscrotectomy and possible local recurrence. Aetiopathogenesis and management options of this rare tumour are discussed, with a review of the literature.

Interstitial cystitis in men.

Interstitial cystitis is an uncommon disease reported predominantly in females. Recently we were involved in the management of 4 men who had the clinical, endoscopic and pathological features consistent with the diagnosis of interstitial cystitis. The rarity of occurrence of the disease in males prompted us to report these cases.

Pyrexia of unknown origin in association with bladder diverticulum tumour.

A case of pyrexia due to a rapidly growing undifferentiated transitional cell carcinoma in a bladder diverticulum is described. The literature is reviewed and the causes of pyrexia associated with neoplasia briefly discussed.

Giant pre-sacral neurofibroma.

We report a case of pre-sacral neurofibroma diagnosed on a routine medical examination. The pathological features and management criteria of these rare tumours are discussed.