Sertoli cell tumor, a rare testicular tumor, our experience and review of the literature.

OBJECTIVE: We report two new cases of Sertoli cell testicular tumors, and a Cochrane and Medline search of cases published worldwide. METHODS: We reviewed our series of testicular tumors, the stromal tumor incidence, clinical presentation, treatment and prognosis, and the experience reflected in the literature. RESULTS: The prevalence of testicular tumors in our health area is of 0.09%, and 2.3% of them are Sertoli cell neoplasms. This figure is slightly higher than the found in other series in which Sertoli tumors range from 0.4% to 1.5% of testicular malignancies in adults and reach 4% in children. CONCLUSIONS: Sertoli cell tumor has an incidence not exceeding 4%. The most common symptom is a painless mass; in cases with endocrine manifestation, up to 10% are malignant depending on the age of the patient.

Retroperitoneal fibrosis: single-centre experience from 1992 to 2010, current status of knowledge and review of the international literature.

OBJECTIVE: The aims of this study were to investigate retroperitoneal fibrosis in a Spanish hospital and present a review of the international literature to attempt to elucidate a diagnostic and therapeutic approach to this unusual pathology. MATERIAL AND METHODS: A database search was performed in the pathology department and in the documentation service using the key words "retroperitoneal fibrosis" and "Ormond's disease", limiting the search to the years 1990-2010. Cases in which secondary retroperitoneal fibrosis was considered were excluded. In addition, a PubMed literature search was performed using the terms "retroperitoneal fibrosis" and "Ormond's", limiting the search to 1985-2011. RESULTS: Twenty-two patients were diagnosed with idiopathic retroperitoneal fibrosis (IRF) or Ormond's disease. The most common symptom at the time of diagnosis was flank pain. With regard to laboratory findings, five patients (22.7%) had anaemia and eight (36.3%) had renal failure. Computed tomography (CT) was performed in 20 patients (90.9%) and the most common finding observed was retroperitoneal mass. Eighteen patients were started on corticosteroids, in six cases in association with azathioprine. Three patients had recurrence at 12, 24 and 72 months, respectively, and 15 patients required emergency surgery. Nine open surgical procedures were performed. CONCLUSIONS: At present, IRF is considered an autoimmune disease that presents with local and systemic signs and symptoms. CT and magnetic resonance imaging are the two tests of choice in IRF diagnosis and follow-up. [(18)F]Fluorodeoxyglucose positron emission tomography is starting to be used for assessment and treatment response. A combination of medical and surgical treatment is usually applied. It is essential to administer corticosteroids alone or in association with other immunosuppressive drugs such as azathioprine. Laparoscopic ureterolysis, or robotic ureterolysis, if available, is the technique of choice.

Tumor de células de sertoli. Un extraño tumor testicular. Nuestra experiencia y revisión de la literatura / Sertolli cell tumor, a rare testicular tumor, our experience and review of the literature

OBJETIVO: Aportamos dos nuevos casos de tumor testicular de células de Sertoli, realizando búsqueda en Medline y Cochrane de los casos publicados a nivel internacional.MÉTODOS: Revisión de nuestra serie de neoplasias testiculares, incidencia de los tumores estromales, presentación, clínica, tratamiento y pronóstico, así como de la experiencia reflejada en la literatura. RESULTADOS:La prevalencia de los tumores testiculares en nuestra área de salud es del 0,09 %, suponiendo el tumor de Sertoli el 2,3 % de ellos. La incidencia es levemente superior a la informada en otros trabajos, con cifras del 0,4% al 1,5% de los tumores testiculares en el adulto y hasta el 4% en los niños. La presentación más habitual es la masa testicular indolora, pudiendo existir semiología secundaria a la producción hormonal.CONCLUSIONES: El tumor de células de Sertoli presenta una incidencia no superior al 4% de las neoplasias testiculares. La clínica más habitual es la tumoración indolora, existiendo casos de manifestaciones endocrinas que varían según la edad del paciente Hasta un 10% de ellos se comportan de manera maligna(AU)

OBJECTIVE: We report two new cases of Sertoli cell testicular tumors, and a Cochrane and Medline search of cases published worldwide.METHODS: We reviewed our series of testicular tumors, the stromal tumor incidence, clinical presentation, treatment and prognosis, and the experience reflected in the literature.RESULTS: The prevalence of testicular tumors in our health area is of 0.09%, and 2.3% of them are Sertoli cell neoplasms. This figure is slightly higher than the found in other series in which Sertoli tumors range from 0.4% to 1.5% of testicular malignancies in adults and reach 4% in children.CONCLUSIONS: Sertoli cell tumor has an incidence not exceeding 4%. The most common symptom is a painless mass; in cases with endocrine manifestation, up to 10% are malignant depending on the age of the patient

Tratamiento quirúrgico en un caso de linfedema escrotal / Surgical treatment in a case of giant scrotal lymphedema

OBJETIVO: El linfedema escrotal (LE) es una patología rara en nuestro medio. Presentamos un caso de linfedema escrotal gigante y realizamos una revisión bibliográfica de la literatura existente en la base de datos Medline en los últimos 10 años.MÉTODO: Presentamos el caso de un varón con linfedema escrotal gigante (43x 40 Cm.), de cuatro años de evolución y de etiología incierta.RESULTADO: Fue tratado quirúrgicamente, mediante exéresis completa escrotal y reconstrucción mediante injertos cutáneos, con resultado exitoso.CONCLUSIONES: El LE es una entidad rara, sobre todo en países industrializados. Independientemente de la causa, si el linfedema es severo, el tratamiento quirúrgico es la opción terapéutica más adecuada. La resección completa hasta tejido sano y la reconstrucción quirúrgica es el tratamiento de elección, cuando afecta a todo el escroto, siendo necesario el uso de injertos cutáneos de piel fina para su reconstrucción(AU)

OBJECTIVE: Scrotal lymphedema (SL) is a rare clinical pathology with multiple etiologies. We report a case of idiopathic giant scrotal lymphedema and review the existing medical literature in Medline from the last ten years.METHODS: We report the case of a male patient with a giant scrotal lymphedema (43x 40 cm) of unknown etiology developed over four years.RESULTS: The patient was treated by scrotal excision and reconstruction with skin graft plasty, with a successful result.CONCLUSIONS: Scrotal Lymphedema is a rare entity, especially in industrialized countries. If the lymphedema is severe, surgery is the most appropriate therapeutic option, whatever the cause is. Complete resection up to healthy tissue and surgical reconstruction is the choice. Thin skin grafts are necessary for reconstruction when it affects the entire scrotum(AU)