Simultaneous testicle and epididymis vasculitis revealing granulomatosis with polyangiitis.

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing granulomatous vasculitis, which predominantly affects small-sized blood vessels. We aimed to report a case of GPA involving testicles and epididymis taken for malignancy. A 75-year-old patient was admitted for a painful left testicular mass. There was no extra urogenital manifestations on examination and the workup was unremarkable. Histological findings after orchidectomy revealed granulomatous inflammation of the testis and epididymis with fibrinoid necrosis and necrotic vasculitis consisting with the diagnosis of GPA. Further investigations regarding ear, nose, throat, pulmonary, and renal involvement were negative. Proteinase 3 antineutrophil cytoplasmic antibodies (PR3-ANCA) test was negative. Furthermore, infectious diseases especially tuberculosis were ruled out. Based on histopathological findings, limited GPA was diagnosed. The patient was treated with methotrexate and prednisone with good outcome. There was no relapse after 1 year of follow-up. Isolated urogenital involvement may occur at the onset of GPA and can be taken for malignancy. Histopathological findings are the gold standard for the diagnosis. Treatment is based on steroids and immunosuppressive drugs.

A Giant Ureteral Inflammatory Myofibroblastic Tumor in a 4-Year-Old Child: A Case Report and Review of the Literature.

Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm of children and young adults. It consists of myofibroblastic cells of borderline malignancy admixed with inflammatory cells. According to the WHO classification, of tumors, it is a soft-tissue tumor with an intermediate malignant potential. It may arise within numerous organs. Ureteral location is exceedingly rare. We report the exceptional case of a 4-year-old boy presenting with a giant right ureteral IMT removed during a nephroureterectomy. Histology and immunohistochemistry confirmed the diagnosis of an IMT with Anaplastic Lymphoma Kinase 1 expression. A 7 months follow-up showed no recurrence or distant metastasis. We also reviewed the literature for similar cases of pediatric ureteral IMT.

Duplication of the urethra in an adult male presenting with scrotal fistula: a rare case report.

Urethral duplication is a rare congenital abnormality with varied clinical manifestations; to this day, <300 cases were reported in the literature. It is affecting mainly males and is nearly always diagnosed in childhood or adolescence. It may be complete or incomplete, and the most widely accepted classification of the different types of urethral duplication was developed by Effman et al. Herein, we present a rare case of urethral duplication revealed by scrotal fistula in an adult man. A duplication is an unusual form of Y-type duplication: it is an incomplete urethral duplication urethra opening on the scrotum without communication with the urethra or bladder.

Right-sided varicocele thrombosis complicating an acute epididymo-orchitis: A case report and review of the literature.

Unilateral right-sided varicocele is a rare and warning condition that should hint at a serious retroperitoneal disease such as renal cell neoplasm. Furthermore, its thrombosis is such an unusual entity that only a few cases have been described. We review the literature and report, to our knowledge, the second case of acute scrotal pain caused by unilateral right-sided varicocele thrombosis complicating an ipsilateral epididymo-orchitis, with no underlying coagulopathy or abdominal neoplasm, to illustrate the clinical, morphologic and therapeutic features of this entity.

Bladder hernia complicated with cystolithiasis and bladder tumor: Two cases' analysis.

Inguinal hernia is frequent and reaches up to 8% of the population. It was reported that over 20 million inguinal hernia repairs are performed annually. The bladder may herniate in 1%-3% of the cases through the inguinal canal that can be responsible for various symptoms. The most specific is the classic "two-stage micturition." However, the diagnosis usually remains unspecific, and a surgeon can fall in the trap of a "simple" inguinal hernia and cause accidental damages to an undiagnosed bladder hernia. Therefore, a clear diagnosis must be assessed based on clinical and radiological findings to avoid complications. In these two presented cases, the patients presented cystolithiasis complicating the bladder herniation. One of the patients also developed a bladder tumor which appeared to be urothelial carcinoma.