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1.
Urologe A ; 59(3): 266-270, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32060579

RESUMO

Considering that Quist et al. first described the acute idiopathic scrotal edema (AISE) already in 1956, there are not many studies published in literature concerning the etiology, the development, and the progress of the disease since then. According to the literature the incidence of AISE is about 20%. Although it is an important differential diagnosis for acute scrotum, it remains extensively unknown. Therefore, AISE should be kept in mind by urologists, pediatric surgeons and pediatricians to avoid needless surgery or antibiotic therapy.


Assuntos
Edema/diagnóstico , Escroto/patologia , Torção do Cordão Espermático/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Doença Aguda , Criança , Diagnóstico Diferencial , Edema/etiologia , Humanos , Masculino , Escroto/diagnóstico por imagem , Torção do Cordão Espermático/diagnóstico
2.
Int Braz J Urol ; 45(6): 1260-1265, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808415

RESUMO

Testicle tumors are a rare entity among men population, accounting for only 1-1.5% of all can-cers among men. The stromal tumors of the sexual cord correspond just 4% of all testicular cancers. Only 10% of them are malignant. The major representative of the sex cord-stromal tumors is the Leydig cell tumor, corresponding to 75 to 80% of the total. It has bimodal age incidence, involving children and adults between 30 and 60 years. We report the caso of a 91-year-old man with malignant Leydig cell tumor, presenting increase of the volume of scrotum, local pain and hyperemia. The are few cases in the literature, only 1 with pacient above 85 years old.


Assuntos
Tumor de Células de Leydig/patologia , Neoplasias Testiculares/patologia , Idoso de 80 Anos ou mais , Anticorpos Antineoplásicos , Humanos , Tumor de Células de Leydig/imunologia , Masculino , Doenças Raras , Escroto/patologia , Neoplasias Testiculares/imunologia
3.
An Bras Dermatol ; 94(6): 721-723, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789252

RESUMO

Primary male genital melanomas are very rare; they are associated with high mortality and late detection. Scrotal melanoma is the least common presentation and only 23 cases have been reported. Herein, the authors present a 30-year-old patient with stage IIIC (T4b, N2a, M0) scrotal melanoma in order to report the characteristics, treatment, and outcome, as well as to emphasize the importance of examination of the genitals, education of patients about self-examination and destigmatizing genital lesions to increase the likelihood of earlier detection.


Assuntos
Neoplasias dos Genitais Masculinos/patologia , Melanoma/patologia , Escroto/patologia , Neoplasias Cutâneas/patologia , Adulto , Antineoplásicos/administração & dosagem , Biópsia , Neoplasias dos Genitais Masculinos/tratamento farmacológico , Humanos , Interferon alfa-2/administração & dosagem , Masculino , Melanoma/tratamento farmacológico , Estadiamento de Neoplasias , Neoplasias Cutâneas/tratamento farmacológico
4.
Arch Esp Urol ; 72(9): 955-964, 2019 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31697257

RESUMO

OBJECTIVE: Unusual intrascrotal lesions in adults generally have been described as case reports in the medical literature. We present two lesions observed in two clinics over more than 28 years, with their radiological, pathological and clinical characteristics. METHODS: Retrospective study preformed between 1989 and 2017 in 446 patients undergoing inguinal orchiectomy. Clinical data were obtained reviewing patient` s tables. All patients were evaluated with physical examination, medical history, serum tumor markers (alpha fetoprotein, beta human chorionic gonadotropin, LDH), and scrotal ultrasound in the perioperative period. RESULTS: In 396 cases (88,78%) the diagnosis was germ cell or non-germ cell tumor and the remainder 50 patients (11.2%) presented 15 different intrascrotal lesions. These lesions were rhabdomyosarcoma (1 patient), intrascrotal cavernous hemangioma (1 patient), dermoid cyst (2 cases), epidermoid cyst (4 patients), paratesticular mesothelioma (1 case), parietal testicular tunica vaginalis cyst (2 patients), spermatic granuloma (3 cases). The number of patients with tuberculosis orchitis was 6 and granulomatous orchitis 8. There were 8 patients with fibrous pseudotumor. 1 patient presented testicular plasmocytoma. Metastatic involvement secondary to lymphoma and leukemia appeared in 4 cases. Brucella epididymitis-orchitis 7 cases. 2 cases of adult pure yolk sac testicular tumors. Additional evaluations and treatments were performed depending on histologic diagnosis. CONCLUSIONS: The exact diagnosis of these lesions is difficult due to their rarity and they must always be considered for differential diagnosis.


Assuntos
Doenças dos Genitais Masculinos , Escroto , Adulto , Doenças dos Genitais Masculinos/diagnóstico , Doenças dos Genitais Masculinos/cirurgia , Humanos , Masculino , Orquiectomia , Estudos Retrospectivos , Escroto/patologia
5.
Clin Nucl Med ; 44(11): 920-922, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31524677

RESUMO

Computed tomography (CT) of a 68-year-old man showed multiple small nodules in the bilateral lungs (maximum 14 mm in the left upper lobe). CT-guided biopsy of left upper lobe lesion showed no tumor or granuloma. Fluorodeoxyglucose (FDG) PET/CT showed multiple nodules with background-to-mild FDG-avid activity, and an incidental left scrotal skin lesion with intensely increased accumulation of F-FDG (SUVmax, 11.7), suspected malignant. After urologist consultation, local dermatological findings suggested a huge wart. Excision was done, and pathology concluded nodular papillary fibroepithelial polyp with acute and chronic inflammation.


Assuntos
Fluordesoxiglucose F18 , Pólipos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Escroto/diagnóstico por imagem , Escroto/patologia , Doença Aguda , Idoso , Doença Crônica , Diagnóstico Diferencial , Humanos , Inflamação/diagnóstico por imagem , Masculino , Pólipos/patologia
6.
Pan Afr Med J ; 33: 88, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489066

RESUMO

Scrotal elephantiasis is defined as an increase in the scrotal volume which can reach a very large size. This study involved O.H, a married man aged 70 years, father of 4 children, farmer, native of and resident in Agadir (south of Morocco). Symptoms started 7 years before when scrotal edema and then an edema in both feet and legs gradually increasing in volume occurred. Physical examination showed scrotal elephantiasis with a circumference measured 80 cm and elephantiasis in both legs and feet. Locoregional assessment was based on pelvic magnetic resonance imaging (MRI). The patient was scheduled for monoblock scrotal resection under spinal anesthesia with removal of all of the tissue affected by the lymphedema around the testicle which were covered using the remaining skin and of the penis which was skin grafted using thin skin. The treatment aimed to ensure penis function and to manage the disfiguration. Conservative treatment based on lymphovenous bypass surgery or on the dilation of lymph vessels is no longer performed. Treatment is based on surgery. Surgery is avoided when there are absolute contraindications.


Assuntos
Elefantíase/diagnóstico por imagem , Linfedema/diagnóstico por imagem , Escroto/cirurgia , Elefantíase/patologia , Elefantíase/cirurgia , Doenças dos Genitais Masculinos/diagnóstico por imagem , Doenças dos Genitais Masculinos/patologia , Doenças dos Genitais Masculinos/cirurgia , Humanos , Linfedema/patologia , Linfedema/cirurgia , Imagem por Ressonância Magnética/métodos , Masculino , Marrocos , Escroto/diagnóstico por imagem , Escroto/patologia
7.
Cytogenet Genome Res ; 158(3): 121-125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31315107

RESUMO

VACTERL association is defined by the occurrence of congenital malformations: vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula with esophageal atresia, radial and renal dysplasia, and limb defects. No genetic alterations have been discovered except for some sporadic chromosomal rearrangements and gene mutations. We report a boy with VACTERL association and shawl scrotum with bifid scrotum who presented with a de novo Yq11.223q11.23 microdeletion identified by array CGH. The deletion spans 3.1 Mb and encompasses several genes in the AZFc region, frequently deleted in infertile men with severe oligozoospermia or azoospermia. Herein, we discuss the possible explanation for this unusual genotype-phenotype correlation. We suggest that the deletion of the BPY2 (previously VCY2) gene, located in the AZFc region and involved in spermatogenesis, contributed to the genesis of the phenotype. In fact, BPY2 interacts with a ubiquitin-protein ligase, involved in the SHH pathway which is known to be implicated in the genesis of VACTERL association.


Assuntos
Canal Anal/anormalidades , Deleção Cromossômica , Cromossomos Humanos Y/genética , Esôfago/anormalidades , Cardiopatias Congênitas/genética , Cardiopatias Congênitas/patologia , Rim/anormalidades , Deformidades Congênitas dos Membros/genética , Deformidades Congênitas dos Membros/patologia , Proteínas/genética , Escroto/patologia , Coluna Vertebral/anormalidades , Traqueia/anormalidades , Canal Anal/patologia , Hibridização Genômica Comparativa , Esôfago/patologia , Estudos de Associação Genética , Humanos , Lactente , Rim/patologia , Masculino , Coluna Vertebral/patologia , Traqueia/patologia , Ubiquitina-Proteína Ligases/metabolismo , Incerteza
8.
Clin Nucl Med ; 44(10): e579-e580, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31246689

RESUMO

Idiopathic scrotal calcinosis, also called dystrophic scrotal calcinosis, is a rare benign condition that causes superficial intradermal scrotal calcifications. We present one such case of a 40-year-old married man who underwent PET/CT scan for staging workup of lymphoma and revealed this rare entity incidentally without any other testicular pathology.


Assuntos
Calcinose/diagnóstico por imagem , Doenças dos Genitais Masculinos/diagnóstico por imagem , Adulto , Calcinose/patologia , Diagnóstico Diferencial , Doenças dos Genitais Masculinos/patologia , Humanos , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Escroto/diagnóstico por imagem , Escroto/patologia
10.
J Coll Physicians Surg Pak ; 29(6): S62-S64, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31142426

RESUMO

We report and discuss a rare case of inguino-scrotal urinary bladder herniation (IBH) complicated with a big urinary bladder stone and contralateral indirect inguinal bowel hernia. A 68-year male patient presented to the outpatient urology department with a 4-year history of right inguino-scrotal pain and swelling, which was gradually increasing in size, and of intermittent swelling in the left groin. Physical examination revealed right irreducible inguino-scrotal hernia and reducible left inguinal hernia extending to the groin. Computerised Tomography (CT) revealed that the right side of urinary bladder was herniating through the inguinal canal into the right hemiscrotum along with a 22 mm urinary bladder stone. The patient underwent bilateral Lichtenstein tension-free mesh hernioplasty through inguinal incisions and transurethral laser cystolithotripsy in the same session. To the best of the authors' knowledge, this is the first reported case of bilateral inguinal hernia with concomitant bladder stone in the literature.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Escroto/patologia , Tomografia Computadorizada por Raios X/métodos , Cálculos da Bexiga Urinária/cirurgia , Doenças da Bexiga Urinária/cirurgia , Bexiga Urinária/diagnóstico por imagem , Idoso , Hérnia Inguinal/diagnóstico por imagem , Humanos , Canal Inguinal/diagnóstico por imagem , Masculino , Escroto/cirurgia , Telas Cirúrgicas/efeitos adversos , Resultado do Tratamento , Cálculos da Bexiga Urinária/diagnóstico por imagem , Doenças da Bexiga Urinária/complicações , Doenças da Bexiga Urinária/diagnóstico
12.
BMJ Case Rep ; 12(5)2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31061191

RESUMO

We present a patient with perforated diverticulitis contained within an inguinal hernia sac-a diagnostic and treatment dilemma. A 61-year-old man presented to the emergency department with left testicular and groin pain, and loose stool. CT imaging showed a left inguinal hernia containing a perforated segment of sigmoid colon. A segmental sigmoidcolectomyy and end colostomy Hartmannn's procedure) was performed after reducing the incarcerated inguinal contents. The inguinal hernia was not repaired because of faecal contamination of the hernia sac and risk for recurrence. Pathological examination of theresectedd bowel specimen showed perforated sigmoid diverticulitis in an inguinal hernia sac. The patient had an uneventful recovery and is awaiting definitive inguinal hernia repair andtakedownn of his colostomy.


Assuntos
Dor Abdominal/diagnóstico por imagem , Colo Sigmoide/cirurgia , Colostomia , Diverticulite/cirurgia , Hérnia Inguinal/cirurgia , Perfuração Intestinal/cirurgia , Escroto/patologia , Dor Abdominal/etiologia , Colo Sigmoide/diagnóstico por imagem , Diverticulite/diagnóstico por imagem , Hérnia Inguinal/diagnóstico por imagem , Humanos , Perfuração Intestinal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Int J STD AIDS ; 30(7): 707-709, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31112488

RESUMO

An atypical early primary syphilis case presentation with multiple umbilicated papular lesions on the penis and a nonreactive syphilis serology was misdiagnosed as molluscum contagiosum. Over a period of eight weeks, prior to dermatologic consultation, the papules enlarged, ulcerated, and healed. New plaque and patch formation on the penis and scrotum led to a differential diagnosis of inverse psoriasis vs. syphilis. Histological examination of a shave biopsy specimen revealed numerous Treponema pallidum organisms and repeat syphilis serological test results confirmed a syphilis diagnosis. Lesions responded to treatment with benzathine penicillin. One must keep a high index of suspicion for syphilis in light of its diverse presentation and increasing incidence.


Assuntos
Doenças do Pênis/diagnóstico , Úlcera Cutânea/diagnóstico , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Biópsia , Cancro/microbiologia , Humanos , Masculino , Penicilina G Benzatina/uso terapêutico , Doenças do Pênis/tratamento farmacológico , Pênis/patologia , Escroto/patologia , Pele/patologia , Úlcera Cutânea/patologia , Sífilis/tratamento farmacológico , Adulto Jovem
14.
Cir Pediatr ; 32(2): 93-98, 2019 Apr 22.
Artigo em Espanhol | MEDLINE | ID: mdl-31056870

RESUMO

OBJECTIVES: To present our experience of 23 years in the treatment of varicocele by embolization in pediatric age. MATERIAL AND METHODS: Observational descriptive study of all patients with varicocele treated by embolization after phlebography, by indication of the pediatric surgery service between 1995 and 2017. We performed descriptive statistical analysis and comparison between pain and testicular asymmetry before and after treatment (SPSSv22). RESULTS: Embolization was performed in 113 patients with left varicocele. The mean age of diagnosis was 12.4 years (5.2-15.5). The main clinical manifestations were: incidental finding (46.7%), increase in scrotal volume (28%) and testicular pain (15.9%). 61.5% were grade 3 and 38.5% grade 2. The selective embolization procedure was performed at an average age of 13.6 years (8-18). There were no serious complications of the procedure or reactive hydrocele. The overall success rate of endovascular treatment was 93.8%. In 85 patients (75.2%) a single procedure was performed and in 21, two procedures (18.6%). Only 4 patients required surgical intervention. The pain disappeared in all cases in which it presented and the testicular asymmetry decreased from 44.7% pre-treatment to 21.2% post-treatment (p<0.05). CONCLUSIONS: Endovascular treatment through embolization allows a selective varicocele management, after venous mapping, with an adequate effectiveness, without altering the arterial flow of the testicle or producing hydrocele. It is a minimally invasive treatment that could be considered the first choice in varicoceles of children and adolescents.


Assuntos
Embolização Terapêutica/métodos , Varicocele/terapia , Adolescente , Criança , Pré-Escolar , Embolização Terapêutica/estatística & dados numéricos , Humanos , Masculino , Dor/etiologia , Escroto/patologia , Doenças Testiculares/etiologia , Fatores de Tempo
16.
Indian J Pathol Microbiol ; 62(2): 306-309, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971563

RESUMO

Primary tumors of the paratesticular region are rare, with sarcomas constituting a major proportion, particularly in the old age. The paratesticular region consists of mesothelial, various epithelial, and mesenchymal cells and may therefore give rise to a variety of tumors. Epithelioid sarcoma usually occurs at the distal extremities of young adults. The proximal-type variant is characterized by a more aggressive course and resistance to treatment. We herein report a case of 32 years male with scrotal swelling diagnosed as proximal-type epithelioid sarcoma of paratesticular region after histopathological examination and immunohistochemistry. To the best of our knowledge, this is only the second case of proximal epithelioid sarcoma of paratesticular region in the English literature. As these tumors are rare, it has been difficult to establish their optimal treatment. Also, these can be easily misdiagnosed as other epithelioid lesions.


Assuntos
Sarcoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias Testiculares/diagnóstico , Adulto , Biomarcadores Tumorais , Diagnóstico Diferencial , Tratamento Farmacológico , Evolução Fatal , Humanos , Imuno-Histoquímica , Masculino , Sarcoma/tratamento farmacológico , Sarcoma/patologia , Escroto/patologia , Escroto/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias Testiculares/patologia , Testículo/patologia
17.
Arch Ital Urol Androl ; 91(1): 53-54, 2019 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-30932432

RESUMO

Varicocele is a dilation of the pampiniform venous plexus, mainly affecting the left side of the scrotum. In rare cases, however, the right side is affected. When this occurs, a retroperitoneal disease should be suspected, such as right-sided renal neoplasm. The present case report highlights the importance of right-sided varicocele in the diagnostic investigation of neoplasm of the right kidney.


Assuntos
Neoplasias Renais/diagnóstico , Escroto/patologia , Varicocele/etiologia , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade , Varicocele/patologia
18.
Radiol Clin North Am ; 57(3): 635-648, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30928082

RESUMO

Ultrasound is the imaging modality of choice to evaluate the scrotum because of its high resolution, Doppler capabilities, availability, and lack of ionizing radiation. Acute urologic emergencies diagnosed with ultrasound include testicular torsion, testicular rupture, and Fournier gangrene. The radiologist's knowledge of sonographic features of vascular, infectious, traumatic, and benign and malignant processes that occur in the scrotum coupled with the patient's presenting symptoms, age, and physical examination allows for the correct diagnosis of a wide spectrum of scrotal pathology.


Assuntos
Escroto/diagnóstico por imagem , Doenças Testiculares/diagnóstico por imagem , Ultrassonografia/métodos , Diagnóstico Diferencial , Humanos , Masculino , Escroto/patologia , Sensibilidade e Especificidade , Doenças Testiculares/patologia
19.
Mycopathologia ; 184(3): 433-439, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30976954

RESUMO

PURPOSE: To characterize the clinical and mycological features of favus of scrotum due to Trichophyton rubrum. METHODS: A single-site prospective study was carried out in an outpatient dermatology clinic. Microscopic examination and fungal culture were done using skin scrapings. Scales on the scrotum were stained with PAS and visualized by microscopy, including in vivo reflectance confocal microscopy (RCM). Two strains were analyzed by RAPD typing. Scutular lesions were fixed for scanning electron microscopy (SEM) and transmission electron microscopy (TEM). RESULTS: Cultures of the scale from the scrotum and/or groin in all patients showed a growth of T. rubrum. T. rubrum strains from scrotum and groins in one patient were demonstrated as the same strain by RAPD typing. The average age of patients was 34.1 ± 12.78 years. The mean course was 8.2 ± 5.07 days. All the patients received only topical treatment for 2 weeks without recurrence. Direct smear, calcofluor-white staining and in vivo RCM study of the scrotal favus in patients showed a massive number of septate branching hyphae, while fewer septate hyphae in scales in the groin. Abundant hyphae were found only in the outer layer of the stratum corneum of the scrotum under SEM and TEM with intact bilateral cell walls, and normal nucleus, liposomes and reticulum. Few distorted hyphae structures, cell wall degeneration, degenerated cytoplasm and the autophagy phenomenon could be seen in scales from groin under TEM. CONCLUSIONS: Scrotal favus due to T. rubrum is still a true infection, which most often occurred in immunocompetent patients.


Assuntos
Escroto/microbiologia , Escroto/patologia , Tinha Favosa/diagnóstico , Tinha Favosa/patologia , Trichophyton/isolamento & purificação , Adolescente , Adulto , Antifúngicos/administração & dosagem , Humanos , Masculino , Técnicas Microbiológicas , Microscopia Confocal , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Pacientes Ambulatoriais , Estudos Prospectivos , Tinha Favosa/tratamento farmacológico , Tinha Favosa/microbiologia , Adulto Jovem
20.
BMC Urol ; 19(1): 22, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30987638

RESUMO

BACKGROUND: Penoscrotal edema is typically caused by lymphatic obstruction, which can have both primary and secondary causes. Studies describing congenital penoscrotal edema are rare. Surgery can be divided into two types: The first approach involves extensive removal of diseased tissue and tissue reconstruction. The second approach is removal of the lesions and creating additional lymphatic vascular anastomoses. CASE PRESENTATION: We present a case report of a 15-year-old patient with recurrent penoscrotal edema and swelling of both lower extremities. The literature were also reviewed to provide additional information. Physical examination revealed slow lymphatic reflux of the lower extremities and no obvious abnormalities in testicular morphology, bilaterally, or blood supply. Surgery was performed by excising the affected skin and subcutaneous tissue and the flaps was cut in the middle in Y shape to cover the penis and scrotum. Postoperative follow-up revealed wound integrity and patient satisfaction with the outcome. CONCLUSION: Excision and reconstructive surgery are the primary treatments for penoscrotal edema. The majority of reported patients undergoing excision and reconstruction achieved satisfactory reshaping and improved their life quality.


Assuntos
Edema/cirurgia , Pênis/cirurgia , Escroto/cirurgia , Edema/diagnóstico , Seguimentos , Humanos , Masculino , Pênis/patologia , Escroto/patologia
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