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1.
Urology ; 135: 4-10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31585196

RESUMO

Ultrasound is the imaging modality of choice to evaluate scrotal pathology. However, differentiating malignant and benign testicular tumors is not always possible, and there is interest in evaluating magnetic resonance imaging (MRI) as a potential adjunct for diagnosis. We conducted a systematic review and found 9 studies related to MRI diagnosis of testicular masses. A total of 220 testicular masses (217 patients) undergoing MRI were identified. Notable findings include malignant masses having a lower apparent diffusion coefficient compared to benign masses (3 of 4 studies) and that quantitative enhancement patterns could differentiate Leydig cell tumors from germ cell tumors in 2 studies. While there were some distinct qualitative characterizations of testicular masses on MRI, further research is needed to identify appropriate clinical contexts for use.


Assuntos
Imagem por Ressonância Magnética , Neoplasias Testiculares/diagnóstico por imagem , Testículo/patologia , Diagnóstico Diferencial , Humanos , Masculino , Orquiectomia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Testículo/diagnóstico por imagem , Testículo/cirurgia , Ultrassonografia
2.
Urology ; 135: 136-138, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31568794

RESUMO

Neonatal testicular torsion is an uncommon event that rarely results in testicular salvage. We present 2 cases in the neonatal intensive care unit of extremely premature males (<28 weeks gestation) with witnessed testicular torsion, prompt diagnosis, surgical detorsion, and good short-term outcomes. Although an uncommon scenario, we present the feasibility of surgery in the extremely premature infant and potential for testicular salvage.


Assuntos
Lactente Extremamente Prematuro , Doenças do Prematuro/cirurgia , Terapia de Salvação/métodos , Torção do Cordão Espermático/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Estudos de Viabilidade , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Unidades de Terapia Intensiva Neonatal , Masculino , Torção do Cordão Espermático/diagnóstico , Testículo/diagnóstico por imagem , Testículo/cirurgia , Resultado do Tratamento , Ultrassonografia Doppler
4.
Medicine (Baltimore) ; 98(41): e17389, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593090

RESUMO

To examine whether scrotoscopy could be used to diagnose testicular rupture (TR) with accuracy.This retrospective study included all patients receiving scrotoscopy followed by immediate open exploration (OE) for suspected TR at two Chinese tertiary care centers between March 2014 and March 2018.Fifteen patients suspected of having TR were included. TR was considered in 8 patients (8/15) via emergency scrotal ultrasound (ESU) examination. Of these 8 patients, 6 cases as well as 3 other cases, a total of 9 cases (9/15) were confirmed TR by scrotoscopy and OE; the remaining 6 patients (6/15) were found disease free. The presence/absence of TR was identified correctly with scrotoscopy in all 15 cases. The rupture size of the testicular tunica albuginea (TTA) varied from 0.5 to 2 cm. Only 3 cases (3/15) had scrotal wall edema and all quickly recovered. The testis was normal in size and blood flow at 6-month follow-up visit.Scrotoscopy accurately diagnoses TR, and may avoid unnecessary OE, especially for the patients confirmed free of disease.


Assuntos
Técnicas de Diagnóstico Urológico , Doenças Testiculares/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Adulto , Humanos , Masculino , Projetos Piloto , Estudos Retrospectivos , Ruptura Espontânea/diagnóstico por imagem , Escroto/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto Jovem
5.
Nucl Med Rev Cent East Eur ; 22(2): 94-95, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482566

RESUMO

We reported a case of 2-year-old child where epididymo-orchitis was misdiagnosed as testicular torsion on scrotal scintigraphy. The scan showed that left hemiscrotum demonstrated a rim of increased activity with a photopenic center in the left testis (halo sign). At surgery, epididymo-orchitis was detected and there was no testicular torsion.


Assuntos
Epididimite/complicações , Orquite/complicações , Orquite/diagnóstico por imagem , Testículo/diagnóstico por imagem , Pré-Escolar , Reações Falso-Positivas , Humanos , Masculino , Cintilografia , Torção do Cordão Espermático/diagnóstico por imagem
6.
Pan Afr Med J ; 33: 47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448010

RESUMO

Introduction: Hypogonadism refers to a syndrome that results from failure of gonads to function properly. The main concern is considerable rise in morbidity, as shown by increased cardiovascular risk, infertility, osteoporosis and above all, the psychological impact on the life of the patients with hypogonadism. Judicious steroid replacement and culturally-sensitive psychological support before and during steroid therapy remains the key tool in the management of this condition. The present study aimed at filling the knowledge gap on hypogonadism in Cameroon. Methods: We conducted a cross-sectional study over a period of 12 months, in 3 reference hospitals of Cameroon. We included males and females diagnosed with hypogonadism, aged 16 to 50 years and 16 to 45 years respectively. After a complete clinical examination, patients were invited to fill the modified middlesex hospital questionnaire for psychoneurotic evaluation. Results: We recruited 59 patients with a sex ratio of 1:1. The mean age of the females and males were 27.7 ± 9.1years and 30.8 ± 11.7 years respectively. Normosmic Idiopathic Hypogonadotropic Hypogonadism (NIHH) was the most common presentation. Compulsive obsessive traits, phobic anxiety and hysterical trait, were most pronounced in these patients. Testosterone titers significantly correlated positively with testicular size and negatively with body mass index (BMI). A significant positive correlation was found between the testicular volumes measured with ultrasound (US) and with the orchidometer. Conclusion: Normosmic idiopathic hypogonadotropic hypogonadism is the most common presentation of hypogonadism in the study population. There is a significant psychosocial impact requiring further investigation and attention.


Assuntos
Hipogonadismo/fisiopatologia , Testículo/diagnóstico por imagem , Testosterona/sangue , Adolescente , Adulto , Índice de Massa Corporal , Camarões , Estudos Transversais , Feminino , Humanos , Hipogonadismo/epidemiologia , Hipogonadismo/psicologia , Histeria/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtornos Fóbicos/epidemiologia , Ultrassonografia , Adulto Jovem
7.
Pediatr Rheumatol Online J ; 17(1): 39, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291964

RESUMO

BACKGROUND: Deficiency of adenosine deaminase 2 (DADA2) is a rare autosomal recessive autoinflammatory condition. Recognised features include vasculitis predominantly affecting medium sized vessels, livedoid skin rash, central and peripheral nervous system involvement, variable degrees of immunodeficiency, and marrow failure, amongst other clinical presentations. We present the case of a six year old male with DADA2 who presented with acute testicular ischaemia secondary to vasculitis, the first such description in DADA2. CASE PRESENTATION: A six year old male presented acute right-sided testicular pain. His history included transient infantile neutropenia, resolved hepatosplenomegaly, and longstanding livedo racemosa, leading to screening and confirmation of DADA2 caused by homozygous c.139G > C (p.G47R) mutation of ADA2. As his only clinical feature was that of mild livedo racemosa with normal laboratory parameters at diagnosis, he was being actively monitored prior to starting any treatment. At a routine clinic follow-up a 24 h history of testicular pain was noted on systems review. He was afebrile, and his only physical signs were that of moderate livedo racemosa, and tenderness of the right testicle. Laboratory parameters revealed C-reactive protein (CRP) 8 mg/L (reference range [RR] < 20 mg/L); erythrocyte sedimentation rate (ESR) 28 mm/hr. (RR < 10); and serum amyloid A (SAA)5 mg/L (RR < 10). Ultrasound-scan of the scrotum revealed significantly reduced perfusion of the right testes, without torsion. Surgical scrotal exploration confirmed testicular ischaemia without torsion. Histology demonstrated ischaemic seminiferous tubules with intervening haemorrhage and acute inflammatory cells, consistent with vasculitis of the testis as the cause. He was treated with high dose intravenous methyl-prednisolone followed by a weaning course of oral prednisolone, and subcutaneous adalimumab (anti-tumour necrosis factor alpha, anti-TNFα). Repeat ultrasound-scan 3 weeks later revealed good testicular perfusion, with a small area of focal infarction. At last follow-up (11 months post-event) he remained asymptomatic, on treatment with adalimumab. CONCLUSION: The phenotype of DADA2 continues to expand, and we add testicular infarction to the features of DADA2. CRP and SAA cannot be relied on as reliable biomarkers to predict tissue ischaemia and hence who to target for anti-TNFα therapy in DADA2, since these remained steadfastly normal before, during, and after testicular infarction in this case.


Assuntos
Adenosina Desaminase/deficiência , Infarto/patologia , Peptídeos e Proteínas de Sinalização Intercelular/deficiência , Doenças Testiculares/patologia , Vasculite/patologia , Adenosina Desaminase/genética , Criança , Doenças Hereditárias Autoinflamatórias/complicações , Doenças Hereditárias Autoinflamatórias/genética , Humanos , Infarto/diagnóstico por imagem , Infarto/etiologia , Peptídeos e Proteínas de Sinalização Intercelular/genética , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/patologia , Masculino , Doenças Testiculares/diagnóstico por imagem , Doenças Testiculares/etiologia , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Testículo/patologia , Vasculite/diagnóstico por imagem , Vasculite/etiologia
8.
Ital J Pediatr ; 45(1): 79, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291982

RESUMO

BACKGROUND: Beckwith-Wiedemann syndrome (BWS) is a rare congenital overgrowth disorder. A major feature is lateralized overgrowth, which can variably involve a single body district up to the entire hemisome. Visceral asymmetrical involvement has been observed, commonly represented by enlargement of one kidney or adrenal gland, rather than one gonad. CASE PRESENTATION: We report the case of a pubertal boy affected by BWS, who developed a progressive testicular enlargement, ipsilateral to the pre-existing external body overgrowth. Asymptomatic unilateral testis enlargement started after regular pubertal onset and worsened over time, without any associated pathological findings in a long-term follow-up. Since biopsy is not indicated in case of benign macro-orchidism, we hypothesize that this asymmetric enlargement could be an expression of visceral lateralized overgrowth in BWS. CONCLUSIONS: At the best of our knowledge, this is the first detailed report of unilateral testicular overgrowth in BWS. We revised common causes of painless unilateral scrotal masses in the pediatric age. Considering both the overall frequency of neoplasia and the malignancies predisposition in BWS, a testicular cancer should be carefully ruled out through a close follow-up, before stating a benign condition. A normal ultrasound pattern, together with normal serum hormonal levels and negative tumor markers, make testicular neoplasms highly unlikely.


Assuntos
Síndrome de Beckwith-Wiedemann/patologia , Testículo/patologia , Adolescente , Síndrome de Beckwith-Wiedemann/diagnóstico por imagem , Humanos , Hipertrofia , Masculino , Testículo/diagnóstico por imagem , Ultrassonografia
9.
J Urol ; 202(4): 742-747, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31163007

RESUMO

PURPOSE: Stage IS testicular cancer is defined by the persistence of elevated serum tumor markers, including α-fetoprotein and/or ß-human chorionic gonadotropin, after orchiectomy without radiological evidence of metastatic disease. Current treatment recommendations include cisplatin based chemotherapy up front but the recommendations are based on limited single center series. MATERIALS AND METHODS: We retrospectively analyzed clinical and pathological characteristics, and long-term outcomes in 110 patients uniformly treated with primary chemotherapy between 1994 and 2016. The primary objective was to evaluate long-term disease-free survival. We also explored factors associated with the need for additional treatment. RESULTS: The elevated prechemotherapy tumor markers were α-fetoprotein in 48% of cases, ß-human chorionic gonadotropin in 14%, and α-fetoprotein and ß-human chorionic gonadotropin in 38%. Median α-fetoprotein and ß-human chorionic gonadotropin values were 71 ng/ml and 80 mIU/ml, respectively. The IGCCCG (International Germ Cell Cancer Collaborative Group) prognostic classification was good in 94% of cases. Mixed nonseminomatous germ cell tumor was found in 78% of cases. Of the patients 103 achieved a complete response to chemotherapy. In 6 patients radiological signs of progressive disease developed during chemotherapy, while 8 experienced relapse after an initial complete response. At a median followup of 108 months 108 patients were alive and disease-free. Five and 10-year disease-free survival rates were 87% and 85%, respectively. The predominance of embryonal carcinoma in the primary tumor was the only factor associated with the probability of needing additional therapy. CONCLUSIONS: Stage IS testicular cancer is more commonly associated with elevated α-fetoprotein, an IGCCCG good prognosis and mixed nonseminomatous germ cell tumor. Treatment with cisplatin based chemotherapy leads to cure in most cases. However, a proportion of patients require the integration of additional therapies, including more frequently when embryonal carcinoma is not predominant.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Embrionário/tratamento farmacológico , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Embrionárias de Células Germinativas/terapia , Orquiectomia , Neoplasias Testiculares/terapia , Adulto , Carcinoma Embrionário/sangue , Carcinoma Embrionário/mortalidade , Quimioterapia Adjuvante/métodos , Gonadotropina Coriônica Humana Subunidade beta/sangue , Intervalo Livre de Doença , Seguimentos , Humanos , Masculino , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias Embrionárias de Células Germinativas/sangue , Neoplasias Embrionárias de Células Germinativas/mortalidade , Neoplasias Testiculares/sangue , Neoplasias Testiculares/mortalidade , Testículo/diagnóstico por imagem , Testículo/patologia , Adulto Jovem , alfa-Fetoproteínas/análise
10.
BMC Urol ; 19(1): 52, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185974

RESUMO

BACKGROUND: Testicular epidermoid cysts (TECs) are rare benign testicular neoplasms. As TECs are rarely associated with germ cell tumours (GCTs), the understanding of biological behaviour and clinical management of TEC is unresolved. METHODS: We retrospectively searched the files of patients treated for testicular neoplasms and germ cell cancer in the time from 2000 to 2017. Those with TEC were subjected to closer review looking to clinical and histological features, and to results from imaging with ultrasonography (US), contrast enhanced sonography (CEUS) and magnetic resonance imaging (MRI). RESULTS: Among 589 patients undergoing surgery for testicular tumour, nine simple TECs were identified (1.5, 95% confidence intervals 0.53-2.50%). Median age was 26 years. Imaging revealed sharply demarcated roundish lesions with avascular central areas. Eight patients underwent testis-sparing excision with no recurrence ensuing. One had orchiectomy because of large size of the mass. Histologically, TECs consisted of cornifying squamous cell epithelium and no accompanying germ cell neoplasia in situ. Two additional cases (0.3% of all) required orchiectomy because these TECs were associated with ipsilateral GCT. CONCLUSIONS: TEC is usually a benign lesion that can safely be diagnosed with US, CEUS and MRI due to its roundish shape and its avascular centre. Histologically, this TEC corresponds to the prepubertal-type teratoma unrelated to germ cell neoplasia in situ of the 2016 WHO classification. The other subtype of TEC that is associated with invasive GCT represents a teratoma of postpubertal-type. From a clinical point of view it could be easier to differentiate between a "simple TEC" which is benign (prepubertal type) and a "complex TEC" which is malignant because of its association with invasive GCT.


Assuntos
Cisto Epidérmico/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adolescente , Adulto , Criança , Cisto Epidérmico/cirurgia , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/cirurgia , Estudos Retrospectivos , Neoplasias Testiculares/cirurgia , Testículo/cirurgia , Adulto Jovem
11.
Endocr J ; 66(6): 575-577, 2019 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-30918167

RESUMO

Partial androgen insensitivity syndrome (PAIS) is a form of disorders of sexual development. Besides the issues of gender assignment, the fate of gonads in these patients poses a challenging problem. Debate still remains on the need and/or timing of gonadectomy in either complete or partial androgen insensitivity syndromes. In this case report, we present a 68-year-old patient who was raised as a woman, stayed married for 45 years and admitted to our endocrinology department with complaint of male type hair distribution after initial examination following move to a nursing home. Physical examination revealed no breast development, a phallus of 6 cm, labia majoras that include testes and a blind ending vagina. Chromosomal analysis confirmed 46,XY with intact SRY and AZF regions. Pelvic ultrasonography and magnetic resonance imaging results indicated testicular tissue in labia majoras in addition to a rudimentary prostate. Gonadectomy was not offered to the patient due to lacking evidence of benefit in this age group and considering possible hormonal side effects. Our patient might be the oldest patient to be diagnosed with PAIS. Treatment and follow-up protocols for adults with PAIS are not standardized and therefore these patients should be individually evaluated and treated. Risks and benefits of surgery should be kept in mind when suggesting gonadectomy.


Assuntos
Síndrome de Resistência a Andrógenos/diagnóstico , Próstata/diagnóstico por imagem , Testículo/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino
12.
J Cancer Res Ther ; 15(Supplement): S167-S169, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30900641

RESUMO

Malignant mesothelioma (MM) of the tunica vaginalis (TV) is a rare tumor. It is seen in elderly patients, with painless scrotal swelling being the most common presentation. The exact etiology is unknown; a few risk factors have been suggested. Here, we present an uncommon case of MM of TV without any known predisposing factors. We also discuss the possible risk factors, clinical presentation, pathological features and the difficulties in diagnosis, and management of this rare malignancy.


Assuntos
Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Escroto/patologia , Neoplasias Testiculares/diagnóstico , Testículo/patologia , Adulto , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Mesotelioma/patologia , Mesotelioma/cirurgia , Orquiectomia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Escroto/diagnóstico por imagem , Escroto/cirurgia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Testículo/diagnóstico por imagem , Testículo/cirurgia , Resultado do Tratamento , Ultrassonografia
13.
Urology ; 128: 78-83, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30885542

RESUMO

OBJECTIVE: To examine the implications of varicoceles and nutcracker phenomenon (NcP) in a large cohort of adolescent patients. Varicoceles are common in adolescent males, generating concerns regarding etiology and management. At our institution, Doppler ultrasound (US) of the renal vessels is routinely obtained with the goal of assessing for an associated nutcracker phenomenon. METHODS: Between 1/2000 and 3/2017, 182 patients with clinical varicoceles were evaluated with US. Retrospective assessment provided complete data in 137, including maximum varicose vein diameter, testicular measurements, left renal vein velocities at the hilum and impingement point by the superior mesenteric artery, and procedural interventions. RESULTS: NcP was detected in 77 patients (56.2%), who experienced higher venous velocity ratios (8.33 vs 2.87; P < 0.001) than those without. Overall, 39 patients (28.5%) had a testicular volume discrepancy >20%, without a significant difference based on the presence or absence of NcP (27.3 vs 30.0%, respectively; P = 0.36). Both groups had similar ages at diagnosis, bilateral volume parameters, volume difference, maximum varicose vein sizes, and follow-up duration (P ≥ 0.05 for all). Intervention was more likely in patients with volume difference >20% (P = 0.014). Having NcP was not associated with a higher incidence of initial (P = 0.59) or reoperative surgery (P = 0.73). CONCLUSION: NcP is common in adolescent patients with a varicocele, but it is not associated with differences in testicular parameters or an increased frequency of initial or reoperative surgery. As such, NcP may have few clinical ramifications as an isolated finding in this patient population, calling into question routine assessment for its presence.


Assuntos
Testículo/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Varicocele/diagnóstico , Adolescente , Criança , Seguimentos , Humanos , Masculino , Ontário/epidemiologia , Prevalência , Estudos Retrospectivos , Varicocele/epidemiologia
14.
J Pediatr Adolesc Gynecol ; 32(4): 443-445, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30825542

RESUMO

BACKGROUND: Complete androgen insensitivity (CAIS) is a difference of sex development, in which there is complete androgen receptor resistance, leading to a female phenotype, despite the presence of normal testes. There is a recognized risk of testicular germ cell tumor in adulthood as high as 15%, and gonadectomy is usually performed in late adolescence or early adulthood. CASE: A 20-year-old patient, with a known diagnosis of CAIS since the age of 16, underwent magnetic resonance imaging of the pelvis, which revealed the testes lying deep into the inguinal canal. The patient was explored laparoscopically and using the technique of transabdominal preperitoneal hernia repair both testes were successfully reduced into the peritoneal cavity and resected. In addition, the defect of the internal inguinal ring was covered and reinforced using a prosthetic polypropylene mesh. SUMMARY AND CONCLUSION: Minimally invasive gonadectomy is feasible even for gonads situated deep into the inguinal canal. Established benefits of laparoscopic surgery such as reduced postoperative pain, rapid recovery, aesthetically small incisions, and early return to normal activities are very important for CAIS patients. Multidisciplinary team work, among gynecologists and general surgeons, provides excellent results in these complex cases.


Assuntos
Síndrome de Resistência a Andrógenos/cirurgia , Castração/métodos , Hérnia Inguinal/cirurgia , Síndrome de Resistência a Andrógenos/diagnóstico , Feminino , Humanos , Laparoscopia , Masculino , Telas Cirúrgicas , Testículo/diagnóstico por imagem , Testículo/cirurgia , Adulto Jovem
15.
Vet Radiol Ultrasound ; 60(3): 338-345, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30859678

RESUMO

Ultrasonography is commonly used to examine testes as part of a breeding soundness examination in sheep, especially, in cases of infertility or when gross testicular abnormalities are present. A descriptive, prospective, prevalence study was conducted to characterize the ultrasonographic, histopathologic, and spermatozoal morphology abnormalities present in a group of yearling tropic hair rams on the island of St. Kitts. Hyperechoic and shadowing abnormalities increased over a 6 month study period. Hyperechoic abnormalities were present in one or both testes in 89% (25/28) of yearling rams and 71% (40/56) of testes at castration. Shadowing abnormalities were present in one or both testes in 46% (13/28) of rams and 34% (19/56) of testes at castration. Shadowing was present more with moderate and severe hyperechoic abnormalities, with few testes in the mild category having any shadowing. As hyperechoic and shadowing abnormalities increased in severity, so did the severity of microscopic lesions including increased interstitial cellularity/fibrosis, interstitial mineralization, seminiferous tubules mineralization (hyperechoic only), and chronic lymphoplasmacytic orchitis. There were no spermatozoal morphologic abnormalities other than an increase in distal cytoplasmic droplets. The study findings detail a pathologic event in this group of yearling rams that has an unknown etiology. Potential causes may include scrotal insulation, trauma, infectious causes, immunity alterations, nutritional imbalances, and ingestion of a toxin. Further studies are required to elucidate the causative agent.


Assuntos
Doenças dos Ovinos/diagnóstico por imagem , Doenças Testiculares/veterinária , Testículo/diagnóstico por imagem , Animais , Masculino , Estudos Prospectivos , São Cristóvão e Névis/epidemiologia , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/patologia , Carneiro Doméstico/anormalidades , Espermatozoides/citologia , Doenças Testiculares/diagnóstico por imagem , Doenças Testiculares/epidemiologia , Doenças Testiculares/patologia , Testículo/anormalidades , Testículo/patologia , Ultrassonografia/veterinária
16.
Trop Anim Health Prod ; 51(6): 1467-1480, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30739277

RESUMO

The present research work entitled "Correlation of testicular ultrasonography, testicular biometry, serum testosterone levels and seminal attributes in pre- and post-pubertal age for breeding soundness evaluation in Osmanabadi bucks" was undertaken in 18 healthy Osmanabadi bucks from the Instructional Livestock Farm Complex, Bombay Veterinary College, Mumbai, Maharashtra. The body weight (kg), scrotal circumference (cm) and testicular biometry (cm) of post-weaning 18 Osmanabadi male kids was recorded every 15 days from weaning, i.e., 120 ± 10 days along with serum testosterone (ng/ml) by radioimmunoassay method at monthly intervals for the next 6 months. Semen was collected six times on the seventh month onward during post-pubertal age at 15-day interval from 18 bucks. The semen was evaluated for macroscopic and microscopic tests. The body weight increased from 14.45 ± 0.67 to 19.57 ± 0.70 kg from four to nine and a half months of age. The average daily body weight gain was 31.27 g. Maximum body weight gain was 01.19 ± 0.16 kg from 5 to 6 followed by 01.15 ± 0.16 kg from 4 to 5 months of age. The scrotal circumference increased from 17.22 ± 0.56 to 19.03 ± 0.55 cm from four to nine and a half months of age with maximum increased between 4 and 5 followed by 6 and 7 months of age. The testicular length, width and thickness of right and left testicles were recorded by ultrasonography method. There was increase in mean right and left testicular length, width and thickness from 5.25 ± 0.19 to 5.84 ± 0.18 and 5.49 ± 0.21 to 6.16 ± 0.20; 2.99 ± 0.12 to 3.32 ± 0.12 and 3.10 ± 0.13 to 3.44 ± 0.12 and 2.97 ± 0.12 to 3.16 ± 0.12 and 3.06 ± 0.12 to 3.31 ± 0.11 cm, respectively by ultrasonography, between four to nine and a half months of age. Testicular length, width and thickness gain was at maximum in 5 to 6 months of age. Left testicular length was more than the right testis. Before puberty, there was sudden gain in body weight, testicular length and width. However, scrotal circumference showed significant increase after puberty. Body weight had highest correlation with ultrasonographic left testicular thickness (r = 1) followed by scrotal circumference, ultrasonographic right and left testicular width, left testicular length, right testicular length and thickness and least by right testicular thickness (r = 0.95). The semen was thin to thick in consistency and average semen density was 3.10 ± 0.05. Average semen volume was 0.81 ± 0.02 ml, mass activity, initial motility, live and dead sperm count, abnormal sperm count and sperm concentration were 3.45 ± 0.13, 76.16 ± 1.16 and 75.16 ± 1.28% and 24.84 ± 1.28, 12.30 ± 0.50% and 2631.04 ± 45.74 million/ml, respectively in 18 bucks in six collection at 15 days. There was significant rise in semen volume, mass activity, initial motility and concentration at 8.5 months and live count, density at 9 months of age which indicates the age of sexual maturity is 8.5 to 9 months in Osmanabadi bucks. The body weight had highest positive correlation with mass activity (r = 98) followed by initial motility, live sperm count and total sperm concentration, semen volume (r = 76). The scrotal circumference had highest positive correlation with initial motility (r = 98) followed by live sperm count, total sperm count, mass activity, semen volume (r = 86). On the other hand, body weight and scrotal circumference were negatively correlated with abnormal and dead sperm count. The mean testosterone concentration increased from 0.02 ± 0.004 to 5.75 ± 0.80 ng/ml between four and half to nine and half months of age, respectively. There was significant rise (p < 0.01) up to 1.38 ± 0.28 ng/ ml at 6.5 months, i.e., age of puberty and up to 5.75 ± 0.80 ng/ml at 9.5 months, i.e., age of sexual maturity. Testosterone had highest positive correlation with testicular length followed by testicular width, length, body weight and scrotal circumference, mass activity, live sperm count, initial motility, while it had highest negative correlation with dead and abnormal sperm count. From the present research work, it was concluded that the scrotal circumference, testicular length, width and thickness increased with increasing body weight. Before puberty, there was sudden gain in body weight, testicular length and width. However, scrotal circumference increased significantly at post-pubertal age. So testicular length, body weight, testicular width in pre pubertal age and scrotal circumference post-pubertal age can be used as indicator for selection of Osmanabadi bucks for breeding purpose. On the other hand, the semen parameters should consider only after 8.5 to 9 months of age for selection of Osmanabadi bucks for breeding.


Assuntos
Cabras/anatomia & histologia , Cabras/fisiologia , Análise do Sêmen/veterinária , Testículo/anatomia & histologia , Testículo/fisiologia , Testosterona/sangue , Animais , Biometria , Humanos , Índia , Masculino , Escroto , Sêmen , Contagem de Espermatozoides/veterinária , Espermatozoides , Testículo/diagnóstico por imagem , Ultrassonografia/veterinária
17.
J Med Case Rep ; 13(1): 2, 2019 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-30609931

RESUMO

BACKGROUND: Cryptorchidism is the most common congenital malformation of the male genitourinary tract. The cryptorchid testis is most often located in the inguinal canal; however, intra-abdominal locations are not rare. The risk of malignancy in an undescended testis is 10% with the highest risk in an intra-abdominal testis. CASE PRESENTATION: Here we describe a case of a 40-year-old fertile man of Fulbe origin who presented with a non-tender lower abdominal mass of 2 months' duration. A scrotal examination revealed just one testis in the right scrotum, with the contralateral scrotum and inguinal canal being empty. An exploratory laparotomy followed by tumor excision and histopathology revealed a testicular seminoma. CONCLUSION: This case report highlights the need for routine scrotal examination in all men presenting with an abdominal mass so as to rule out the possibility of an intra-abdominal seminoma.


Assuntos
Cavidade Abdominal/cirurgia , Criptorquidismo/diagnóstico por imagem , Seminoma/diagnóstico por imagem , Seminoma/cirurgia , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/cirurgia , Cavidade Abdominal/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Testículo/diagnóstico por imagem , Testículo/cirurgia , Ultrassonografia
18.
Clin Nucl Med ; 44(4): 297-298, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30688733

RESUMO

Extramedullary multiple myeloma (EM) has negative prognostic implications on the overall survival as well as progression-free survival. Testis is a rare site of EM, which can be a part of diffuse involvement in multiple myeloma or a site of recurrence in patients with remission. We present a case of EM of testes and left spermatic cord in an 80-year-old man who presented with painless progressive enlargement of the scrotum. F-FDG PET/CT revealed tracer avidity of both testes and left spermatic cord. Bilateral radical orchidectomy was subsequently performed, and the diagnosis of multiple myeloma was confirmed on histopathology.


Assuntos
Fluordesoxiglucose F18 , Mieloma Múltiplo/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Cordão Espermático/diagnóstico por imagem , Testículo/diagnóstico por imagem , Idoso de 80 Anos ou mais , Humanos , Masculino , Mieloma Múltiplo/patologia , Prognóstico , Cordão Espermático/patologia , Testículo/patologia
19.
Metab Syndr Relat Disord ; 17(2): 102-107, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30614770

RESUMO

BACKGROUND: In adult studies, obese subjects with nonalcoholic fatty liver disease (NAFLD) have been shown to have poor sperm quality, and lower testosterone and luteinizing hormone levels. The aim of this study was to investigate the pubertal status and gonadal functions in obese boys with NAFLD. MATERIALS AND METHODS: The study included 119 obese and 78 nonobese age-matched adolescents. The obese boys were separated into two groups based on the presence (NAFLD group) or absence of liver steatosis with high transaminases (non-NAFLD group). The levels of serum AMH (anti-Mullerian hormone), inhibin B, gonadotropins, total testosterone, lipids, high-sensitivity C-reactive protein, fasting glucose, insulin levels, and aortic intima media thickness were measured in all subjects. RESULTS: Of the total 197 children, 174 had reached puberty. There were no significant differences between the groups in respect of testicular sizes and the prevalence of pubertal status among the groups (84.3% of NAFLD vs. 70.6% of non-NAFLD vs. 98.7% of control subjects). No significant differences were found in respect of gonadotropins and AMH levels. Total testosterone levels in the NAFLD group were significantly lower than those of the non-NAFLD obese group (P < 0.001) and the control group (P < 0.001). Inhibin B levels were also significantly lower in all (NAFLD and non-NAFLD) obese groups compared to the control group (P = 0.008). CONCLUSIONS: The results of the study demonstrated that diminished testosterone and inhibin B levels occur in pubertal obese boys with NAFLD. No significant differences were detected according to pubertal status, AMH levels, and testicular volumes in the age-matched groups.


Assuntos
Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Obesidade/fisiopatologia , Puberdade , Testículo/fisiopatologia , Adolescente , Criança , Hormônios/sangue , Humanos , Inibinas/sangue , Testes de Função Hepática , Masculino , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Tamanho do Órgão , Testículo/diagnóstico por imagem , Testículo/patologia , Testosterona/sangue , Túnica Íntima/diagnóstico por imagem , Túnica Íntima/patologia , Ultrassonografia
20.
Ultrasound Med Biol ; 45(3): 720-731, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30600129

RESUMO

We prospectively evaluated the performance of combined shear wave elastography (SWE) and conventional ultrasound (US) for the characterization of 89 testicular focal masses. Testes were evaluated with B-mode, color Doppler and SWE measurements, locating a region of interest on the normal and pathologic parenchyma. Thirty-seven malignant tumors (MTs), 12 burned out tumors (BOTs), 28 Leydig cell tumors (LCTs), 2 dermoid cysts and other benign lesions were included. MTs + BOTs exhibited more microliths and macrocalcifications compared with benign lesions (p < 10-4). LCTs manifested mostly a dominant peripheral vascularization pattern compared with other lesions. MTs + BOTs were stiffer compared with benign lesions (p < 2 × 10-4) but with a moderate area under the receiver operating characteristic curve (AUROC) of 80%. By focusing on LCTs versus MTs + BOTs, diagnostic performance led to an AUROC of 89% for the best stiffness parameter. For combined conventional US and SWE, the diagnostic performance to differentiate all benign lesions versus MTs + BOTs and LCTs versus MTs + BOTs increased to AUROCs of 93% and 98%, respectively.


Assuntos
Neoplasias Testiculares/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Técnicas de Imagem por Elasticidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Testículo/diagnóstico por imagem , Adulto Jovem
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