Classical testicular seminoma in young man.

A 29 year old man was admitted in Urology Department of County Hospital of Constanta for left testicular increased size in last six months, without other symptoms. Testicular tumor was palpated and visualized by ultrasound. Computed tomography did not revealed metastatic lymph nodes. Beta-human chorionic gonadotropin and alpha-fetoprotein were within the normal range. We diagnosed the case as a left testicular tumor and performed high orchiectomy. Histological examination revealed typical seminoma. Subsequently, the patient was given two courses of systemic chemotherapy (bleomycin, etoposide, cisplatin) as an adjuvant therapy. The patient has remained free of disease six months after discharge.

ETHICAL AND GENETIC ASPECTS REGARDING PRESYMPTOMATIC TESTING FOR NEURODEGENERATIVE DISEASES.

Neurodegenerative diseases, such as Alzheimer's dementia, Huntington's chorea, Parkinson's disease or spinocerebellar ataxia, manifests into adulthood with an insidious onset, slowly of progressive symptoms. All of these diseases are characterized by presimptomatic stages that preceded with many years of clinical debut. In Parkinson's disease, more than half of the dopaminergic neurons of the black substance are lost before the advent of motor characteristic manifestations. In Huntington's chorea, the progressive neurodegenerative disease could be diagnose prenatal and presymptomatic by analyse of the number of CAG repeats in exon 1 of the huntingtin gene. A similar mechanism represented by expansion of trinucleotide repeats during hereditary transmission from parents to children was identified in fragile X syndrome, spinocerebellar ataxia, spinal muscular and bulbar atrophy, or myotonic dystrophy. Presymptomatic diagnosis in all these progressive diseases raise many ethical issues, due to the psychological impact that can cause the prediction of a disease for which there is currently no curative treatment. Therefore, a positive result can produce serious psychological trauma and major changes in the lifestyle of the individual, instead, a negative result can bring joy and tranquillity. But the problem arises if presymptomatic testing in these neurodegenerative diseases brings greater benefits compared to the possible psychological damage, which can add the risk of stigmatization or discrimination.

Morphological characteristics of a mucinous adenocarcinoma of the prostate: differential diagnosis considerations.

Mucoid adenocarcinoma of the prostate is a very rare variant, account less than 1% of prostatic adenocarcinomas. In this respect, the most common histopathological type of prostate cancer is acinar adenocarcinoma. Diagnosis of this variant is very important due to peculiarities: aggressive biologic behavior, poor response to radiotherapy. Although these tumors are not as hormonally responsive as acinar adenocarcinomas, some of them respond to androgen withdrawal. Before making a diagnosis of primary mucinous adenocarcinoma, is necessary to exclude an extraprostatic malignant neoplasia, especially from the bladder or bowel. We present the case of a male patient who suffered a transurethral prostatic resection surgery. Histopathological examination revealed malignant tumor cells floating in a pool of mucus or even acini mixed with signet ring cells. A particular aspect is that floating mucus cells have a non-papillary pattern similar to colloid carcinoma of the breast. The use of monoclonal antibody revealed positive immunoreaction of malignant cells for prostatic specific markers and excluded neoplastic invasion of the bladder or bowel carcinoma.