Cryptorchidism ; diagnosis ; Hernia, Inguinal ; diagnosis ; Humans ; Infant ; Male ; Scrotum ; pathology ; Ultrasonography

Urogenital emergencies are fairly common in the pediatric population, and a timely and correct diagnosis is necessary to avoid possible future infertility. In this field, ultrasonography is essential, as it has the advantages of being radiation-free and readily accessible. In particular, a high-frequency transducer allows precise evaluation of the morphology and vascularity of the scrotum, which is on the surface of the body. Beyond conventional techniques, new advanced imaging techniques have been developed, including elastography and contrast-enhanced ultrasonography. However, several pitfalls remain in the diagnosis of urogenital diseases using ultrasonography. Thus, accurate knowledge and sufficient experience with the technique are essential for making a correct diagnosis. This review provides an overview of pediatric urogenital emergency pathologies and recent ultrasonography techniques.
Contrast Media ; Diagnosis ; Elasticity Imaging Techniques ; Emergencies* ; Infertility ; Pathology ; Pediatrics ; Scrotum ; Testis ; Transducers ; Ultrasonography*

Polyorchidism is an uncommon congenital anomaly, which is defined as the presence of more than two testes, and may be associated with urological pathologies, such as an undescended testis, inguinal hernia, testicular torsion and testicular tumor. In the absence of any concomitant disorder, and if testicular tumor can be ruled out, using magnetic resonance imaging and ultrasonography, then a surgical exploration or biopsy is unnecessary. We report a case of polyorchidism in a 3 year-old-boy, with three testes in the right scrotum.
Biopsy ; Cryptorchidism ; Hernia, Inguinal ; Magnetic Resonance Imaging ; Male ; Pathology ; Scrotum ; Spermatic Cord Torsion ; Testis ; Ultrasonography

Adenocarcinoma of the rete testis arising in the mediastinum testis is a rare, highly malignant neoplasm. Wedescribe one such case in a 25-year-old male who presented with a palpable right scrotal mass which metasta-sizedto the right inguinal lymph node eight months later. Ultrasonography of this tumor showed a complex cystic andsolid mass in the swollen right scrotum, which was separate from the right testis. Ultrasonographic and clinicalfindings suggested that the mass was, indeed, paratesticular. Surgical pathology following right radicalorchiectomy and hemiscrotectomy, however, confirmed the presence of an exophytic adenocarcinoma of the retetestis. A pelvic CT performed to evaluate a right inguinal mass, which was palpated eight months later, revealed amainly cystic mass in the right inguinal area. Metastasis was confirmed by biopsy.
Adenocarcinoma* ; Adult ; Biopsy ; Humans ; Lymph Nodes ; Male ; Mediastinum ; Neoplasm Metastasis ; Pathology, Surgical ; Rete Testis* ; Scrotum ; Testis ; Ultrasonography

We report a case of adult granulosa cell tumor arising in the scrotal tunics. The patient was a 34-year-old man who presented with right scrotal swelling, first noticed four months previously. Under the initial clinical impression of epididymo-orchitis, antibiotic treatment was instituted but there was no response. The paratesticular nodules revealed by ultrasound and magnetic resonance imaging mimicked intratesticular lesion, and radical orchiectomy was performed. Although several cases of adult testicular granulosa cell tumor, have been reported, the occurrence of this entity in the paratesticular area has not, as far as we are aware, been previously described.
Adult ; Case Report ; Granulosa Cell Tumor/*diagnosis/surgery ; Human ; Magnetic Resonance Imaging ; Male ; Scrotum/*pathology/*ultrasonography ; Testicular Neoplasms/*diagnosis/surgery

A 47-year-old man presented with a scrotal swelling. Ultrasonography of the testes showed that it was an extratesticular swelling. However, the swelling was intraoperatively found to be intratesticular. Histology showed an intratesticular leiomyoma, which is extremely rare.
Diagnosis, Differential ; Humans ; Leiomyoma ; diagnosis ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Scrotum ; pathology ; Testicular Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Treatment Outcome ; Ultrasonography

OBJECTIVETo evaluate the differential diagnosis of scrotal mass with color Doppler ultrasound.

METHODSRetrospective analysis was made of 21 cases of scrotal mass confirmed both surgically and pathologically in our hospital.

RESULTSEight of the total number were malignancy of the testis origin, accounting for 38.1% of whole study group and 13 were benign, accounting for 61.9%. Of the 13 benign cases, only 2 were of the testis origin (15.4%) while the other 11 (84.6%) were not.

CONCLUSIONColor Doppler ultrasound plays an increasingly important role in the differential diagnosis of scrotal mass.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Genital Neoplasms, Male ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Scrotum ; Ultrasonography, Doppler, Color ; methods

Testicular microlithiasis (TM) refers to the calcium deposits within the seminiferous tubules. Owing to the wide use of scrotal ultrasonography, more cases of TM have been diagnosed clinically. TM can be associated with many conditions, including cryptorchidism, infertility, varicocele, testicular torsion, Klinefelter's syndrome, intratubular germ cell neoplasia (IGCN) and testicular germ cell tumor (TGCT), and its frequent association with IGCN, TGCT and infertility is the particular concern of urologists and andrologists. The etiology of TM is not yet certain. Its biological meaning and clinical significance have not been well defined. Currently, there are controversies on the correlation of TM with IGCN, TGCT and infertility. This article reviews the definition, prevalence, etiology, and histopathology of TM, and summarized its association with IGCN, TGCT, and male infertility as well as the management of the disease.
Calculi ; diagnostic imaging ; Germinoma ; diagnostic imaging ; Humans ; Incidence ; Male ; Scrotum ; diagnostic imaging ; Testicular Diseases ; diagnosis ; epidemiology ; pathology ; Testicular Neoplasms ; diagnostic imaging ; Ultrasonography

PURPOSE: Testicular microlithiasis (TM) is a relatively rare clinical entity of controversial significance characterized by the existence of hydroxyapatite microliths located in the seminiferous tubules. The aim of this study was to observe the natural course of changes in the calcific density of pediatric TM. MATERIALS AND METHODS: We included a total of 23 TM patients undergoing scrotal ultrasound (US) on at least two occasions from July 1997 to August 2014. We retrospectively analyzed the patient characteristics, clinical manifestations, specific pathological features, and clinical outcomes. We measured the calcified area and compared the calcific density between the initial and final USs. RESULTS: The mean age at diagnosis was 11.3+/-4.6 years, and the follow-up period was 79.1+/-38.8 months (range, 25.4-152.9 months). During the follow-up period, no patients developed testicular cancer. Calcific density on US was increased in the last versus the initial US, but not to a statistically significant degree (3.74%+/-6.0% vs. 3.06%+/-4.38%, respectively, p=0.147). When we defined groups with increased and decreased calcification, we found that diffuse TM was categorized into the increased group to a greater degree than focal TM (10/20 vs. 4/23, respectively, p=0.049). In addition, five of eight cases of cryptorchidism (including two cases of bilateral cryptorchidism) were categorized in the increased calcification group. CONCLUSIONS: Diffuse TM and cryptorchidism tend to increase calcific density. Close observation is therefore recommended for cases of TM combined with cryptorchidism and cases of diffuse TM.
Adolescent ; Calcification, Physiologic ; *Calculi/complications/epidemiology/pathology/physiopathology ; Child ; Cryptorchidism/diagnosis/etiology ; Densitometry/methods ; Follow-Up Studies ; Gonadoblastoma/diagnosis/etiology ; Humans ; Male ; Republic of Korea ; Scrotum/*ultrasonography ; Seminiferous Tubules/*pathology ; *Testicular Diseases/complications/epidemiology/pathology/physiopathology ; *Testicular Neoplasms/diagnosis/epidemiology/etiology

A 59-year-old Korean man complained of a painless scrotal hard nodule and weak urine stream. The ultrasound scan revealed a 2.2-cm sized round heteroechogenic nodule located in the extratesticular area. Microscopic hematuria was detected in routine laboratory examinations. On scrotal exploration, multiple spargana were incidentally found in the mass and along the left spermatic cord. On cystoscopy, a 10-mm sized mucosal elevation was found in the right side of the bladder dome. After transurethral resection of the covered mucosa, larval tapeworms were removed from inside of the nodule by forceps. Plerocercoids of Spirometra erinacei was confirmed morphologically and also by PCR-sequencing analysis from the extracted tissue of the urinary bladder. So far as the literature is concerned, this is the first worm (PCR)-proven case of sparganosis in the urinary bladder.
Animals ; Cystoscopy ; DNA, Helminth/chemistry/genetics ; Hematuria/diagnosis ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Scrotum/*parasitology/*pathology/ultrasonography ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Sparganosis/*diagnosis/parasitology ; Spirometra/*isolation & purification ; Urinary Bladder Diseases/*parasitology/*pathology/surgery