PURPOSE: Various causes may be the etiology of gynecomastia. We investigated the levels of serum estradiol (E2), testosterone (T), ratio of E2 to T (E2/T) as well as associated diseases, drugs as the cause of gynecomastia. MATERIALS AND METHODS: E2, T, E2/T in 37 patients from gynecomastia patients (GP) and 10 healthy men were measured, and the associated diseases and drugs in 68 GP were also evaluated. Ultrasound for the adrenal gland diseases, physical examination or ultrasound for the testicular pathology were performed. RESULTS: The cause of gynecomastia varied according to the age. The levels of E2, T, E2/T in control group (CG) were 35.3 3.9 pg/ml, 5.0 0.4 ng/ml, 7.1 0.5. Those in GP were 48.7 7.1 pg/ml, 4.3 0.3 ng/ml, 12.0 1.8, respectively. The difference of E2/T as well as E, T between CG and GP was not significant. Various associated diseases or drugs were found in GP. Adrenal diseases or testicular cancer were not found in GP. CONCLUSIONS: The difference of E2/T between CG and GP is not the only cause of gynecomastia. Thus, the consideration of the age as well as associated diseases or drugs will be helpful for the better understanding of high E2/T as the cause of gynecomastia
Adrenal Gland Diseases ; Estradiol ; Gynecomastia* ; Humans ; Male ; Pathology ; Physical Examination ; Testicular Neoplasms ; Testosterone ; Ultrasonography

OBJECTIVETo investigate the clinical significance and diagnosis of testicular microlithiasis (TM).

METHODSWe reported 2 cases of TM, reviewed the relevant published literature and analyzed the clinical significance of the condition.

RESULTSUltrasonographic (US) scanning of the scrotal revealed multiple small calcifications diffusely scattered throughout the testicular parenchyma with rare pinpoint-like 1-2 mm shadows but without acoustic ones, which were diagnosed by scrotal sonography as right limited TM and classic TM accompanied with left varicocele and epididymitis. The testicular tumor markers of AFP, hCG, LDH and testosterone were shown to be normal, so that no intervention was performed for TM. During the 6-8 months follow-up, no abnormality was found in physical examinations and testicular tumor markers, and no characteristic additive change was revealed by testicular ultrasound.

CONCLUSIONTM is a rare, usually asymptomatic and non-progressive abnormality, usually detected incidentally during the ultrasound examination of the testis. Though it is still controversial whether TM should be regarded as a premalignant lesion or not, regular follow-up and routine ultrasound examination are quite necessary for TM patients.

Adolescent ; Adult ; Calculi ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; Humans ; Male ; Retrospective Studies ; Scrotum ; diagnostic imaging ; Testicular Diseases ; diagnostic imaging ; Testicular Neoplasms ; diagnostic imaging ; Ultrasonography

PURPOSE: The improvement of testicular volume, testosterone levels and sperm concentration was suggested to be significantly associated with the number of internal spermatic veins (ISVs) ligated during varicocelectomy. Herein, we investigated preoperative color Doppler ultrasonography (CDU) findings as potential preoperative predictors of the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: In a prospective evaluation of 40 patients, maximal vein size and maximal reflux velocity were measured, while the total cross-sectional area of the affected testicular veins during a Valsalva maneuver was calculated using CDU by a single uroradiologist. Microsurgical subinguinal varicocelectomies were performed by one urologist. RESULTS: Among the semen parameters, semen morphology showed significant improvement (p=0.033), which was much clearer in the patients with a higher number of ISVs ligated than a lower number of ISVs ligated. Among the various preoperative variables, maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated (r=-0.442, p=0.004; r=0.594, p=0.000, respectively). Furthermore, univariate and multivariate linear regression analyses showed that maximal reflux velocity and total cross-sectional area on CDU were independent predictive factors of the number of ISVs ligated. CONCLUSION: Maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated. This means that the maximal reflux velocity and total cross-sectional area measured by preoperative CDU can predict the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy, which might be related to significant improvement of semen parameters after varicocelectomy.
Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Prospective Studies ; Semen/metabolism ; Testicular Diseases/ultrasonography ; Ultrasonography, Doppler, Color/*methods ; Varicocele/pathology/*ultrasonography ; Veins/*ultrasonography ; Young Adult

With the increased attention to men's health and development of ultrasound imaging technology, clinicians are achieving a better understanding of testicular microlithiasis. This review presents an overview on recent studies of the etiology, pathogenesis, and imaging characteristics of testicular microlithiasis, its impact on male reproductive function, and its relation ship with testis tumors and other related diseases, as well as its treatment strategies and follow-up proposals, aiming to provide some new evidence for further understanding and management of the disease.
Adult ; Calculi ; diagnostic imaging ; etiology ; physiopathology ; therapy ; Disease Management ; Humans ; Male ; Reproduction ; physiology ; Testicular Diseases ; diagnostic imaging ; etiology ; physiopathology ; therapy ; Testicular Neoplasms ; etiology ; Ultrasonography

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

OBJECTIVETo diagnose tubular ectasia of the rete testis with color flow Doppler imaging.

METHODSSonographic, CDFI and pulse wave Doppler appearance in tubular ectasia of the rete testis was described.

RESULTSThe characteristic ultrasound appearance with no associated soft-tissue abnormality and no flow on color flow Doppler imaging was seen.

CONCLUSIONColor Doppler ultrasound imaging is the first choice for the diagnosis of tubular ectasia of the rete testis.

Aged ; Aged, 80 and over ; Humans ; Male ; Rete Testis ; diagnostic imaging ; Testicular Diseases ; diagnostic imaging ; Ultrasonography, Doppler, Color

Primary testicular carcinoid is a rare disease, accounting for less than 1% of all testicular neoplasms, with the potential for distant metastasis. We report a case of primary testicular carcinoid in a 44-year-old-man who presented with a painless, palpable mass in the left testis. Preoperative testicular ultrasound examination revealed a solid mass. Radical orchiectomy was performed, and pathologic examination showed a carcinoid tumor confined to the testis. There was no evidence of carcinoid syndrome, and a 24-hour urinary 5-HIAA assay was normal. Abdominopelvic CT scan and gastrointestinal contrast study showed no evidence of carcinoid in other organ. At 12 months postoperatively, the patient was without evidence of tumor recurrence.
Carcinoid Tumor* ; Humans ; Hydroxyindoleacetic Acid ; Neoplasm Metastasis ; Orchiectomy ; Rare Diseases ; Recurrence ; Testicular Neoplasms ; Testis* ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo investigate the application value of high-frequency color Doppler ultrasonography in the diagnosis of polyorchidism.

METHODSWe retrospectively studied 6 cases of polyorchidism diagnosed by ultrasound, 5 of which were pathologically confirmed, and analyzed the sonographic and clinical findings.

RESULTSAll the 6 cases were triorchidism, 4 located in the scrotum, and 2 in the same groin with indirect hernia. The supernumerary testis was linked to the epididymis in 3 cases, 1 accompanied with repeated epididymis and vas deferens, and 2 connected to no vas deferens and epididymis. Color Doppler ultrasonography revealed blood flow signals in 4 cases, but not in the other 2.

CONCLUSIONPolyorchidism has typical sonographic appearances, and high-frequency color Doppler ultrasonography plays an important role in its diagnosis.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Male ; Retrospective Studies ; Testicular Diseases ; diagnostic imaging ; Testis ; abnormalities ; diagnostic imaging ; Ultrasonography, Doppler, Color

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

OBJECTIVETo evaluate ultrasonography in the diagnosis and differential diagnosis of testicular tumor.

METHODSUltrasound findings and post-operation pathological results were retrospectively studied in 172 men with testicular mass 1998 to 2005.

RESULTSOf the total number, 50 cases were testicular hematoma, 13 testicular cyst, 26 testicular inflammatory node, 25 testicular tuberculosis and 58 testicular tumor. Among 59 testicular tumor cases, 50 were germ cell tumor (including 41 cases of seminoma and 9 cases of nonseminoma germ cell tumor), 6 were non-germ cell tumor and 3 were secondary tumor. The sonographic features of typical seminoma, teratomas, epidemic cyst, interstitial cell tumor and malignant lymphoma were obvious.

CONCLUSIONUltrasonography, contributive to the preliminary diagnosis and differential diagnosis of testicular tumor and capable of evidence for further treatment, can be the first choice in medical imaging for the diagnosis of testicular tumors.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diagnosis, Differential ; Endodermal Sinus Tumor ; diagnostic imaging ; Hematoma ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Seminoma ; diagnostic imaging ; Teratoma ; diagnostic imaging ; Testicular Diseases ; surgery ; Testicular Neoplasms ; diagnostic imaging ; Ultrasonography