Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent.
Diagnosis, Differential ; Diagnostic Errors ; Humans ; Male ; Middle Aged ; Orchiectomy ; Sparganosis/*diagnosis/pathology/ultrasonography ; Testicular Neoplasms/diagnosis/ultrasonography ; Testis/pathology

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

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

Painless scrotal masses are clinical syndromes composed of variable causes such as benign disease and testicular cancer. So, the methods of treatment are differ from each causes and in the case of testicular cancer, as its painless nature, the delayed treatment can be alter the methods of treatment and the prognosis. During 21 months, between June 1994 and March 1996, we evaluated the confirmed diagnosis, the method of treatment, the diagnostic method and the distribution of age from the 125 cases of 109 patients who are admitted to the hospital from the painless scrotal mass and underwent surgical treatment and pathologic typing, retrospectively. Of the 125 cases, 57 cases (46%) were below 20 years old and communicating hydrocele was most common case (51case) and 66 cases were age of over 20 years old. In 66 cases, 17 cases (25%) were chronic epididymitis, 15 cases (22.1%) were noncommunicating hydrocele and 9 cases (13.2%) were varicocele, respectively. Malignant neoplasm was distributed to the 1 case of pediatric group and 3 cases (4.4%) of adult group. Transillumination test, generally, revealed negative or equivocal finding except to hydrocele. On the ultrasonographic test (35 cases). most cases were identical or correspond to the postoperative diagnosis and 1 case was misdiagnosed (accuracy rate, 97.1%) but in the case of inflammatory disease, it was difficult to differentiate between specific and non-specific infection. We conclude that the work up for the painless scrotal mass should begin with careful physical examination, and when the physical examination, scrotal transillumination and scrotal ultrasonography show the equivocal finding, surgical exploration with inguinal incision will be necesssary to prevent sequelae or complication of malignant disease.
Adult ; Diagnosis ; Epididymitis ; Humans ; Male ; Physical Examination ; Prognosis ; Retrospective Studies ; Testicular Neoplasms ; Transillumination ; Ultrasonography ; Varicocele ; Young Adult

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 study the clinical characteristics of yolk sac tumor of the testis with concomitant testicular hydrocele in children and the association between the two conditions in order to improve the diagnosis and treatment of the disease.

METHODSWe retrospectively analyzed the clinical data of 7 cases of stage-I yolk sac tumor of the testis with concomitant testicular hydrocele. The patients ranged in age from 6 to 14 (mean 11) months. As treatment, we performed radical high spermatic cord orchiectomy after diagnosis established on intraoperative frozen sections, and conducted follow-up visits by medical examination, serum alpha-fetoprotein (AFP) detection, chest X-ray, ultrasonography and CT for 3-41 (mean 17) months, every month in the first year, every 3 months in the second year and every 6 months in the third year after surgery.

RESULTSPostoperative pathology confirmed yolk sac tumor in all the cases, with negative incisal margin. The level of serum AFP were decreased to normal in 6 cases within 1 month after surgery, all diagnosed as at stage I, and cured without chemotherapy. The other 1 case, with the serum AFP level of 116 microg/L at 1 month after operation, was diagnosed as at stage II and received PVC chemotherapy, but lost to follow-up at 3 months post-operatively.

CONCLUSIONYolk sac tumor of the testis with concomitant testicular hydrocele is easily misdiagnosed in children. Ultrasonography is necessitated as routine examination in its diagnosis. Radical high spermatic cord orchiectomy can be performed for patients in stage I, and chemotherapy should follow for those in stage II. Its prognosis is similar to that of other yolk sac tumors. Hitherto, there has been no evidence for a definitive correlation between yolk sac tumor of the testis and hydrocele in children.

Endodermal Sinus Tumor ; diagnosis ; diagnostic imaging ; surgery ; Humans ; Infant ; Male ; Orchiectomy ; Retrospective Studies ; Spermatic Cord ; surgery ; Testicular Hydrocele ; diagnosis ; diagnostic imaging ; surgery ; Testicular Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Testis ; pathology ; Ultrasonography ; alpha-Fetoproteins ; metabolism

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

Contrast-enhanced ultrasound (CEUS) is a new form of ultrasound (US) that can dynamically display microvessels in a highly sensitive manner. The purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional US. Forty-seven patients with testicular lesions were enrolled. The histopathology results revealed that 31 cases were neoplastic (11 cases of seminomas, 8 nonseminomatous germ cell tumors, 8 lymphomas, 2 Leydig cell tumors, and 2 nonspecific tumors), and 16 cases were nonneoplastic (8 cases of infarctions, 3 epidermoid cysts, and 5 inflammation). The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell tumors. More indicators on CEUS were found to be useful for characterizing testicular lesions. All the neoplastic lesions showed hyperenhancement on CEUS. Moreover, germ cell tumors presented with heterogeneous enhancement (73.7%, 14/19), a twisted blood vessel pattern, rapid wash-in and wash-out, and peripheral rim hyperenhancement signs. Lymphoma was characterized by nonbranching linear vessel patterns (87.5%, 7/8), rapid wash-in and slow wash-out. In nonneoplastic lesions, infarction and epidermoid cysts showed no enhancement, and abscesses were observed with marginal irregular enhancement. The sensitivity, specificity, and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%, 93.8%, and 97.9%, respectively, and these values were higher than those for conventional US (90.3%, 62.5%, and 80.9%, respectively). CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.
Contrast Media ; Diagnosis, Differential ; Epidermal Cyst ; Humans ; Lymphoma ; Male ; Neoplasms, Germ Cell and Embryonal/diagnostic imaging* ; Sensitivity and Specificity ; Testicular Neoplasms/diagnostic imaging* ; Ultrasonography/methods*

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

OBJECTIVETo improve the diagnosis of the testicular tumor.

METHODSFifty-seven cases, including their signs and symptoms, imaging studies, tumor markers and histologic diagnoses, were reviewed.

RESULTS31.3% of the patients failed to go to hospital in time. B mode ultrasound and CDFI had sensitivity of 93.5% and 96.4% respectively. Compared with final diagnoses, 23 from 26 cases (88.5%) were correspondingly diagnosed by intraoperative frozen section examination (FSE), which, however, had no definitive influence on the surgical management. Histologic examination showed 22 patients with seminoma, 9 with embryonal carcinoma, 7 with teratoma, 3 with yolk sac tumor, 9 with combined patterns, 4 with lymphoma, and 3 with other histologic types of tumor.

CONCLUSIONSFor earlier diagnosis, patients testicular self-examination counts for much, and ultrasound and CT should be used before possible histologic examination, while all patients with testicular tumors should have intraoperative FSE, which is very practical in identifying malignant and benign masses, and in choosing between enucleation of the tumor and radical orchiectomy.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Frozen Sections ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Testicular Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color