Papillary cystadenoma of the epididymis is a rare benign tumor that represents the epididymal component of von Hippel-Lindau Syndrome. A case of epididymal papillary cystadenoma is presented in a 36 years old man. He also had pancreatic cysts, the pancreatic component of von Hippel-Lindau syndrome. His younger brother, who died of intracranial hemorrhage at age 27, revealed hemangioblastoma of the cerebellum, angioma of the retina and renal cell carcinoma on radiologic studies. These findings suggest familial occurrence of von Hippel-Lindau syndrome.
Hemangioma

PURPOSE: The purpose of our study was to assess the usefulness of ultrasounddetermined testicular volume in the evaluation of the infertile men with azoospermia. MATERIALS AND METHODS: A computerized search from October 2005 to June 2010 generated a list of 45 infertile men with azoospermia (mean age, 34 years; age range, 26-44 years) who underwent both scrotal ultrasound and testis biopsy. Ultrasounddetermined testicular volumes were compared between infertile men with obstructive azoospermia and those with non-obstructive azoospermia. RESULTS: Testicular volume for obstructive azoospermia ranged from 6.4 ml to 26.9 ml, with a median volume of 14.0 ml. This volume was significantly larger than that of those with non-obstructive azoospermia, which ranged from 1.0 ml to 12.8 ml, with a median volume of 6.1 ml (p < 0.001). The area under the ROC curve for distinguishing non-obstructive azoospermia from obstructive azoospermia using testicular volume was 0.91. A cutoff value of less than or equal to 11.4 ml could distinguish non-obstructive azoospermia from obstructive azoospermia, with a sensitivity of 94.1% (95% CI; 71.3-99.9%) and a specificity of 73.3% (95% CI; 54.1-87.7%). CONCLUSION: Ultrasound-determined testicular volume can be helpful in the differentiation of obstructive azoospermia from non-obstructive azoospermia.
Azoospermia ; Biopsy ; Humans ; Male ; ROC Curve ; Sensitivity and Specificity ; Testis