Tumors Of Epididymis Research Articles

Leimyoadenomatoid tumor of epididymis: An uncommon diagnosis with review of literature.

Leimyoadenomatoid tumor of epididymis: An uncommon diagnosis with review of literature.

Outcomes of nephron sparing surgery and cortical sparing adrenalectomy in the management of Von Hippel\u2013Lindau syndrome

BackgroundThe management of Von Hippel–Lindau syndrome (VHLS) is multidisciplinary. The urologist is involved in treating the renal, epididymal tumors and often adrenal pheochromocytoma. Preservation of renal and adrenal function is a challenge. We present 17 cases of VHLS in a tertiary care center in South India.MethodsA retrospective review of the patients who underwent surgical treatment under urology for VHLS from January 2009 to November 2018 was conducted. The demographic data, the spectrum of manifestation, treatment, change in glomerular filtration rate, adrenal insufficiency, and recurrence-free survival were analyzed.ResultsThere were 17 patients diagnosed with VHLS. The median age of diagnosis was 39 years (range 23–41). The spectrum of clinical manifestation was: multifocal RCC (88%), pancreatic cysts/tumors (70%), cerebellar hemangioblastoma (59%), retinal angiomas (47%), epididymal cysts/tumors (47%), pheochromocytomas (41%), and spinal hemangiomas (30%). There were seven patients with ten pheochromocytoma lesions. Three underwent cortical sparing and seven total adrenalectomies; 13 patients underwent nephron sparing surgery (NSS), of which seven patients had bilateral tumors. The median duration of follow-up was 6.5 years (range 2–12 years). Following NSS, seven patients had a local recurrence, and one developed pancreatic metastasis. Two patients (11%) were lost to follow-up. Renal function was preserved in all patients at the last follow-up, and there was no postoperative adrenal crisis or mortality.ConclusionNephron sparing surgery and cortical sparing adrenalectomy are the treatment of choice for multifocal RCC and pheochromocytomas in patients with VHLS providing good oncological outcomes and preservation of renal and adrenal function.

Contemporary analysis of epididymal tumors using a national database.

IntroductionEpididymal tumors are rare malignancies with sparse research available to guide recommendations. We sought to characterize malignant epididymal tumors in the United States using population level data.Material and methodsThe Surveillance, Epidemiology, and End-Results database was queried for patients diagnosed with malignant epididymal tumors between 1975–2016. International classification of disease for oncology code C63.0 was used to identify population with disease of interest. Primary objective was to characterize patient demographics, disease characteristics, and management. Secondary objectives included overall and cancer-specific survival (CSS) utilizing Kaplan-Meier (KM) analysis.ResultsA total of 66 cases of malignant epididymal tumors were identified during the study period. The cohort was largely white (84.8%), with a mean age of diagnosis of 46.9 years old. The predominant histology consisted of rhabdomyosarcoma 26%, leiomyosarcoma 23%, liposarcoma 17%, adenocarcinoma 9%, and malignant fibrous histiocytoma 5%. During histopathological assessment, 21.1% of tumors were classified as high-grade while 71.2% exhibited sarcomatoid elements. Majority of patients presented with localized disease (68.2%), whereas regional (18.2%) and distant (13.2%) disease was less frequently discovered. All patients were diagnosed by surgical therapy consisting of radical epididymectomy (39.4%), partial epididymectomy (27.3%) or ‘unknown surgery’ (33.3%). Meanwhile, 15.2% and 34.8% received radiation and chemotherapy, respectively. KM analysis revealed an 84.9% CSS at 5-years. Over 60% of documented cases have arisen since 2000, with 3.0% of the cohort diagnosed in 2016, increased from 1.5% of the diagnoses in 1975.ConclusionsMalignant epididymal tumors are exceedingly rare and typically present with localized disease. Surgical excision is associated with an estimated 85% CSS at 5-years.

Adenomatoid tumor of epididymis - A rare case report

Adenomatoid tumor of epididymis - A rare case report

COT-02 TREATMENT EXPERIENCE OF PAZOPANIB FOR A CASE OF VON-HIPPEL LINDAU DISEASE

INTRODUCTIONvon Hippel-Lindau (VHL) disease is an autosomal dominant genetic disorder associated with neoplastic lesions in multiple organs. Here, we report our experience with a patient with VHL disease presenting with complications of renal tumors, wherein pancreatic cystic lesions and renal neoplastic lesions were reduced in size with the administration of pazopanib at our department.PATIENTThe patient was a 26-year-old man who presented with hiccups and was diagnosed with medullary hemangioblastoma with a cyst that was resected. The other central nervous system lesions were located in the right optic nerve sheath, cervical and thoracic spinal cord, with multiple cystic type tumors in the pancreas, renal tumors, and epididymal tumors. Although the family history was unclear, the clinical diagnostic criteria for VHL disease were met, and mutations were found in the VHL gene analysis. Six months after the initiation of pazopanib therapy at a dose of 800 mg/day, there was no remarkable change in the hemangioblastoma on imaging; however, the pancreatic and renal lesions had shrunk. In addition, new lesions did not appear. Adverse events included diarrhea, graying of hair.DISCUSSIONPazopanib is a multi-tyrosine kinase inhibitor that inhibits angiogenesis and inhibits tumor growth. In VHL disease, pancreatic and renal tumors influence the survival prognosis, and for hemangioblastoma, the lesions increase in number and size and the corresponding surgery affects the functional prognosis. Although there was a poor tumor-reduction effect on the hemangioblastoma, there was a supposed inhibitory effect on the appearance of new lesions and the enlargement of the existing lesions.CONCLUSIONPazopanib administration resulted in the shrinkage or regression of pancreatic and renal lesions. In addition, it inhibited the increase in number and size of hemangioblastomas. Further, prolonging the surgical treatment interval may help maintain the patient’s quality of life.

Jejunal adenocarcinoma manifesting as epididymal mass: a rare case scenario

Epididymal tumors are rare lesions which we come across in routine practice nbsp It is also a rare site of solid tumor metastases and mimics the chronic mass forming inflammatory pathologies leading to a diagnostic dilemma Most of the cases of epididymal metastases are diagnosed incidentally Most cases of epididymal metastases are from genitourinary and gastrointestinal malignancies We present a case of a middle aged male presenting with complaints of pain and palpable lump in left inguino scrotal region where ultrasound revealed epididymal mass The diagnosis of epididymal metastases from jejunal adenocarcinoma was made on the basis of CT

Scrotal filariasis in a Caucasian child in Greece

Lymphatic filariasis is very rare in Greece, despite her geographical position. Only a few cases about affected young men and children have been published during the last century. We report a 2-year-old Caucasian boy presented to our emergency department with a painless swelling in the right scrotum during the last 10 days. Neither fever nor discomfort was reported. In the clinical examination, the right scrotum was hard but painless. An ultrasound and a computed tomography (CT) scan showed a mass (d 2.04 x 1.34x 2.48 cm) in the right epididymis and it was thought to be a solid tumor of epididymis. A decision of an exploratory scrotal surgery was made and a right orchiectomy was performed. The histological examination showed that here were a lot of eosinophil, lymphocytes and some parasites, namely Wuchereria bancrofti in the parenchyma of both testis and epididymis. Then some more specific blood tests were done, which were negative for filariasis, and it was decided that chemotherapy was not needed. In a follow-up period of one and two years after the surgery, all the tests (blood tests and CT scan) were normal and the child had a normal everyday life. Sometimes some clinical cases in children could be tricky. In Europe, such parasitic diseases, as filariasis, are very rare and their diagnosis is difficult for even an experienced pediatric surgeon.

Scrotal Masses: Considerations on two Cases of Epididymal Tumors:

The scrotum is a fibromuscular sac that contains the testis, epididymis, spermatic cord and the associated fibrous coatings. All these components can be affected by different variety of pathologic phenomena, including congenital, inflammatory and neoplastic events. When a scrotal mass is observed, there are two basic questions to be answered, i.e. if the mass is intratesticular or extratesticular, and if it is of cystic or solid nature. Apart from a few rare exceptions, intratesticular solid masses should be considered malignant, while extratesticular masses with liquid content are generally benign. CASE REPORTS. Two cases of tumor are hereby presented: they originated from the epididymis, and their clinical presentations did not allow making a differential diagnosis between benign and malignant tumor during the preoperative examinations. After presenting the diagnostic doubts to patients, and once obtained their informed consent, surgeries were performed allowing for a precise histological diagnosis, and at the same time, proving to be also valid therapeutic tools.

Adenomatoid Tumor of Epididymis

Adenomatoid tumors are rare benign neoplasms in the scrotum that can occur in both sexes. The majority of the patients was asymptomatic and was incidentally found with scrotal mass. It is difficult to distinguish adenomatoid tumors from malignant intratesticular solid tumors, which may result in unnecessary orchiectomy. The present report describes a 64-year-old male presented with right testicular enlargement for 6 months. Radiological images and intra-operative findings all showed cystic mass attached to right testis. Right orchiectomy was performed and final pathology was adenomatoid tumor. The present report also summarizes the morphological and immunohistochemical features of adenomatoid tumors and reviews the literature to share this rare intrascrotal benign tumors.

Papillary cystadenoma of the fallopian tube not associated with von hippel-lindau disease: a case report.

Papillary cystadenoma (PC) is an epithelial tumor believed to be of mesonephric origin[1] that is found rarely in the female genital tract. Since the original report by Gersell and King in 1988[2], only 14 cases have been reported in the English literature[1,3-5]. All of the reported cases occurred in the mesosalpinx or the broad ligament. Most of the tumors (12 out of 14) were associated with von Hippel-Lindau disease (VHL), similar to epididymal tumors[6]. We report a case of PC within the wall of the fallopian tube (rather than in the mesosalpinx or the broad ligament) in a patient with no clinical history of VHL. A comprehensive review of the literature with regard to differential diagnosis and immunohistochemical profile is provided.

English

Paratesticular tumours are rare but generally benign neoplasms, of mesothelial in origin. Adenomatoid tumours of epididymis are uncommon and accounts for 30% of all paratesticular neoplasms. A case of Adenomatoid tumor arising from tail of right epididymis is presented with ultrasound imaging features and review of literature.

A Patient Presenting with Concurrent Testis Torsion and Epididymal Leiomyoma

Leiomyomas are the second most common tumors of epididymis. Patients with leiomyomas are sometimes misdiagnosed with testicular tumors. A Case of a patient with a scrotal mass presenting with testicular torsion is reported. Concurrent occurrence of testicular torsion and epididymal leiomyoma is an extremely rare condition.

Primary Leydig cell tumour of epididymis: a rare case report with review of literature

Leydig cell tumour (LCT) is an uncommon tumour that typically occurs in the testis. Primary epididymal LCT is extremely rare. To the best of our knowledge, only two cases have been reported in the world literature. Herein, we report a case of primary epididymal LCT in a 41-year-old Chinese male. The patient presented with right epididymal swelling for 3months without endocrine manifestations, including gynaecomastia and decreased libido. Scrotal ultrasound demonstrated a mass about 1.5cm in diameter entirely in the cephalic region of right epididymis. No abnormality was found in his bilateral testes. The patient underwent total mass resection without post-operative therapy. Histological examination revealed that the well-circumscribed tumour was separated by conspicuous hyalinised fibrous stroma; the tumour cells were large and polygonal with round nuclei and abundant eosinophilic cytoplasm. Immunophenotypically, the tumour cells expressed four markers of sex cord differentiation (calretinin, melanA, CD99 and inhibin). There was no recurrence at 2-year follow-up. Our observation once again confirms that LCT could primarily occur in the epididymis, and we suppose that it probably originates from the ectopic Leydig cells. As little is known about the pathogenesis and prognosis for such a rare disease, accumulation of more pathological and clinical data can help to better interpret this tumour.

Fine needle aspiration cytology of epididymal nodules

Background:The incidence of non neoplastic lesions are much more common in epididymis. Clinically, epididymal nodules are easily accessible to fine needle aspiration cytology (FNAC) procedure. There are very few literature reports documenting the role of cytology in evaluation of epididymal nodules. Thus, we studied patients presenting with palpable epididymis nodules in the out patient department (OPD) from a tertiary care general hospital.Aim:This study is aimed to put forth the diagnostic utility of FNAC in palpable lesions of epididymis.Materials and Methods:A total of 40 palpable epididymal nodules were aspirated as a routine OPD procedure as part of this study. Smears were fixed in isopropyl alcohol and air dried. In all the cases, wet fixed papanicoloau stained and air dried giemsa stained smears were studied. Zeihl Neelsen stain was performed in cases which yielded caseous aspirate.Results:Except for two cases of adenomatoid tumor of epididymis all other lesions were nonneoplastic and included 14 cases (35%) of tuberculous granulomatous inflammation, 10 (25%) cystic nodules (9 spermatoceles and 1 encysted hydrocele), 5 (12.5%) of nonspecific inflammations, 3 (7.5%) filarial infection, 3 (7.5%) sperm granulomas and 3 (7.5%) adenomatous hyperplasia of rete testes. Except for the two tumors, one adenomatous hyperplasia and one tuberculous lesion, no other lesion was excised. Follow up and response to therapy was available in 78% patients and resolution indicated appropriateness of the diagnosisConclusions:Thus, as most of the lesions in epididymis are non neoplastic responding to medical line of treatment and FNAC served to aid diagnosis of non specific inflammation and avoid surgical excision in most cases.

Epididymal leiomyoma: an unusual intrascrotal tumor in a child

A 13-year-old boy presented with a large painless scrotal mass and underwent radical orchiectomy with the presumptive diagnosis of testicular tumor. The diagnosis was epididymal leiomyoma (EL). The treatment of paratesticular tumors is excision of the tumor without orchiectomy whenever possible. Even when the epididymal origin of the tumor is detected during operation, it may be impossible to spare the testis because of the tumor's large size or incorporation of the testis into the tumor mass. This case is presented because of the extremely rare incidence of epididymal tumors and of EL and to emphasize the diagnosis and treatment of epididymal tumors.

Tumor adenomatoide de epidídimo e intratesticular: a propósito de nueve casos clínicos y revisión de la literatura

To report the cases of adenomatoid tumors seen at Hospital Universitario La Paz in the last 15 years. A clinical, pathological, and surgical study was conducted of males with testicular or paratesticular tumors with a histological report of adenomatoid tumor. Among the nine cases studied, seven had paratesticular and two intratesticular adenomatoid tumors. Treatment of choice was mass removal for epididymal tumors and orchidectomy for intratesticular tumors. Adenomatoid tumors are uncommon benign neoplasms of a possible mesothelial origin. Because of their benign nature, the treatment of choice is local excision (conservative surgery), but orchidectomy was performed in two cases due to tumor location.

Scrotal Masses: Considerations on two Cases of Epididymal Tumors

The scrotum is a fibromuscular sac that contains the testis, epididymis, spermatic cord and the associated fibrous coatings. All these components can be affected by different variety of pathologic phenomena, including congenital, inflammatory and neoplastic events. When a scrotal mass is observed, there are two basic questions to be answered, i.e. if the mass is intratesticular or extratesticular, and if it is of cystic or solid nature. Apart from a few rare exceptions, intratesticular solid masses should be considered malignant, while extratesticular masses with liquid content are generally benign. Case Reports Two cases of tumor are hereby presented: they originated from the epididymis, and their clinical presentations did not allow making a differential diagnosis between benign and malignant tumor during the preoperative examinations. After presenting the diagnostic doubts to patients, and once obtained their informed consent, surgeries were performed allowing for a precise histological diagnosis, and at the same time, proving to be also valid therapeutic tools.

Tumor adenomatoide de epidídimo: El tumor más frecuente de las estructuras paratesticulares

IntroductionParatesticular tumours are rare but generally benign neoplasms, usually treated by local excission. Adenomatoid tumours of epididymis are the most common of these tumours. Objectives: Analyze paratesticular tumours treated in our center and describe dyagnosis and treatment of adenomatoid tumours of epididymis Material and MethodsWe retrospectively review 8 patients with paratesticular tumours treated from July 1997 to July 2007. We analyze clinical presentation, dyagnostic suspicion given by image technique, treatment followed and final dyagnosis ResultsPatients median age was 44.1 years (22-69), presenting most of them subacute scrotal tumour with median size by ultrasound of 2.8 cm (1.5-7). All of them were locally extirpated except one with suspicion of a malignant polyorchidism and another one with an apparently intratesticular lesion of great size. Just in two cases peroperatory biopsy was performed. Dyagnosis was in 4 cases adenomatoid tumour of epididymis, in two cases fibrous pseudotumour of epididymis, in one case leiomyoma of epididymis and in one case angiolipoma of spermatic cord. Just in one case diagnosed of adenomatoid tumour of epididymis ultrasound confirmed solid tumour suggesting the final dyagnosis ConclusionsAdenomatoid tumors of epididymis are rare tumours which may present at any age. Ultrasound may help in dyagnosis, but its capacity to distinguish this lesions is low. Benignity of adenomatoid tumour of epididymis as well as most of the other paratesticular tumours should make local excission the treatment of choice and, when any doubt existed, peroperatory biopsy should be performed

Tumor adenomatoide de epidídimo: Aportación de dos casos

Tumors of the epididymis are rare. They are unusually benign and adenomatoid tumors are the most frequent. Report of two cases of this kind of tumor of the epididymis.We report two cases of adenomatoid tumor of the epididymis diagnosed at our hospital during last year. Two males, 35 and 54 years old respectively asked for urology consultation about a palpable scrotal mass. They didn't have any other symptoms. Imaging techniques revealed a solid epididymal mass. Epididymectomy was performed. Pathological diagnosis was adenomatoid tumor.The majority of epididymal tumors follow a benign course. In the finding of an epididymal mass, after palpation and imaging tests, organ sparing surgery (epididymectomy) is recommended. We will avoid unnecessary orchiectomies.

Tumor adenomatoide de epididimo

ObjectiveParatesticular tumors are very rare and mostly bening. Wa aport a new case of adenomatoid tumor of epididymis MethodMale of 40 years old with solid lesion in epidididymis tale treated with mass exéresis ResultsAdenoamotid tumor of the epididymis confirmed with hystopathologic technique ConclusionAdenomatoid tumor of epididymis is the most frequent paratesticular tumors and when is suspected, conservative surgery must be performed