Unilateral Testicular Enlargement Research Articles

Testicular enlargement, abdominal pain and vomiting in 3‐month‐old, male, entire Airedale terrier

AbstractNon‐neoplastic scrotal testicular torsions in juvenile dogs have been rarely reported. This case report describes a scenario in which a patient presented with abdominal pain, vomiting and unilateral testicular enlargement. The primary veterinarian performed abdominal radiographs that were suspicious for a hernia. The patient was referred to a specialty hospital for further diagnostics and treatment. Upon referral, an abdominal ultrasound revealed a suspected non‐neoplastic scrotal testicular torsion. The patient underwent hemicastration to remove the affected testis and recovered uneventfully.

Unilateral testicular enlargement in a 5-year-old Arabian stallion.

Unilateral testicular enlargement in a 5-year-old Arabian stallion.

Testicular Teratocarcinoma in a Ferret (Mustela putorius furo)

A 7-month-old male domestic ferret (Mustela putorius furo) was presented for evaluation of unilateral testicular enlargement. Microscopic examination of the left testicle revealed a neoplasm with differentiation along multiple cell lines (ectoderm, endoderm, mesoderm) including respiratory epithelium, bone and haired skin. A poorly differentiated epithelial component was dispersed throughout the neoplasm with invasion of testicular lymphatics. The animal developed progressive dysuria and was euthanized. At necropsy, metastasis of the poorly differentiated epithelial component was present in the urinary bladder, ureters, prostate gland, pelvic fat, abdominal and thoracic lymph nodes, kidney and lung. This is the first report of a malignant testicular teratoma with widespread metastasis in this species.

EP18 Testicular sarcoidosis: a challenging diagnosis

EP18 Testicular sarcoidosis: a challenging diagnosis

Unilateral testicular enlargement in a teenager with Beckwith-Wiedemann syndrome: a case report

BackgroundBeckwith-Wiedemann syndrome (BWS) is a rare congenital overgrowth disorder. A major feature is lateralized overgrowth, which can variably involve a single body district up to the entire hemisome. Visceral asymmetrical involvement has been observed, commonly represented by enlargement of one kidney or adrenal gland, rather than one gonad.Case presentationWe report the case of a pubertal boy affected by BWS, who developed a progressive testicular enlargement, ipsilateral to the pre-existing external body overgrowth. Asymptomatic unilateral testis enlargement started after regular pubertal onset and worsened over time, without any associated pathological findings in a long-term follow-up. Since biopsy is not indicated in case of benign macro-orchidism, we hypothesize that this asymmetric enlargement could be an expression of visceral lateralized overgrowth in BWS.ConclusionsAt the best of our knowledge, this is the first detailed report of unilateral testicular overgrowth in BWS. We revised common causes of painless unilateral scrotal masses in the pediatric age. Considering both the overall frequency of neoplasia and the malignancies predisposition in BWS, a testicular cancer should be carefully ruled out through a close follow-up, before stating a benign condition. A normal ultrasound pattern, together with normal serum hormonal levels and negative tumor markers, make testicular neoplasms highly unlikely.

Paracrine Effects of Leydig Cell Nodular Hyperplasia, Two Case Reports: A Neglected Phenomenon

ABSTRACTLeydig cell nodular hyperplasia (LCNH) is a lesion that is less characterized than the familiar Leydig cell tumors. The paracrine effects of these lesions on adjacent gonadal stroma have not been widely documented. We present two cases of precocious puberty in pre-pubertal boys found to have a single LCNH with adjacent focal maturation of the seminiferous tubules. Blood tests showed elevated serum testosterone and dehydroepiandrosterone (DHEAS). Ultrasound revealed unilateral testicular enlargement with irregular echogenicity. Radical orchiectomy was performed. Histologically Leydig cell nodular proliferation without destruction of surrounding tubules was seen. Mature seminiferous tubules undergoing spermatogenesis were noted adjacent to the lesion, while away from the lesion seminiferous tubules were as expected in pre-pubescent boys. These cases emphasize the potential presence of both paracrine and endocrine effects in Leydig cell nodular hyperplasia. However, instances of the endocrine effects of hyperplastic Leydig cell lesions are more widely reported than the paracrine effects.

Spontaneous Nonmetastatic Choriocarcinoma, Yolk Sac Carcinoma, Embryonal Carcinoma, and Teratoma in the Testes of a Swiss Albino Mouse

A 12-week-old Swiss Albino mouse was presented with unilateral (left) testicular enlargement of approximately 1.5 cm in diameter and the right testicle mildly reduced in size and weight. Histopathology evaluation revealed three distinct neoplasms in the left testicle: choriocarcinoma, yolk sac carcinoma, and embryonal carcinoma. Teratoma was diagnosed in the right testicle. The histomorphological and immunohistochemical characteristics of the tumor are presented here. To the best of the authors' knowledge, this is the first report of spontaneous nonmetastasizing choriocarcinoma, yolk sac carcinoma, embryonal carcinoma, and teratoma in testes of a Swiss albino mouse.

Unilateral Seminoma in a Dromedary Camel

A 10-year-old, clinically healthy, male dromedary camel had presented a history of progressive unilateral testicular enlargement over the past 5 years. The animal had mated with 32 females during that period; all had conceived. The sex ratio of his offspring was one male to 31 females. Ultrasound examination of the right testicle revealed a diffusely heterogeneous parenchyma with no identifiable normal testicular tissue. The enlarged testicle was surgically removed. Macroscopically, the testicle had a glistening pink surface and contained multiple soft, bulging nodules. Histopathologically, a well-differentiated, diffuse seminoma was diagnosed. In conclusion, this study describes the fertility, sex ratio, clinical findings and ultrasonographic imaging in a male dromedary camel affected with unilateral testicular seminoma.

Metastasizing testicular seminoma in a pet rabbit

In the present study, a case of a spontaneously metastasizing seminoma in 9-year-old pet lionhead rabbit is described. The rabbit was presented with unilateral testicular enlargement and a palpable abdominal mass. Spiral computed tomography revealed the presence of an abdominal-pelvic mass in the region of the sublumbar lymph nodes. Testes and lymph nodes were collected, fixed in formalin, and submitted for histopathological examination. Microscopically, the normal architecture of the enlarged testis and lymph node was completely replaced by a diffuse malignant seminoma.

Testicular Neoplasms (Interstitial and Sertoli Cell Tumours) in a Domestic Ferret (Mustela putorius furo)

Unilateral testicular enlargement was detected in a 5-years-old domestic ferret during a routine sterilization. The right testicle showed two different types of proliferative lesions: (i) round nodules, well demarcated, showing a soft yellow tissue; (ii) white nodules, firm, with irregular-shaped invaginations. Microscopically, the neoplastic proliferations were identified as an interstitial neoplasm and Sertoli cell tumour, respectively. The left testicle was small and showed intense testicular atrophy. Clinical evaluation of the ferret did not show any other apparent pathological processes. This study is the first case reporting the concomitant occurrence of a Sertoli cells tumour and an interstitial cell tumour in a domestic ferret.

McCune-Albright syndrome presenting with unilateral macroorchidism and bilateral testicular masses

Bilateral synchronous intratesticular masses are rare but can be caused by metastatic disease to the testicle, primary testicular masses or benign etiologies such as congenital adrenal hyperplasia and granulomatous orchitis. We present an unusual case of McCune-Albright syndrome presenting with unilateral testicular enlargement and bilateral testicular masses secondary to Sertoli cell hyperplasia. To our knowledge, this is a unique case of testicular masses secondary to McCune-Albright syndrome.

Unilateral testicular mastocytoma in a Peruvian Paso stallion

SummaryA 12‐year‐old Peruvian Paso stallion was examined for scrotal swelling and unilateral testicular enlargement of 4–6 weeks duration. Physical examination and ultrasonography of the scrotum revealed an enlarged, nonpainful right testis with a well encapsulated mass at the cranial‐medial aspect containing echodense flocculent material. Unilateral castration was performed and the testis, spermatic cord and vaginal tunic were submitted for histological examination, which revealed a mastocytoma with accompanying evidence of malignancy. Short‐term follow‐up examination did not reveal any evidence of abdominal metastasis and the stallion has since successfully achieved pregnancy in a small number of mares. Although considered rare, mast cell neoplasia should be considered as a differential diagnosis when unilateral testicular enlargement is encountered.

Diagnosis of isolated tuberculous orchitis by fine-needle aspiration cytology

An isolated tuberculous Orchitis without epididymal involvement is rare. This case report describes an extra pulmonary tuberculosis with exclusively testicular presentation. The confirmatory diagnosis of which was made on FNAC of the testis. A 22-year-old adult presented with unilateral testicular enlargement and scrotal ulcer on the same side. FNAC was performed and subsequent smear examination revealed epitheloid granuloma in a necrotic background. This was suggestive of tubercular orchitis, which was further confirmed by demonstration of very occasional acid fast bacilli in the smear. Isolated tuberculous orchitis is a rare entity; FNAC is a useful first choice of investigation. It provides a successful diagnosis thereby preventing unnecessary orchidectomy.

Follicular Large Cell Lymphoma Localized to the Testis in Children

Primary follicular lymphoma of the testis in childhood is rare with only 6 cases previously reported. We present 3 additional cases. We extensively analyzed primary follicular lymphoma of the testis in 3 boys. Clinical data were obtained by reviewing patient charts. The patients were 4, 5 and 11 years old, respectively. Two patients presented with painless unilateral testicular enlargement and 1 presented with unilateral hydrocele. Laboratory findings were within normal limits in all patients. Radical orchiectomy was done in all cases. The excised testes were partially or completely replaced by tumor. In all cases the features were those of follicular, large cell-type malignant lymphoma. Tumor cells in all cases were CD20 and CDw75 positive, focally CD23 positive and bcl-2 negative, while in 2 they were CD10 positive and bcl-6 positive. Surface Ig was absent in the 2 cases studied. Karyotyping in 1 case showed a normal karyotype. Staging revealed no evidence of extratesticular disease. All patients underwent combination chemotherapy and were in complete remission 7 to 59 months after therapy. We present 3 cases of pediatric primary follicular lymphoma of the testis. Pathological findings and clinical features were similar to those in the 6 previously reported cases and suggest that primary pediatric testicular follicular lymphoma may represent unique subset of follicular lymphoma with a particularly good prognosis.

Idiopathic unilateral benign macro-orchidism

Unilateral benign macro-orchidism is a rare condition. An 11-year-old boy who had painless unilateral testicular enlargement is presented. The diagnosis was confirmed histologically. The differential diagnosis includes neoplastic disease, and biopsy of the testis is recommended to establish the diagnosis.

Unilateral enlargement of the testis in childhood: Does it need exploration?

Unilateral testicular enlargement in the pubertal boy is not an indication for exploration and biopsy, if the clinical features and investigations show no evidence of malignancy. In the prepubertal boy, unilateral testicular enlargement is not necessarily an indication for exploration if there are no clinical or investigational grounds for suspicion of neoplasia. Close follow-up is essential.

BACK PAIN—A PRESENTATION OF METASTATIC TESTICULAR GERM CELL TUMOURS

9 patients (21%) from a total of 42 young men with testicular germ cell malignancy had back pain as a major presenting symptom; 2 had back pain without unilateral testicular enlargement. Time to correct diagnosis from first visit to a doctor was significantly longer in those with back pain than in those with testicular symptoms. All patients with back pain had para-aortic node metastases. Young men with back pain should be examined for testicular disease and should also be asked about past testicular abnormalities.

Schistosomiasis presenting with testicular enlargement in elderly male:'

An eighty-eight-year-old Puerto Rican presented with painless enlargement of one testicle which proved histologically to he due to Schistosoma mansoni. Intratesticular ovum deposits were not associated with inflammation. granidomas, or infarction, but marked sclerosing periorchitis was present. The case illustrates a cent rare form of presentation of chistosomiasis which should be considered in the differential diagnosis of unilateral testicular enlargement in patients from an endemic area, despite the fact that orchiectomy will usually be necessary to establish a definitive histopathologic diagnosis.