scholarly journals Giant Testicular Cancer: Clinical Picture

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammed M ◽  
◽  
Dieudonne ZOJ ◽  
Jaafar M ◽  
Youness R ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Initial Management ◽  
Young Males ◽  
Left Testicle ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
History Of ◽  
Chronic Smoking ◽  
Operative Assessment ◽  
Hard Consistency

Testicular tumour is the most malignant cancer in young males 15 to 34 years of age. Its accounts for 1% of all male cancer and 5% of urological malignancy [1]. The management of this type of cancer is radical inguinal orchiectomy which is the gold standard for the diagnosis and initial management of a suspected testicular cancer. Trans -scrotal orchiectomy is discouraged because scrotal violation is associated with higher rates of local recurrence and altered pathways of metastatic dissemination [2]. We report a young patient 23 years old. History: Chronic smoking, cannabis. Admitted for large bursa evolving for 14 months. The history of the disease dates back to 14 months by the gradual increase in the volume of the bursa with an alteration of the general status with a weight loss estimated at 10kgs. Clinical examination showed: right hemi-scrotum increased in volume with a hard consistency with a left testicle repressed in extreme lateral and some inflammatory lesions. Right testis was not palpable with a cord repulsed and glued to the inguinal orifice. The ultrasound of the scrotal content showed: large right testis hypervascularized with moderate anterior cloisonnae hydrocele, bilateral testicular microlithiasis. Tumor markers: Lactate Dehydrogenase (LDH) 229IU, beta-Human Chorionic Gonadotropin (beta-hCG) 29.73mUI/ ml, Alpha-Foetoprotein (AFP) 400IU/ml. Patient benefited from a complete pre-operative assessment that did not object to any abnormality. Programmed for a right inguinal orchiectomy and reduction scrotoplasty (Figure 1).

scholarly journals Vitamin D Deficiency in Testicular Cancer Survivors: A Systematic Review

2021 ◽  
Vol 22 (10) ◽  
pp. 5145
Author(s):  
Giuseppe Schepisi ◽  
Caterina Gianni ◽  
Sara Bleve ◽  
Silvia De Padova ◽  
Cecilia Menna ◽  
...  
Keyword(s):  
Vitamin D ◽  
Testicular Cancer ◽  
Vitamin D Deficiency ◽  
Molecular Mechanisms ◽  
Hypovitaminosis D ◽  
Young Males ◽  
Report Data ◽  
Testicular Cancer Survivors ◽  
Patients Experience

Testicular cancer (TC) is the most frequent tumor in young males. In the vast majority of cases, it is a curable disease; therefore, very often patients experience a long survival, also due to their young age at diagnosis. In the last decades, the role of the vitamin D deficiency related to orchiectomy has become an increasingly debated topic. Indeed, vitamin D is essential in bone metabolism and many other metabolic pathways, so its deficiency could lead to various metabolic disorders especially in long-term TC survivors. In our article, we report data from studies that evaluated the incidence of hypovitaminosis D in TC survivors compared with cohorts of healthy peers and we discuss molecular mechanisms and clinical implications.

scholarly journals Bowel incarceration within the vaginal tunic in a three-and-half-year-old bilaterally cryptorchid Lhasa Apso

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Dorcas Oyueley Kodie ◽  
Noah Segun Oyetayo ◽  
Oladotun Solomon Awoyemi ◽  
Cecelia Omowunmi Oguntoye ◽  
Oghenemega David Eyarefe
Keyword(s):  
Risk Factor ◽  
Sertoli Cell ◽  
Epidural Anaesthesia ◽  
Spermatic Cord ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
Spermatic Cord Torsion ◽  
Left Testicle ◽  
History Of ◽  
Sertoli Cell Tumours

Abstract Background Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle. Case presentation A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed. Conclusion Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies.

scholarly journals Fetal Warfarin Syndrome – a case report

2022 ◽  
Vol 9 (1) ◽  
pp. 82-84
Author(s):  
Syed Sajid Hussain Shah ◽  
Bibi Aaliya
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Family Planning ◽  
Plastic Surgery ◽  
Valve Replacement ◽  
Male Infant ◽  
Provisional Diagnosis ◽  
Initial Management ◽  
History Of ◽  
Nasal Hypoplasia

A two-month-old male infant presented with history of respiratory difficulty and got admitted with provisional diagnosis of pneumonia. On examination patient was having unilateral nasal hypoplasia and cyanosis with echocardiography showing truncus arteriosus. Detail history revealed that mother had valve replacement and she was taking warfarin during pregnancy. After initial management patient was referred to pediatric cardiac surgery and plastic surgery for further management. Parents were counseled regarding contraception and family planning.  

scholarly journals Organophosphorus Poisoning

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Buddhi Prasad Paudyal
Keyword(s):  
Signs And Symptoms ◽  
Clinical Problem ◽  
Acute Poisoning ◽  
The Body ◽  
Organophosphorus Insecticides ◽  
Basic Principles ◽  
Initial Management ◽  
Organophosphorus Poisoning ◽  
Life Threatening ◽  
History Of

Acute poisoning by organophosphorus (OP) compounds is a major global clinical problem, withthousands of deaths occurring every year. Most of these pesticide poisoning and subsequentdeaths occur in developing countries following a deliberate self ingestion of the poison. Metacid(Methyl parathion) and Nuvan (Dichlorovos) are commonly ingested OP pesticides; Dimethoate,Profenofos, and Chlorpyrifos are other less frequently ingested compounds in Nepal. The toxicityof these OP pesticides is due to the irreversible inhibition of acetylcholinesterase (AChE) enzymeleading to accumulation of acetylcholine and subsequent over-activation of cholinergic receptorsin various parts of the body. Acutely, these patients present with cholinergic crisis; intermediatesyndrome and delayed polyneuropathy are other sequel of this form of poisoning. The diagnosisdepends on the history of exposure to these pesticides, characteristic manifestations of toxicityand improvements of the signs and symptoms after administration of atropine. The supportivetreatment of OP poisoning includes the same basic principles of management of any acutelypoisoned patient i.e., rapid initial management of airways, breathing, and circulation. Gastriclavage and activated charcoal are routinely used decontamination procedures, but their valuehas not been conclusively proven in this poisoning. Atropine is the mainstay of therapy, andcan reverse the life threatening features of this acute poisoning. However, there are no clearcut guidelines on the dose and duration of atropine therapy in OP poisoning. Cholinesterasereactivators, by regenerating AChE, can reverse both the nicotinic and muscarinic effects;however, this benefit has not been translated well in clinical trials. All these facts highlight thatthere are many unanswered questions and controversies in the management of OP poisoningand there is an urgent need for research on this aspect of this common and deadly poisoning.Key Words: poisoning, organophosphorus insecticides, decontamination, antidotes

scholarly journals The marks that humans’ leave are too often scars

2020 ◽  
Vol 9 (12) ◽  
pp. 5163
Author(s):  
Nandita Sushilkumar Kaushal ◽  
Shrikrushna Vasant Chavan ◽  
Arundhati Gundu Tilve ◽  
C. V. Hegde
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Chorionic Gonadotropin ◽  
Innovative Approach ◽  
Previous Caesarean Section ◽  
Caesarean Scar ◽  
Obstetric Emergency ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Products Of Conception

Caesarean scar ectopics are the newest member of this obstetric emergency. Although rare, are associated with torrential haemorrhage. Gravida 3 para 2 with previous two caesarean sections with spotting per vaginum. Ultrasound showed a pregnancy embedded in the scar of previous caesarean section. MRI confirmed it. Beta human chorionic gonadotropin (HCG) was 15000 which dropped to 5000 after. An innovative approach was taken to laparoscopically evacuate the pregnancy. The products of conception were removed and the incision sutured so as to achieve haemostasis. Beta HCG was 15000 which dropped to 5000. Patient was haemodynamically stable and discharged on day 3. An innovative approach with skilled surgical technique not only decreased the morbidity but also avoided an unnecessary hysterectomy.

Intermittent Testicular Torsion

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 908-911
Author(s):  
Thomas J. Stillwell ◽  
Stephen A. Kramer
Keyword(s):  
Primary Care Physicians ◽  
Testicular Torsion ◽  
Separate Entity ◽  
Scrotal Pain ◽  
Young Males ◽  
Testicular Pain ◽  
Acute Scrotal Pain ◽  
History Of ◽  
Scrotal Swelling ◽  
Physical Findings

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys and should be foremost in the minds of primary care physicians evaluating these children. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. Acute and intermittent sharp testicular pain and scrotal swelling, interspersed with long intervals without symptoms, are characteristic. Physical findings may include horizontal or very mobile testes, an anteriorly located epididymis, or bulkiness of the spermatic cord from partial twisting. Awareness of this entity and early elective orchiopexy will improve testicular salvage in patients with intermittent testicular torsion.

scholarly journals Spermatogenesis Abnormalities following Hormonal Therapy in Transwomen

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Sirachai Jindarak ◽  
Kasama Nilprapha ◽  
Taywin Atikankul ◽  
Apichai Angspatt ◽  
Pornthep Pungrasmi ◽  
...  
Keyword(s):  
Hormonal Therapy ◽  
Medical Records ◽  
Hormonal Treatment ◽  
University Hospital ◽  
Sex Reassignment Surgery ◽  
Sex Reassignment ◽  
Testicular Germ Cell ◽  
Left Testicle ◽  
History Of ◽  
Normal Spermatogenesis

Objective. To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze the association between hormonal therapy duration and infertility severity.Design. Retrospective study.Setting. University hospital.Patients. One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015.Interventions. All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records.Main Outcome Measures. Histological examinations of orchidectomy specimens were performed to assess spermatogenesis.Results. One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P=0.81) or patient age at the time of surgery (P=0.88). Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P=0.001andP=0.026, right testicle and left testicle, resp.).Conclusion(s). Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.

scholarly journals Persistent free-floating pelvic trophoblastic cysts following an interstitial ectopic pregnancy

2019 ◽  
Vol 12 (8) ◽  
pp. e229732
Author(s):  
Kaitlin D Crawford ◽  
Melissa J Chen ◽  
Melody Y Hou ◽  
Mitchell D Creinin
Keyword(s):  
Ectopic Pregnancy ◽  
The Novel ◽  
Interstitial Pregnancy ◽  
Heterophilic Antibodies ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Pathological Evaluation ◽  
Radiologic Investigation ◽  
Interstitial Ectopic Pregnancy ◽  
Trophoblastic Tissue

Persistent trophoblast after ectopic pregnancy has been demonstrated at the surgical site or as peritoneal implants. A 37-year-old woman (G5P2) experienced persistently low levels of beta-human chorionic gonadotropin (hCG) after surgical treatment for an interstitial pregnancy. Evaluation for persistent trophoblast, gestational trophoblastic neoplasm and heterophilic antibodies was negative. After 15 months without resolution, she elected for hysterectomy. We found four smooth, freely floating avascular cysts intraoperatively; pathological evaluation identified the cysts as trophoblastic tissue. Serum beta-hCG resolved postoperatively and remained negative at 1 year. Our case demonstrates the novel finding of trophoblastic tissue existing as free-floating cysts in the peritoneal cavity. With appropriate suspicion, these cysts can be identified on radiologic investigation and removed laparoscopically.

scholarly journals Case of Ruptured Ectopic Pregnancy in the Uterosacral Ligament and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yasmin Abedin ◽  
Kanchi Chadha
Keyword(s):  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Uterosacral Ligament ◽  
Free Fluid ◽  
Fallopian Tubes ◽  
Review Of The Literature ◽  
Chorionic Villi ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Potential Risk Factors

Pregnancies that implant on the uterosacral ligament are rare. Here, we describe a case of ruptured ectopic pregnancy in the left uterosacral ligament in a patient with potential risk factors including possible endometriosis and recent hysteroscopic procedure. A 29-year-old female, para 0, presented to the emergency department with generalized abdominal pain. Pelvic examination was significant for fullness in the posterior cul-de-sac. Laboratory values were significant for beta-human chorionic gonadotropin (hCG) level of 6311 mIU/mL. Sonogram findings were significant for no intrauterine gestation, a 6.9×4.6×4.7 cm3 complex left adnexal mass, and moderate free fluid within the posterior cul-de-sac. The patient underwent laparoscopy, which revealed hemoperitoneum and unremarkable bilateral fallopian tubes and ovaries. An abnormal area was noted in the left uterosacral ligament. Tissue was bluntly removed and pathologically confirmed as chorionic villi within the left uterosacral ligament. After one week, her beta-hCG decreased to 784 mIU/mL. After two weeks, she was seen as an outpatient and was doing well without any symptoms. More information is required regarding these unique pregnancies to help understand the pathophysiology and determine the management.

The clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation

2004 ◽  
Vol 14 (2) ◽  
pp. 366-369 ◽  
Author(s):  
A. M. Gillespie ◽  
E. A. Lidbury ◽  
J. A. Tidy ◽  
B. W. Hancock
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Gestational Trophoblastic Disease ◽  
Surgical Removal ◽  
Molar Pregnancy ◽  
Initial Management ◽  
Trophoblastic Disease ◽  
Treatment Centre ◽  
History Of ◽  
Park Hospital

The objective of this study was to determine the clinical presentation, treatment, and outcome of patients diagnosed with possible ectopic molar gestation registered with the Trophoblastic Disease Screening and Treatment Centre, Weston Park Hospital, Sheffield between 1986 and 2000. From the 5581 women registered, those with a diagnosis of ectopic molar pregnancy were identified from a computer database. Information regarding the relevant history of each patient and the clinical presentation, treatment, and outcomes of gestational trophoblastic disease (GTD) was determined by reviewing referral forms, case notes, and pro formas completed by the referring gynecologist. Histological review of the cases was undertaken where possible. Suspected ectopic molar gestations comprised 31/5581 (0.55%) of registrations. Known risk factors for ectopic pregnancy were identified in 79% of cases. Central histological review confirmed only six cases of GTD: three choriocarcinoma and three early complete moles. Four patients subsequently required chemotherapy. All patients are now in complete remission. We conclude that ectopic GTD is uncommon, with a UK incidence of approximately 1.5 per 1,000,000 births. Initial management is usually surgical removal of the conceptus, pathological suspicion of the diagnosis and registration with a screening center. Chemotherapy may be required and the prognosis is excellent.

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