Asymmetry of the male internal reproductive organs in Mantophasmatodea

Background Asymmetries are a widespread phenomenon in otherwise bilaterally symmetric organisms, and investigation of asymmetric structures can help us gather insights into fundamental evolutionary processes such as the selection for morphological novelties caused by behavioural changes. In insects, asymmetric genitalia have evolved in almost every order, and usually it’s the sclerotized parts and most conspicuous male phallic organs that are known to exhibit asymmetries. While external copulatory organs in insects have often been subject to investigations concerning asymmetries and the evolution thereof, internal reproductive structures have received far less attention. Here we describe the internal and external male genitalia in three species of Austrophasmatidae, Mantophasmatodea, using μ-CT imaging and light microscopy. Mantophasmatodea is the most recently discovered insect order, and with 21 species described to date, it is among the smallest insect orders currently known. Results We confirm that male heelwalkers exhibit asymmetries in the external genitalia and associated structures, represented by asymmetric phallic lobes and cerci. Moreover, we found an extreme asymmetry within the internal male genitalia: in all adult males investigated (N = 5), the seminal vesicle, a dilatation of the vas deferens, was only developed on the right side of the male while missing on the left side. Conclusion The false-male-above mating position exhibited by Mantophasmatodea and especially the long copulation duration of ca. 3 days might select for this unusual absence asymmetry of the left seminal vesicle. If this holds true for all heelwalker species, this absence asymmetry constitutes another autapomorphy for Austrophasmatidae or even the insect order Mantophasmatodea.

Zinner Syndrome—A Rare Cause of Recurrent Epididymitis and Infertility

Zinner syndrome (ZS) is a rare disorder that affects only men. It is characterized by a triad of abnormalities, including unilateral renal agenesis, ipsilateral seminal vesicle cysts, and atresia of the ejaculatory tract. Unfortunately, there is no consensus on the best treatment modality. We describe a case of a young male patient with recurrent epididymitis, dysuria, and frequent urination. In the diagnostic evaluation, we found an extended right seminal vesicle in the ultrasound with hyperechoic fluid inside and an absence of the right kidney. We performed magnetic resonance imaging, computed tomography, and semen analysis confirming Zinner syndrome and deteriorated semen parameters. Urethroscopic evaluation and ultrasound-guided puncture of the seminal vesicle were performed. An abscess was excluded. The cytologic evaluation showed hemosiderophages. Tamsulosin was introduced. We found no signs of relapse in a six-month observation, and the patient had no further symptoms. Therefore, minimally invasive treatment is a feasible option in young patients found with early-stage Zinner syndrome.

Dosimetric Feasibility of Moderately Hypofractionated/dose Escalated Radiation Therapy for Localised Prostate Cancer With Intensity-modulated Proton Beam Therapy Using Simultaneous Integrated Boost (SIB-IMPT) and Impact of Hydrogel Prostate-rectum Spacer

Purpose: To examine the dosimetric feasibility of hypofractionated/dose escalated radiation therapy in patients with localized prostate carcinoma using simultaneous integrated boost intensity-modulated proton beam therapy (SIB-IMPT) in absence or presence of prostate-rectum spacer. Methods: IMPT technique was implemented in 23 patients with intermediate- and high-risk prostate cancer treated at West German Proton Therapy Centre from March 2016 till June 2018, using SIB technique prescribing 60 GyRBE and 72 GyRBE in 30 fractions to PTV1 (prostate and seminal vesicle) and PTV2 boost (prostate and proximal seminal vesicle), respectively. In 15 patients, a transperineal injection of hydrogel was applied prior to radiotherapy to increase the distance between prostate and rectum. Planning and all treatments were performed with a 120 ml fluid-filled endorectal balloon customised daily for each patient. For each patient, 2 lateral IMPT beams were implemented taking a field-specific range uncertainty (RU) into account. Dose volume histograms (DVH) were analyzed for PTV2, PTV2 with range uncertainty margin (PTV2RU), rectum, bladder, right/left femoral heads, and penile bulb. For late rectal toxicities, the normal tissue complication probabilities (NTCP) were calculated using different biological models. A DVH- and NTCP-based dosimetric comparison was carried out between non-spacer and spacer groups. Results: For the 23 patients, high-quality plans could be achieved for target volume and for other organs at risk (OARs). For PTV2, the V107% was 0% and the Dmax did not exceed 106.2% of the prescribed dose. The volume PTV2RU covered by 95% of the dose ranged from 96.16- 99.95%. The conformality index (CI) for PTV2RU was 1.12±0.057 and the homogeneity index (HI) was 1.04±0.014. Rectum Dmax and rectal volume receiving 73 to 50 Gy could be further reduced for the spacer-group. Significant reductions in mean and median rectal NTCPs (stenosis/necrosis, late rectal bleeding ≥ 2, and late rectal toxicities ≥ 3) were predicted for the spacer group in comparison to the non-spacer group. Conclusion: Hypofractionated/dose escalated radiotherapy with SIB-IMPT is dosimetrically feasible. Further reduction of the rectal volumes receiving high and medium dose levels (73 -50 Gy) and rectal NTCP could be achieved through injection of spacers between rectum and prostate.

Cystadenoma of the seminal vesicle – Potential diagnostic pitfall: A case report and literature review

Background: Cystadenomas of the seminal vesicles are benign cystic tumours, currently classified into the group of mixed epithelial-stromal tumours (MEST). Primary tumours arising in the seminal vesicles are quite rare, benign tumours being rarer than malignant ones, with only a few cases reported in the English literature since 1944. Cystadenomas represent a potential diagnostic pitfall, as they can be clinically confused with malignant neoplasms and histologically with non-neoplastic inflammatory lesions or other cystic tumours, even malignant. Objective and methods: We report a case of a 23-year-old man presenting with a cystic mass of the seminal vesicle, clinically suspected to be a malignant neoplasm. On pathological examination, a diagnosis of cystadenoma was made. Diagnostic criteria to make a diagnosis of this tumour are questionable. Therefore, we carried out a literature review in attempt to compare clinico-pathological findings of 28 cases reported in the English literature as cystadenomas of the seminal vesicle. Results: Only 28 cases of cystadenomas of seminal vesicles were reported in the English literature. The available data show the difficulty to rule out malignancy preoperatively in a patient with a solid-cystic mass in the pelvic region, and that morphological findings observed were often reported incompletely. Conclusions: The current classification appears debatable, as well as histopathological criteria to diagnose a cystadenoma of the seminal vesicle. For the proper management of these lesions, a multidisciplinary approach is mandatory. Level of evidence: Not applicable