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Wang Y, Wang K, Yu L, Ma X. A rare case of scrotal emergency: torsion of epididymal cyst-a case report and literature review. Front Pediatr 2024; 11:1245842. [PMID: 38264504 PMCID: PMC10803493 DOI: 10.3389/fped.2023.1245842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024] Open
Abstract
As a benign disease, the incidence of epididymal cyst (EC) is 5%-25%, and it is relatively common in adults but rare in children. Although the pathogenesis of EC is still unclear, the symptoms of most asymptomatic patients can disappear with conservative treatment. EC torsion is even rarer in adults and children. Only ten cases have been reported in the literature, and we add this 3-year-old boy as the eleventh case of EC torsion. He was admitted to the hospital due to scrotum emergency without a history of EC or recent scrotal trauma. The ultrasonic examination revealed signs of an epididymal cyst. However, the pain and swelling of his scrotum were very similar to those of patients with testicular torsion, so we performed surgery on him. Therefore, EC torsion is very necessary to attract our attention as a differential diagnosis of testicular torsion in scrotal emergencies. Furthermore, our case is also the second youngest case of EC torsion.
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Affiliation(s)
| | | | | | - Xue Ma
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Reitman DS, Orionzi B, Acholonu CJ. Structured Examination of the Scrotum and Penis. Pediatr Ann 2024; 53:e5-e9. [PMID: 38194659 DOI: 10.3928/19382359-20231114-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Primary care pediatricians, family practitioners, and primary care advanced practice clinicians frequently need to examine male adolescent genitalia as part of a comprehensive physical examination. Although this part of the examination may be uncomfortable for clinicians, taking a structured approach to the examination can mitigate clinicians' apprehension as well as enhance their ability to use this evaluation to identify potential pathology for the patient. Familiarity with the male genitourinary examination will also allow clinicians to definitively identify medical urgencies and emergencies for timely intervention. This review will provide the clinician with a structured approach to the male genitourinary examination while highlighting common pathology that may be encountered during the examination. [Pediatr Ann. 2024;53(1):e5-e9.].
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Sosnowska-Sienkiewicz P, Januszkiewicz-Lewandowska D, Mańkowski P. Testicular and scrotal abnormalities in pediatric and adult patients. POLISH JOURNAL OF SURGERY 2023; 96:88-96. [PMID: 38348982 DOI: 10.5604/01.3001.0053.9349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Testicular and scrotal abnormalities can occur in children, adolescents, and adults. The lesions, often accompanied by pain and swelling/enlargement of the scrotum, can cause anxiety in patients and their parents. Regardless of age, proper diagnosis is based on adequate anamnesis and physical examination. Color Doppler ultrasound is the first-line test in the differential process of testicular and scrotal diseases. Testicular and scrotal lesions require differentiation for benign and malignant processes as well as therapeutic management, including urgent surgical intervention. The aim of this paper is to present the most common causes of testicular and scrotal abnormalities in pediatric and adult patients and to outline the symptoms and diagnostic and therapeutic management.
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Affiliation(s)
| | | | - Przemysław Mańkowski
- Department of Pediatric Surgery, Traumatology and Urology, Poznań University of Medical Sciences, Poland
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Silva GF, Cunha R, Carvalho F, Ribeiro M, Rocha A, Amorim I, Guimarães T. Case report: Long term follow-up of a large unilateral epididymal cyst in a stallion used for teaching: Is this condition associated with infertility? Front Vet Sci 2023; 10:1145742. [PMID: 37065254 PMCID: PMC10090384 DOI: 10.3389/fvets.2023.1145742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
A 30-year-old Lusitano stallion presented with an enlarged right epididymis. The ultrasound scan revealed a cyst-like formation and the histopathological examination was compatible with epididymal cyst located at the body/tail transition, epididymal spermatocele and sperm granuloma and epididymitis. However, these conditions did not seem to affect the animal's reproductive performance, nor did the semen parameters analyzed over the 8 years after the diagnosis show significant changes. Nevertheless, since the ejaculate contains mostly sperm cells from the tail of the epididymis, where fertile spermatozoa are stored until ejaculated, a deep knowledge of the different conditions that can affect this organ is of the utmost importance.
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Affiliation(s)
| | - Raquel Cunha
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
- Center for the Study of Animal Sciences (CECA), ICETA, University of Porto, Campus Agrário de Vairão, Vairão, Portugal
| | - Fátima Carvalho
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - Mário Ribeiro
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
| | - António Rocha
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
- Center for the Study of Animal Sciences (CECA), ICETA, University of Porto, Campus Agrário de Vairão, Vairão, Portugal
| | - Irina Amorim
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
- Institute of Molecular Pathology and Immunology, University of Porto (IPATIMUP), Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto (UP), Porto, Portugal
- *Correspondence: Irina Amorim
| | - Tiago Guimarães
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal
- Center for the Study of Animal Sciences (CECA), ICETA, University of Porto, Campus Agrário de Vairão, Vairão, Portugal
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Torsion of Spermatic Cord Cyst; a Case Report. Nephrourol Mon 2022. [DOI: 10.5812/numonthly-120682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: In general surgery, the acute scrotum is equivalent to the acute abdomen, and any delay in treatment may be risky for testis functions, especially in children. Among acute scrotal etiologies, spermatic cord cyst or hydrocele could be misleading. Spermatic cord cysts can evoke long-term scrotal pain with acute exacerbation. Case Presentation: Here we report a boy aged 14 years old referring to the emergency clinic with the complaint of high riding testis, acute scrotal pain, and decreased testicular perfusion in Doppler ultrasound, which all warranted immediate scrotal exploration. According to exploration, a cyst was found twisting around the testis, lacking any sign of ischemia. The cyst was marsupialized, and the contained serum liquid was drained. Conclusions: Management of torsion of the spermatic cord cyst can be conservative if it is confirmed with absolute certainty. Hence, spermatic cord cyst torsion possibly is a source of confusion requiring further research to improve the precision of diagnoses. A spermatic cord cyst or hydrocele torsion is a rare cause of acute scrotum with a good prognosis. However, every suspicion must be confirmed by scrotal exploration.
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Salama N, Hassan OS. A Post-Aspiration Giant Spermatocele in a Young Man: A Case Report and Literature Review. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2022; 15:11795476221097218. [PMID: 35591974 PMCID: PMC9112308 DOI: 10.1177/11795476221097218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
Abstract
We report a case of a post-aspiration giant unilocular spermatocele in a young
man. A 27-year-old man sought medical advice for a huge right scrotal swelling.
The swelling first appeared following scrotal trauma and was aspirated. Shortly
after, it reappeared and persisted for several years with a sense of heaviness,
infrequent periods of right scrotal pain, and cosmetic concerns. Ultrasonography
of the scrotum revealed a huge fluid cyst pushing the testis antero-inferiorly
in the right hemi-scrotum. Scrotal exploration suggested the spermatocele nature
of the cyst that emerged from the head of the epididymis. The cyst was excised,
and its fluid content and wall underwent pathological examination for
confirmation.
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Affiliation(s)
- Nader Salama
- Department of Urology, Alexandria Faculty of Medicine, Alexandria, Egypt
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Gupta S, Shinde S, Rathod V, Shinde RK. Asymptomatic Bilateral Giant Multilocular Epididymal Cyst in a Middle-Aged Patient. Cureus 2022; 14:e24722. [PMID: 35677005 PMCID: PMC9166520 DOI: 10.7759/cureus.24722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
Bilateral multilocular huge epididymal cysts are a rare entity with few reports in the literature. Epididymal cysts are mostly found in middle-aged men with or without symptoms. We present the case of a 45-year-old man with asymptomatic bilateral scrotal swelling, which was clinically diagnosed as a right epididymal cyst with left hydrocele. However, an ultrasound of the scrotum revealed bilateral epididymal cysts with normal testes. Intraoperatively, it demonstrated bilateral huge epididymal cysts for which the patient underwent excision of bilateral epididymal cysts. Postoperatively, the patient is doing well on follow-up. Thus, it is concluded that when the epididymal cyst is larger than 10 mm or 1 cm and does not involute with time, surgery is indicated. In comparison, epididymal cysts smaller than 10 mm or 1 cm are managed conservatively.
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