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Song X, Niu H, Yang M, Wang X. Granulomatous orchitis: A case report of misdiagnosis and review of the literature. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024; 52:470-472. [PMID: 38288520 DOI: 10.1002/jcu.23640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 05/08/2024]
Abstract
Granulomatous orchitis is a relatively rare clinical testicular lesion. The imaging manifestations and clinical symptoms are similar to those of testicular tumors. In order to improve the understanding of this disease, this article reports the ultrasonographic manifestations of a case of granulomatous orchitis and reviews the relevant literature with.
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Affiliation(s)
- Xinrong Song
- Department of Graduate School, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Huimin Niu
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Ming Yang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xiaona Wang
- Department of Ultrasound, Hebei General Hospital, Shijiazhuang, Hebei, China
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Nazar T, Gopalakrishnabhaktan A, Tashrifwala FAA, Sathish A, Dave T. Testicular mesothelioma disguised as hydrocele: a case report. J Med Case Rep 2024; 18:114. [PMID: 38409016 PMCID: PMC10898004 DOI: 10.1186/s13256-024-04348-y] [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] [Received: 12/02/2023] [Accepted: 12/29/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Testicular tumors have many different manifestations. The majority of these cases are presented as an incidental finding during hydrocelectomy. Malignant mesotheliomas are uncommon tumours that can arise from the coelomic epithelium of the pleura, peritoneum, pericardium, and tunica vaginalis. CASE PRESENTATION We present a 51-year-old South Asian (Indian) male patient with a rare case of mesothelioma, presenting with right hydrocele, to whom a right hydrocelectomy was performed. Any history of trauma or asbestos exposure was not present. Histopathological and immunohistochemistry reports revealed a malignant mesothelioma of tunica vaginalis. There was no invasion of the tumour to the epididymis and spermatic cord. Imaging studies showed no signs of metastasis. 1 month later, a high inguinal orchidectomy was performed. The patient underwent adjuvant chemotherapy thereafter and is still on follow-up. CONCLUSION Although hydrocele is common, detailed evaluation is mandatory to rule out certain rare tumours-testicular and paratesticular variants.
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Affiliation(s)
- Tanya Nazar
- VPS Lakeshore Hospital & Research Centre, Kochi, Kerala, India
| | | | | | - Aroma Sathish
- VPS Lakeshore Hospital & Research Centre, Kochi, Kerala, India
| | - Tirth Dave
- Bukovinian State Medical University, Chernivtsi, Ukraine.
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Pagliuca F, Lucà S, De Sio M, Arcaniolo D, Facchini G, De Martino M, Esposito F, DE Vita F, Chieffi P, Franco R. Testicular/paratesticular mesothelial tumours: Uncommon histopathologic entities in a very complex anatomical site. Pathol Res Pract 2024; 253:155069. [PMID: 38181581 DOI: 10.1016/j.prp.2023.155069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
Mesothelial tumours of the testicular/paratesticular region are uncommon, poorly characterised and difficult-to-diagnose lesions. They encompass entirely benign proliferations (adenomatoid tumour) and malignant, very aggressive tumours (mesothelioma) whose morphological features can be overlapping, highly variable and confounding. Moreover, testicular/paratesticular mesothelial tumours comprise relatively new entities with indolent behaviour (well-differentiated papillary mesothelial tumour) as well as tumours which cannot be correctly included in any of the aforementioned categories and whose classification is still controversial. The molecular profile of such tumours represents an open issue. In fact, despite the recent discoveries about the genomic landscape of mesothelial proliferations at other sites (pleura, peritoneum), testicular/paratesticular mesothelial tumours, and namely mesotheliomas, are too rare to be extensively studied on large case series and they could arguably hide relevant differences in their molecular background when compared to the more common pleural/peritoneal counterparts.The aim of this review is to provide a guide for the pathological assessment of testicular/paratesticular mesothelial tumours. Herein, we describe the most recent updates on this topic according to the latest (year 2022) World Health Organisation Classification of Urinary and Male Genital Tumours (5th edition) and current literature. The diagnostic criteria, the main differentials and the role of ancillary techniques in the diagnosis of mesothelial testicular/paratesticular tumours are discussed.
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Affiliation(s)
| | - Stefano Lucà
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy; Urology Unit, Azienda Policlinico Unversità 'L. Vanvitelli', 80131 Naples, Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy; Urology Unit, Azienda Policlinico Unversità 'L. Vanvitelli', 80131 Naples, Italy
| | - Gaetano Facchini
- Oncology Unit, "S. Maria delle Grazie" Hospital, ASL NA2 NORD, 80078 Pozzuoli, Naples, Italy
| | - Marco De Martino
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy; Institute of Endocrinology and Experimental Oncology of the CNR, 80131 Naples, Italy
| | - Francesco Esposito
- Institute of Endocrinology and Experimental Oncology of the CNR, 80131 Naples, Italy
| | - Ferdinando DE Vita
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
| | - Paolo Chieffi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy.
| | - Renato Franco
- Pathology Unit, Azienda Policlinico Unversità 'L. Vanvitelli, Italy; Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy
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Corvino A, Catalano O, Faggian G, Delli Pizzi A, Tafuri D, Corvino F, Borzelli A, Picchi SG, Lassandro G, Boccatonda A, Schips L, Cocco G. Multiparametric Ultrasound Diagnostic Approach to Malignancy-Mimicking Adenomatoid Tumors of the Scrotum: Is Strain Elastography Enough? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1261. [PMID: 37512071 PMCID: PMC10384894 DOI: 10.3390/medicina59071261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
Background: Paratesticular tumors (PTs) are very uncommon, accounting for almost 5% of intrascrotal tumors. Of these, adenomatoid tumors (ATs) represent about 30% and most frequently arise in the tail of the epididymis. Ultrasound (US) examination is the first-choice imaging method employed for the evaluation of the scrotum. Unfortunately, there are no specific US-imaging features useful for distinguishing an AT from a malignant lesion. To increase diagnostic accuracy and confidence, new sonographic techniques have incorporated real-time tissue elastography (RTE) under the assumption that malignant lesions are "harder" than benign lesions. Case report: In our paper, we describe a very rare case of a 60-year-old patient with a giant paratesticular mass mimicking malignancy when examined using RTE, i.e., it was stiffer than the surrounding tissue (a hard pattern), which, upon histologic examination, was identified as an AT. Discussion: Our case underscores that there is also a significant overlap between different types of scrotal lesions when RTE is used for examination. Thus, if a PT is found, the imaging approach should always be supplemented with more definitive diagnostic methods, such as FNAC or FNAB, which are the only diagnostic methods capable of leading to a certain diagnosis. Conclusions: Alongside underlining the importance of pre-operative imaging for making correct diagnoses and selecting the correct therapy, we wish to draw our readers' attention to this report in order to demonstrate the clinical implications of a giant AT presenting as stiff lesions when examined using SE.
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Affiliation(s)
- Antonio Corvino
- Movement Sciences and Wellbeing Department, University of Naples "Parthenope", Via Medina 40, I-80133 Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Istituto Diagnostico Varelli, I-80126 Naples, Italy
| | - Guido Faggian
- Advanced Biomedical Sciences Department, University Federico II of Naples, I-80131 Naples, Italy
| | - Andrea Delli Pizzi
- Department of Innovative Technologies in Medicine and Dentistry, University "G. D'Annunzio", I-6610 Chieti, Italy
| | - Domenico Tafuri
- Movement Sciences and Wellbeing Department, University of Naples "Parthenope", Via Medina 40, I-80133 Naples, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, I-80131 Naples, Italy
| | - Antonio Borzelli
- Vascular and Interventional Radiology Department, Cardarelli Hospital, I-80131 Naples, Italy
| | | | - Giulia Lassandro
- Radiology Department, Ospedale del Mare, ASL NA1 Centro, I-80147 Naples, Italy
| | - Andrea Boccatonda
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, I-40010 Bologna, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University, Urology Unit, SS Annunziata Hospital, I-6610 Chieti, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, I-6610 Chieti, Italy
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G. D'Annunzio" University, I-6610 Chieti, Italy
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Phatak SV, Manoj M, Bhansali PJ, Ghanta P. Adenomatoid Tumor of Epididymis Associated with Tubular Ectasia of Rete Testis: Sonographic Evaluation. J Med Ultrasound 2023; 31:157-159. [PMID: 37576421 PMCID: PMC10413400 DOI: 10.4103/jmu.jmu_10_22] [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: 01/21/2022] [Revised: 02/13/2022] [Accepted: 03/30/2022] [Indexed: 08/15/2023] Open
Abstract
Paratesticular tumors are a relatively rare group of mesenchymal tumors, accounting for 7%-10% of all intrascrotal tumors. Adenomatoid tumor of the epididymis is the most common epididymal tumor. It is difficult to distinguish intra- versus paratesticular tumors and to know the nature of the lesion (benign versus malignant) on clinical examination since they may have similar presentation; therefore, ultrasound examination of these lesions is required to demonstrate its extratesticular location and also to suggest its benign nature. Elastography can further help in characterizing the lesion by evaluating the stiffness of the tumor. Here, we present a case of adenomatoid tumor of the left epididymis with tubular ectasia of the rete testis.
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Affiliation(s)
- Suresh Vasant Phatak
- Department of Radio-Diagnosis, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | - Megha Manoj
- Department of Radio-Diagnosis, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | | | - Prasanthi Ghanta
- Department of Radio-Diagnosis, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
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The Application Value of Contrast-Enhanced Ultrasound in Testicular Occupied Lesions. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:9962970. [PMID: 34194540 PMCID: PMC8214501 DOI: 10.1155/2021/9962970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022]
Abstract
Objective To discuss the clinical application value of contrast-enhanced ultrasound (CEUS) in testicular occupied lesions. Methods Nine conventional-ultrasound-found testicular occupied lesions which underwent CEUS meantime were analyzed retrospectively. The CEUS perfusion pattern was compared with the surgical pathological result or follow-up findings. Results Among all the 9 testicular occupied lesions, there were 5 testicular malignant tumors, 1 testicular benign tumor, 1 testicular tuberculosis, and 2 testicular hematomas. CEUS diagnosed 6 testicular malignant tumors, 1 testicular benign tumor, and 2 testicular hematomas, and its diagnostic accuracy was about 88.9%. Conclusion CEUS has high clinical application value in the differential diagnoses of benign and malignant testicular occupied lesions.
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Rafailidis V, Huang DY, Sidhu PS. Paratesticular lesions: Aetiology and appearances on ultrasound. Andrology 2021; 9:1383-1394. [PMID: 33864338 DOI: 10.1111/andr.13021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/12/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ultrasound (US) is the primary modality for the investigation of scrotal pathology, including both intra- and paratesticular abnormalities. OBJECTIVE To describe the abnormalities of the paratesticular space. MATERIALS/METHODS The paratesticular space contains the epididymis, spermatic cord and the tunica vaginalis cavity and is affected by a variety of inflammatory or tumoral entities. Differential diagnosis based on US criteria is frequently problematic, as the findings are non-specific. RESULTS Some general rules apply: (i) unlike testicular lesions, extra-testicular entities are usually benign in the adult, (ii) the first steps to accurate diagnosis include careful localization of the lesion and assessment of its consistency (solid or cystic) and (iii) magnetic resonance imaging can be useful for further tissue characterization of lesions suspected to contain fat, but surgical biopsy will often provide the definite diagnosis. Contrast-enhanced ultrasound (CEUS) has been applied with limited experience indicating a narrow role, primarily for the differential diagnosis of echogenic cystic entities and the delineation of a necrotic abscess from a solid neoplasm. DISCUSSION The various abnormalities are discussed and illustrated. CONCLUSION This manuscript summarizes the literature on paratesticular lesions and the value of US in diagnosis.
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Affiliation(s)
- Vasileios Rafailidis
- Department of Radiology, King's College London, King's College Hospital, London, UK
| | - Dean Y Huang
- Department of Radiology, King's College London, King's College Hospital, London, UK
| | - Paul S Sidhu
- Department of Radiology, King's College London, King's College Hospital, London, UK
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