Unusual case of classic testicular seminoma in a 90-year-old patient: a case report

BACKGROUND

Seminoma is the most common subtype of testicular cancer and occurs most commonly in patients aged 30-49 years, but decreases to a very low level in men in their 60s or older.

CASE PRESENTATION

A 90-year-old Syrian man with a 6-year history of an increase in size of his right scrotum, presented to the urological clinic and, on clinical examination, the findings suggested testicular tumor. After orchiectomy and histology results based on microscopic and immunohistochemical examinations, a pure seminoma was diagnosed, so we describe in this case report the second-oldest patient with classical seminoma in the medical literature.

CONCLUSION

This case report has been written to focus on the probability of any type of testicular tumor occurring at any age or decade; urologists should consider seminoma as a differential diagnosis with any testicular swelling even in elderly patients.

In vitro effect of Escherichia coli on human sperm acrosome reaction

Escherichia coli are known to reduce human sperm motility. The purpose of the present study was to examine whether these bacteria may also affect the acrosome reaction, which is another important sperm function. The acrosome reaction was determined in spermatozoa from 29 fertile men by triple stain after 3-h incubation at 37 degrees C with 2 x 10(6) E. coli/mL or without bacteria (control). Each sample was treated with 0.1% DMSO (spontaneous acrosome reaction) or calcium ionophore A23187 (induced acrosome reaction) for 1 h at 37 degrees C. The inducibility of the acrosome reaction was significantly lower in semen samples pretreated with E. coli than in the control samples (9.8 +/- 4.2% vs. 12.7 +/- 5.3%; p < .05). The results demonstrate that E. coli affect the inducibility of the acrosome reaction in vitro and may impair the fertilizing capacity of human spermatozoa.

Analysis of intra-operative aspirates taken during microsurgical refertilization in obstructive azoospermia--preliminary results. The BMFT Study Group for Microsurgery, Giessen

The reasons for the discrepancy between 'patency' and 'pregnancy' in the outcome of microsurgical refertilization are partially unknown. The quality of the intra-operative aspirate and of the spermatozoa at the level of the anastomosis are discussed worldwide as important factors influencing the success of fertilization in the case of post-operative patency. In 152 men undergoing microsurgical refertilization (vasovasostomy, tubulovasostomy, microsurgical epididymal sperm aspiration, transurethral resection of the ejaculatory duct), 281 aspirates were classified intra-operatively according to Silber, and post-operatively using the Shorr staining technique. In 62 aspirates a computer-aided sperm analysis (CASA) was performed. The percentage of intact spermatozoa decreased from 94.9% at the caput to 9.4% at the cauda epididymidis. The post-operative classification demonstrated an acceptable correlation (0.71) to all grades of intraoperative classification. There was a good correspondence in Silber 4 and 5 but worse in Silber 1 and 2. In CASA, the percentage of motile spermatozoa was not different between epididymal and post-epididymal aspirates. Furthermore, velocity parameters did not differ significantly, but there was a significantly higher straightness of post-epididymal spermatozoa in comparison to epididymal spermatozoa.