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Abdominal lump in an infertile man

Biswal BM, Madhavan M, Anas SR

Postgrad Med J, 2000 Nov;76(901):719-20, 728-9.
PMID: 11060156
Matched MeSH terms: Testicular Neoplasms/diagnosis*; Testicular Neoplasms/etiology; Testicular Neoplasms/therapy
A case of abdominal testis complicated by tumour formation and acute torsion of the cord

Chitty EC

Malayan Medical Journal, 1933;8:203.

Matched MeSH terms: Testicular Neoplasms
Fulltext Imaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review

Chun KH, Inn FX, Hing EY, Hong GE

Urol Ann, 2017 11 10;9(4):387-389.
PMID: 29118545 DOI: 10.4103/UA.UA_69_17

Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered. The choice of imaging study could affect the management and outcome. A 60-year-old male presented with an enlarging right inguinal scrotal swelling for 5 years. Clinical examination showed a swelling extended from the right inguinal region down to the right scrotum, firm, not reducible, and not separable from the right testis. Differential diagnoses range from the malignant testicular tumor, irreducible inguinal hernia to the soft-tissue tumor. Ultrasonography and computed tomography scan were unable to conclude the origin of the tumor and involvement of the right testis. Inguinal exploration with potential radical orchiectomy was planned and caused much distress to the patient, resulted in delay in surgery. Intraoperatively, the mass was separated from the testis and spermatic cord, and thus, excision biopsy was performed sparing the testis and spermatic cord. Histopathological examination showed cellular angiofibroma. The right choice of imaging modality is important to provide a precise diagnosis and better treatment plan. This could avoid the unnecessary distress to the patient for potential organ lost. A review through the literature showed the ability of magnetic resonance imaging to better delineate the anatomy of inguinal scrotal soft-tissue mass and thus should have been the imaging modality of choice.

Matched MeSH terms: Testicular Neoplasms
Fulltext Growing teratoma syndrome of mediastinal nonseminomatous germ cell tumor

Diong NC, Dharmaraj B, Joseph CT, Sathiamurthy N

Ann Thorac Med, 2020 01 02;15(1):38-40.
PMID: 32002046 DOI: 10.4103/atm.ATM_296_19

Mediastinal nonseminomatous germ cell tumor (NSGCT) is rare. NSGCT shows excellent response to cisplatin-based chemotherapy. However, some tumors continue to enlarge despite normal tumor markers after chemotherapy, a rare condition called growing teratoma syndrome (GTS). Recognition of this condition is imperative for prompt surgical resection to prevent further cardiopulmonary compression and to improve survival. Multidisciplinary team meeting is important for perioperative preparation and care to improve the outcome of this high-risk surgery. Here, we report two cases of mediastinal GTS and underwent surgical resection, of which one died of pericardial decompression syndrome and the other is well.

Matched MeSH terms: Testicular Neoplasms
Testicular adenocarcinoma of infancy

Dutt AK, Kutty MK

Med J Malaya, 1969 Jun;23(4):298-9.
PMID: 4242177
Matched MeSH terms: Testicular Neoplasms*
Fulltext Extra-gonadal germ cell tumour – what about the testis!

Johann, F.K., Praveen, S., Christopher, C.K.H., Goh, E.H., Razman, J., Zulkifli, M.Z.

Journal of Surgical Academia, 2011;1(1):28-31.
MyJurnal

Extra-gonadal germ cell tumours (EGGCT) are rare. Therefore further investigations of the testis is aimed at sourcing a possible primary origin of gonadal tumour. Over the years, various case series on EGGCT have been reported questioning its true nature as in a majority of them, a primary source is found in the testis, thus representing a metastatic gonadal tumour. The testis pathology could be either a true germ cell foci, an intra-tubular epithelial neoplasia or an area of fibrosis, indicating a ‘burnt out tumour’. We report a 39-year-old male who underwent laparotomy and excision of a retroperitoneal tumour. Histopathological examination revealed retroperitoneal lymph node of mixed germ cell tumour origin. Clinical and ultrasound examination of bilateral testis was normal. The patient refused orchidectomy or a testicular biopsy. He underwent four cycles of bleomycin, cisplatin, and etoposide with no evidence of tumour recurrence on follow up and remains disease free after 12 months of diagnosis. A literature review of EGGCT, its relation and factors relating with future testicular tumour is presented.

Matched MeSH terms: Testicular Neoplasms
Case series of testicular adrenal rest tumours in boys with congenital adrenal hyperplasia: A single centre experience

Karen Leong SW, Wu LL

Med J Malaysia, 2019 02;74(1):92-93.
PMID: 30846672

Testicular adrenal rest tumours (TART) are aberrant adrenal tissue within the testes (1). Although benign, they can lead to obstruction of the seminiferous tubules and infertility in patients with congenital adrenal hyperplasia (CAH). We report six boys who developed TART, a complication of CAH. Diagnosis was confirmed by ultrasound and testicular vein sampling of elevated 17-hydroxyprogesterone (17-OHP) levels. Glucocorticoids dosages were increased 1½-2 folds to suppress size of the aberrant adrenal tissues. Despite reductions in 17-OHP, the lesions remained unchanged. Three patients had testis-sparing surgery to excise the TART and to preserve normal testicular tissues.

Matched MeSH terms: Testicular Neoplasms/diagnosis*; Testicular Neoplasms/drug therapy
Current progress in treatment technologies for plastic waste (bisphenol A) in aquatic environment: Occurrence, toxicity and remediation mechanisms

Kataria N, Bhushan D, Gupta R, Rajendran S, Teo MYM, Khoo KS

Environ Pollut, 2022 Dec 15;315:120319.
PMID: 36183872 DOI: 10.1016/j.envpol.2022.120319

Bisphenol-A (BPA) is a type of endocrine disrupting compound (EDC) that is being widely used in the production of polycarbonate and epoxy resins. In the last few years, human exposure to BPA has been extensively high due to the continuous increment in the Annual Growth Rate (AGR) of the BPA global market. The presence and transportation of BPA in the environment could cause serious damage to aquatic life and human health. This paper reviewed the literature on the exposure and toxicity mechanisms of BPA and advanced analytical techniques for the detection of BPA in the environment and human beings. The study indicated that BPA can cause damaging effects on numerous tissues and organs, including the reproductive system, metabolic dysfunction, respiratory system, immune system and central nervous system. On the basis of reported studies on animals, it appears that the exposure of BPA can be carcinogenic and responsible for causing a variety of cancers like ovarian cancer, uterine cancer, prostate cancer, testicular cancer, and liver cancer. This review paper focused mainly on the current progress in BPA removal technologies within last ten years (2012-2022). This paper presents a comprehensive overview of individual removal technologies, including adsorption, photocatalysis/photodegradation, ozonation/advance oxidation, photo-fenton, membranes/nanofilters, and biodegradation, along with removal mechanisms. The extensive literature study shows that each technology has its own removal mechanism and their respective limitations in BPA treatment. In adsorption and membrane separation process, most of BPA has been treated by electrostatic interaction, hydrogen boning and π-π interations mechanism. Whereas in the degradation mechanism, O* and OH* species have played a major role in BPA removal. Some factors could alter the removal potential and efficiency of BPA removal. This review paper will provide a useful guide in providing directions for future investigation to address the problem of BPA-containing wastewater treatment.

Matched MeSH terms: Testicular Neoplasms*
Fulltext Chylothorax and central vein thrombosis, an under-recognized association: a case series

Kho SS, Tie ST, Chan SK, Yong MC, Chai SL, Voon PJ

Respirol Case Rep, 2017 May;5(3):e00221.
PMID: 28250931 DOI: 10.1002/rcr2.221

Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognized cause of chylothorax in the adult population and is commonly related to central venous catheterization. Case 1 illustrates a patient with AIDS and disseminated tuberculosis with left chylothorax and central vein thrombosis after a month of antituberculosis therapy. Case 2 was a patient with advanced seminoma who presented with left chylothorax and central vein thrombosis while on chemotherapy. Chylothorax resolved with anticoagulation for both cases. Case 3 was a lymphoma patient with central vein thrombosis who developed chylothorax during chemotherapy. Chylothorax resolved with the continuation of anticoagulation and did not recur despite his progressive underlying lymphoma. There was no central venous catheterization in any of these three cases. These cases illustrate the unique association of central vein thrombosis and chylothorax and the importance of anticoagulation in its management.

Matched MeSH terms: Testicular Neoplasms
Fulltext An omental fibroma resembling a testicular tumour but presented as an irreducible inguinal hernia

Khoo PJ, Jacob S

J Surg Case Rep, 2017 Aug;2017(8):rjx161.
PMID: 28852466 DOI: 10.1093/jscr/rjx161

We present a case of omental fibroma, which posed a surgical diagnostic dilemma. Primary tumours of the omentum are uncommon, and omental fibromas account for 2% of these. The rarity of omental fibroma and paucity of available information hamper an accurate diagnosis. In this particular case, the diagnostic process was misleading. The history was classical of an irreducible inguinal hernia, but the physical examination and imaging studies were suggestive of a testicular tumour. However, intraoperatively, an omental tumour and a normal testicle were found in the scrotum. Histopathological examination proved the tumour to be a fibroma. The presentation of an omental fibroma in an inguinal hernia sac had never been reported in literature. Due to the rarity of such cases, a thorough history, detailed examination, and objective investigation are the pillars to attain the correct diagnosis.

Matched MeSH terms: Testicular Neoplasms
Beware the undescended testis and abdominal mass

Koh KB

Aust N Z J Surg, 1996 Dec;66(12):851-3.
PMID: 8996073

We report five patients who presented with seminoma of an undescended testis to highlight the importance of dealing with adult cryptorchidism. On the basis of the literature review and our experience, we advocate orchidectomy for post-pubertal cryptorchid patients of any age because follow-up may be difficult, and treatment for the tumour may be unsuccessful.

Matched MeSH terms: Testicular Neoplasms/etiology*; Testicular Neoplasms/therapy
Fulltext Malignant ovarian mixed germ cell tumour: a rare combination

Koshy M, Vijayananthan A, Vadiveloo V

Biomed Imaging Interv J, 2005 Oct;1(2):e10.
PMID: 21625278 MyJurnal DOI: 10.2349/biij.1.2.e10

Ovarian germ cell tumours are very rare and affect mainly young girls and women. Due to this, the conservation of reproductive potential is of great concern. One of the most remarkable advances in oncology is in the treatment of malignant ovarian germ cell tumours. Two histological groups are distinguished: dygerminomas, equivalent to testicular seminomas, and non-dysgerminomatous tumours. We report a case of a 30-year-old nulliparous woman who presented with persistent per vaginal bleeding and was found to have a malignant mixed germ cell tumour comprising of both embryonal carcinoma and choriocarcinoma.

Matched MeSH terms: Testicular Neoplasms
Cervical metastasis of testicular cancer: Case Report and Review of Literature

Kumarasamy G, Balasubramanian A, Abdullah B

Gulf J Oncolog, 2018 May;1(27):73-77.
PMID: 30145556

Testicular cancer is an uncommon malignancy of the male reproductive organ, accounting for 1% of all cancers in men. Distant cervical metastasis from testicular cancer has been reported in 5% of patients. We present 2 cases of non-seminomatous testicular cancers that were diagnosed retrospectively in patients who presented with pure cervical lymph nodes. A comprehensive approach bearing in mind the possible differentials, pathogenesis and treatment options are discussed.

Matched MeSH terms: Testicular Neoplasms/pathology*; Testicular Neoplasms/therapy
Fulltext Radioimmunoassay of serum alpha-fetoprotein in patients with different maliganant tumors

Lie-Injo LE, Caldwell J, Ganesan S, Ganesan J

Cancer, 1976 Jul;38(1):341-5.
PMID: 59626 DOI: 10.1002/1097-0142%28197607%2938%3A1<341%3A%3AAID-C

The level of serum alpha-fetoprotein (AFP) was estimated by radioimmunoassay in 153 normal healthy Malysians of different ethnic groups. The mean level was 7.5 In1/ml (SD 2.28InU/ml). Among 330 patients with malignant tumors, 11 had increased levels of AFP. The only patient who had hepatoma had a very high level of serum AFP. High levels were also found in three of four patients with dysgerminoma of the ovary, in the only two patients with carcinoma of the testis, and in one patient with secondary carcinoma of the humerus of unknown origin. Lower, but significantly increased levels were observed in one patient (of 48) with breast carcinoma, one patient (of 8) with basal cell carcinoma of the nose, one patient (0f 27) with carcinoma of the lung, and one patient (of 59) with nasopharynegeal carcinoma.

Matched MeSH terms: Testicular Neoplasms/blood
Testicular relapse in childhood acute lymphoblastic leukaemia in Malaysia, 1967-82

Lin HP, Taib NM, Singh P, Sinniah D, Lam KL

Aust Paediatr J, 1984 Mar;20(1):53-6.
PMID: 6590027

From 1967-82, 9 children with testicular relapse (TR) of acute lymphoblastic leukaemia (ALL) were diagnosed out of 99 boys treated, an incidence of 9.1%. The median time from the onset of ALL until diagnosis was 28 months (range 3-41 months). All were asymptomatic; six were detected on routine examination while three were diagnosed only on biopsy. Routine biopsy prior to stopping chemotherapy is useful in detecting occult TR. Biopsies should be done on both the testes regardless of the clinical findings. The age, leucocyte count and hepatosplenomegaly at diagnosis of ALL were not found to be significant factors in influencing relapse. Eight children were in bone marrow remission at the time of TR, but three had preceding or concurrent meningeal leukaemia while in the other five the testis was the first and only site of relapse. Radiotherapy was effective in local disease control but failed to prevent bone marrow relapse in all except two patients despite continuation of chemotherapy. The median time from onset of TR until bone marrow relapse was 7 months (range 3-13 months) and the median time until death, was 11 months (range 6-18 months). The frequency of testicular relapse may be related to the intensity of either the initial induction therapy or the consolidation chemotherapy. Further studies are required to determine whether the incidence of testicular relapse will decline with more intensive early treatment.

Matched MeSH terms: Testicular Neoplasms/diagnosis*; Testicular Neoplasms/drug therapy
Fulltext C-kit proto-oncogene expression in uterine leiomyosarcomas: case series

Naik, V.R., Hasnan, J.

International Medical Journal Malaysia, 2008;7(2):51-54.
MyJurnal

Introduction: The proto-oncogene c-kit is the cellular homologue of the oncogene v-kit of HZ4 feline sarcoma virus. It is located on chromosome 4 (4q11-12) in the human genome. Interaction between the c-kit receptor and its ligand, stem cell factor, is essential in the development of tissues. C-kit expression has been identified in a number of different neoplasms like seminoma/dysgerminoma, and gastrointestinal stromal tumors (GIST). Recently it has been reported that c-kit is also present in leiomyosarcomas. Tyrosine kinase inhibitors (TKIs) are a promising new therapy in the treatment of cancer. These agents target cellular proteins like kit and its related homologues decreasing cellular proliferation and survival. TKIs may be helpful in treating leiomyosarcomas expressing c-kit. Materials and Methods: In this study a total of 6 cases diagnosed as leiomyosarcomas at Department of Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia, were investigated for reactivity for c-kit using immunohistochemical stain. Stain was considered positive if more than 10 percent of the cells showed membrane or cytoplasmic positivity. Results: Two leiomyosarcomas stained faintly with c-kit and in less than 10 percent of the cells. The other 4 cases showed no staining. The control showed good membrane and cytoplasmic positivity. Conclusion: Uterine leiomyosarcomas did not express c-kit. The reason for this could be that the tumors are inherently c-kit negative. More study using larger number of cases is required to validate these findings and further molecular characterization of these mesenchymal tumors is needed to identify the true nature of these sarcomas.

Matched MeSH terms: Testicular Neoplasms
Fulltext A Testicular Cancer that was Thought to be an Inguino-Scrotal Hernia

Norly S, Sivanes C, Ros'aini P

Med J Malaysia, 2014 Dec;69(6):275-6.
PMID: 25934959

We present a case of a young man with a 5-year history of testicular swelling which was initially thought to be inguinoscrotal hernia. Intra-operatively it was found to be a testicular tumour and histopathological examination confirmed a mixed germ cell tumour. He had an orchidectomy and later underwent chemotherapy. It is interesting to note that the patient had kept the tumour for 5 years with no evidence of distant metastasis at diagnosis. This is probably the longest presentation of a testicular tumour.

Matched MeSH terms: Testicular Neoplasms
Hook wire localization for testis sparing surgery

Ong TA, Yaakup NA, Sivalingam S, Razack AH

Urology, 2013 Apr;81(4):904-7.
PMID: 23537760 DOI: 10.1016/j.urology.2012.10.077

To describe a novel technique for localizing small testicular mass during testicular-sparing surgery (TSS).

Matched MeSH terms: Testicular Neoplasms/surgery*; Testicular Neoplasms/ultrasonography
Fulltext An increasingly notorious mimicker of testicular tumours; crossing borders

Periyasamy P, Subramaniam SR, Rajalingham S

BMJ Case Rep, 2011;2011.
PMID: 22675021 DOI: 10.1136/bcr.09.2011.4816

Data from the WHO state that up to 85% of cases of human schistosomiasis are from Africa. The common sites of this parasitic infection are the intestine and bladder. Testicular schistosomiasis is extremely rare but the number of reported cases worldwide has doubled over the past decade. The authors report a case of testicular schistosomiasis of a Myanmar immigrant in Malaysia who presented with a 6-month history of progressively enlarging left testicular swelling. His biochemical markers and cultures were not suggestive of an ongoing infection. Hence, a testicular malignancy was strongly suspected, for which, he underwent a left orchidectomy. Our clinical suspicion was proven wrong when the histopathology of the removed left testis revealed schistosomal eggs with granulamatous tissue formation. Subsequently, the patient was treated with praziquantel.

Matched MeSH terms: Testicular Neoplasms/diagnosis*
Large-cell calcifying Sertoli cell tumour with macrocalcification in partially resected testis of young adult patient

Potić Floranović M, Ristić Petrović A, Stojnev S, Potić M, Petrović F, Janković Veličkovic L

Malays J Pathol, 2018 Dec;40(3):343-348.
PMID: 30580367

INTRODUCTION: There are less than 100 cases of Large-cell calcifying Sertoli cell tumour (LCCSCT) reported in English literature. Most of them are benign, bilateral and affect paediatric population. Malignant cases occur in older patients. LCCSCT is often associated with Carney complex or Peutz-Jaghers syndrome. We present the clinicopathological features of a young adult, with unilateral "stone-like" LCCSCT, without changes in hormonal status and no clinical characteristics of noted genetic disorders.
CASE REPORT: A 24-year-old male presented with painless hardening of the right testis. There was no gynaecomastia, and serum levels of human chorionic gonadotropin and α-fetoprotein were normal. Ultrasound depicted hyperechogenic, clearly demarcated intratesticular lesion. Partial orchiectomy was performed. Macroscopically, tumour appeared as almost entirely calcified round mass, measuring 10 mm. Histopathological evaluation showed well-circumscribed, unencapsulated tumour composed of massive calcified geographic formations, surrounded with tumour cells. Neoplastic cells were large, polygonal, with abundant eosinophilic cytoplasm, and formed irregular cords, pseudo tubular structures, and nests in a fibrous and myxoid stroma, surrounded with lymphocytes. Other forms of calcification were also present: Needle-like deposits and lamellar, mulberry-like structures. There was no necrosis, mitotic activity and nuclear pleomorphism. Immunohistochemical study was positive for inhibin α and negative for Melan A, EMA, synaptophysin, chromogranin and AFP.
DISCUSSION: LCCSCT needs to be differentiated from other, more frequent, sex cord stromal tumours. Clinical and genetical evaluation of these patients had to be performed, due to connection of LCCSCT with genetic abnormalities. In evidently benign cases, organ-sparing surgery should be considered for younger patients, followed by long term follow-up.

Matched MeSH terms: Testicular Neoplasms/pathology*; Testicular Neoplasms/surgery

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