Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been propo...Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.展开更多
Prostate cancer is one of the most common malignancies in men. Previous research has determined that androgen deprivation therapy （ADT） may be accompanied by an unfavourable metabolic profile. In this prospective st...Prostate cancer is one of the most common malignancies in men. Previous research has determined that androgen deprivation therapy （ADT） may be accompanied by an unfavourable metabolic profile. In this prospective study, 133 men were recruited, including 46 prostate cancer patients who had undergone bilateral orchiectomy and been on flutamide （the ADT group）, 37 men with prostate cancer who had undergone radical prostatectomy （the non-ADT group） and 50 normal control subjects （the control group）. All subjects were followed for at least 12 months. From baseline to 3 months, men in the ADT group had increased levels of fasting serum insulin and low-density lipoprotein compared to the other two groups （P〈0.05）. No obvious changes were found in the other parameters （P〉0.05）. After 12 months, men in the ADT group had increased levels of waist circumference, fasting serum insulin and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein compared to the other two groups （P〈0.05）. Additionally, the morbidity rate of metabolic syndrome in the ADT group was higher （P〈0.05） compared to the other two groups. ADT through surgical castration for men with prostate cancer may be associated with unfavourable metabolic changes. The benefits of the therapy should be balanced prudently against these risks.展开更多
The changes of blood erythrocytes transport function in patients with prostate adenocarcinoma have been studied according to alterations in Na+/K+-ATP-ase activity and permeability of Na+ and K+ ions, before and after...The changes of blood erythrocytes transport function in patients with prostate adenocarcinoma have been studied according to alterations in Na+/K+-ATP-ase activity and permeability of Na+ and K+ ions, before and after the plastic orchiectomy. The results of the study revealed that activity of Na+/K+-ATP-ase was increased compared with the data before the orchiectomy, but this parameter was reduced compared with control group. The increased amounts of the Na+ as well as K+ ions were also observed in the extracellular area compared with the same data before the orchiectomy. The amount of cholesterol, after plastic orchiectomy, was reduced compared with the data gained before orchiectomy, but the data were greater than those of the control group. It may be presumed that one of the reasons for change of Na+/K+-ATP-ase activity is variation of cholesterol content in erythrocyte membrane. Changes of the active transport system, in turn, affect the transport function of the erythrocyte membrane. In spite of surgical intervention, full recovery of patients does not take place after the plastic orchiectomy. Comparative normalization and approaching to the control group of the given indices in post-operation period (~6 months after surgery) indicate strengthening of the immune system and correspondingly—protective abilities of an organism, which was proved by the anamneses of patients.展开更多
This study aims to investigate the effect of different local testicular treatments and validate common prognostic factors on primary testicular lymphoma （PTL） patients. We retrospectively reviewed the clinical recor...This study aims to investigate the effect of different local testicular treatments and validate common prognostic factors on primary testicular lymphoma （PTL） patients. We retrospectively reviewed the clinical records of 32 patients from 1993 to 2017 diagnosed with PTL and included 22 patients for analysis. The Kaplan-Meier method, Log-rank test, and multivariate Cox proportional hazard regression analysis were applied to evaluate progression-free survival （PFS）, overall survival （OS）, and determine prognosis predictors. The median follow-up time was 30 months. Median OS and PFS were 96 months and 49 months, respectively. In univariate analysis, advanced Ann Arbor stage （Ill/IV） （P 〈 0.001）, B symptoms （P 〈 0.001）, and extranodal involvement other than testis （P = 0.001） were significantly associated with shorter OS and PFS. In multivariate analysis, Ann Arbor stage was significantly associated with OS （OR = 11.58, P = 0.049）, whereas B symptom was significantly associated with PFS （OR = 11.79, P = 0.049）. In the 10 patients with the systemic usage of rituximab, bilateral intervention could improve median OS from 16 to 96 months （P = 0.032）. The study provides preliminary evidence on bilateral intervention in testes in the rituximab era and validates common prognostic factors for Chinese PTL patients.展开更多
December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristi...December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.展开更多
A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China. The prosthesis was produced in different sizes to ...A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China. The prosthesis was produced in different sizes to imitate the normal testis of the patient. To investigate the effects and safety of the testicular prosthesis, 20 patients receiving testicular prosthesis implantation were recruited for this study. Follow-up after 6 months revealed no complications in the patients. All the patients answered that they were satisfied with their body image and the position of the implants, 19 patients were satisfied with the size and 16 patients were satisfied with the weight. These results show that the testicular prosthesis used in this study can meet patient＇s expectations. Patients undergoing orchiectomy should be offered the option to receive a testicular prosthesis implantation. The dimensions and weight of the available prosthetic implants should be further addressed to improve patient satisfaction.展开更多
Gastric cancer(GC) is the most prevalent malignancy in the world,especially in China.GC has been postulated to spread via several different routes,including through hematogenous channels,lymphatic vessels,the seeding ...Gastric cancer(GC) is the most prevalent malignancy in the world,especially in China.GC has been postulated to spread via several different routes,including through hematogenous channels,lymphatic vessels,the seeding of peritoneal surfaces,direct extension through the gastric wall,and retrograde extension through the vas deferens or lymphatics.Testicular metastasis is rare.We show here a 53-year-old patient with GC who underwent a radical total gastrectomy approximately 22 mo ago after he presented with a sensation of heaviness and swelling of the right hemiscrotum.The diagnosis of metastatic adenocarcinoma was made after a rightside orchiectomy.We report the first case of testicular metastasis from gastric adenocarcinoma in China's Mainland and summarize the clinicopathologic features of the disease based on previously published papers.展开更多
The testicular prosthesis can be an afterthought for providers when performing an orchiectomy for testicular cancer,torsion,atrophic testis,or trauma.However,data suggest that patients find the offer of a testicular p...The testicular prosthesis can be an afterthought for providers when performing an orchiectomy for testicular cancer,torsion,atrophic testis,or trauma.However,data suggest that patients find the offer of a testicular prosthesis and counseling regarding placement to be extremely important from both a pragmatic and a psychosocial perspective.Only two-thirds of men undergoing orchiectomy are offered an implant at the time of orchiectomy and of those offered about one-third move forward with prosthesis placement.The relatively low acceptance rate is in stark contrast with high patient satisfaction and low complication rates for those who undergo the procedure.The most common postoperative patient concerns are minor and involve implant positioning,size,and weight.Herein,we provide an up-to-date review of modern preoperative evaluation,patient selection,expectation management,surgical technique,and expected outcomes for testicular prostheses.展开更多
Aim: To observe the changes in thymocyte and its microenvironment in aged mice after bilateral testicular resection.Methods: In male old mice, at the 25th day after testicular resection, the peripheral blood and thymu...Aim: To observe the changes in thymocyte and its microenvironment in aged mice after bilateral testicular resection.Methods: In male old mice, at the 25th day after testicular resection, the peripheral blood and thymus were collect-ed . Blood and thymus suspension smears were prepared for quantitative histochemistry and immunohistochemistry studyunder light and electron microscopes. Results; In testes resected mice the size and the weight of thymus weremarkedly increased. The demarcation between cortex and medulla was clear. The cortex was thickened and the celldensity was increased. The ratio of cortex/medulla stereometry was increased. The total cell count, thymocyte count,the percentage of acid a-naphthyl acetate esterase (ANAE) positive thymocytes, nonlymphocytes and the rosette forma-tion of macrophages and thymocytes were all increased. The thymocytes surrounded closely to the light thymic epithelialcells, dendritic cells or macrophages. The lymphocytes, particularly the ANAE positive lymphocytes of peripheralblood were increased. Conclusion; After bilateral testicular resection, the thymus of aged male mice showed mor-phological regeneration and the thymocytes and its microenvironment appeared to be definitely improved. It is suggestedthat testicular resection may improve immune function. (Asian J Androl 2001 Dec; 3; 271 — 275)展开更多
Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related ost...Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.展开更多
Objective:Testicular torsion is a common urological emergency,mainly in the younger population.Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability.Methods:Patien...Objective:Testicular torsion is a common urological emergency,mainly in the younger population.Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability.Methods:Patients who were older than 13 years of age and were discharged with the diagnosis of testicular torsion were reviewed.Data obtained included demographic data,history,physical examination results,ultrasound findings including size,color Doppler flow,and echotexture,torsion degrees,and surgical procedure.In addition,the histopathological findings of patients who underwent orchiectomy were reviewed.Results:A total of 71 cases were diagnosed with testicular torsion between January 2016 to December 2018.The mean age at presentation was 20.4±7.0 years.The average time from the onset of pain until the presentation was 36.0±55.1 h.Out of the 71 ultrasound scans reviewed,45.1%showed homogenous echotexture and 54.9%showed heterogeneous echotexture of the affected testis.On scrotal exploration,the mean degree of torsion was 475.7±301.8 degrees;66.2%of the patients had a viable testis;and bilateral orchidopexy was done.The remaining 33.8%had a non-viable testis.Homogenous echotexture was after an average of 13.5 h of scrotal pain,while heterogeneous echotexture presented after 53.7 h of scrotal pain.There was a statistically significant difference between the time of presentation and echotexture changes on scrotal ultrasonography(p<0.01).The relationship between echotexture changes and testicular viability was statistically significant as well(p<0.001).Conclusion:A long time since the onset of pain coupled with heterogeneous changes in testicular parenchyma is a good indicator of non-viability.However,we still advocate for surgical exploration as the gold standard in diagnosis and management.展开更多
Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph ...Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph nodes,who developed bilateral painful swollen testes 3 years after the initial diagnosis of prostate cancer.He had first presented with lower urinary tract symptoms(LUTS)with suspicious findings on digital rectal examination of the prostate,and an elevated serum prostate specific antigen(PSA)level of 129 ng/mL.Transrectal prostate biopsy revealed Gleason 4þ5 adenocarcinoma.Radiological staging showed locally advanced prostate cancer with extensive metastases to bone and pelvic and retroperitoneal lymph nodes.He was given hormonal therapy for over 2 years until progression to CRPC.Six months later he developed painful bilateral testicular swellings,and serum markers for testicular germ cell cancer were normal.Bilateral orchiectomy was performed,showing metastatic prostate cancer(Gleason 4þ5)on histology.One month postoperatively his PSA level dropped to 0.1 ng/mL from a presurgery level of 6.24 ng/mL.展开更多
BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of ...BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment strategy.CASE SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 d.Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal region.The patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of Urology.After performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed.After surgery,he was transferred to the intensive care unit for further management.CONCLUSION Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.展开更多
Inhibin B is a gon adal horm one that down regulates the pituitary production of follicle-stimulati ng horm one (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a pred...Inhibin B is a gon adal horm one that down regulates the pituitary production of follicle-stimulati ng horm one (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a predictive factor for the recovery of fertility in patients undergoing orchiectomy and antineoplastic treatments. We propose to study inhibin B levels in orchiectomised testicular cancer patients, in order to identify a minimum value representative of normal semen quality. This retrospective study evaluates horm onal and semen parameters of 290 no rmozoospermic patie nts atte nding the Laboratory of Semi no logy - Sperm Bank "Loredana Gandini"(Rome, Italy) for cryopreservation of seminal fluid following a diagnosis of testicular cancer (TC group) and 117 healthy, normozoospermic men as a control group (CTR group). The percentile distribution of gonadotropin and inhibin B values in the TC and CTR groups was analyzed. There was a statistically significant differenee between the two groups in the levels of all hormones (P ≤ 0.001) and in all semen parameters (P < 0.05). About 20% of TC patients revealed inhibin B levels below the 5th percentile of CTR group, despite normozoospermia, and 31.4% had normal spermatogenesis in the presenee of FSH values >95^th percentile of CTR group. Orchiectomised patients for testicular cancer presented inhibin B levels lower than healthy patients, despite normozoospermia. Our study revealed the poor sensitivity of the current inhibin B reference range when applied to monorchidic patients, suggesting the need to establish more representative ranges to enable more appropriate counseling in relation to the patienfs new endocrine condition.展开更多
Aim: Epididymal proteins are known to play an important role in the maturation of spermatozoa, we ougnt to deter-mine if there are regional differences in androgen-dependent epididymal proteins. Methods: A group of ad...Aim: Epididymal proteins are known to play an important role in the maturation of spermatozoa, we ougnt to deter-mine if there are regional differences in androgen-dependent epididymal proteins. Methods: A group of adult rats wascastrated and epididymides were removed three days following castration. The epididymides were dissected into caput,corpus and cauda segments, homogenized, and proteins were fractionated by anion exchange HPLC. Proteins in select-ed fractions were resolved by SDS-PAGE and visualized by silver staining. Results: It was observed that the levels ofmultiple proteins drastically reduced in the various regions of epididymis of the orchiectomized rats. Conclusion: Theepididymal proteins appear to be useful markers to study androgenic action in the epididymis.展开更多
Orchiectomy is the recommended treatment for many testicular conditions.However,testicular prosthesis placement is not always performed for different reasons.In this study,we aimed to evaluate patients'opinions an...Orchiectomy is the recommended treatment for many testicular conditions.However,testicular prosthesis placement is not always performed for different reasons.In this study,we aimed to evaluate patients'opinions and the impact on sexual function and quality of life.This retrospective observational single-center study included patients who underwent orchiectomy between January 2014 and December 2020 at the Department of Urology,Braga's Hospital(Braga,Portugal),where testicular implants were always available and the decision to undergo the procedure was made fully independent of cost.Patients completed four questionnaires that assessed demographic data,satisfaction,self-esteem,and sexual function.Of the 96 patients who underwent orchidectomy,59 replied to the questionnaires,and of these patients,86.4%decided to undergo silicone-based testicular prostheses implantation.The remaining 13.6%refused the implant based on concerns about complications(37.5%),because they felt that it was unnecessary(37.5%),or because it was not offered by the doctor(25.0%).Overall,96.1%of these patients were satisfied with the implant;however,25.5%classified it as"too firm".No statistically significant differences were found in sexual function(all P>0.05).However,it can be observed that there are more patients with prostheses presenting normal sexual activity compared to patients without prostheses(74.0%vs 50.0%),and none of them reported severe erectile dysfunction(0 vs 16.7%).Regarding self-esteem,both patients with and without prostheses present very similar average scores with no statistically significant differences.The present study highlights the highest level of satisfaction among patients who received testicular prostheses.Testicular prostheses implantation is a safe procedure that does not hamper sexual function after orchiectomy.展开更多
BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibrob...BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibroblasts,vascular smooth muscle cells,or fibroblasts,and displays various phenotypes of myofibroblasts and abnor-mal muscle arteries.Aggressive angiomyolipoma was first identified in 1983 and fewer than 50 male patients have been reported to date.It is an extremely rare mesenchymal tumour and often confused with other diseases.Patients with epididymal aggressive angiomyolipoma lack typical symptoms,most of which occur incidentally,although some patients may experience mild pain,discomfort,and swelling.Pain may be exacerbated by pressure from the mass.CASE SUMMARY A 66-year-old male was admitted to the hospital on January 14,2022 with chief complaint of swelling in the left scrotum for one year.There was no apparent cause for the swelling.The patient did not consult with any doctor or receive any treatment for the swelling.The enlarged scrotum increased in size gradually until it reached approximately the size of a goose egg,and was accompanied by discom-fort and swelling of the left cavity of the scrotum.The patient had no history of any testicular trauma,infection,or urinary tract infection.The patient urinated freely,1-2 times at night,without urgency,dysuria(painful urination),or haematuria.There was no significant family history of malignancy.The patient underwent excision of the enlarged tumour and the left epididymis under general anaes-thesia on January 18,2022.Twelve months of follow-up revealed no recurrence.The patient was satisfied with the treatment.CONCLUSION Aggressive angiomyolipoma is extremely rare clinically and often confused with other diseases.The pathogenesis of aggressive angiomyolipoma is unclear and the clinical presentation is mostly a painless enlarged mass.The diagnosis of aggressive angiomyolipoma requires a combination of medical history,preoperative imaging such as computed tomography and magnetic resonance imaging,cytological examination and preoperative and postoperative pathological biopsy.The preferred treatment is surgery,with the possibility of a new alternative treatment option after hormonal therapy.Aggressive angiomyolipoma should be considered in the differential diagnosis of parametrial tumors of the male genital area that present as clinically significant masses.The high recurrence rate of aggressive angiomyolipoma may be related to incomplete tumor resection,and patients with aggressive angiomyolipoma are advised to undergo annual postoperative follow-up and imaging for recurrence.展开更多
Introduction: The purpose of this work is to evaluate the epidemiological, clinical and therapeutic aspects of spermatic cord in our context. Patients and Methods: This is a retrospective study over a period of 4 year...Introduction: The purpose of this work is to evaluate the epidemiological, clinical and therapeutic aspects of spermatic cord in our context. Patients and Methods: This is a retrospective study over a period of 4 years from January 1, 2014 to June 30, 2018. Results: We collected 55 cases divided into 26 cases, 44.27% for the Thies Regional Hospital, 21% or 38.18% for the Mbour EPS and 8 cases representing 14.55% for the Saint Jean de Dieu Hospital. We found an average age of 20.03 years with extremes of 4 years and 56 years. In 28 patients or 50% of cases, we found no particular pathological history, while in 4 patients or 7.14%, we found a notion of recurrent ipsilateral testicular pain. We recorded 67.27% (n = 37) of the cases received for testicular pain;15 patients or 27.27% presented a large painful pouch. Two patients (3.64%) were received for inguinal swelling and 1 patient (1.82%) presented testicular atrophy. The average consultation time is 16.9 hours with extremes of 2 hours and 96 hours. The torsion was in 59.61% of cases (n = 32) located on the right versus 40.38% (n = 22) on the left. There was no bilateral form. The pick-up time was 3 hours with extremes of 1 h to 24 h. All patients benefited from an exploratory scrotomy. We found a total of 22 patients or 40% of cases with ischemic testis, 8 cases or 14.55% of patients with necrotic testis and 2 cases or 3.64% where the testis was normal. Orchidopexy was performed in 46 patients or 83.63% and orchiectomy in 9 patients. Conclusion: Care is urgent. There is a need for better awareness of the population and the medical staff for the early diagnosis.展开更多
Gunshot wound is rare on the testicles and involves the patient’s reproductive function. The authors report a case of open gunshot wound trauma to the testicles in a 45-year-old patient with no particular information...Gunshot wound is rare on the testicles and involves the patient’s reproductive function. The authors report a case of open gunshot wound trauma to the testicles in a 45-year-old patient with no particular information, except, living with two women and eight children. Emergency sharing noted a fracture of the right testicle with damage of the cord components. After the surgery, the left testicle was necrotic, so a left orchiectomy was performed. The aftermaths of this second surgery were simple. However, the management of this hunting accident resulted in castration, which poses the problem of the patient’s sexuality.展开更多
Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an int...Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an interesting case of PTL managed by a combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years, consulted for an increase in the volume of the right testicle without associated pain, all evolving in the context of a slight decline in general condition. Clinical examination revealed a large painless mass in the right scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The patient had undergone inguinal orchiectomy. Pathological analysis showed diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET-CT) showed no suspicious hypermetabolism. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The evolution was marked by the death of the patient six months after the end of the scrotal radiotherapy following a diffuse lymph node relapse with a profound alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the disease. The therapeutic approach is multimodal and combined based on orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL is an aggressive malignant with a poor prognosis. Randomized trials are needed to define a better therapeutic strategy.展开更多
文摘Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.
文摘Prostate cancer is one of the most common malignancies in men. Previous research has determined that androgen deprivation therapy （ADT） may be accompanied by an unfavourable metabolic profile. In this prospective study, 133 men were recruited, including 46 prostate cancer patients who had undergone bilateral orchiectomy and been on flutamide （the ADT group）, 37 men with prostate cancer who had undergone radical prostatectomy （the non-ADT group） and 50 normal control subjects （the control group）. All subjects were followed for at least 12 months. From baseline to 3 months, men in the ADT group had increased levels of fasting serum insulin and low-density lipoprotein compared to the other two groups （P〈0.05）. No obvious changes were found in the other parameters （P〉0.05）. After 12 months, men in the ADT group had increased levels of waist circumference, fasting serum insulin and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein compared to the other two groups （P〈0.05）. Additionally, the morbidity rate of metabolic syndrome in the ADT group was higher （P〈0.05） compared to the other two groups. ADT through surgical castration for men with prostate cancer may be associated with unfavourable metabolic changes. The benefits of the therapy should be balanced prudently against these risks.
文摘The changes of blood erythrocytes transport function in patients with prostate adenocarcinoma have been studied according to alterations in Na+/K+-ATP-ase activity and permeability of Na+ and K+ ions, before and after the plastic orchiectomy. The results of the study revealed that activity of Na+/K+-ATP-ase was increased compared with the data before the orchiectomy, but this parameter was reduced compared with control group. The increased amounts of the Na+ as well as K+ ions were also observed in the extracellular area compared with the same data before the orchiectomy. The amount of cholesterol, after plastic orchiectomy, was reduced compared with the data gained before orchiectomy, but the data were greater than those of the control group. It may be presumed that one of the reasons for change of Na+/K+-ATP-ase activity is variation of cholesterol content in erythrocyte membrane. Changes of the active transport system, in turn, affect the transport function of the erythrocyte membrane. In spite of surgical intervention, full recovery of patients does not take place after the plastic orchiectomy. Comparative normalization and approaching to the control group of the given indices in post-operation period (~6 months after surgery) indicate strengthening of the immune system and correspondingly—protective abilities of an organism, which was proved by the anamneses of patients.
文摘This study aims to investigate the effect of different local testicular treatments and validate common prognostic factors on primary testicular lymphoma （PTL） patients. We retrospectively reviewed the clinical records of 32 patients from 1993 to 2017 diagnosed with PTL and included 22 patients for analysis. The Kaplan-Meier method, Log-rank test, and multivariate Cox proportional hazard regression analysis were applied to evaluate progression-free survival （PFS）, overall survival （OS）, and determine prognosis predictors. The median follow-up time was 30 months. Median OS and PFS were 96 months and 49 months, respectively. In univariate analysis, advanced Ann Arbor stage （Ill/IV） （P 〈 0.001）, B symptoms （P 〈 0.001）, and extranodal involvement other than testis （P = 0.001） were significantly associated with shorter OS and PFS. In multivariate analysis, Ann Arbor stage was significantly associated with OS （OR = 11.58, P = 0.049）, whereas B symptom was significantly associated with PFS （OR = 11.79, P = 0.049）. In the 10 patients with the systemic usage of rituximab, bilateral intervention could improve median OS from 16 to 96 months （P = 0.032）. The study provides preliminary evidence on bilateral intervention in testes in the rituximab era and validates common prognostic factors for Chinese PTL patients.
基金supported by the National Natural Science Foundation of China(No.81873828)Chongqing Municipal Health Commission(High-Level Medical Reserved Personnel Training Project of Chongqing),the Innovation Program for Chongqing's Overseas Returnees(cx2019030)the Senior Medical Talents Program of Chongqing for Young and Middle-Aged.
文摘December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.
文摘A new type of testicular prosthesis made of silastic with an elliptical shape to mimic a normal testis was developed by our team and submitted for patenting in China. The prosthesis was produced in different sizes to imitate the normal testis of the patient. To investigate the effects and safety of the testicular prosthesis, 20 patients receiving testicular prosthesis implantation were recruited for this study. Follow-up after 6 months revealed no complications in the patients. All the patients answered that they were satisfied with their body image and the position of the implants, 19 patients were satisfied with the size and 16 patients were satisfied with the weight. These results show that the testicular prosthesis used in this study can meet patient＇s expectations. Patients undergoing orchiectomy should be offered the option to receive a testicular prosthesis implantation. The dimensions and weight of the available prosthetic implants should be further addressed to improve patient satisfaction.
文摘Gastric cancer(GC) is the most prevalent malignancy in the world,especially in China.GC has been postulated to spread via several different routes,including through hematogenous channels,lymphatic vessels,the seeding of peritoneal surfaces,direct extension through the gastric wall,and retrograde extension through the vas deferens or lymphatics.Testicular metastasis is rare.We show here a 53-year-old patient with GC who underwent a radical total gastrectomy approximately 22 mo ago after he presented with a sensation of heaviness and swelling of the right hemiscrotum.The diagnosis of metastatic adenocarcinoma was made after a rightside orchiectomy.We report the first case of testicular metastasis from gastric adenocarcinoma in China's Mainland and summarize the clinicopathologic features of the disease based on previously published papers.
基金Figure 1,2,3,Table 2,and testicular implant market data were provided by Coloplast Corporation(Minneapolis,MN,USA)with written permission.
文摘The testicular prosthesis can be an afterthought for providers when performing an orchiectomy for testicular cancer,torsion,atrophic testis,or trauma.However,data suggest that patients find the offer of a testicular prosthesis and counseling regarding placement to be extremely important from both a pragmatic and a psychosocial perspective.Only two-thirds of men undergoing orchiectomy are offered an implant at the time of orchiectomy and of those offered about one-third move forward with prosthesis placement.The relatively low acceptance rate is in stark contrast with high patient satisfaction and low complication rates for those who undergo the procedure.The most common postoperative patient concerns are minor and involve implant positioning,size,and weight.Herein,we provide an up-to-date review of modern preoperative evaluation,patient selection,expectation management,surgical technique,and expected outcomes for testicular prostheses.
文摘Aim: To observe the changes in thymocyte and its microenvironment in aged mice after bilateral testicular resection.Methods: In male old mice, at the 25th day after testicular resection, the peripheral blood and thymus were collect-ed . Blood and thymus suspension smears were prepared for quantitative histochemistry and immunohistochemistry studyunder light and electron microscopes. Results; In testes resected mice the size and the weight of thymus weremarkedly increased. The demarcation between cortex and medulla was clear. The cortex was thickened and the celldensity was increased. The ratio of cortex/medulla stereometry was increased. The total cell count, thymocyte count,the percentage of acid a-naphthyl acetate esterase (ANAE) positive thymocytes, nonlymphocytes and the rosette forma-tion of macrophages and thymocytes were all increased. The thymocytes surrounded closely to the light thymic epithelialcells, dendritic cells or macrophages. The lymphocytes, particularly the ANAE positive lymphocytes of peripheralblood were increased. Conclusion; After bilateral testicular resection, the thymus of aged male mice showed mor-phological regeneration and the thymocytes and its microenvironment appeared to be definitely improved. It is suggestedthat testicular resection may improve immune function. (Asian J Androl 2001 Dec; 3; 271 — 275)
基金Supported by GRF of Hong Kong SAR (project no. 464508)a direct grant for research from the Chinese University of Hong Kong (project no.2041501)
文摘Objective To investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. Methods Orchiectomized and ovariectomized rat models are used to investigate sex hormone deficiency related osteoporosis and efficacy of different therapies. A rat vertebral body can be longitudinally divided into central portion, which contain more trabecular bone, and para-endplate portions which contain more compact bone. In matured male and female Wistar and Sprague-Dawley rat lumbar spines, we investigated baseline bone mineral density （BMD） characteristics and the differential segmental responses in bone loss within the lumbar vertebral body post gonadal surgery with clinical multidetector computed tomography. Results Para-endplate sections had a higher BMD than central sections. The cephalad para-endplate sections had a higher BMD than the caudad para-endplate sections. Eight weeks after gonadal removal, there was more bone loss in central sections than para-endplate sections. The relative difference of bone loss between para-endplate and central sections was more apparent in male rats than in female rats. There was more bone loss in caudad sections than cephalad sections; this lead to a further increase of BMD difference between caudad para-endplate sections and cephalad para-endplate sections post gonadal surgery. Conclusion The approach described in this study provided a consistent way to study BMD change within predominantly compact bone portion and trabecular bone portion of the vertebral body.
文摘Objective:Testicular torsion is a common urological emergency,mainly in the younger population.Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability.Methods:Patients who were older than 13 years of age and were discharged with the diagnosis of testicular torsion were reviewed.Data obtained included demographic data,history,physical examination results,ultrasound findings including size,color Doppler flow,and echotexture,torsion degrees,and surgical procedure.In addition,the histopathological findings of patients who underwent orchiectomy were reviewed.Results:A total of 71 cases were diagnosed with testicular torsion between January 2016 to December 2018.The mean age at presentation was 20.4±7.0 years.The average time from the onset of pain until the presentation was 36.0±55.1 h.Out of the 71 ultrasound scans reviewed,45.1%showed homogenous echotexture and 54.9%showed heterogeneous echotexture of the affected testis.On scrotal exploration,the mean degree of torsion was 475.7±301.8 degrees;66.2%of the patients had a viable testis;and bilateral orchidopexy was done.The remaining 33.8%had a non-viable testis.Homogenous echotexture was after an average of 13.5 h of scrotal pain,while heterogeneous echotexture presented after 53.7 h of scrotal pain.There was a statistically significant difference between the time of presentation and echotexture changes on scrotal ultrasonography(p<0.01).The relationship between echotexture changes and testicular viability was statistically significant as well(p<0.001).Conclusion:A long time since the onset of pain coupled with heterogeneous changes in testicular parenchyma is a good indicator of non-viability.However,we still advocate for surgical exploration as the gold standard in diagnosis and management.
文摘Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph nodes,who developed bilateral painful swollen testes 3 years after the initial diagnosis of prostate cancer.He had first presented with lower urinary tract symptoms(LUTS)with suspicious findings on digital rectal examination of the prostate,and an elevated serum prostate specific antigen(PSA)level of 129 ng/mL.Transrectal prostate biopsy revealed Gleason 4þ5 adenocarcinoma.Radiological staging showed locally advanced prostate cancer with extensive metastases to bone and pelvic and retroperitoneal lymph nodes.He was given hormonal therapy for over 2 years until progression to CRPC.Six months later he developed painful bilateral testicular swellings,and serum markers for testicular germ cell cancer were normal.Bilateral orchiectomy was performed,showing metastatic prostate cancer(Gleason 4þ5)on histology.One month postoperatively his PSA level dropped to 0.1 ng/mL from a presurgery level of 6.24 ng/mL.
文摘BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital organs.It is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment strategy.CASE SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 d.Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal region.The patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of Urology.After performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed.After surgery,he was transferred to the intensive care unit for further management.CONCLUSION Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.
文摘Inhibin B is a gon adal horm one that down regulates the pituitary production of follicle-stimulati ng horm one (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a predictive factor for the recovery of fertility in patients undergoing orchiectomy and antineoplastic treatments. We propose to study inhibin B levels in orchiectomised testicular cancer patients, in order to identify a minimum value representative of normal semen quality. This retrospective study evaluates horm onal and semen parameters of 290 no rmozoospermic patie nts atte nding the Laboratory of Semi no logy - Sperm Bank "Loredana Gandini"(Rome, Italy) for cryopreservation of seminal fluid following a diagnosis of testicular cancer (TC group) and 117 healthy, normozoospermic men as a control group (CTR group). The percentile distribution of gonadotropin and inhibin B values in the TC and CTR groups was analyzed. There was a statistically significant differenee between the two groups in the levels of all hormones (P ≤ 0.001) and in all semen parameters (P < 0.05). About 20% of TC patients revealed inhibin B levels below the 5th percentile of CTR group, despite normozoospermia, and 31.4% had normal spermatogenesis in the presenee of FSH values >95^th percentile of CTR group. Orchiectomised patients for testicular cancer presented inhibin B levels lower than healthy patients, despite normozoospermia. Our study revealed the poor sensitivity of the current inhibin B reference range when applied to monorchidic patients, suggesting the need to establish more representative ranges to enable more appropriate counseling in relation to the patienfs new endocrine condition.
文摘Aim: Epididymal proteins are known to play an important role in the maturation of spermatozoa, we ougnt to deter-mine if there are regional differences in androgen-dependent epididymal proteins. Methods: A group of adult rats wascastrated and epididymides were removed three days following castration. The epididymides were dissected into caput,corpus and cauda segments, homogenized, and proteins were fractionated by anion exchange HPLC. Proteins in select-ed fractions were resolved by SDS-PAGE and visualized by silver staining. Results: It was observed that the levels ofmultiple proteins drastically reduced in the various regions of epididymis of the orchiectomized rats. Conclusion: Theepididymal proteins appear to be useful markers to study androgenic action in the epididymis.
文摘Orchiectomy is the recommended treatment for many testicular conditions.However,testicular prosthesis placement is not always performed for different reasons.In this study,we aimed to evaluate patients'opinions and the impact on sexual function and quality of life.This retrospective observational single-center study included patients who underwent orchiectomy between January 2014 and December 2020 at the Department of Urology,Braga's Hospital(Braga,Portugal),where testicular implants were always available and the decision to undergo the procedure was made fully independent of cost.Patients completed four questionnaires that assessed demographic data,satisfaction,self-esteem,and sexual function.Of the 96 patients who underwent orchidectomy,59 replied to the questionnaires,and of these patients,86.4%decided to undergo silicone-based testicular prostheses implantation.The remaining 13.6%refused the implant based on concerns about complications(37.5%),because they felt that it was unnecessary(37.5%),or because it was not offered by the doctor(25.0%).Overall,96.1%of these patients were satisfied with the implant;however,25.5%classified it as"too firm".No statistically significant differences were found in sexual function(all P>0.05).However,it can be observed that there are more patients with prostheses presenting normal sexual activity compared to patients without prostheses(74.0%vs 50.0%),and none of them reported severe erectile dysfunction(0 vs 16.7%).Regarding self-esteem,both patients with and without prostheses present very similar average scores with no statistically significant differences.The present study highlights the highest level of satisfaction among patients who received testicular prostheses.Testicular prostheses implantation is a safe procedure that does not hamper sexual function after orchiectomy.
文摘BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibroblasts,vascular smooth muscle cells,or fibroblasts,and displays various phenotypes of myofibroblasts and abnor-mal muscle arteries.Aggressive angiomyolipoma was first identified in 1983 and fewer than 50 male patients have been reported to date.It is an extremely rare mesenchymal tumour and often confused with other diseases.Patients with epididymal aggressive angiomyolipoma lack typical symptoms,most of which occur incidentally,although some patients may experience mild pain,discomfort,and swelling.Pain may be exacerbated by pressure from the mass.CASE SUMMARY A 66-year-old male was admitted to the hospital on January 14,2022 with chief complaint of swelling in the left scrotum for one year.There was no apparent cause for the swelling.The patient did not consult with any doctor or receive any treatment for the swelling.The enlarged scrotum increased in size gradually until it reached approximately the size of a goose egg,and was accompanied by discom-fort and swelling of the left cavity of the scrotum.The patient had no history of any testicular trauma,infection,or urinary tract infection.The patient urinated freely,1-2 times at night,without urgency,dysuria(painful urination),or haematuria.There was no significant family history of malignancy.The patient underwent excision of the enlarged tumour and the left epididymis under general anaes-thesia on January 18,2022.Twelve months of follow-up revealed no recurrence.The patient was satisfied with the treatment.CONCLUSION Aggressive angiomyolipoma is extremely rare clinically and often confused with other diseases.The pathogenesis of aggressive angiomyolipoma is unclear and the clinical presentation is mostly a painless enlarged mass.The diagnosis of aggressive angiomyolipoma requires a combination of medical history,preoperative imaging such as computed tomography and magnetic resonance imaging,cytological examination and preoperative and postoperative pathological biopsy.The preferred treatment is surgery,with the possibility of a new alternative treatment option after hormonal therapy.Aggressive angiomyolipoma should be considered in the differential diagnosis of parametrial tumors of the male genital area that present as clinically significant masses.The high recurrence rate of aggressive angiomyolipoma may be related to incomplete tumor resection,and patients with aggressive angiomyolipoma are advised to undergo annual postoperative follow-up and imaging for recurrence.
文摘Introduction: The purpose of this work is to evaluate the epidemiological, clinical and therapeutic aspects of spermatic cord in our context. Patients and Methods: This is a retrospective study over a period of 4 years from January 1, 2014 to June 30, 2018. Results: We collected 55 cases divided into 26 cases, 44.27% for the Thies Regional Hospital, 21% or 38.18% for the Mbour EPS and 8 cases representing 14.55% for the Saint Jean de Dieu Hospital. We found an average age of 20.03 years with extremes of 4 years and 56 years. In 28 patients or 50% of cases, we found no particular pathological history, while in 4 patients or 7.14%, we found a notion of recurrent ipsilateral testicular pain. We recorded 67.27% (n = 37) of the cases received for testicular pain;15 patients or 27.27% presented a large painful pouch. Two patients (3.64%) were received for inguinal swelling and 1 patient (1.82%) presented testicular atrophy. The average consultation time is 16.9 hours with extremes of 2 hours and 96 hours. The torsion was in 59.61% of cases (n = 32) located on the right versus 40.38% (n = 22) on the left. There was no bilateral form. The pick-up time was 3 hours with extremes of 1 h to 24 h. All patients benefited from an exploratory scrotomy. We found a total of 22 patients or 40% of cases with ischemic testis, 8 cases or 14.55% of patients with necrotic testis and 2 cases or 3.64% where the testis was normal. Orchidopexy was performed in 46 patients or 83.63% and orchiectomy in 9 patients. Conclusion: Care is urgent. There is a need for better awareness of the population and the medical staff for the early diagnosis.
文摘Gunshot wound is rare on the testicles and involves the patient’s reproductive function. The authors report a case of open gunshot wound trauma to the testicles in a 45-year-old patient with no particular information, except, living with two women and eight children. Emergency sharing noted a fracture of the right testicle with damage of the cord components. After the surgery, the left testicle was necrotic, so a left orchiectomy was performed. The aftermaths of this second surgery were simple. However, the management of this hunting accident resulted in castration, which poses the problem of the patient’s sexuality.
文摘Background and Aim: Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents for 1% - 2% of non-Hodgkin’s lymphoma, and mostly affects the elderly. We describe an interesting case of PTL managed by a combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years, consulted for an increase in the volume of the right testicle without associated pain, all evolving in the context of a slight decline in general condition. Clinical examination revealed a large painless mass in the right scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The patient had undergone inguinal orchiectomy. Pathological analysis showed diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose positron emission tomography (18-FDG-PET-CT) showed no suspicious hypermetabolism. Lumbar puncture did not reveal malignant cells in the cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The evolution was marked by the death of the patient six months after the end of the scrotal radiotherapy following a diffuse lymph node relapse with a profound alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the disease. The therapeutic approach is multimodal and combined based on orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL is an aggressive malignant with a poor prognosis. Randomized trials are needed to define a better therapeutic strategy.
