Early diagnosis and aggressive treatment of testicular rhabdomyosarcomas including surgery and chemotherapy significantly reduce local recurrence and improve survival rates in young adults with metastases. Adjuvant chemotherapy is highly recommended to enhances prognosis and survival outcomes.

暂无摘要。

Testicular tumors are rare in children, representing a small percentage of pediatric solid tumors, with an incidence of 2 cases per 100,000 males. Teratomas, which are the most prevalent tumors in infants, may manifest in mature, immature, or malignant forms. While mature teratomas are typically found in the abdomen, intratesticular prepubertal-type teratomas in infants are infrequent. The present study describes the case of an infant with an intratesticular mature teratoma. A 6-month-old male infant presented with right-sided scrotal swelling, which was noted by his parents. There was no family history of similar conditions, and an investigation of his medical history did not reveal any notable findings. A physical examination revealed a non-reducible, solid mass indistinguishable from the right testicle, with no signs of inflammation or systemic symptoms. A scrotal sonography confirmed a large intratesticular cyst. The levels of α-fetoprotein and β-human chorionic gonadotropin were normal. Surgical tumor enucleation was performed, and the histopathological examination revealed a benign, prepubertal-type teratoma composed entirely of mature elements. Surgical intervention is commonly used for the management of benign testicular tumors in pediatric patients, including prepubertal teratomas. This approach demonstrates an excellent prognosis as it does not elevate the likelihood of recurrence. Prepubertal-type teratomas have rarely been reported in the infantile testis. They may present as a solid mass indistinguishable from the testicle, with no signs of inflammation.

A 32-year-old man visited the emergency department complaining of the right scrotal pain, which occurred suddenly during sexual intercourse. Palpation revealed induration and tenderness on the caudal side of the right testis. Ultrasonography revealed a mosaic-like mass on the caudal side of the testis and no difference in blood flow between the right and left testes. The patient underwent a thorough examination the next day. Although the blood test did not show elevated tumor marker levels, testicular MRI revealed a mass with heterogeneous signal in the right scrotum. Subsequently, the patient was referred to another hospital for surgery. The pathological examination revealed a mixed germ cell tumor: seminoma (60%), teratoma (20%), and embryonal carcinoma (20%). One year postoperatively, the patient has had no recurrence. Testicular tumors are rarely discovered in acute scrotum, and few such cases have been reported. Torsion of the tumor, hemorrhage, necrosis, rupture, and infection have been reported as mechanisms of occurrence. When acute scrotum is diagnosed, testicular tumor should be considered as a differential diagnosis.

Bilateral testicular tumors account for 1 to 5% of all testicular tumors. Most bilateral tumors are observed metachronously. Synchronous tumors usually present with the similar histological pattern. Bilateral synchronous testicular tumors with discordant pathology are extremely rare. Only 56 cases have been documented since Bidard first described synchronous testicular tumors with discordant pathology in 1853. To our best knowledge, this study will be the 57th case in the literature.

Malignant mesothelioma of the tunica vaginalis testis (MMTVT) is a rare tumor of the testicular sheath. More than 50% of cases initially present as recurrent hydrocele, but there have also been documented cases with hematocele, inguinal hernia, or epididymitis. Due to the non-specific symptoms and signs of the disease, it is almost always diagnosed intra- or postoperatively. The lack of standardized therapy protocols, as well as the lack of evidence supporting systemic chemotherapy, have fueled arguments in favor of the necessity of retroperitoneal lymph node dissection (RPLND) in the treatment of the disease, especially in the case of lymph node metastasis. We present a case of MMTVT achieving prolonged remission after timely and extensive surgical treatment.

OBJECTIVE: Ultrasound (US) is the primary imaging modality when a testicular tumor is suspected. Superb microvascular imaging (SMI) is a novel, highly sensitive Doppler technique that allows quantification of flow signals by determination of the Vascular Index (VI). The aim of the present study is to investigate the diagnostic significance of the SMI-derived VI in normal testicular tissue and testicular cancer.
METHODS: This retrospective analysis included patients who underwent testicular US in our department from 2018 to 2022. Inclusion criteria were: i) sufficient image quality of the stored images, ii) US with standardized SMI-default setting (colour gain of 44 ± 5), iii) patient age ≥ 18 years, and iv) normal testicular findings or testicular tumor with histopathological workup. US examinations were performed as part of clinical routine using a high-end ultrasound system (Aplio i800/i900, Canon Medical Systems Corporation, Tochigi, Japan). Statistical analysis included Chi-square test and Mann-Whitney U tests and receiver operating characteristic (ROC) curve analysis.
RESULTS: A total of 62 patients (31 each with normal findings and testicular tumors) were included. The VI differed statistically significantly (p < 0.001) between normal testis (median 2.5 %) and testicular tumors (median 17.4 %). Like vascular patterns (p < 0.001), the VI (p = 0.030) was shown to distinguish seminomas (median 14.8 %), non-seminomas (median 17.6 %) and lymphomas (median 34.5 %).
CONCLUSIONS: In conclusion, our study has shown the VI to be a quantitative tool that can add information for differentiating testicular tumor entities. While further confirmation in larger study populations is desirable, our results suggest that the VI may be a useful quantitative parameter.

A 5-year-old intact male mixed-breed cat weighing 4.5 kg was referred to our hospital with a left testicular mass. CT revealed mild heterogeneous contrast enhancement and calcification in the testicular mass. A well-defined, contrast-enhancing, multiloculated mass with fluid-filled areas was extended from the testicular mass in the scrotum to the caudal aspect of the left kidney. The abdominal mass extended to the right crus of the diaphragm, and the gastrointestinal tract was compressed dorsally. Histopathology was consistent with teratoma. Characteristic CT findings in a feline testicular teratoma may include calcification and cystic areas.

Peripheral precocious puberty (PPP) refers to the early onset of sexual maturation that is independent of central nervous system control. The extensive differential diagnosis includes congenital and acquired causes. Presenting features depend on which class of sex steroids is involved, and diagnosis rests on hormonal and, if indicated, imaging and/or genetic studies. Effective treatment exists for nearly all causes of PPP. Ongoing research will advance our therapeutic armamentarium and understanding of the pathophysiologic basis of these conditions.

Spermatocytic tumor is a very rare germ cell testicular neoplasm that accounts for less than 1% of testicular cancers. It generally affects older men with a mean age of 53.6 years (range 19-92 years). Spermatocytic tumor is classified within the group of germ cell tumors not related to germ cell neoplasia in situ. It presents clinicopathological characteristics different from classic seminoma and is not considered a variant of the latter. Due to a morphologic overlap with classical seminoma, it was called \"sperm cell seminoma\" in the past. The anaplastic variant of spermatocytic tumor is exceptional, few cases have been described in the literature, it presents an earlier onset compared to spermatocytic tumor and a benign behavior despite showing histological patterns similar to classic seminoma. We present the second case of bilateral synchronous anaplastic spermatocytic tumor, in a young patient treated with orchiectomy and chemotherapy.