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The article discusses a rare case of recurrent metastatic spermatocytic tumor successfully treated with salvage systemic chemotherapy. Spermatocytic tumors are a rare subtype of testicular neoplasm, with less than 1% of all testicular neoplasms being of this type. The patient in the case study had an aggressive form of the tumor but showed a favorable response to second-line chemotherapy, highlighting the need for further research and collaboration in understanding the molecular landscape of rare tumors like spermatocytic tumors. [Extracted from the article]

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Colorectal cancer, with the liver being themost common site of distant metastasis, followed by the lungs and bones. Although reports of metastasis to the testis exist, paratesticular metastasis is extremely rare. A 37-year-old male presented with scrotal swelling. Ultrasound revealed hydrocele of the tunica vaginalis. The patient underwent routine surgical treatment, and postoperative pathology of the tunica vaginalis indicated adenocarcinoma of gastrointestinal origin. Colonoscopic biopsy confirmed adenocarcinoma of the sigmoid colon. After six months of systemic therapy, tumor reduction surgery was performed in conjunction with tunica vaginalis excision. Postoperative pathology suggested histological similarity in both sites, with immunohistochemistry results supporting the diagnosis of sigmoid colon adenocarcinoma metastasizing to the tunica vaginalis. We conducted a literature review, summarizing and discussing clinical presentations, metastatic pathways, and diagnostic approaches. [ABSTRACT FROM AUTHOR]

Purpose: To critically appraise studies to identify experiences of unmet supportive care needs of individuals affected by testicular cancer. Methods: A registered priori systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. CINAHL, PsycINFO, and MEDLINE were searched for quantitative, qualitative, and mixed methods studies using a wide range of search terms. All articles were double screened according to a pre-determined eligibility criterion. Reference lists of the final included studies were checked for further eligible studies. The review process was managed using Covidence systematic review software. Data from the studies were extracted, methodological quality appraisal conducted, and a narrative synthesis conducted. Results: Of the 72 papers identified, 36 studies were included. In descending order of frequency of need, psychological needs were identified in 26/36, physical needs 18/36, interpersonal/intimacy needs 19/36, health system/information needs 11/36, cognitive needs 9/36, social needs 7/36, and of equal frequencies counts of 4/36 for family, practical, and patient-clinician information needs. Only one study explored spiritual needs and no daily living needs were identified. Conclusions: The experience of needs varied in terms of frequency and distress which were commonly influenced by the age of the individual across the cancer care continuum persisting after 1-year post-treatment. Implications for Cancer Survivors: When caring for individuals affected by testicular cancer, clinicians are encouraged to take a holistic lens to cancer care, particularly to explore issue or concerns that young men affected by testicular cancer might be embarrassed or reticent to discuss. [ABSTRACT FROM AUTHOR]

Objective: Masculinities have been explored in men with testicular cancer (TC), though limited contemporary research is available on traditional masculine norms important to masculine self‐perception. The purpose of this research was to explore the discourse of TC experience in relation to masculine self‐perception. Methods: A qualitative descriptive study was conducted consisting of semi‐structured interviews with 21 men. Men were aged between 31 and 47 (Mage = 35.7). Most men were diagnosed with Stage 1 cancer (66.6%), all men had finished active treatment and time since diagnosis ranged from 17.3 to 71.8 months (M = 47.2). Independent coding was conducted by two researchers and was refined in coding meetings with authors. Themes were developed in a predominantly deductive manner, and analysis of themes was undertaken using a reflexive analysis approach. Results: Traditional masculine norms showed differing relationships to masculine self‐perception. Two main themes were identified [1] Maintained or enhanced masculine self‐perception and [2] threats to masculine self‐perception. Subthemes demonstrated that maintaining emotional control, strength and 'winning' was important to men, and reduced physical competencies (i.e., strength, sexual dysfunction, virility) challenged self‐perception. Strict adherence to traditional norms in response to threatened self‐perception related to psychological distress. Conclusion: Leveraging traditionally masculine norms such as physical strength and control and developing flexible adaptations of masculinities should be encouraged with men with TC to retain self‐perception and potentially enable better coping. Masculine self‐perception of gay/bisexual men may centre around sexual functioning, though further research is required. [ABSTRACT FROM AUTHOR]

We present a case of a 17‐year‐old male with a testicular tumour diagnosed after trauma. A 17‐year‐old male patient came to our clinic with swelling in the right hemiscrotum. The patient had a history of right scrotal blunt trauma 3 weeks before the admission and had no history of urological surgery or chronic disease. The patient doesn't use tobacco, alcohol, or illicit drugs. Genitourinary system examination revealed swelling and tenderness on palpation in the right hemiscrotum. The right testicle was not palpable. The left hemiscrotum was normal. The left testicle had a normal size and shape. Testicular tumour markers were high (AFP:196 μg/L (N: 0–8 μg/L), b‐HCG: 916 mIU/mL (N: <10 mIU/mL), LDH: 364 U/L (N: 0–265 U/L). Scrotal ultrasonography and magnetic resonance imaging revealed that there were areas of 9 × 9 × 11 cm in size of the right scrotal region without viable testis tissue, hematoma area, and areas compatible with necrosis. These findings were related to intratesticular rupture due to trauma. Abdominal tomography revealed lymphadenopathies of approximately 6 × 3 cm in the anterior paracaval area and approximately 4 × 3 cm in the anterior aspect of the psoas muscle. We performed right radical inguinal orchiectomy on the patient. Testicular tumour markers were still high on the 8th postoperative day (AFP:120 μg/L (N: 0–8 μg/L), bHCG: 680 mIU/mL (N: <10 mIU/mL), LDH: 200 U/L (N: 0–265 U/L)). The testicular tumour was diagnosed as mixed germ cell tumour (50% Yolk Sac, 30% Embryonal Carcinoma, 20% Teratoma). The tumour diameter was 9 cm, surgical margins were intact, there was rete testis invasion, and no tumour was detected in the tunica vaginalis. No tumour invasion was seen in the soft tissue around the spermatic cord (pT2). The patient received 3 cycles of chemotherapy with bleomycin, etoposide, and cisplatin. We suggest that patients presenting with scrotal trauma should be carefully evaluated for testicular malignancy, and if malignancy is suspected, radical inguinal orchiectomy should be preferred for the operation. [ABSTRACT FROM AUTHOR]

We describe a unique presentation of acute lower limb ischaemia due to metastatic seminoma in a middle-aged man with a large retroperitoneal mass. The patient underwent vascular bypass surgery of the right lower limb, completed chemotherapy, and had a right scrotal orchiectomy. The patient had pre-existing vascular risk factors including peripheral vascular disease and smoking. To our knowledge this is the first published case in the literature that has described a large retroperitoneal seminoma compressing the abdominal aorta resulting in acute lower limb ischaemia.

Objective: Psychological distress is common in men with testicular cancer (TC), and masculinities may work to explain this. This study aimed to compare masculinities and distress in TC and healthy control (HC) populations and explore relationships between correlates of distress (psychological flexibility and coping style) and masculinities in TC. Methods: A cross‐sectional, online survey was completed by 92 men with TC (Mage = 34.8) and 90 HC (Mage = 30.7). Measures included psychological distress (Patient‐Reported Outcomes Measurement Information System Depression/Anxiety, fear of cancer recurrence inventory‐short form), masculinities (gender role conflict‐short form, inventory of subjective masculinity experiences/subjective masculinity stress scale, masculinity in chronic disease inventory), coping style (mini‐mental adjustment to cancer) and psychological flexibility (comprehensive assessment of acceptance commitment therapy). Linear regressions were conducted to compare groups and analyse associations. Results: There were no differences in masculinities or psychological distress between populations (all p > 0.05 and all Cohen's d < 0.20), except for subjective masculine stress and restrictive affectionate behaviour between men. For men with TC, restrictive affection/emotion, conflicts between family/work and subjective masculine stress were associated with psychological distress (rs 0.21–0.58). Optimistic action was negatively associated with depression/anxiety, helplessness/hopelessness coping (rs −0.27 to −0.42) and positively associated with psychological flexibility (r = 0.35). Conclusions: Masculinities are implicated in psychological distress in men with TC. Psychological flexibility as well as leveraging masculine beliefs (e.g., optimistic action) may be modifiable targets to reduce distress in men with TC. [ABSTRACT FROM AUTHOR]

BackgroundThe incidence rate of testicular cancer has risen in many countries during recent decades. This study aimed to outline the impact of testicular cancer on the Middle East and North Africa (MENA) region from 1990 to 2019, examining its burden by age group and according to the socio-demographic index (SDI).MethodsData on the incidence, death, and disability-adjusted life-years (DALYs) due to testicular cancer were retrieved from the Global Burden of Disease study 2019. The counts and age-standardized rates (per 100,000) were reported, and all rates were accompanied by 95% uncertainty intervals (UIs).ResultsIn MENA, the age-standardized incidence rate of testicular cancer was 1.4 per 100,000 in 2019, showing a 244.0% increase since 1990. Similarly, the annual death rate, at 0.1, experienced a 2.6% rise during the same period. In 2019, testicular cancer accounted for 31.1 thousand DALYs, marking an age-standardized rate of 5.0, which was 2.8% higher than in 1990. The 1-4 age group exhibited the largest incidence rate in 2019. In addition, in both 1990 and 2019 the MENA/Global DALY ratio was higher than one in the 1-14 year age groups. During the period 1990 to 2019, the age-standardized DALY rate of testicular cancer steadily rose with higher SDI values, except for a decrease observed at an SDI of 0.8.ConclusionOver the last thirty years, there has been a notable rise in the burden of testicular cancer in the MENA region.

Abstract Background Testicular Sertoli cell tumor (SCT) is very rare sex cord-gonadal stromal tumor, and sclerosing SCT (SSCT) is even rarer. So far, no more than 50 cases of SSCT have been reported. 80% of SSCTs are less than 2 cm in diameter, large volume mass is pretty unusual. SSCT is usually benign with very low malignant potential. However, it is easily misdiagnosed as a malignant tumor resulting in the removal of the entire testicle. Case presentation A 55-year-old Chinese male patient presented with a six months’ history of right testis progressively enlargement and negative tumor markers. The physical examination was nothing special except for swelling in the right testicle. Imaging identified a large mass in right testicle with rich blood. A right radical orchiectomy was performed on suspicion of malignancy. However, the tumor was postoperatively diagnosed as SSCT, which pathologically consisted of a tubular pattern with regular nuclei and embedded in a densely collagenous stroma, as well as diffusely positive for vimentin, β-catenin and synaptophysin. After 7 months of follow up, no evidence of local recurrence and metastasis has been observed. Conclusion This rare case is helpful to expand the knowledge of the testicular tumor and alert us fully understand the rare variant of SCTs in order to choose the optimal management when they encounter SSCT.

Abstract Background Splenogonadal fusion (SGF) is a rare congenital malformation in which the spleen is abnormally connected to the gonads or to the mesonephric derivatives. There is no obvious causality between SGF and testicular neoplasm. However, cryptorchidism, which is a well-known risk factor of testicular germ cell tumors, are the most frequent malformations associated with SGF. To our knowledge, there are only four reported cases of SGF associated with testicular neoplasm so far. Herein, we reported a patient of this condition, and briefly reviewed the related literature. Case presentation A 48-year-old man was diagnosed with bilateral cryptorchidism 30 years prior, and only underwent a right orchiopexy for the left testicle could not be explored during the operation. At that time, doctors failed to realize the possibility of SGF due to the lack of sufficient knowledge of this condition. This time, the patient was treated for a left abdomen mass that was diagnosed as stage III metastatic seminoma. Then, a right orchiectomy, robot-assisted laparoscopic left retroperitoneal tumor resection, and left retroperitoneal lymph node dissection was performed after four cycles of BEP (bleomycin + etoposide + cisplatin) systemic chemotherapy in our center. The final diagnosis of SGF was made by postoperative pathology. The patient was re-examined in our center at 3 months and 6 months after the operation, and no obvious abnormalities were found. Conclusions Surgeons should always bear in mind the possibility of association between bilateral cryptorchidism and splenogonadal fusion to avoid malignant transformation caused by delayed treatment.

Fibrous pseudo tumor of the tunica vaginalis is a rare lesion affecting men representing a challenge in its diagnosis and treatment. We reported the case of a 17 year old male patient who presented for a right scrotal mass. Surgical resection of the mass was performed and the histological diagnosis was a fibrous pseudo tumor of the tunica vaginalis. It is usually affecting men in the third decade and the fear is to miss its main differential diagnosis which is testicular cancer. Studies should give more concern to this entity, so that we can avoid unnecessary orchiectomy.

Testis cancer is highly curable. However, historical data point to differences between urban and rural areas with more advanced diseases at presentation and worse outcomes in the latter. In a cohort of 296 men with testis cancer diagnosed and treated at the Inselspital Berne between 2010 and 2020, we found no clinically relevant differences in presentation and outcomes depending on their residential area. [ABSTRACT FROM AUTHOR]

Abstract Background Survivors of testicular cancer may experience long-term morbidity following treatment. There is an unmet need to investigate techniques that can differentiate individuals who need additional therapy from those who do not. 2-18fluoro-deoxy-D-glucose (FDG) positron emission tomography (PET) with computerised tomography (CT) may be helpful in select settings and may be used outside of current evidence-based recommendations in real-world practice. Methods A institutional FDG-PET/CT database of scans performed between 2000 and 2020 for adults with testicular seminoma was interrogated. Endpoints of interest included the positive (PPV) and negative (NPV) predictive value of FDG-PET/CT for identifying active seminoma (defined by progressive radiology, response to treatment or biopsy); or no active seminoma within 24-months for patients with stage 1 and advanced seminoma. An exploratory analysis examining predictive role of SUVmax was also performed. Results 249 patients met eligibility criteria for the analysis, including 184 patients with stage 1 and 77 patients with advanced testicular seminoma. Of 193 FDG-PET/CT performed in stage 1 seminoma with available follow-up data, 79 were performed during active surveillance. 18 (23%) of these were positive, all of which had confirmed recurrent seminoma (PPV 100%). Of 45 negative FDG-PET/CT during active surveillance, 4 recurrences developed corresponding to a NPV 91%. When clinical suspicion precipitated FDG-PET/CT (n = 36): PPV 100%, NPV 86%. Of 145 FDG-PET/CT in advanced seminoma with available follow-up data, 25 (17%) were performed at baseline (within 2 months of diagnosis), 70 (48%) post-treatment for evaluation of treatment response and 50 (34%) during follow-up following prior curative treatment. 10 (14%) post-treatment FDG-PET/CT were positive corresponding to a PPV 60%. Of 46 negative FDG-PET/CT, 5 recurrences occurred (NPV 89%). During follow-up after prior curative treatment, 24 (50%) FDG-PET/CT were positive corresponding to a PPV 83%; of 20 negative FDG-PET/CT, 1 recurrence occurred, NPV 95%. When clinical suspicion indicated FDG-PET/CT (n = 36): PPV 100%, NPV 94%. Conclusion FDG-PET/CT offers high PPV for identifying seminoma and accurately predicts non-recurrence across a clinically relevant 24-months. Notably, FDG-PET/CT may prevent unnecessary treatment in 45% of patients undergoing investigation for clinical suspicion of recurrence during follow-up of advanced seminoma. The use of FDG-PET/CT in selected patients now, may help prevent unnecessary treatment of people with testicular seminoma.

Background: Testicular Sertoli cell tumor (SCT) is very rare sex cord-gonadal stromal tumor, and sclerosing SCT (SSCT) is even rarer. So far, no more than 50 cases of SSCT have been reported. 80% of SSCTs are less than 2 cm in diameter, large volume mass is pretty unusual. SSCT is usually benign with very low malignant potential. However, it is easily misdiagnosed as a malignant tumor resulting in the removal of the entire testicle. Case presentation: A 55-year-old Chinese male patient presented with a six months' history of right testis progressively enlargement and negative tumor markers. The physical examination was nothing special except for swelling in the right testicle. Imaging identified a large mass in right testicle with rich blood. A right radical orchiectomy was performed on suspicion of malignancy. However, the tumor was postoperatively diagnosed as SSCT, which pathologically consisted of a tubular pattern with regular nuclei and embedded in a densely collagenous stroma, as well as diffusely positive for vimentin, β-catenin and synaptophysin. After 7 months of follow up, no evidence of local recurrence and metastasis has been observed. Conclusion: This rare case is helpful to expand the knowledge of the testicular tumor and alert us fully understand the rare variant of SCTs in order to choose the optimal management when they encounter SSCT. [ABSTRACT FROM AUTHOR]

Background: Splenogonadal fusion (SGF) is a rare congenital malformation in which the spleen is abnormally connected to the gonads or to the mesonephric derivatives. There is no obvious causality between SGF and testicular neoplasm. However, cryptorchidism, which is a well-known risk factor of testicular germ cell tumors, are the most frequent malformations associated with SGF. To our knowledge, there are only four reported cases of SGF associated with testicular neoplasm so far. Herein, we reported a patient of this condition, and briefly reviewed the related literature. Case presentation: A 48-year-old man was diagnosed with bilateral cryptorchidism 30 years prior, and only underwent a right orchiopexy for the left testicle could not be explored during the operation. At that time, doctors failed to realize the possibility of SGF due to the lack of sufficient knowledge of this condition. This time, the patient was treated for a left abdomen mass that was diagnosed as stage III metastatic seminoma. Then, a right orchiectomy, robot-assisted laparoscopic left retroperitoneal tumor resection, and left retroperitoneal lymph node dissection was performed after four cycles of BEP (bleomycin + etoposide + cisplatin) systemic chemotherapy in our center. The final diagnosis of SGF was made by postoperative pathology. The patient was re-examined in our center at 3 months and 6 months after the operation, and no obvious abnormalities were found. Conclusions: Surgeons should always bear in mind the possibility of association between bilateral cryptorchidism and splenogonadal fusion to avoid malignant transformation caused by delayed treatment. [ABSTRACT FROM AUTHOR]

Introduction: Testicular biopsies are performed for both diagnostic and therapeutic purposes. Diagnostic testicular biopsies are usually performed as a part of a male infertility work-up. Therapeutic testicular excision biopsies are performed for a wide range of disorders, including neoplastic lesions, inflammatory lesions, cryptorchidism, testicular trauma, and as a part of prophylactic treatment of carcinoma prostate. Aim: To evaluate the indications for orchidectomy and diagnostic testicular biopsies and to understand the histopathological spectrum of testicular lesions and concordance with clinical diagnosis. Materials and Methods: This was a retrospective study conducted in the Department of Pathology, Father Muller Medical College, Mangalore, Karnataka, India. The study period is from July 2017 to June 2020. Data was collected and analysed in August 2020. All testis' biopsies, including excision and diagnostic biopsies, are included in the study. Histopathological findings and the clinical diagnosis were evaluated for concordance. Data were tabulated and statistically evaluated for age distribution, laterality, and frequency using Microsoft Excel 2021. Percentages for the variables and concordance rate were calculated. Results: A total of 139 cases (mean age 54.5 years) were included in the study. Prophylactic orchidectomy for carcinoma prostate (64/139=46.04%) was the most common clinical indication. Non neoplastic lesions account for 48.20% (67/139). Frequent non neoplastic lesions are testicular torsion (23/139=16.55%) and abscess (12/139=8.63%), followed by cryptorchidism (9/139=6.47%). Left-sided lesions are more frequent than right-sided lesions. Histopathology confirmed two cases of suspected male infertility and Androgen Insensitivity Syndrome (AIS). Neoplastic lesion accounts to 6.47% (9/139). Frequent neoplasm in the study was seminoma (3/139=2.16%), followed by lymphoma (2/139=1.44%). Other neoplasms included in the study were mixed germ cell tumours, post-pubertal teratoma, and spermatocytic tumour. Testicular tuberculosis accounts to 1.44% (2/139) in the present population. Conclusion: Non neoplastic lesions were common compared to testicular neoplasms. Testicular torsion, followed by abscess, was the most common indication for orchidectomy. Testicular Tuberculosis can mimic a neoplasm on clinical and radiological work-up. Hence, careful evaluation has to be performed in young suspected cases of tuberculosis. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to estimate the epidemiological characteristics, histological types, and subtypes of testicular neoplasm according to the WHO classification in our patient group. Material & Methods: This was a retrospective study done over a period of ten years from January 2010 - December 2020 in our institution. Histopathological slides were retrieved and reviewed for tumour. Testicular Neoplasm patients who underwent orchidectomy and chemotherapy clinical data including the patient’s age, tumor location, tumor side, pathological finding, tumor marker, chemotherapy regiment, prognosis, chemotherapy response, and side effect were observed. All the data were analyzed descriptively and using SPSS 17.0. Results: A total of 31 cases of testicular and paratesticular neoplasm were encountered in our study with a mean age of 32.516.2 years. The highest incidence was 15-35 years old (48.3). Scrotum mass was the most frequent clinical presentation (70.96%) and left side became the predominant area (52%). Most of the patients come in late stage T3 (51.61%) and N3 (67.74%) with no metastatic process (70.96). The major pathological finding was Seminoma (64.51%), Teratoma (16.12), Yolk Sac (12.9%), Embryonal, and Mixed (3.22%). AFP, B-HCG, and LDH were elevated in some Seminoma, Teratoma, and Yolk Sac groups. The most wide chemotherapy used was 4 series BEP (87.09%). Patient prognosis highest incidence were Intermediate (70.96%). Most of the patients showed complete response (67.74) of chemotherapy. Nausea, vomiting, alopecia, and mucositis were observed as chemotherapy side effect in all patients. Conclusion: Testicular neoplasm peak incidence appears in young male. Most patients come to health care service in late stage. Seminoma become the highest testicular neoplasm incidence in our study. Elevated tumor markers were found in some patients. Four cycle BEP chemotherapy regiment showed great outcome for these patients. Keywords: Epidemiological, histological, testicular neoplasm.

Objective: The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's view of their masculinity.Methods: Searches were conducted across four databases (MEDline, PsycInfo, CINAHL Plus and Scopus) for articles published before April 2022 that included (1) TC and (2) masculinity. Two researchers independently rated studies for inclusion with a third resolving conflicts. Of the 6464 articles screened, 24 articles (10 quantitative and 14 qualitative) were included in the review. Articles were rated for quality and a narrative synthesis was performed.Results: Overall, results indicated some men experience a shift in the way they relate to their sense of masculinity following diagnosis and treatment for TC. Being single and without children was related to the experience of negative masculinity-related outcomes, possibly due to a compounding lack of relational support and being unable to conform to protector, provider traditions. Men who described testicle loss as symbolic of their diminished masculinity were also negatively impacted. However, recent, high-quality literature on the topic using standardised masculinity measures was limited.Conclusion: Some men experience a reduced sense of masculinity after TC, however the impact of TC on masculinity remains person dependent. Further research using validated masculinity measures is required to uncover psycho-social variables that may account for whether and how meaning is made between TC and its treatment and any subsequent impact on perceived masculinity. Such factors may better support these men in life beyond cancer.Systematic Review Registration: PROSPERO. International Prospective Register of Systematic Reviews: CRD42020185649. [ABSTRACT FROM AUTHOR]

Large cell calcifying Sertoli tumor is an uncommon testicular neoplasm. We present a case of a 36-year-old man with a late-onset large cell calcifying Sertoli tumor that resulted in a solitary lung metastasis 5 years after radical orchiectomy. Pulmonary wedge resection was performed, and there was no recurrence at the 18-month follow-up after resection of the lung metastasis. Because of its malignant potential, late-onset large cell calcifying Sertoli tumor requires long-term follow-up.

Background: There are few studies examining retroperitoneal lymph node dissection (RPLND) for testicular cancer in Australia. This study examines the perioperative outcomes, complications and survival rates following RPLND, by a high volume, single surgeon. Methods: A retrospective, case series of a single surgeon, multi‐centre study included all patients who underwent RPLND following testicular cancer at Westmead Public Hospital, Westmead Private Hospital, and Macquarie University Hospital 2005–2020. One hundred one patients identified, with 94 having sufficient available data. Results: At time of operation, median age was 29.5 years. 84.2% had T1 or T2 primary tumours at diagnosis. Most common RPLND indication was residual mass post‐chemotherapy (92.6%), with bleomycin, etoposide and cisplatin (BEP)x3 and BEPx4 most common chemotherapy regimens (50% and 35% respectively). Post‐chemotherapy, largest residual mass ranged from 0.9 to 20 cm (median 3.32 cm). Post‐chemotherapy, 95.7% masses were found in retroperitoneum (64.4% para‐aortic region). 93.6% had open approach. 42.5% had bilateral nerve sparing. Majority (97.1%) did not require blood transfusion. No complications reported in 52.1% of patients. No deaths recorded within 90 days of surgery. At time of analysis, 91.5% had recurrence free survival, and 92.6% overall survival, at a median follow‐up since surgery of 47.5 months (range 11 to 200 months). Conclusions: This retrospective study, addressing peri‐operative surgical outcomes for RPLND surgery in Australia, is comparable to high‐volume international urological centre studies, and shows that centralisation of post‐chemotherapy RPLND to an experienced surgeon, results in low perioperative morbidity and mortality. [ABSTRACT FROM AUTHOR]

The prevalence of segmental testicular infarction is extremely uncommon and very few cases have been reported in literature. Clinical and sonographic presentation of this condition can mimic testicular neoplasms or testicular torsion. Therefore, accurate diagnosis of segmental testicular infarction is imperative in the treatment process. This case study presents the sonographic diagnosis of testicular infarction in a 49-year-old man who reported mild testicular tenderness. A conservative treatment approach was used, saving the patient unnecessary surgical intervention. [ABSTRACT FROM AUTHOR]

Testicular cancer, a highly prevalent malignancy among young adults, has witnessed an alarming rise in recent decades. This study delves into the therapeutic potential of isoalantolactone (IATL), a natural product extracted from Inula helenium and Inula racemosa, against testicular cancer. Employing MTT assays and flow cytometry, we observed a dose-dependent reduction in cell viability and induction of cell cycle arrest at sub-G1 phase with increasing IATL concentrations. Furthermore, Annexin V/PI dual staining revealed IATL-induced apoptosis. Human Apoptosis Array analysis demonstrated IATL's influence on HIF-1α and TNF R1 expression, implicating its role in cancer cell growth and death regulation. Next-generation sequencing (NGS) and pathway analysis highlighted the involvement of ferroptosis and HIF-1 signaling in IATL-mediated effects. Western blotting validated the downregulation of key proteins associated with apoptosis inhibition and activation, confirming IATL's potential as an anticancer agent. Moreover, IATL induced ferroptosis by modulating expression levels of GPX4, xCT, NRF2, and HO-1. Our findings shed light on IATL's multifaceted anticancer mechanisms, emphasizing its potential as a therapeutic candidate for testicular cancer.

Isolated tuberculous epididymo-orchitis (TBEO) is an exceptionally rare type of genitourinary tuberculosis (GUTB). It carries a very small percentage of incidence and most of the time are missed or picked up late due to its benign presentation. The clinical presentation can be varied and due to its nature of presentation, the diagnosis can be misleading and lead to a delay in treatment. We report a peculiar case of disseminated tuberculosis (TB) with tuberculous epididymo-orchitis in a middle-aged man who presented to us with a chronic right testicular swelling which initially worked-up for testicular malignancy. Patient underwent high ligation right orchidectomy and the histopathology examination (HPE) reported as necrotizing granulomatous inflammation of the right testis. Patient is treated with anti-tuberculous chemotherapy and a complete recovery is achieved after 6 months of treatment. Sufficient and detailed evaluation of testicular mass, particularly in the middle-aged population is important as the timing of diagnosis may yield a better prognosis. Tuberculous epididymo-orchitis has very similar clinical presentation with other testicular pathology. Due to lack of highly sensitive investigations preoperatively to diagnose it, no wonder it is considered as a "great mimicker". [ABSTRACT FROM AUTHOR]

Introduction: Testis cancer is highly curable. However, historical data point to differences between urban and rural areas with more advanced diseases at presentation and worse outcomes in the latter. In a cohort of 296 men with testis cancer diagnosed and treated at the Inselspital Berne between 2010 and 2020, we found no clinically relevant differences in presentation and outcomes depending on their residential area., Competing Interests: Es bestehen keine Interessenskonflikte., (© 2024 Aerzteverlag medinfo AG.)

Growing teratoma syndrome (GTS) is an uncommon clinical condition that presents with enlarging teratoma masses of the retroperitoneum or other locations. This enlargement typically occurs during or after systemic chemotherapy as part of the treatment for nonseminomatous germ cell tumors (NSGCT) of the testes, with normalized tumor markers. In our case, a 29-year-old man underwent right orchiectomy and four cycles of bleomycin, etoposide and platinum chemotherapy for T2 mixed NSGCT (40% teratoma, 40% choriocarcinoma and 20% seminoma). After chemotherapy, the assessment through a computed tomography scan revealed the appearance of new, subcentimeter lung nodules and the existing pulmonary nodular lesions with different behaviors, one showing significant growth (RUL), while the other has decreased significantly (LLL), along with a decrease in the size of retroperitoneal lymph nodes. His alpha-fetoprotein was 3.34 ng/ml, lactate dehydrogenase was 285.75 U/I, and beta subunit of human chorionic gonadotropin was 0.28 m UI/ml. According to the medical literature, the treatment is surgical. Thus, the patient was referred to the thoracic surgery department for the excision of the remaining tumors, and at present we are waiting for the histological findings. [ABSTRACT FROM AUTHOR]

Adenomatoid tumours are rare benign neoplasm involving the para testicular region, mostly the tail of the epididymis. They are typically small, firm and asymptomatic masses in the scrotal region and often discovered incidentally during physical examination or imaging studies. It is very challenging to differentiate them clinically and radiologically from malignant intratesticular solid tumours, which may lead to unnecessary orchidectomies. This case report presents the clinical management of a 57-year-old male patient with adenomatoid tumour of the epididymis, highlighting the diagnostic workup, surgical approach and postoperative outcomes. In addition, a comprehensive literature review was conducted to discuss the morphological and immunohistochemical features to improve understanding of these rare lesions and assist in accurate diagnosis and appropriate management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Farah et al.)

The neoplasms of the testis are sporadic tumors among men. Furthermore, the rarest subset of these is neoplasms belonging to the stromal tumors of the sex cord. Leydig cell tumors are the most common form among the testicular stromal tumors. In our case, the underlying risk factor associated with the development of Leydig cell tumors was cryptorchidism. While mostly unilateral, cases of bilateral cryptorchidism may be present and have been rarely reported. We report a 36-year-old gentleman who presented to us with the inability to carry off intercourse without difficulty attaining erection on stimulation for the past two years. He had a history of left undescended testis since birth, for which he underwent left orchidopexy 20 years ago. An ultrasound of the pelvis showed an oval hypoechoic-shaped heterogeneous mass in the right mid-inguinal canal. Relevant blood investigations showed a deranged hormonal profile. He then underwent an uneventful right radical orchiectomy, histopathology of which was consistent with Leydig cell tumor. LCT with a history of bilateral cryptorchidism has rarely been reported. This case highlights its clinical presentation, management, and further follow-up in such patients. Bilateral congenital cryptorchidism may be associated with Leydig cell tumor years later in life hence long-term follow-up is required for these patients. The clinical presentation of these tumors may vary among individuals. Any change in physical appearance, hormonal assay, and imaging studies should promptly be followed for possible surgical resection and close monitoring. • Bilateral congenital cryptorchidism may be associated with LCT, years later in life. • The clinical presentation of these tumors may vary among individuals. • Such patients need periodic monitoring of hormonal profiles and imaging studies. [ABSTRACT FROM AUTHOR]

Objective: To review the current situationof biomarkers used in the diagnosis, prognosis,treatment response and relapse of testicular cancer., Methods: A non systematic review was performedof clinical guidelines and articles published within thelast years regarding biomarkers in testicular cancer., Results: The most commonly used biomarkersare alphafetoprotein (AFP) and beta human corionicgonadotropin (β-HCG).The enzyme lactate dehydrogenase (LDH) is presentin multiple tissues and is elevated in advancedgerminal tumors. A few micro molecules of RNA (micro-RNA) have demonstrated to be specifically elevatedin testicular germinal tumors. However, its clincalbenefit, as well as its standardization is currently underinvestigation., Conclusions: Classic biomarkers AFP, β-HCG,and LDH are of some utility confirming the diagnosisif they are elevated. However, its limited sensibility isnot enough to rely the diagnosis on themselves. Thereare promising results with Micro-RNA but its daily usedoes not seem imminent.