Zinner syndrome (ZS) is a rare disorder that affects only men. It is characterized by a triad of abnormalities, including unilateral renal agenesis, ipsilateral seminal vesicle cysts, and atresia of the ejaculatory tract. Unfortunately, there is no consensus on the best treatment modality. We describe a case of a young male patient with recurrent epididymitis, dysuria, and frequent urination. In the diagnostic evaluation, we found an extended right seminal vesicle in the ultrasound with hyperechoic fluid inside and an absence of the right kidney. We performed magnetic resonance imaging, computed tomography, and semen analysis confirming Zinner syndrome and deteriorated semen parameters. Urethroscopic evaluation and ultrasound-guided puncture of the seminal vesicle were performed. An abscess was excluded. The cytologic evaluation showed hemosiderophages. Tamsulosin was introduced. We found no signs of relapse in a six-month observation, and the patient had no further symptoms. Therefore, minimally invasive treatment is a feasible option in young patients found with early-stage Zinner syndrome.
Adrenal incidentaloma (AI) is an asymptomatic mass localized in the adrenal gland, usually detected during diagnostic imaging performed due to other health issues than the suspected adrenal disease. It occurs in 2% of adults and 0,2% of children. Pediatric AI may cause many difficulties in the diagnostic processes. Neuroblastoma is one of the most common malignant tumors in children. Usually, it is localized in the medulla of the adrenal gland. Many patients do not have any symptoms, but some may present with fever, weariness, weight loss, pain, enlarging mass, etc. The majority of cases are high- risk and the survival rate is less than 50%. The diagnostic protocol consists of laboratory tests and radiological imagining. Treatment depends on the risk group that the patient is assigned to. Pheochromocytoma is a rare catecholamine-secreting tumor in children originating in the adrenal medulla. Most pediatric patients present with sustained hypertension. 60% of pheochromocytoma cases are sporadic. The surgical removal of the tumor through adrenalectomy is a standard procedure. To the group of pediatric adrenocortical tumors (ACT), benign adrenocortical adenoma (ACA) and malignant adrenocortical carcinoma (ACC) are included. ACA is found in only 20% of cases of ACT. Most of the patients present with signs of virilization, Cushing Syndrome, or both. The 5-years survival rate of ACC in the pediatric population is 46-55%. An adrenal incidentaloma is an unpredictable and possibly dangerous disorder in the pediatric population. Due to the rarity of the finding and their variety, there is not much data and clear recommendations about AI management. Doctors need to know about the prevalence of different types of adrenal tumors in the pediatric population based on age.
Introduction and purpose Polycystic Ovary Syndrome(PCOS) is one of the most common endocrinological disorders, and it affects 7-8 % of women globally. It is very heterogenous disease, which pathogenesis is complex and composed of many factors like genetics, hormonal changes, environmental factors and insulin resistance. PCOS has many symptoms, which appearance is dependent on comorbidities like obesity, diabetes mellitus, hypercholesterolemia. Due to complexity of the pathogenesis of PCOS it may have four phenotypes: A,B,C,D. The pregnancy pathologies connected to PCOS are mainly gestational diabetes mellitus, pregnancy induced hypertension. Pregnant women with PCOS have 3-4 times a higher risk of developing pregnancy induced hypertension (PIH) and preeclampsia and a three times higher risk of gestational diabetes mellitus (GDM). More than 64% of pregnancies in women with PCOS were terminated via caesarean section. Metformin, although still controversial may be a good option for the treatment of PCOS before and during pregnancy as a second-line therapy. PCOS is a disease which affects the women in childbearing age and may have negative impact on its course. Pathologies connected to PCOS during pregnancy affect not only mothers, but foetus and according to new researches also children and adults from mothers with PCOS. It is very essential to extract women with PCOS to implement treatment and prevent its complications. Moreover, due to its common association with obesity patients should be under cardiologists care due to higher cardiovascular risk.
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