e present a 75-year-old male patient with the following medical history: Bilateral inguinal herniorrhaphy, hypertension, gastroesophageal reflux, and Stage III-A immunoglobulin G (IgG) kappa multiple myeloma with advanced bone disease. He attended the urology hospital consultation by request from Primary Healthcare Unit due to an increase in the size of the right testicle for 1 month.Physical examination revealed right scrotum with double size of the left, hard consistency testis with no pain on palpation, and normal left testicle. The patient had not had fever or previous trauma and neither had associated voiding symptoms.Testicular ultrasound reported the presence of a normal left testicle, heterogeneous 35 × 22 × 52 mm right testis with decreased echogenicity, increased vascularization, no nodular lesions, and more hypoechoic and vascularized solid area that was located in the most caudal part of the testicle and surrounded it laterally, being about 55 mm thick. Both of the epididymis were normal and mild bilateral hydrocele was observed.With the diagnostic of testicular tumor, blood tests were performed with tumor markers that were within normality (alpha-fetoprotein 0.72 IU/ml and beta-human chorionic gonadotropin 2 IU/l). The thoracoabdominal computed tomography scan showed the absence of extratesticular disease and the presence of multiple bone involvement in relation to his history of multiple myeloma.With a correct preoperative study, a right inguinal orchiectomy was performed. The patient was discharged after 24 h.The pathological anatomy study revealed the following findings. The right orchiectomy specimen of 10 × 6 × 4.5 cm length and weighing 131.20 g [Figure 1]. On section, smoothwalled cystic tunica vaginalis was observed and testis was
e present a 47-year-old male with no known drug allergies. His pathological history included left inguinal herniorrhaphy, circumcision, and sinusitis. He went to the urology outpatient clinic to request a vasectomy, being father of a child. In the anamnesis, he commented that on occasions, he had had enuresis. The vasectomy surgical technique and possible side effects were explained and he understood and accepted it.On the other hand, and due to the presence of enuresis, we decided to perform the following complementary tests.Blood test: Normal (glomerular filtration rate >90 ml/min, prostate-specific antigen 0.59 ngr/ml, and total testosterone 13.2 nmol/l). Basic urine test: Normal. Urine culture: Negative.
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