Segmental infarction of the testis: an exceptional complication of diabetes microangiopathy

Abstract

We report a case of segmental infarction of the testis in a 55-year-old man. Past medical history included 12 years of type II diabetes and hypertension. The patient presented with a 2-month history of testicular pain and was found clinically and sonographically to have a testicular tumour. The pathological examination of the partial orchiectomy specimen revealed segmental infarction of the testicle secondary to diabetes microangiopathy. We propose diabetes microangiopathy as a localization and aetiology of segmental testicular infarction. A possible testicular sparing procedure through an inguinal approach may be considered in cases of testicular masses for which the clinical and imaging findings are suggestive of focal testicular infarction.

Segmental Testicular Infarction: Partial Orchiectomy in a Very Rare Pathology

“…The treatment of small intratesticular lesions is controversial, since most authors choose radical orchiectomy for suspected neoplasm [3]; however, in cases where tumor markers are normal, well-circumscribed and small lesions are present on ultrasound, our group is in agreement with other authors in the need for partial orchiectomy and organ-preserving surgery [1,2]. …”

“…Global infarction of the testis is relatively frequent due to known causes of testicular torsion, incarcerated hernia, trauma and others [2]; however, the segmental infarction is very rare with fewer than 50 cases being gathered up to 2003 [4]. The etiology of partial infarction is varis and some cases are classified as idiopathic, especially in young patients who show no pathology or risk factors.…”

“…Color Doppler ultrasound is a test of easy access and quick use in the emergency department in case of acute scrotal pain. This imaging test is the initial one in scrotal pathology [1,2,3,4]. A recent study has shown that the performance of contrast-enhanced ultrasound improves sensitivity and specificity of color Doppler ultrasound in cases of acute scrotal pain.…”

Reversal of Diastolic Blood Flow in the Testis of a Patient With Impending Infarction Due to Epididymitis

“…8 Testicular infarction is frequently seen in torsion of the spermatic cord and less so in epididymo-orchitis. As a rare complication, it has been reported in cases of herniorrhaphy and varicocelectomy, 9 diabetes mellitus, 10 Wegener granulomatosis, 11 trauma, 12 sickle cell disease, 13 polyarteritis nodosa, 14 and protein S deficiency. 15 Infarction can be complete or segmental.…”

Segmental Testicular Infarction

“…Case reports have described it in relation to epididymoorchitis, trauma, sickle cell disease, polycythemia, hypersensitivity angitis, intimal fibroplasia of the testicular artery, and as a complication of recent surgery. [1][2][3][4][5] Most cases, however, have no clear etiology and are considered idiopathic. 6 Scrotal pain is the predominant presenting symptom.…”