Segmental Testicular Infarction: Conservative Management is Feasible and Safe

Madaan, Sanjeev; Joniau, Steven; Klockaerts, Katrien; Dewever, Liesbeth; Lerut, Evelyne; Oyen, Raymond; Poppel, Hendrik Van

doi:10.1016/j.eururo.2007.03.061

Cited by 45 publications

(41 citation statements)

References 12 publications

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“…Its etiology is not always well defined, and it may be, at first, clinically mistaken for a testicular tumour [153, 154]. Common causes for testicular infarction are torsion of the spermatic cord, incarcerated hernia, infection, trauma, and vasculitis [131].…”

Section: Testicular Infarctionmentioning

confidence: 99%

Sickling Cells, Cyclic Nucleotides, and Protein Kinases: The Pathophysiology of Urogenital Disorders in Sickle Cell Anemia

Claudino

Fertrin

2012

Anemia

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Sickle cell anemia is one of the best studied inherited diseases, and despite being caused by a single point mutation in theHBBgene, multiple pleiotropic effects of the abnormal hemoglobin S production range from vaso-occlusive crisis, stroke, and pulmonary hypertension to osteonecrosis and leg ulcers. Urogenital function is not spared, and although priapism is most frequently remembered, other related clinical manifestations have been described, such as nocturia, enuresis, increased frequence of lower urinary tract infections, urinary incontinence, hypogonadism, and testicular infarction. Studies on sickle cell vaso-occlusion and priapism using bothin vitroandin vivomodels have shed light on the pathogenesis of some of these events. The authors review what is known about the deleterious effects of sickling on the genitourinary tract and how the role of cyclic nucleotides signaling and protein kinases may help understand the pathophysiology underlying these manifestations and develop novel therapies in the setting of urogenital disorders in sickle cell disease.

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Section: Testicular Infarctionmentioning

confidence: 99%

Sickling Cells, Cyclic Nucleotides, and Protein Kinases: The Pathophysiology of Urogenital Disorders in Sickle Cell Anemia

Claudino

Fertrin

2012

Anemia

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“…presenting the ultrasounds of 19 cases of segmental testicular infarction showed a hypoechoic lesion in 74%, mixed echogenicity in 21%, and a hyperechoic lesion in 5% of the cases [8]. The lesions were described as being wedge-shaped, rounded, or consisting of multiple foci with absent or low blood flow [8]. …”

Section: Discussionmentioning

confidence: 99%

Segmental testicular infarction: a case report

Smets

Reichman²,

Michielsen³

2017

J Med Case Reports

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BackgroundSegmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment.Case presentationWe report a clinical case of a 36-year-old white man who presented at our emergency department with subacute testicular pain. A urine analysis, Doppler ultrasound, surgical exploration, blood analysis, and magnetic resonance imaging were performed to diagnose his condition, to exclude a testicular torsion, and to raise confidence in its non-malignancy. He was treated conservatively. At follow-up, a few months after the incident, he no longer had complaints. Ultrasonography showed remaining hypo-echogenicity of the left upper pole, indicating a sequel of ischemia.ConclusionsSegmental testicular infarction is a rare condition which can be easily confused with a testicular torsion or a testicular tumor. This case report can be helpful in recognizing and diagnosing this condition. Making the right diagnosis is important since it can prevent an unnecessary radical treatment.

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“…In spite of accessible image modalities, the diagnosis of segmental testicular infarction is controversial. The radiological and pathological correlation is suboptimal in most cases, and the final diagnosis is established by performing orchiectomy (11,12).…”

Section: Discussionmentioning

confidence: 99%

A Rare Case: Segmental Testicular Infarction

Karabulut¹,

Yılmaz²,

Koç³

et al. 2017

Istanbul Med J

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IntroductionTesticular infarction is usually observed globally, and its most common causative factor is testicular torsion. Testicular adnexa, acute epididymitis, and epididymo-orchitis can be included in the differential diagnosis. Strangulated inguinal hernia, segmental testicular infarction, testicular tumor, and idiopathic scrotal edema are among the rarer causes of acute scrotum. Global infarction is a diagnosis of urologic emergency. Segmental testicular infarction is a rare case, and it is seen in the second and fourth decades of life. Although its clinical symptom is similar to testicular torsion in the beginning, late acute stages and radiological images can be mixed with testicular tumors. Therefore, it may result in radical intervention. In the early period, it is observed as a heterogeneous hypoechoic focus with an unclear margin. Infection, trauma, tumors, bleeding, iatrogenic causes, and torsion are responsible for its etiology (1). In our study, we aimed to present the case of a patient in whom we conducted partial orchiectomy due to the presence of testicular mass lesion and whose pathology result was indicative of segmental testicular infarction. Case ReportA 32-year-old male patient applied our clinic due to left testicular pain. No pathology could be detected in his scrotal examination. It was learned from his anamnesis that he had undergone left varicocelectomy a year ago, and his pain had begun afterward; it was also learned that he was infertile. The results of requested laboratory analyses were normal. A 18×15-mm mass lesion inside the left testis without hypoechoic heterogeneous internal blood supply was observed on performing scrotal Doppler ultrasonography (GE Healthcare®; USA) and the right testis was observed to be normal. A 2-cm mass lesion not displaying apparent contrast enhancement in T2 sequences was observed when pelvic magnetic resonance imaging (MRI) (Siemens® Germany) in the patient with a pre-diagnosis of testicular tumor (Figure 1). No pathological lymph node was observed. Tumor marker levels were normal (lactic acid dehydrogenase : 98 U/L, alpha-fetoprotein: 1.92 ng/mL, and serum beta human chorionic gonadotropin: <1.2 mIU/mL). He was found to have oligospermia based on his spermiogram.A decision of perform partial orchiectomy was made as there was no blood supply and contrast enhancement, his tumor marker levels were normal, he was infertile, and his tumor burden was below 30%. Informed consent was obtained from the patient. The layers were opened via a inguinal incision under general anesthesia. The testicle was passed through, and the tunica vaginalis and albuginea were opened. The lesion described in the radiological images was palpated in the testicle. It was opened (Figure 2) and removed after excising it from the surrounding tissues (Figure 3). Biopsies were taken from around the lesion. The defect that occurred was primarily closed (Figure 4). The patient was discharged without A Rare Case: Segmental Testicular Infarction Bu çalışmada nadir rastlanan segmental enfa...

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Segmental Testicular Infarction: Conservative Management is Feasible and Safe

Cited by 45 publications

References 12 publications

Sickling Cells, Cyclic Nucleotides, and Protein Kinases: The Pathophysiology of Urogenital Disorders in Sickle Cell Anemia

Sickling Cells, Cyclic Nucleotides, and Protein Kinases: The Pathophysiology of Urogenital Disorders in Sickle Cell Anemia

Segmental testicular infarction: a case report

A Rare Case: Segmental Testicular Infarction

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