Segmental testicular infarction due to cholesterol embolism: Not the first case, but the first report

Adachi, Shiro; Tsutahara, Kohichi; Kinoshita, Tatsuya; Hatano, Koji; Kinouchi, Toshio; Kobayashi, Masao; Inoue, Hitoshi; Takada, Tsuyoshi; Hara, Tsuneo; Yamaguchi, Seiji

doi:10.1111/j.1440-1827.2008.02304.x

Cited by 13 publications

(17 citation statements)

References 39 publications

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“…Although thrombi formation itself is similar to usual atherothrombotic emboli, which implies cholesterol embolism characterized by atheromatous debris with cholesterin deposition and macrophage in a variety of organs from atherosclerotic plaque, 15 the difference between the present case and atherothrombotic emboli is considered to be the distribution of the thrombus and the clinical course. Usually, atherosclerotic emboli due to aortic aneurysm occur in kidney, spleen, gastrointestinal tract, and leg skin.…”

Section: Discussionmentioning

confidence: 70%

Heparin‐induced thrombocytopenia with multiple organized thrombi accompanied by unusual cholesterin deposition: Autopsy case after long‐term follow up

Ichinoe¹,

Mikami²,

Ujiie

et al. 2009

Pathology International

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Heparin-induced thrombocytopenia (HIT) is characterized by a reduction in the platelet count and systemic thromboembolism during heparin therapy. Herein is reported a case of HIT with characteristic thrombus formation. A 68-year-old man who had been treated for hypertension for 27 years suffered a brain infarction and was treated with heparin. After this treatment, other new infarctions occurred in multiple organs. Because serum antibodies against heparin/PF4 complex were detected, he was diagnosed as having HIT, and warfarin and argatroban were administered instead of heparin. He died, however, 119 days after the first onset. At autopsy infarction due to organized thrombi with cholesterin deposition in multiple organs were found, similar to usual atherosclerotic emboli, but different to them with regard to clinical course and distribution of thrombi. This case in which organization and frequent cholesterin deposition were found in thromboembolized lesions of multiple organs after relatively long-term follow up, is unusual. The findings suggest that HIT accompanied by marked hypercholesterolemia of long duration contributes to a characteristic form of thromboembolism that needs careful management.

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Section: Discussionmentioning

confidence: 70%

Heparin‐induced thrombocytopenia with multiple organized thrombi accompanied by unusual cholesterin deposition: Autopsy case after long‐term follow up

Ichinoe¹,

Mikami²,

Ujiie

et al. 2009

Pathology International

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“…Therefore some authors recommend testicular exploration and biopsy when a patient presents with an indistinct lesion [14]. Ruibal et al .…”

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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“…Some cases were described as being associated with protein S deficiency (Lee et al. , 2001), cholesterol embolism (Adachi et al. , 2008) or nonbacterial thrombotic endocarditis in Wegener’s granulomatosis (Paik et al.…”

Section: Discussionmentioning

confidence: 99%

“…, 1999). The cases lacking known cause have been reported as idiopathic segmental testicular infarction (Adachi et al. , 2008).…”

Section: Discussionmentioning

confidence: 99%