Seminoma in the Testis Presenting as Hemospermia

Beji, Sami; Hoejgaard, Martin; Lyngdorf, Peter

doi:10.1159/000343245

Cited by 5 publications

(3 citation statements)

References 6 publications

(6 reference statements)

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“…Benign prostatic hypertrophy and inflammatory diseases of prostate such as prostatitis may also cause hematospermia as well as rare diseases such as primary adenocarcinoma of the seminal vesicle [8]. In addition, it may be the initial symptom of testicular tumors [9]. Malignancies should be kept in mind in individuals, especially older than 40 years, suffering from recurrent hematospermia with other symptoms [10].…”

Section: Discussionmentioning

confidence: 99%

Unusual presentation of epidermoid cyst from testis in an aging male

Akan

Uruç

2019

The Aging Male

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Epidermoid cysts, which constitute 1% of all testicular tumors, are considered to be benign even though histogenesis is not clear. Patients usually suffer from painless scrotal mass or this mass is realized during the routine physical examination. Hematospermia may be a finding for both benign and malignant testicular tumors. Many authors advocate the testicular sparing surgery in the treatment but epidermoid cysts are usually treated with radical inguinal orchiectomy, because of the difficulties in the diagnosis, concurrence of the malignant tumors, and the debate on the histogenesis.

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Section: Discussionmentioning

confidence: 99%

Unusual presentation of epidermoid cyst from testis in an aging male

Akan

Uruç

2019

The Aging Male

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“…It is difficult to ascertain the true significance of this relationship and although rare, has been reported in other case reports. [9,10] One patient with concomitant hematuria had a diagnosis of G1pTa urothelial carcinoma of the bladder.…”

Section: Literature Reviewmentioning

confidence: 99%

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Satchi¹,

Katelaris²,

Smékal³

et al. 2022

Current Urology

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Background: Hematospermia, although often found to be a benign condition, can be an alarming sign. Consequently, patients can undergo multiple investigations with no current standardized pathway based on data from large series. The aim of this study was to evaluate the incidence of an underlying pathology and the value of diagnostic investigations performed in patients presenting with hematospermia. Materials and methods: A retrospective review of 393 consecutive men who underwent investigations for hematospermia was performed in a single tertiary center. Patient demographics, radiological and microbiological results were recorded together with symptoms of concomitant hematuria and clinical outcomes. Results: In this cohort, the overall prostate cancer detection rate was 5.3% and 7.2% in the ≥40 years group. One patient was diagnosed with testicular seminoma detected on scrotal ultrasound scan and one with G1pTa urothelial carcinoma of the bladder detected on flexible cystoscopy. In addition, 5.6% of patients were found to have a significant benign pathology for which intervention was proposed. A total of 288 patients underwent a transrectal ultrasound scan and 58.7% (n = 169) of these patients were found to have a positive finding. One hundred ten patients underwent a multiparametric magnetic resonance imaging and 73.6% (n = 81) had a positive finding. Conclusions: Apart from transrectal ultrasound and multiparametric magnetic resonance imaging, the remaining investigations have a low diagnostic yield. Prostate cancer detection was 5.3%; 7.2% in the ≥40 years group, and two further patients were diagnosed with testicular and bladder malignancy. Based on our results, we propose an algorithm for the management of hematospermia to limit unnecessary investigations with the majority requiring reassurance.

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“…In most cases, it is caused by inflammation of the prostate and seminal vesicles, but in a small percentage of men, it may be a manifestation of genitourinary malignancy, particularly prostate cancer or testicular cancer. 6,7 The current recommendations state that an initial investigation should include a focused history, clinical examination, digital rectal examination, serum prostate-specific antigen, urine cultures and screening for sexually transmitted diseases but not scrotal ultrasonography. 6 Recently, an algorithm for haematospermia put forth by the American Academy of Family Physicians recommended scrotal examination and ultrasonography to exclude infection and testicular cancer.…”

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confidence: 99%