Context: - Testicular germ cell tumors with lymphovascular invasion (LVI) are staged pT2, and those with spermatic cord involvement are staged pT3.
Objective: - To study the clinical significance of LVI within the spermatic cord without direct involvement of the cord soft tissues.
Design: - A retrospective, multi-institutional review was performed on testicular GCTs with spermatic cord LVI in the absence of cord soft tissue invasion.
Results: - Forty-four germ cell tumors had LVI in the spermatic cord without soft tissue invasion; 37 of 44 patients (84%) had nonseminomatous germ cell tumors (NSGCT), and 7 (16%) had pure seminomas. Patients with NSGCTs and spermatic cord LVI had worse clinical outcomes compared with patients with pure seminoma and spermatic cord LVI (P = .008). We then compared patients with NSGCTs and spermatic cord LVI (n = 37) to patients with NSGCTs and LVI limited to the testis (n = 32). A significantly greater percentage of patients with LVI in the spermatic cord presented with advanced clinical stage (76% versus 50%; P = .01). There was no statistically significant difference in disease recurrence/progression or death between patients with spermatic cord LVI and patients with LVI limited to the testis (P = .40; P = .50). There was no significant difference in the presence of embryonal dominant histology (P = .30) or rete testis invasion (P = .50) between the 2 groups. More hilar soft tissue invasion was seen in patients with LVI present in the spermatic cord (P = .004).
Conclusions: - In patients with NSGCTs, LVI in the spermatic cord, without soft tissue invasion, is associated with worse clinical stage at presentation compared with patients with LVI confined to the testis.
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http://dx.doi.org/10.5858/arpa.2016-0226-OA | DOI Listing |
Cureus
December 2024
Surgery, Morsani College of Medicine, University of South Florida, Tampa, USA.
Introduction: We report a novel approach to open inguinal hernia repair in patients with known ascites in which the cord, hernia sac, and attached testicle on the affected side are repositioned into the retroperitoneum through the inguinal ring. By avoiding invasion of the peritoneum and limiting dissection of the sac off the spermatic cord, the risk of ascites leak and testicular ischemia is theoretically decreased.
Methodology: This is a retrospective case series report.
Histopathology
January 2025
Department of Diagnostic and Molecular Pathology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Aims: Extragonadal yolk sac tumour (YST) is rare, and may present a diagnostic challenge. YST differentiation was recently reported in some somatically derived tumours in the sinonasal location and in the female genital tract, together with a SMARCB1/INI1 loss. We report two paratesticular/inguinal tumours with striking morphological and immunohistochemical similarities with YST, further expanding the spectrum of extragonadal tumours with YST-like morphology and SMARCB1/INI1 loss.
View Article and Find Full Text PDFJ Nippon Med Sch
January 2025
Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School Hospital.
The reliable engraftment of skin grafts into areas with complex shapes can be challenging. Here, we report a case of successful fixation of a genital skin graft using negative pressure wound therapy (NPWT) with RENASYS Cotton Filler. A 44-year-old male with no relevant medical history underwent split-thickness skin grafting for a genital skin defect caused by Fournier's gangrene.
View Article and Find Full Text PDFRev Int Androl
December 2024
Department of Sports Science, College of Education, Zhejiang University, 310058 Hangzhou, Zhejiang, China.
Background: Testicular torsion-detorsion damage is a common ischemia-reperfusion injury brought on by an excess of reactive oxygen species. Reactive oxygen species may affect cellular differentiation by regulating gene expression. The gene expression in the testis is essential for spermatogenesis.
View Article and Find Full Text PDFSci Rep
December 2024
Department of Neurosciences, Biomedicine and Movement Sciences, Biochemistry Section, University of Verona, Verona, Italy.
Undescended testis and testicular torsion represent two frequent andrological diseases that affect the pediatric age. Despite these testicular disorders having different causes, they both negatively influence fertility in adulthood mainly due to the accumulation of reactive oxygen species (ROS), which represents the primary molecular damage underlying their long-term effects. The gold standard of treatment for both pathologies is surgery; however, it cannot guarantee an optimal fertility outcome in all clinical cases, underscoring the need to identify effective adjuvant therapies that may target the augmented ROS levels.
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