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Tsitouridis I, Maskalidis C, Panagiotidou D, Kariki EP. Eleven patients with testicular leydig cell tumors: clinical, imaging, and pathologic correlation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1855-1864. [PMID: 25253834 DOI: 10.7863/ultra.33.10.1855] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We present the sonographic and magnetic resonance imaging findings of Leydig cell tumors in a series of patients, along with a brief review of the literature. We evaluated the sonographic features of 11 cases of Leydig cell tumors, including echogenicity, size, margins, and patterns of vascularity. The magnetic resonance imaging characteristics of 9 patients were also assessed, with special attention to the appearance of the tumors on T2-weighted imaging and postcontrast T1-weighted imaging. Seven tumors were hypoechoic, and 4 were almost isoechoic. Ten patients showed various patterns of hypervascularity in the tumors, combined in some cases with feeding vessels. One case presented with a single feeding vessel. The tumors showed homogeneous or heterogeneous low signal intensity on T2-weighted imaging and marked enhancement on postcontrast T1-weighted imaging. The small size of these tumors, the various patterns of vascularity on color and power Doppler sonography, and the marked enhancement on postcontrast T1-weighted imaging are considered valuable but generally nonspecific for identification of these tumors.
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Affiliation(s)
- Ioannis Tsitouridis
- Department of Radiology, Papageorgiou General Hospital, Thessaloniki, Greece
| | | | | | - Eleni P Kariki
- Department of Radiology, Papageorgiou General Hospital, Thessaloniki, Greece
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2
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Eilts BE, Pechman RD. B-mode ultrasound observations of bull testes during breeding soundness examinations. Theriogenology 2009; 30:1169-75. [PMID: 17087906 DOI: 10.1016/0093-691x(88)90292-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/1988] [Accepted: 10/07/1988] [Indexed: 11/29/2022]
Abstract
The testes of 78 adult Beefmaster bulls (13 to > 31 mo old) were scanned with a 5 MHz, linear array portable ultrasound unit during routine breeding soundness examinations. Videotape recordings were used to measure mediastinum testis width and fluid width between visceral and parietal tunics (fluid width), and to count the number of fibrotic foci. Ultrasound results were compared to breeding soundness score parameters, which included total score, age classification, and percentage of primary and secondary sperm abnormalities. The overall mean mediastinum testis width and fluid width were 0.33 cm +/- 0.133 and 0.10 cm +/- 0.13, respectively; 15 testes had 1-8 fibrotic foci. There were no significant differences in mediastinum testis width and fluid width between left and right testes when compared by breeding soundness score classification or by age classification. There were no significant differences in mediastinum testis width, fluid width, breeding soundness score, or primary or secondary sperm abnormalities in bulls with fibrotic foci compared to bulls without fibrotic foci. There appears to be no significant information that routine testicular ultrasound examination adds to accepted breeding soundness evaluations performed on the same day.
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Affiliation(s)
- B E Eilts
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
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3
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Acar C, Gurocak S, Sozen S. Current Treatment of Testicular Sex Cord-stromal Tumors: Critical Review. Urology 2009; 73:1165-71. [DOI: 10.1016/j.urology.2008.10.036] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 09/19/2008] [Accepted: 10/17/2008] [Indexed: 11/25/2022]
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4
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Abstract
Ultrasound is a vital adjunct to clinical examination in diagnosing scrotal disease, as a number of different processes may present similarly. Potential applications range from the acute emergency to long-term screening as well as cases in which a distinct scrotal abnormality may or may not be palpable. Differentiating acute epididymitis/epididymoorchitis from testicular torsion is possible sonographically, thereby guiding appropriate medical or surgical management. Distinguishing between cystic, solid, or complex scrotal masses is readily performed with this modality. It clearly depicts simple versus complex hydroceles and determines the presence of underlying testicular or epididymal disease. Not only is ultrasound the best imaging modality for longitudinal screening in patients (testicular microlithiasis, cryptorchidism) at risk for testicular tumors, it also provides valuable information in the infertile male by documenting the presence or absence of a varicocele.
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Affiliation(s)
- Monica Smith Pearl
- Department of Radiology, The George Washington University Hospital, Washington, DC 20037, USA
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Conkey DS, Howard GCW, Grigor KM, McLaren DB, Kerr GR. Testicular Sex Cord–Stromal Tumours: The Edinburgh Experience 1988–2002, and a Review of the Literature. Clin Oncol (R Coll Radiol) 2005; 17:322-7. [PMID: 16097561 DOI: 10.1016/j.clon.2005.04.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS Sex cord-stromal tumours of the testis are uncommon tumours, accounting for around 5% of testicular neoplasms. Treatment is primarily surgical, with no adjuvant therapy of proven benefit. We present a single-centre experience over a period of 15 years. MATERIALS AND METHODS From 1988 to 2002, 18 patients with a diagnosis of sex cord-stromal tumour were referred to our centre. A retrospective analysis of their case notes was made and a pathological review undertaken. RESULTS Sixteen were Leydig-cell tumours and two were Sertoli cell. For the Leydig-cell tumours, the median age at presentation was 42 years, 50% presented with a testicular mass and 31% with gynaecomastia. Two patients followed a malignant course: one revealing disease dissemination at initial staging, and a second 12 months after potentially curative orchidectomy. Salvage retroperitoneal lymphadenectomy in the latter patient proved unsuccessful. Clinical outcome correlated strongly with the presence of adverse pathological features described previously in the literature. After a median follow-up of 46 months, two patients have developed progressive disease, and two patients have died, one of metastatic Leydig-cell tumour. No patient defined as being of low malignant potential on pathological examination has relapsed outside our review period of 2 years. CONCLUSION We confirm the overall excellent prognosis for most of the patients with sex cord-stromal tumours of the testis. Compared with most previous reports, pathological features seem to predict with reasonable accuracy the risk of malignant behaviour, and can adequately inform the subsequent review policy.
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Affiliation(s)
- D S Conkey
- Urological Oncology Section, Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
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6
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Maizlin ZV, Belenky A, Kunichezky M, Sandbank J, Strauss S. Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:959-964. [PMID: 15292565 DOI: 10.7863/jum.2004.23.7.959] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To determine the gray scale and color Doppler sonographic features of Leydig cell tumors of the testis in a series of patients. METHODS We retrospectively analyzed the sonographic appearance of 10 proven Leydig cell tumors in 9 patients aged 26 to 47 years. Sonographic features that were reviewed included the size and echogenicity of the tumors, presence of cystic areas or calcifications, and distribution pattern of detectable blood flow on color or power Doppler imaging. RESULTS The tumors ranged from 0.4 to 3.0 cm in diameter, but most were less than 1.0 cm in diameter. In 1 testis, 2 discrete Leydig cell tumors were found. Nine (90%) of the 10 tumors were homogeneously hypoechoic. Only 1 tumor was isoechoic with the testis. None of the tumors contained calcifications. Of 8 tumors with color Doppler imaging, 7 (88%) showed a characteristic pattern of increased peripheral blood flow, which was either circumferential or punctate. Only 1 tumor was found with internal hypervascularity. CONCLUSIONS Peripheral hypervascularity in a hypoechoic testicular tumor that has little or no internal color Doppler flow should suggest the possibility of a Leydig cell tumor, and consideration should be given to testicle-sparing surgery.
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Affiliation(s)
- Zeev V Maizlin
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
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7
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Fernández GC, Tardáguila F, Rivas C, Trinidad C, Pesqueira D, Zungri E, San Miguel P. MRI in the diagnosis of testicular Leydig cell tumour. Br J Radiol 2004; 77:521-4. [PMID: 15151977 DOI: 10.1259/bjr/31653779] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We report the appearance of three cases of Leydig cell tumours on MRI. This imaging method showed well-defined and peripheral intratesticular tumours displaying marked and homogeneous enhancement when contrast medium was used. This latter finding was only observed in Leydig cell tumours when they were compared in a series of 104 patients with different scrotal pathologies.
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Affiliation(s)
- G C Fernández
- Department of Radiology, Povisa Medical Centre, Salamanca St. 5, 36211 Vigo (Pontevedra), Spain
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8
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Rich MA, Keating MA. Leydig cell tumors and tumors associated with congenital adrenal hyperplasia. Urol Clin North Am 2000; 27:519-28, x. [PMID: 10985151 DOI: 10.1016/s0094-0143(05)70099-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Testicular cancers occur at a rate of 2 cases per 100,000 males. Gonadal stromal tumors, including Leydig cell tumors and tumors of the adrenogenital syndrome, account for 1% to 3% of these neoplasms. Despite their rarity, these hormone-producing tumors are particularly interesting because of their potential for causing endocrinologic manifestations in prepubertal and adult males. They are also clinically significant, and early identification is critical to avoid profound and often irreversible developmental changes in affected children. An accurate diagnosis is important to differentiate tumors that will respond to medical management from tumors that require definitive surgical therapy.
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Affiliation(s)
- M A Rich
- Department of Pediatric Urology, Nemours Children's Clinic, Orlando, Florida, USA
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Abstract
Most testicular masses are germ cell malignancies and require radical orchiectomy. There are other causes of testicular masses, however, some of which have characteristic imaging and clinical features. A presumptive diagnosis may be possible for some of these atypical testicular masses. This may result in testis-preserving surgery or nonoperative management.
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Affiliation(s)
- F V Coakley
- Department of Radiology, University of California San Francisco, USA
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10
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Dempsey TJ, Brooks JP. Malignant gonadal stromal tumor: sonographic findings with pathologic correlation. JOURNAL OF CLINICAL ULTRASOUND : JCU 1994; 22:408-411. [PMID: 8071461 DOI: 10.1002/jcu.1870220610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- T J Dempsey
- Department of Radiology, Veteran's Administration Medical Center, Memphis, Tennessee 38104
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11
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Horstman WG, Haluszka MM, Burkhard TK. Management of testicular masses incidentally discovered by ultrasound. J Urol 1994; 151:1263-5. [PMID: 8158772 DOI: 10.1016/s0022-5347(17)35227-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Incidental nonpalpable testicular masses were discovered in 9 patients during approximately 1,600 scrotal ultrasound examinations done for other indications. Of the 9 lesions 7 (78%) were benign (4 Leydig cell tumors, 2 Sertoli cell tumors and 1 interstitial fibrosis) and 2 (22%) were malignant (1 teratocarcinoma and 1 seminoma). Five lesions (55%) were less than 1 cm (4 benign and 1 malignant), while 4 (45%) were 1 to 2 cm (3 benign and 1 malignant). Seven lesions (78%) were hypoechoic, 1 (11%) was hyperechoic and 1 (11%) was cystic. We conclude that incidentally discovered nonpalpable lesions are usually benign. Management should include inguinal exploration with frozen section diagnosis. The testis can be spared if the lesion is benign. Ultrasound followup should be used only if there is a strong clinical suspicion of a nonneoplastic lesion, such as recent trauma or infection. It is suggested that nonpalpable tumors discovered in patients with metastatic germ cell tumor should be treated as malignant.
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Affiliation(s)
- W G Horstman
- Department of Radiology, Naval Medical Center San Diego, California 92134-5000
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12
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Affiliation(s)
- J E Langer
- Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104
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13
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Abstract
As testicular ultrasound has evolved, nonpalpable masses have been detected for which an evaluation and treatment protocol has not been established. Our experience with nonpalpable testis masses detected only by ultrasound in 5 patients is presented, with all patients found to have nonmalignant lesions. We recommend that such cases with negative serum tumor markers and normal chest radiographs be followed with serial ultrasounds. Benign masses will resolve completely, while stable or enlarging masses can be locally excised and inguinal orchiectomy completed only if cancer is found by frozen section. A modified staging system to follow these patients is proposed to determine these patients' prognoses: Stage Ia for inguinally removed nonpalpable cancers, Stage Ib for excised nonpalpable cancers without orchiectomy (false-negative frozen section), and Stage Ic for inguinally removed palpable cancers.
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Affiliation(s)
- D Corrie
- Urology Service, Walson Army Community Hospital, Fort Dix, New Jersey
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14
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Avery GR, Peakman DJ, Young JR. Unusual hyperechoic ultrasound appearance of testicular Leydig cell tumour. Clin Radiol 1991; 43:260-1. [PMID: 2025998 DOI: 10.1016/s0009-9260(05)80251-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Patients with a testicular mass are usually investigated by ultrasound and the ultrasound appearances have been correlated with the histology. The authors describe two patients with Leydig cell tumours. The first had bilateral tumours which although histologically typical of Leydig cell tumours, had differing ultrasound appearances, one with a previously unreported hyperechoic appearance. The second patient had an impalpable tumour with similar ultrasound appearances to those previously described. The paper illustrates the difficulty of giving an accurate diagnosis of solid testicular lesions and also shows that the previously described appearance of Leydig cell tumour is not pathognomonic.
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Affiliation(s)
- G R Avery
- Department of Radiology, Queen Elizabeth Hospital, Gateshead, Tyne & Wear
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15
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Haas GP, Pittaluga S, Gomella L, Travis WD, Sherins RJ, Doppman JL, Linehan WM, Robertson C. Clinically occult Leydig cell tumor presenting with gynecomastia. J Urol 1989; 142:1325-7. [PMID: 2810523 DOI: 10.1016/s0022-5347(17)39077-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
An occult Leydig cell tumor is described in a patient who presented with gynecomastia. Diagnosis was established by means of testicular ultrasonography and selective testicular venous sampling. The pathophysiology and management of this rare disease entity are discussed.
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Affiliation(s)
- G P Haas
- Urologic Oncology Section, National Cancer Institute, Bethesda, Maryland
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16
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Abstract
We present a case study of a patient with seminoma who had normal testicles on palpation. Testicular ultrasound is the technique of choice to locate occult nonpalpable testis lesions. We recommend its use in the search for the source of any retroperitoneal mass of undetermined origin.
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Affiliation(s)
- D J Weaver
- Department of Surgery, University of Missouri, Columbia
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17
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Mellor SG, McCutchan JD. Gynaecomastia and occult Leydig cell tumour of the testis. BRITISH JOURNAL OF UROLOGY 1989; 63:420-2. [PMID: 2653559 DOI: 10.1111/j.1464-410x.1989.tb05230.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Two patients with Leydig cell tumours of the testis are described. Both presented with gynaecomastia, but on initial examination had apparently normal testes. The causative tumour did not become obvious for some months, despite being carefully sought. Review of the literature suggests that gynaecomastia preceding a readily palpable tumour is a recognised problem. The detection and management of Leydig cell tumours of the testis are discussed.
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Affiliation(s)
- S G Mellor
- Department of Surgery, Cambridge Military Hospital, Aldershot
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18
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Buckspan MB, Klotz PG, Goldfinger M, Stoll S, Fernandes B. Intraoperative ultrasound in the conservative resection of testicular neoplasms. J Urol 1989; 141:326-7. [PMID: 2643723 DOI: 10.1016/s0022-5347(17)40756-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In a series of approximately 400 patients investigated for oligospermia 4 had small testicular tumors demonstrated by high resolution real-time ultrasound. The lesions ranged in size from 3 to 6 mm., were clinically impalpable and were demonstrated on repeated sonograms. Exploration was done in all 4 patients with the aid of intraoperative high resolution ultrasound. This procedure allowed for conservative resection of the tumor with preservation of the testicle. The pathological diagnosis in all cases was benign Leydig cell tumor.
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Affiliation(s)
- M B Buckspan
- Department of Urology, Mount Sinai Hospital, Toronto, Ontario, Canada
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19
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O'Donovan JJ, Terry TR, Williams G. Occult Leydig cell testicular tumour presenting with gynaecomastia. J R Soc Med 1989; 82:49-50. [PMID: 2926746 PMCID: PMC1291968 DOI: 10.1177/014107688908200122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- J J O'Donovan
- Department of Urology, Charing Cross Hospital Medical School, London
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20
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Conway GS, MacConnell T, Wells G, Slater SD. Importance of scrotal ultrasonography in gynaecomastia. BMJ (CLINICAL RESEARCH ED.) 1988; 297:1176-7. [PMID: 3144337 PMCID: PMC1834975 DOI: 10.1136/bmj.297.6657.1176] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- G S Conway
- Endocrine Unit, Cobbold Laboratories, Middlesex Hospital, London
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21
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Kromann-Andersen B, Hansen LB, Larsen PN, Lawetz K, Lynge P, Lysen D, Nielsen SP, Stockholm KH, Foged P. Clinical versus ultrasonographic evaluation of scrotal disorders. BRITISH JOURNAL OF UROLOGY 1988; 61:350-3. [PMID: 3289677 DOI: 10.1111/j.1464-410x.1988.tb13973.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Clinical and ultrasonographic examinations of scrotal disorders were compared in 166 patients in order to determine their ability to distinguish between those diseases requiring surgery and those requiring clinical follow-up only. Ultrasound examinations were efficient in discriminating between normal and pathological findings. Extra-testicular lesions were readily differentiated from testicular ones. Although both clinical and ultrasonographic examinations had high sensitivity (90%) in detecting testicular cancer, the number of false positive findings was smaller after ultrasound examination. This gave a predictive value of a positive test of 53% after ultrasound examination but only 33% after clinical examination. Ultrasound examination may, therefore, reduce the number of surgical explorations in the scrotum and should be performed in patients with suspected testicular pathology based on history and palpatory findings.
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22
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Glavind K, Søndergaard G. Leydig cell tumour: diagnosis and treatment. Case report and review. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1988; 22:343-5. [PMID: 3238343 DOI: 10.3109/00365598809180811] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A case of unilateral Leydig cell tumour in the testis with associated gynecomastia is reported. New methods of diagnosis and treatment are reviewed.
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Affiliation(s)
- K Glavind
- Department of Urology, Aalborg Sygehus Nord, Denmark
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23
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Kuhn JM, Mahoudeau JA, Billaud L, Joly J, Rieu M, Gancel A, Archambeaud-Mouveroux F, Steg A, Luton JP. Evaluation of diagnostic criteria for Leydig cell tumours in adult men revealed by gynaecomastia. Clin Endocrinol (Oxf) 1987; 26:407-16. [PMID: 3308189 DOI: 10.1111/j.1365-2265.1987.tb00797.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Gynaecomastia caused by Leydig cell tumours (LCT) in adult men may appear a long time before clinical evidence of testicular swelling. To evaluate the diagnostic criteria for LCT, hormonal status was studied in 14 cases and compared with results of a control group (CG) and 10 men with idiopathic gynaecomastia (IG). The mean plasma T level was significantly (P less than 0.005) lower in LCT (16.7 +/- 1.7 SEM nmol/l) than in CG (23.0 +/- 1.3 nmol/l). However, individual plasma T levels were in the normal range in 9/14 LCT. The mean plasma E2 level was significantly (P less than 0.001) higher in LCT (204.9 +/- 27.6 pmol/l) than in CG (87.9 +/- 7.7 pmol/l). However, individual plasma E2 levels were in the normal range in 5/14 LCT. In LCT, neither means of basal gonadotrophin levels nor the gonadotrophin responses to LHRH were different from CG. The mean of the plasma T responses to hCG did not differ between LTC, CG and IG. However the mean of E2 peak responses appeared significantly (P less than 0.005) higher in LCT (735.3 +/- 103.4 pmol/l) than in CG (420.5 +/- 40.4 pmol/l). The mean of the E2 peak responses was significantly (P less than 0.001) lower in IG (196.5 +/- 33.4 pmol/l) than in CG. Likewise the mean of plasma E2 levels, measured on day three following hCG administration, remained significantly (P less than 0.001) higher in LCT (662 +/- 94 pmol/l) than either in CG (228 +/- 14 pmol/l) or in IG (158 +/- 25 pmol/l). On day 3 following hCG administration, there was no overlap in individual plasma E2 levels between either LCT and CG or LCT and IG. In all LCT, plasma beta-hCG levels were in the normal range. A testicular echogram, performed in 12 LCT, confirmed the presence of a palpable tumour in 10 and revealed an occult tumour in two cases. We conclude that normal plasma beta-hCG levels, a prolonged plasma E2 response to hCG and testicular echogram appear to be the best criteria for early diagnosis of LCT responsible for gynaecomastia in adult men.
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Affiliation(s)
- J M Kuhn
- Centre de Recherches Endocrinologiques, hôpital Cochin, Paris, France
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24
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Corrie D, Norbeck JC, Thompson IM, Rodriguez F, Teague JL, Rounder JB, Spence CR. Ultrasound detection of bilateral Leydig cell tumors in palpable normal testes. J Urol 1987; 137:747-8. [PMID: 3550153 DOI: 10.1016/s0022-5347(17)44201-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We report a case of synchronous, nonpalpable, bilateral Leydig cell tumors that were detected only by ultrasound evaluation and gonadal vein sampling for estradiol. A review of the diagnostic and management options for Leydig cell tumors is presented.
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25
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Pechman RD, Eilts BE. B-mode ultrasonography of the bull testicle. Theriogenology 1987; 27:431-41. [PMID: 16726248 DOI: 10.1016/0093-691x(87)90231-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/1986] [Accepted: 12/02/1986] [Indexed: 11/17/2022]
Abstract
The scrotum and testicles from 20 bulls aged 6 mo to 10 yr were obtained from a slaughterhouse and ultrasonically scanned to determine the normal echographic anatomy Ultrasonically, the normal bull testicle was homogeneous and moderately echogenic. The mediastinum testis was a linear structure in the center of the testicle and was slightly more echogenic than the parenchyma. The head and tail of the epididymis were easily identified on all testicles, but the epididymal body and ductus deferens were difficult to identify consistently. Ultrasound scanning of the testicles may prove to be a valuable noninvasive diagnostic technique for evaluating testicular diseases in bulls.
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Affiliation(s)
- R D Pechman
- Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge, LA 70803 USA
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26
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Scott RF, Bayliss AP, Calder JF, Garvie WH. Indications for ultrasound in the evaluation of the pathological scrotum. BRITISH JOURNAL OF UROLOGY 1986; 58:178-82. [PMID: 3516298 DOI: 10.1111/j.1464-410x.1986.tb09022.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Scrotal ultrasound scans carried out on 156 patients were reviewed in a retrospective study and the sonographic findings and indications evaluated. Ultrasound was able accurately to distinguish the normal from the pathological scrotum. Extratesticular lesions were readily differentiated from testicular lesions. Abnormal testicular echo patterns were usually associated with tumours, but orchitis, granulomas and haematomas were found to have a similar appearance. Occult testicular tumours could readily be identified. Ultrasound was also useful in excluding underlying pathology in hydroceles, in the diagnosis and follow-up of epididymitis and other epididymal lesions and in the assessment of underlying testicular damage in traumatic haematoceles. Ultrasound may also be useful in post-orchiectomy follow-up examinations to exclude tumour in the contralateral testis.
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27
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Scrotal Ultrasound. Radiol Clin North Am 1985. [DOI: 10.1016/s0033-8389(22)02386-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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