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PubMed1988

[Epidermoid cyst of the scrotum: report of a case].

A 61-year-old male visited our hospital with the chief complaint of a mass in the right scrotum on October 4, 1985. Under the diagnosis of intrascrotal tumor, the mass was resected surgically. It was a subcutaneous tumor, and had no relation to any intrascrotal organ, such as testis, epididymis or spermatic cord. The mass was 7 x 6 x 5 cm. Pathological diagnosis was epidermoid cyst of the scrotum. Epidermoid cyst of the scrotum is a rare disease and only 7 cases have been reported in Japan.

Epidermal Cyst↗
PubMed1988

The acute scrotum.

In boys and adolescents, the acute scrotum usually results from one of three diseases: torsion of the spermatic cord, torsion of the appendix testis, or epididymitis. A rapid diagnosis of torsion of the cord, if present, is essential, and as soon as this diagnosis is made, arrangements must be made for timely surgical correction. Although a diagnosis for the acute scrotum in this age group can sometimes be made on the basis of the history, pathognomonic signs, and basic laboratory analysis of the urine and a urethral discharge, in the usual case diagnosis requires a Doppler ultrasound examination (which if positive for torsion makes the diagnosis), a radionuclide scan (for cases negative or indeterminate for torsion on the Doppler examination), or, as a last resort, scrotal exploration. In men, by far the most common cause of the acute scrotum is epididymitis, with the torsions being much less common. In heterosexual young men with epididymitis, N. gonorrhoeae and C. trachomatis are the most likely etiologic organisms; in homosexual men and older men (and boys), E. coli, Pseudomonas sp., and the gram-positive cocci are the most common pathogens. Ceftriaxone plus tetracycline is the initial antimicrobial regimen of choice in heterosexual young men; in the absence of evidence of a sexually transmitted pathogen, one of the antimicrobials effective against common urinary tract pathogens is the initial antimicrobial of choice in all other patients. When torsion of the cord is suspected in adult male patients, the Doppler examination and the radionuclide scan (if the Doppler is negative or indeterminate) can again make the diagnosis or rule it out.

Acute Disease↗
PubMed1985

The acutely painful scrotum in children: review of 113 consecutive cases.

A young boy who presents with an acutely painful scrotum can be a diagnostic challenge to his physician. It is important to differentiate the various causes of this symptom and to institute prompt management. Failure to do so could jeopardize the patient's future fertility. In a review of 113 consecutive cases of a painful scrotum at a children's hospital, torsion of the testicle was found in 51 patients (45%). Torsion of the appendix testis was found in 40 patients (35%) and acute epididymitis, once considered rare in children, was diagnosed in 17 (15%). The importance of prompt diagnosis of torsion is emphasized. The clinical diagnosis of the acutely painful scrotum is notoriously difficult, and in this series of cases surgical exploration was required in 92%. Only 2 of the 17 cases of epididymitis were associated with a bacterial urinary tract infection.

Adolescent↗
PubMed1982

The effect of long-term HCG or TP administration on reproductive functions in adult male rabbits. I. Histomorphological changes in the scrotum.

The effect of long-term treatment with various doses of HCG or TP on the scrotum was studied in 36 adult rabbits of pure Bouscat breed. The epidermis of the scrotum exhibited a more significant dose-related increase in thickness in animals injected with TP than those treated with HCG. The hair follicles in animals injected with higher doses of HCG or TP were thicker in diameter and extended deeper within the dermis where they curved to grow parallel to the surface of the skin. The high dose of HCG was more effective in demonstrating higher glandular activity than that seen in rabbits treated with high doses of TP. The vascularization in the scrotum was more prominent in rabbits treated with higher doses of HCG. The fibers of the Tunica dartos were much thicker in animals treated with high doses of HCG or TP.

Animals↗
PubMedDate not supplied

[Acute scrotum in childhood: considerations on 457 cases].

The Authors present their experience about 457 consecutive cases of acute scrotum, occurring from 1980 to 1990, at their Pediatric Surgery Unit. The condition is caused by torsion of the appendage of the testis (78.1%), torsion of the funicle (9.6%), acute idiopathic oedema of the scrotum (2.87%), and also tumours (1.17%). Also in their experience, the surgical approach is the correct treatment for the acute scrotum in order to prevent the irreversible damage of the testis. The surgical treatment present no problem and all the post-operatives were uneventful. In children under 2 years, the interventions were performed by inguinal incision, above 2 years by scrotal incision. The contralateral orchiopexy, in case of torsion of the funicle, was performed in the same session, or performed later, because of the anesthetic consideration.

Acute Disease↗
PubMed1997

Accessory scrotum with imperforate anus.

Accessory scrotum is the rarest anomaly of the scrotum; less than two dozen cases have been reported. A case of accessory scrotum with imperforate anus is reported.

Anus, Imperforate↗
PubMed2002

Localised necrosis of scrotum (Fournier's gangrene) in a spinal cord injury patient - a case report.

BACKGROUND: Men with spinal cord injury (SCI) appear to have a greater incidence of bacterial colonisation of genital skin as compared to neurologically normal controls. We report a male patient with paraplegia who developed rapidly progressive infection of scrotal skin, which resulted in localised necrosis of scrotum (Fournier's gangrene). CASE PRESENTATION: This male patient developed paraplegia at T-8 level 21 years ago at the age of fifteen years. He has been managing his bladder by wearing a penile sheath. He noticed redness and swelling on the right side of the scrotum, which rapidly progressed to become a black patch. A wound swab yielded growth of methicillin-resistant Staphylococcus aureus (MRSA). Necrotic tissue was excised. Culture of excised tissue grew MRSA. A follow-up wound swab yielded growth of MRSA and mixed anaerobes. The wound was treated with regular application of povidone-iodine spray. He made good progress, with the wound healing gradually. CONCLUSION: It is likely that the presence of a condom catheter, increased skin moisture in the scrotum due to urine leakage, compromised personal hygiene, a neurogenic bowel and subtle dysfunction of the immune system contributed to colonisation, and then rapidly progressive infection in this patient. We believe that spinal cord injury patients and their carers should be made aware of possible increased susceptibility of SCI patients to opportunistic infections of the skin. Increased awareness will facilitate prompt recourse to medical advice, when early signs of infection are present.

Adult↗
PubMed1997

Accessory scrotum with imperforate anus

Accessory scrotum is the rarest anomaly of the scrotum; less than two dozen cases have been reported. A case of accessory scrotum with imperforate anus is reported.

Journal Article↗
PubMed1996

Ultrasound in the assessment of the acute scrotum.

Color Doppler imaging (CDI) has become the study of choice in evaluation of the scrotum due to technological advances resulting in superior resolution and sensitive Doppler systems. CDI has become particularly helpful in evaluating the scrotum in the setting of acute disorders, such as torsion of the spermatic cord, epididymal and testicular inflammation, and scrotal trauma. CDI should be the study of choice to evaluate for torsion of the spermatic cord and demonstrates a high degree of accuracy. CDI in such a setting, however, does require operator experience, sensitive Doppler ultrasound equipment, and operator knowledge of the limitations of CDI. With epididymitis or epididymo-orchitis, CDI has proven to be quite helpful in evaluating the scrotal contents for the presence of inflammation and associated complications. In scrotal trauma, CDI's utility remains somewhat controversial, but with further investigation its appropriate application in this situation may become clear.

Acute Disease↗
PubMed1978

Leiomyosarcoma of the scrotum: a case report with electron microscopy.

A case of leiomyosarcoma of the scrotum is presented. The tumor measured 3 X 2.5 X 2 cm and had been present as a slowly enlarging mass in the right scrotum for three months prior to excision. Light microscopy demonstrated the typical interlacing fasicles of neoplastic cells with eccentric cigar-shaped nuclei and electron microscopy confirmed the neoplastic cells to be of smooth muscle origin. A review of the world's literature revealed this to be the fifth reported case of leimyosarcoma confined to the scrotal wall.

Adult↗
PubMed1989

Paget's disease primarily involving the scrotum.

Three cases of Paget's disease primarily involving the scrotum are reported. One case exhibited positive staining for prostate specific antigen (PSA) and was associated with an underlying, invasive poorly differentiated adenocarcinoma of unknown primary. The other cases were not associated with any underlying or visceral malignancy. The literature on Paget's disease primarily involving the scrotum including clinical presentation, differential diagnosis, treatment, prognosis, and possible histogenetic mechanisms of this disease is discussed.

Adenocarcinoma↗
PubMed2004

A rare case of primary malignant melanoma of the scrotum diagnosed by fine-needle aspiration.

We report a case of a 55-yr-old man with malignant melanoma of scrotum. He was referred to our Hospital with a complaint of gradual focal enlargement of the scrotum in a period of 3 yr. On physical examination, a pigmented, poorly marginated mass, with central necrosis was observed. A fine-needle aspiration (FNA) of the lesion was performed. Cytological examination revealed highly cellular smears, containing malignant cells, dispersed or arranged in loose aggregates. Cellular morphology and characteristics were identical to those of malignant melanoma arising elsewhere in the skin. The immunocytochemical study revealed positivity of neoplastic cells for anti-melanoma monoclonal antibody (HMB-45) antigen. Histological confirmation finally was provided after wide excision of the lesion. We emphasize the difficulties in differential diagnosis considerations and diagnostic pitfalls of scrotal lesions.

Biopsy, Fine-Needle↗
PubMed1987

Ultrasonography of the acute scrotum.

The acute scrotum remains a difficult clinical challenge because of numerous etiologies including inflammatory processes, testicular torsions, traumas, and tumors that can justify early surgery. Ultrasound study appears to be the imaging modality of choice to confirm the clinical assessment. We reviewed 825 scrotal scans performed with high-resolution scanners; 283 were considered pathologic and classified as follows: 27 tumors (9.5%), 21 traumas including torsions (7.4%), 142 infectious diseases (50.1%), 99 dystrophic diseases (29.2%), and 16 miscellaneous (5.6%). Acute scrotal pain was the only symptom in 83 cases (29.3%). In this paper, we emphasize the different roles of ultrasound depending on the initial clinical presentation, which determines the clinician's questions. In the typical cases, ultrasound has a major role in the prognosis, as it allows evaluation of the severity of the lesions. On the other hand, in atypical cases, ultrasound has a decisive role in planning the management, which will be immediate surgery when sonographic findings highly suspicious for testicular torsion or acute ischemia of the testis are found. Based on our experience, we believe that ultrasound is a highly reliable modality for guiding medical or surgical treatment of an acute scrotum.

Acute Disease↗
PubMedDate not supplied

High-resolution ultrasonography in the diagnosis of scrotal pathology: I. Normal scrotum and benign disease.

Ultrasonography is a readily accessible imaging modality. It is relatively inexpensive, is noninvasive, and requires no ionizing radiation or previous preparation. For these reasons, ultrasonography is the examination of choice in the study of the scrotum and its contents. We present a review of the pathology of the scrotum and its contents. For that, we cite multiple sources of the current medical literature and illustrate them with cases performed at the University of California Davis Medical Center during the last 2.5 years. Due to the extent of the pathology in consideration, we have divided it in two parts. This article deals with normal ultrasonography anatomy, technique, epididymal and testicular cysts, scrotal calcifications, acute and chronic inflammatory disease, testicular torsion, scrotal trauma, varicocele, undescended testis, and miscellaneous conditions.

Genital Diseases, Male↗
PubMed1991

Thermoregulation of the scrotum and testis: studies in animals and significance for man.

This article reviews the extensive information available from experiments on animals concerning the thermal monitoring provided by the scrotum. Cutaneous temperature receptors initiate responses which follow unique pathways and undergo "switching" processing within the central nervous system. These pathways evoke reflex responses which are subject to control from receptors in other regions of the body, including the skin and temperature sensitive neurones in the brain and spinal cord. The local thermoregulatory responses of the scrotum, e.g., sweating and vasomotor changes, clearly have a role to play in the protection of the testis against temperature elevation in both man and animals. It is as yet more difficult to propose how general reflex responses may be of benefit in the protection of spermatogenesis against heat damage. This meeting should provide the stimulus for further work. The need is urgent since it may also provide a means to apply this knowledge to a better understanding of male infertility and possibly to speed the development of male methods of fertility regulation.

Animals↗
PubMed1996

Aggressive angiomyxoma occurring in the scrotum: report of a case.

The authors recently treated a case of aggressive angiomyxoma occurring in the left scrotum. A 61-year-old Japanese man was diagnosed as having an inguinal irreducible hernia that descended to the bottom of the scrotum preoperatively. However, during the operation a large tumor was found between the spermatic fascia and the skin pressing the testis upward. The tumor measured 20 x 15 x 15 cm, was yellowish with a smooth surface encapsulated by a membrane similar to the pleura, and the cut surface was gelatinous. The histological findings indicated that the tumor had thick-walled vessels which had prominently increased in size, delicately waved collagen fibers, and stromal cells in a myxoid background. The patient has remained recurrence-free as of 11 months after surgery.

Capillaries↗
PubMed2003

Perineal accessory scrotum.

A boy with perineal accessory scrotum but without any other congenital anomaly is being described. He presented with a rugose skin tag on a midline perineal mound and the diagnosis could be confirmed by the histological findings of subcutaneous smooth muscles. Other reports of perineal scrota have been reviewed and a simple classification has been proposed for such cases, based on the appearance of the accessory scrotum and the associated anomalies.

Humans↗