[睾丸横向异位伴偶发性睾丸肿瘤,症状性睾丸扭转时发现]。

Richi Okusue, Koki Maeda, Yuri Mori, Wataru Sato, Yoshimasa Harada
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引用次数: 0

摘要

横向睾丸异位是一种睾丸穿过中线并通过对侧腹股沟管下降的情况,两个睾丸位于同一阴囊隔室。据报道,在睾丸无法触及的人群中,约有2%的人患有此病。大多数横向睾丸异位症患者在儿童早期接受睾丸切除术;然而,在极少数情况下,他们在成年后被诊断为睾丸肿瘤。一位40岁的男子到我们医院就诊,抱怨右腹部疼痛。他的右睾丸在右阴囊中可触及;然而,左侧阴囊隔室似乎是空的,右侧阴囊隔室的上部有一个疼痛的肿块。计算机断层扫描显示,两条精索都穿过右腹股沟管,诊断为横向睾丸异位。超声检查显示右阴囊上部左侧睾丸循环缺失。在诊断为左睾丸扭转后,进行了紧急手术。在右阴囊中,有一个正常的右睾丸和一个坏死的左睾丸,左睾丸在其轴线上向头侧扭曲了180度。切除的左睾丸的组织病理学显示有一个偶发的精原细胞瘤pT1。手术后的肿瘤标志物为阴性,在两年零五个月的随访中没有观察到复发的证据。无法感觉到的睾丸扭转也可能是横向睾丸异位。因此,有必要根据患者的年龄来考虑恶性肿瘤。
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[TRANSVERSE TESTICULAR ECTOPIA WITH INCIDENTAL TESTICULAR TUMOR, DISCOVERED UPON SYMPTOMATIC TESTICULAR TORSION].

Transverse testicular ectopia is a condition in which a testicle crosses the midline and descends through the contralateral inguinal canal, with both testes in the same scrotal compartment. It is reported to be present in about 2% of persons who present with non-palpable testicles. Most transverse testicular ectopia patients undergo orchiopexy in early childhood; however, in rare cases, they are diagnosed in adulthood upon detection of testicular tumors.A 40-year-old man visited our hospital complaining of right abdominal pain. His right testis was palpable in the right scrotum; however, the left scrotal compartment seemed empty and there was a painful mass on the upper part of the right scrotal compartment. Computed tomography showed that both spermatic cords traversed through the right inguinal canal, and transverse testicular ectopia was diagnosed. Ultrasonography showed absent left testicular circulation on the upper part of the right scrotum. Upon diagnosis of left testicular torsion, emergency surgery was conducted. In the right scrotum, there was a normal right testicle, and a necrotic left testicle which was twisted 180 degrees on its axis, towards the cranial side. Histopathology of the excised left testicle revealed an incidental seminoma, pT1. Tumor markers following surgery were negative, and there was no evidence of recurrence observed with two years and five months of follow-up.Non-palpable testicular torsion may also be a transverse testicular ectopia. Therefore, it is necessary to consider malignant tumors based on the patient's age.

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