Tumor del saco vitelino de testículo en pediatria: presentación de un caso / Yolk sac tumor of the testis in pediatrics: a case report

Los tumores del saco vitelino (TSV) representan los tumores de células germinales (TCG) testiculares malignos más frecuentes en la edad pediátrica. Dicha neoplasia se ha visto vinculados con factores de riesgo tales como criptorquidia, antecedentes familiares, disgenesia gonadal y microlitiasis testicular. En general, se presentan como masas testiculares asintomáticas, por lo que comúnmente los padres o los médicos de atención primaria son los primeros en identificarlas. Los TSV característicamente son productores de alfa feto proteína (AFP), por lo que este se considera el marcador serológico más importante, para el diagnóstico y el seguimiento posterior al tratamiento. El ultrasonido escrotal se considera la herramienta diagnóstica más importante para la caracterización de las masas testiculares por lo general los tumores del saco vitelino se presentan como masas sólidas, hipervasculares. La mayoría de los pacientes se presentan inicialmente con enfermedad estadío I, siendo la orquiectomía radical la única terapia requerida en esta fase. Caso clínico: Niño de 1 año y 11 meses presenta masa de consistencia dura, indolora en el testículo izquierdo identificada por la madre, al ultrasonido testicular muestra masa sólida, homogénea hipervascularizada asociado a adenopatías inguinales y retroperitoneales. El único marcador tumoral elevado fue Alfafetoproteina. Se le realiza orquiectomía izquierda radical con evolución postquirúrgica satisfactoria, se confirma el diagnóstico por anatomía patológica e inmunohistoquímica; Tumor de células germinales, no seminomatoso de saco vitelino prepuberal.

Yolk sac tumors (SVT) represent the most frequent malignant testicular germ cell tumors (GCT) in the pediatric age. This neoplasm has been linked to risk factors such as cryptorchidism, family history, gonadal dysgenesis and testicular microlithiasis. They generally present as asymptomatic testicular masses, so parents or primary care physicians are often the first to identify them. SVT are characteristically producers of alpha feto protein (AFP), which is why this is considered the most important serological marker for diagnosis and follow-up after treatment. Scrotal ultrasound is considered the most important diagnostic tool for characterizing testicular masses. Yolk sac tumors generally present as solid, hypervascular masses. Most patients initially present with stage I disease, with radical orchiectomy being the only therapy required in this phase. Clinical case: A 1-year-oid and 11-month-old boy presented with a hard, painless mass in the left testicle identified by the mother. Testicular ultrasound shows a solid, homogeneous hypervascularized mass associated with inguinal and retroperitoneal lymphadenopathies. The only elevated tumor marker was Alpha-fetoprotein. A radical left orchiectomy was performed with satisfactory post-surgical evolution, the diagnosis was confirmed by pathological anatomy and immunohistochemistry; Nonseminomatous germ cell tumor of the prepubertal yolk sac.

Seminoma mixto testicular / Mixed Testicular Seminoma

Introducción: El cáncer de testículo es una neoplasia rara a pesar de ser el tumor sólido más frecuente en hombres de 15 a 35 años de edad. Objetivo: Describir la presentación de un caso atendido en el Hospital General de Cienfuegos. Caso clínico: Se trata de un varón de 21 años sin factores de riesgo, que acude con masa escrotal, ginecomastia y adenopatías, los exámenes complementarios demostraron un seminoma clásico con áreas de anaplásico y una diseminación notable que lo clasifica como estadio III. Conclusiones: La mortalidad por cáncer de testículo es en gran medida prevenible, el examen físico constituye la piedra angular del diagnóstico precoz, es imprescindible tener presente su posibilidad diagnóstica sobre todo en adultos jóvenes. A pesar de la disminución de la letalidad por esta enfermedad, el diagnóstico tardío y en etapas avanzadas, como en este caso, ensombrecen el pronóstico(AU)

Introduction: Testicular cancer is a rare neoplasm, despite being the most frequent solid tumor in men aged 15-35 years. Objective: To describe the case of a patient who received attention at the General Hospital of Cienfuegos. Clinical case: This is the case of a 21-year-old man without risk factors who presents with a scrotal mass, gynecomastia and adenopathies. The complementary texts showed a classic seminoma with anaplastic areas and notable spread, which allowed to classify it as a stage-III neoplasm. Conclusions: Mortality from testicular cancer is largely preventable. The physical examination is the cornerstone of early diagnosis. It is essential to bear in mind its diagnostic possibility, particularly in young adults. Despite the decrease in mortality from this disease, late diagnosis or in advanced stages, as in this case, hides prognosis(AU)

Metástase de seminoma em região orbital em cão - relato de caso / Metastatic seminoma in the orbital region in a dog - case report

O seminoma é uma neoformação testicular originária de células germinativas de ocorrência comum em cães, com maior prevalência em animais senis. Em geral, o comportamento biológico do seminoma canino é benigno. Relata-se neste trabalho um caso de seminoma com metástase em região orbital em um cão com 14 anos de idade. O animal foi atendido com queixa de aumento de volume em órbita esquerda, com posterior detecção de nódulo testicular. A punção aspirativa por agulha fina da massa orbital sugeriu tratar-se de linfoma de alto grau, contudo o diagnóstico definitivo de seminoma difuso foi estabelecido pela avaliação histopatológica, a qual revelou tratar-se de neoplasia maligna pouco diferenciada, sendo o diagnóstico de seminoma difuso confirmado pelo exame imunoistoquímico. Relatos de seminomas metastáticos em cães são incomuns. Objetivou-se com este trabalho relatar um caso de seminoma anaplásico difuso em cão cujo foco principal de metástase ocorreu em região orbital, além de descrever e discutir as dificuldades diagnósticas encontradas.(AU)

Seminoma is a testicular neoformation originating from germ cells, commonly occurring in dogs. With higher prevalence in senile animals, the biological behavior of canine seminomas generally benign. This case reports seminoma with mestastasis in the orbital region in a 14-year-old dog. The animal was treated with a complaint of increased volume in the left orbit, and later a nodule in the testicle was discovered. Fine-needle aspiration of the orbit mass initially indicated a high-grade lymphoma. The definitive diagnosis of diffused seminoma was established by histopathological examination, resulting in poorly differentiated malignant neoplasia. Finally, the diagnosis was confirmed through immunohistochemistry, being the result compatible with diffused seminoma. Metastatic seminomas reported in dogs are quite uncommon. In this work we report a case of diffused anaplastic seminoma in dogs, where the main focus of metastasis was observed in the orbital region, and we also describe and discuss the difficulties encountered in the diagnostic.(AU)

Tumor de células de sertoli esclerosante. Reporte de un caso / Sclerosing sertoli cell tumor. Case report

RESUMEN El tumor esclerosante de células de Sertoli del testículo es una entidad patológica infrecuente, con todo, que solo se han descrito 22 casos en la literatura científica. Son descritos como tumores unilaterales que en su mayoría se presentan entre la tercera y sexta década de vida, siendo carentes de malignidad, sin embargo, en ninguno de los casos reportados se han realizado seguimientos por periodos prolongados. Se presenta un caso clínico cuyo objetivo es socializar el primer caso de tumor esclerosante de células de Sertoli (SSCT), diagnosticado por el departamento de patología de la Universidad industrial de Santander, que se registra en Colombia. Después de tres años de seguimiento clínico el paciente no presenta recidiva, así como tampoco otras lesiones tumorales. Se considera la orquiectomia el tratamiento curativo.(AU)

SUMMARY Sclerosing tumor of Sertoli cells of the testis is an infrequent pathological entity, only 22 cases have been described in the scientific literature. They are described as unilateral tumors that mostly occur between the third and sixth decade of life, being devoid of malignancy, however, in none of the cases have been followed for prolonged periods. We present a clinical case whose objective is to socialize the first case of Sertoli cell sclerosing tumor (SSCT), diagnosed by the pathology department of the industrial university of Santander, which is registered in Colombia. After three years of clinical follow-up, the patient does not present recurrence, as well as other tumor lesions. Orchiectomy is considered the curative treatment.(AU)

Criptorquidia: desde la embriología al tratamiento / Cryptorchidism: from embryology to treatment

La criptorquidia es la anomalía genital más común en el recién nacido varón y a pesar de que su evaluación y tratamiento han progresado con las décadas, siguen existiendo muchas controversias al respecto. En todo niño, el examen físico genital debe buscar la presencia de las gónadas en el escroto, en su ausencia, debe tratar de distinguirse si la anomalía es unilateral o bilateral, definiéndose con la mayor precisión posible la posición de estas y distinguiéndose entre testículo criptórquido, ectópico y retráctil junto con la valoración de la existencia de tejido testicular funcional a través de estudios hormonales. El tratamiento puede ser hormonal o quirúrgico, este último no se recomienda antes del año de edad además corresponde a la terapia más exitosa para reubicar el testículo en el escroto en aquellos pacientes con gónadas en posición inguinal alta, abdominal o en posición ectópica, o en aquellos en los que la terapia hormonal ha fallado. Por otro lado, la terapia hormonal se recomienda en mayor medida cuando las gónadas están en posición inguinal media, baja o escrotal alta. El tratamiento apunta a reducir, aunque no siempre logra evitar los posibles problemas a largo plazo de infertilidad y cáncer de testículo. MÉD UIS. 2015;28(3):371-80.

Cryptorchidism is the most frequent genital anomaly in the newborn male. Although significant progress has been made in the assessment and treatment of cryptorchidism, several controversies still exist. In every boy, the physical examination should seek the presence of the gonads in the scrotum. Otherwise, it should be made clear whether cryptorchidism is unilateral or bilateral, the position of the gonad should be defined as precisely as possible, distinguishing between cryptorchidism, ectopia and retractile testes. Hormonal laboratory studies help assessing the existence of functional testicular tissue. Treatment may be hormonal or surgical. The latter is not recommended before the age of 1 year. Surgery has the highest rates of success in patients with gonads in high inguinal, abdominal or ectopic position, or when hormonal treatment has failed. Hormonal treatment may be successful in patients with gonads in low inguinal or high scrotal position. Treatment aims to reduce, although it does not always avoids, the risks of infertility and of testicular cancer in the long term. MÉD UIS. 2015;28(3):371-80.

Sertolioma unilateral como causa de morte súbita por hemorragia interna em ganso Anser cygnoides / Unilateral Sertolioma as a cause of sudden death by internal bleeding in a Anser cygnoides goose

Um ganso adulto macho (Anser cygnoides), da família Anseriformes, de idade desconhecida, proveniente de uma criação da Universidade Luterana do Brasil, foi encontrado morto, sem apresentar histórico clínico, e foi submetido à investigação post mortem no Setor de Patologia Veterinária do Hospital Veterinário. Com base nos achados de necropsia e no exame histopatológico, definiu-se como causa da morte do animal hemorragia interna em razão da ruptura de vasos sanguíneos em uma neoplasia no testículo direito (sertolioma), com metástase no fígado...

An adult male goose (Anser cygnoides) of unknown age, raised at the Lutheran University of Brazil, was found dead without showing clinical history and was submitted for post mortem investigation in the Department of Pathology of the Veterinary Hospital. From the necropsy and histopathological findings, the cause of death was defined as exsanguination due to intestinal hemorrhage from ruptured vessels in a tumor in the right testis, which also presented hepatic metastasis...

Significado de la sexualidad en adultos jóvenes sometidos a quimioterapia por neoplasia testicular / Meaning of sexuality in young adults undergoing chemotherapy for testicular neoplasm

El cáncer es una enfermedad que provoca un fenómeno social y humano muy importante; así, el cáncer testicular es el tumor maligno más común en hombres entre los 15-35 años, siendo una de las neoplasias sólidas más curables. La presente investigación cualitativa descriptiva, con enfoque fenomenológico, pretende describir el significado que otorgan a su sexualidad seis adultos jóvenes que recibieron tratamiento con quimioterapia por cáncer testicular en la ciudad de Puerto Montt, de marzo a diciembre del 2010, respecto de su autoestima, relación de pareja y vida sexual. El análisis de datos se realizó utilizando el programa computacional Atlas Ti. Se observó que el significado que le otorga el adulto joven a su sexualidad está comprendido por la valoración propia y de su entorno, en función de la red de apoyo que cada uno tiene, donde la vida sexual sigue siendo importante, pero no trascendente ni primordial. La pareja es un aspecto que contribuye a la formación de un proyecto de vida y es en esa relación de pareja que la vida sexual se torna relevante. Por lo anterior, los efectos físicos ocasionados por el tratamiento, a pesar de las inevitables implicancias que conlleva, no condicionan la autoimagen, vida sexual ni la relación de pareja, lo que nos acerca a una gestión del cuidado, en estos pacientes, más integral e integradora, considerándolo un ser biopsicosocial en relación constante con el entorno.

Cancer is a disease that causes social and human phenomenon very important, so the testicular cancer is the most common malignancy in men aged 15-35 years, one of the most curable solid neoplasms. This qualitative, phenomenological approach to describe the meaning they assign to their sexuality six young adults treated with chemotherapy for testicular cancer in the city of Puerto Montt, from March to December 2010, on their self-esteem, relationship partner and sexual life. Data analysis was performed by using the computer program Atlas Ti. It was noted that the significance the young adult gives to sexuality is understood by the self assessment and its environment, depending on the network of support that each one has, where the sexual life remains important, but not transcendent or primary. The couple is a key contributing factor to the formation of a life plan and is in that relationship that sexual life becomes relevant. Therefore, the physical effects caused by treatment, despite the inevitable implications involved, do not influence the self-image, sex life or relationship, which brings us to a careful management of these patients in a more comprehensive and inclusive way, regarding a biopsychosocial being in constant contact with the environment.

Spleno-gonadal Fusion

Spleno-gonadal fusion is a rare malformation consisting of an abnormal connection between the spleen and the gonad. Spleno-gonadal fusion has been classified into two types: continuous and discontinuous. The majority of the cases present as a scrotal mass, scrotal tenderness and for suspicion of testicular pathology. Some are incidental findings at the time of herniotomy or orchiodopexy. About 25% of the reported cases of continuous spleno-gonadal fusion have associated anomalies. None of these anomalies has been reported in the discontinuous spleno-gonadal fusion. An incidental case of discontinuous spleno-gonadal fusion in a three year old boy after a patent processus vaginalis ligation procedure is reported.

Prepubertal testicular tumors: Our 10 years experience.

Background: Testicular tumors in the pediatric population are distinct from those of the adults. In contrast to the prevalence data reported in tumor registries, several studies have shown that a majority of the prepubertal testis tumors are benign. We retrospectively analyzed a series of prepubertal testicular tumors. Materials and Methods: A retrospective review of all testicular tumors at our institution was done from Jan 1999 to Dec 2008. Data relating to presentation, evaluation, and management were collected. Results: A total of 22 children with prepubertal testicular tumors were identified. The mean age at presentation was 4.6 years. Mature teratoma, epidermoid cysts, immature teratoma, and yolk sac tumor accounted for 49.94%, 13.62%, 9.08%, and 18.16%, respectively. All surgeries were successful with respect to cancer control and testicular preservation. Conclusions: Benign tumors formed the majority (72.64%) of the tumors that were encountered, with yolk sac tumors (18.16%) being a minority. Testicular preserving surgery appears to be a feasible option for benign tumors and is safe and efficacious in long-term follow-up.

A Study on Apoptosis and Expression of Fas, bax and bcl-2 Proteins in Testicular Carcinoma / 中国医师杂志

Objective To explore the role of apoptosis and Fas, bax and bcl-2 proteins in the pathogenesis of testicular carcinoma. Methods Cell apoptosis was determined with TUNEL and flow cytometry, and the expression of Fas, bax and bcl-2 proteins were detected by cellular immunofluoresence technique in 56 cases of testicular carcinomas. Results Apoptotic index was closely correlated with the pathological type and lymph node metastasis of testicular carcinomas(P0.05). The apoptotic index was positively correlated with Fas and bax expression, and negatively correlated with bcl-2 expression (P