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Introdução: a neoplasia testicular é pouco frequente e o cisto epidermoide é uma lesão benigna rara. A cirurgia poupadora de testículo deve ser realizada quando evidenciada essa lesão no exame de imagem. Relato do caso: homem de 31 anos, com nódulo indolor no testículo esquerdo. A ultrassonografia revelou nódulo de 3,2 cm, com margens irregulares e sinais de fluxo ao Doppler. Os marcadores tumorais eram normais. Realizou-se orquiectomia radical esquerda cujo anatomopatológico evidenciou achados compatíveis com cisto epidermoide. Considerações finais: melhorias nos exames de imagem auxiliarão na precisão diagnóstica para realização de tratamento menos agressivo para esse tipo de lesão.

Introduction: testicular neoplasia is uncommon, and epidermoid cysts are a rare benign lesion. Testis-sparing surgery should be performed upon preoperative diagnosis. Case report: 31-year-old man with a painless nodule in the left testicle. Ultrasonography revealed a 3.2cm nodule with irregular margins and signs of flow on Doppler. Tumor markers were normal. A left radical orchiectomy was performed, and the histological sections showed findings compatible with an epidermoid cyst. Final considerations: improvements in imaging exams will help with diagnostic accuracy to provide less aggressive treatment for this type of injury

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Objetivo: Los tumores testiculares prepuberales representan menos del 1% de los tumores. Suelen ser tumores de células germinales (teratomas benignos y tumores del saco vitelino) y quistes epidermoides (benignos). La orquiectomía parcial se considera el manejo estándar, permitiendo preservación de la función testicular, con baja tasa de recurrencia. El objetivo de este trabajo es caracterizar los tipos tumorales más frecuentes en la población de pacientes prepuberales con diagnóstico de masas testiculares. Método: Estudio observacional de tipo serie de casos de pacientes prepuberales con diagnóstico de masa testicular sometidos a orquiectomía radical, parcial o biopsia testicular, entre 2014 y 2020 en tres instituciones colombianas. Resultados: Se identificaron 21 pacientes; dos tenían antecedente de neoplasia linfoproliferativa. El tumor del saco vitelino se identificó como el tumor testicular más frecuente. Nueve fueron sometidos a orquiectomía parcial según los hallazgos de la biopsia por congelación. Tres pacientes recibieron quimioterapia adyuvante por el resultado histopatológico. La mediana de seguimiento fue de 26 meses. Un paciente requirió de linfadenectomía retroperitoneal y lobectomía por compromiso metastásico (actualmente libre de enfermedad); un paciente falleció por compromiso metastásico. Conclusiones: Identificamos el tumor del saco vitelino como el tumor testicular más frecuente. La biopsia por congelación constituye una herramienta confiable para el diagnóstico, que permite orientar el abordaje quirúrgico hacia un manejo conservador, pudiendo evitar la orquiectomía radical en pacientes prepuberales, preservando la estética, fertilidad y función hormonal a largo plazo.

Objective: Prepubertal testicular tumors represent less than 1% of tumors. These are usually germ cell tumors (benign teratomas and yolk sac tumors), and epidermoid cysts (benign). Partial orchiectomy is considered the standard management, allowing preservation of testicular function, with low recurrence rate. The aim of this study is to characterize the most frequent tumor types in the population of prepubertal patients diagnosed with testicular masses. Method: Observational case series study of prepubertal patients with diagnosis of testicular masses submitted to radical orchiectomy, partial or testicular biopsy, between 2014 and 2020 in three Colombian institutions. Results: Twenty-one patients were identified; two had a history of lymphoproliferative neoplasia. Yolk sac tumor was identified as the most frequent testicular tumor. Nine underwent partial orchiectomy based on freeze biopsy findings. Three patients received adjuvant chemotherapy based on histopathologic outcome. The median follow-up was 26 months. One patient required retroperitoneal lymphadenectomy and lobectomy for metastatic involvement (currently disease free); one patient died of metastatic involvement. Conclusions: We identified yolk sac tumor as the most frequent testicular tumor. Freezing biopsy is a reliable tool for diagnosis, which allows guiding the surgical approach towards a conservative management, avoiding radical orchiectomy in prepubertal patients, preserving aesthetics, fertility, and hormonal function in the long term

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The study "Oncological outcomes in non-seminomatous testicular tumors and residual mass after cisplatin-based chemotherapy" by Ocampo-Gómez et al., aims to describe the oncological outcomes of patients with clinical stages II and III non-seminomatous germ cell tumors (NSGCT) that developed residual masses (RMs) post-quimiotherapy and were treated with either retroperitoneal lymph node dissection (RPLND) or observation1. Their findings highlight the superiority RPLND over observation, with higher rates of progression-free survival (PFS) and overall survival, particularly in patients with stage II NSGCT

El estudio «Resultados oncológicos en tumores testiculares no seminomatosos y masa residual tras quimioterapia basada en cisplatino¼ de Ocampo-Gómez et al., tiene como objetivo describir los resultados oncológicos de pacientes con tumores de células germinales no seminomatosos (TCGNS) germinales no seminomatosos (NSGCT) que desarrollaron masas residuales (MRs) post-quimioterapia y que fueron tratados bien con disección de ganglios linfáticos retroperitoneales (DGLRP) u observación1. Sus resultados destacan la superioridad de la RPLND sobre la observación, con mayores tasas de supervivencia libre de progresión (SLP) y supervivencia global, especialmente en pacientes con NSGCT en estadio II.

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Se comunican 2 personas transfemeninas (transgénero de varón a mujer) que consultaron al endocrinólogo a los 20 años para terapia hormonal de afirmación de género. Durante los primeros 18 meses fueron tratadas con esquema múltiple clásico con análogos del GnRH o Medroxiprogesterona, espironolactona o flutamida y gel de estrógeno; no se logró descender la testosterona plasmática constatándose muy escasa desmasculinización. Cumplido estrictamente el tratamiento se comprobó una persistente frenación de gonadotrofinas en ambos casos. Este hecho sugirió una fuente androgénica patológica testicular o suprarrenal. Esta última se descartó por haber acusado una pubertad normal y por ausencia de masas suprarrenales. Una de las transfemeninas presentó un tumor testicular cuya histopatología demostró un seminoma. Se analiza el impacto de esta terapia hormonal feminizante en el testículo, más aún con el antecedente de criptorquidea. La terapia hormonal permitió desenmascarar el tumor testicular y realizar su tratamiento precoz. PET/ CT de control poscirugía (-). En ambas transfemeninas solo la orquiectomía bilateral logró bajar la testosterona plasmática al nivel de lo señalado como feminización.

This study explores the case of two transfeminine (male-to-female transgender) individuals who initiated gender-affirming hormone therapy in adulthood, whose plasma testosterone levels remained unresponsive during the first 18 months of gender affirming hormone therapy, including analogues of GnRH or Medroxyprogesterone to curb gonadotropins, spironolactone or flutamide as antiandrogens, as well as estrogen gel. Minimal demasculinization was observed. After strictly following treatment, a complete and persistent gonadotropin suppression was confirmed. This fact suggested a pathological androgenic testicular or adrenal source. An adrenal origin was discarded due to the patient's normal puberty and absence of adrenal masses. There was no self-administration of exogenous testosterone. In both transfeminine cases, bilateral orchiectomy was the sole intervention that effectively reduced plasma testosterone to feminizing levels (under 50 ng/dl). One of the cases presented a testicular tumor, the histology of which revealed a pure seminoma. The impact of this hormone therapy on the testicle is analyzed. In both, testosterone reached levels of feminization only with orchiectomy.

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Objetivo: Caracterizar la supervivencia global (SG) y la supervivencia libre de recurrencia (SLR) de pacientes con carcinoma testicular de células germinales no seminomatoso (NSGCT) estadio I derivados a diferentes opciones de adyuvancia. Método: Búsqueda de pacientes con NSGCT estadio I llevados a orquiectomía radical del 2010-2022. La descripción se hizo con medidas de tendencia central. Resultados: En el modelo de regresión no hubo diferencias. Conclusiones: No se encontraron diferencias en SG o SLR. Se requieren estudios prospectivos para corroborar hallazgos

Objective: To characterize overall survival (OS) and recurrence-free survival (RFS) in patients with stage I testicular non-seminomatous germ cell carcinoma (NSGCT) referred to different adjuvant treatment options. Method: Patient search included individuals with stage I NSGCT who underwent radical orchiectomy from 2010 to 2022. The statistical description was conducted using measures of central tendency. Results: In the regression model, no differences were observed. Conclusions: No differences were found in OS or RFS. Prospective studies are needed to confirm these findings

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Introdução: Os tumores de células germinativas testiculares representam cerca de 97% dos cânceres testiculares. Histologicamente, classificam-se em seminomas e não seminomas, tendo aplicabilidade diagnóstica e prognóstica. O sucesso terapêutico depende do diagnóstico precoce associado ao correto estadiamento, sendo então de grande importância a avaliação de biomarcadores que possam contribuir para o manejo dessa doença. Objetivo: Identificar os genes que podem estar correlacionados com o prognóstico e a sobrevida no câncer testicular. Método: Análise de bioinformática utilizando 137 amostras de câncer testicular do The Cancer Genome Atlas e 165 amostras de tecido testicular normal do The Genotype-Tissue Expression. A identificação dos genes e análises subsequentes foram feitas pelo GEPIA2. Resultados: Inicialmente avaliou-se, em relação à expressão gênica, os 500 genes mais associados com a sobrevida global do câncer testicular e os 500 com a sobrevida livre de doença. Em seguida, foi realizada a sobreposição dessas duas listas e construído um diagrama de Venn mostrando os 13 genes em comum. Destes, mantiveram-se apenas os codificadores de proteína, verificando quais diferiram significativamente do tecido normal em relação à expressão gênica. Somente ATP10A, SAMD14 e PCAL4 mostraram diferença com significância estatística, todos subexpressos no câncer testicular. A análise deles em conjunto foi ainda mais significativa para a sobrevida global e livre de doença. Conclusão: Foram identificados nesta análise in silico três genes que demonstraram associação significativa de sua expressão com a sobrevida e o prognóstico dos pacientes com câncer testicular.

Introduction: Testicular germ cell tumors represent approximately 97% of testicular cancers. Histologically, they are classified into seminomas and non-seminomas, having diagnostic and prognostic applicability. Therapeutic success depends on early diagnosis associated with correct staging, the evaluation of biomarkers is important for the correct management of this disease. Objective: To identify genes that may be correlated with prognosis and survival in testicular cancer. Method: Bioinformatics analysis was performed using 137 testicular cancer samples from The Cancer Genome Atlas and 165 normal testicular tissue samples from The Genotype-Tissue Expression. Gene identification and subsequent analyzes were performed using GEPIA2. Results: Initially, in relation to gene expression, the 500 genes most significantly associated with overall survival from testicular cancer and the 500 with disease-free survival were evaluated. These two lists were then superimposed and a Venn diagram was constructed showing the 13 genes in common. Of these, only the protein-coding genes were kept, investigating which ones differed significantly from normal tissue in relation to gene expression. Only ATP10A, SAMD14 and PCAL4 showed a statistically significant difference, all of which were under-expressed in testicular cancer. The joint analysis of these genes was even more significant for overall and disease-free survival. Conclusion: Three genes were identified in the analysis in silico which demonstrated significative association of the expression with survival and prognosis of patients with testicular cancer.

Introducción: Los tumores de células germinales testiculares representan aproximadamente el 97% de los cánceres de testículo. Histológicamente se clasifican en seminomas y no seminomas, teniendo aplicabilidad diagnóstica y pronóstica. El éxito terapéutico depende de un diagnóstico temprano asociado a una correcta estadificación, siendo esta última altamente beneficiosa debido a los marcadores genéticos que indican cómo tratar la enfermedad. Objetivo: Identificar genes que puedan estar correlacionados con el pronóstico y la supervivencia en el cáncer testicular. Método: El análisis bioinformático se realizó utilizando 137 muestras de cáncer testicular de The Cancer Genome Atlas y 165 muestras de tejido testicular normal de The Genotype-Tissue Expression. La identificación de genes y los análisis posteriores se realizaron utilizando GEPIA2. Resultados: Inicialmente, en relación con la expresión génica, se evaluaron los 500 genes más significativamente asociados con la supervivencia global del cáncer testicular y los 500 con la supervivencia libre de enfermedad. Luego se superpusieron estas dos listas y se construyó un diagrama de Venn que muestra los 13 genes en común. De ellos, sólo se mantuvieron las codificantes de proteínas, comprobando cuáles diferían significativamente del tejido normal en relación con la expresión génica. Sólo ATP10A, SAMD14 y PCAL4 mostraron una diferencia estadísticamente significativa, todos los cuales estaban subexpresados en el cáncer testicular. El análisis conjunto de estos fue aún más significativo para la supervivencia general y libre de enfermedad. Conclusión: Los tres genes que se identificaron en este análisis in silico se expresan diferencialmente y demostraron una asociación significativa entre su expresión, la supervivencia y pronóstico de los pacientes con cáncer testicular.

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A hiperplasia adrenal congênita (HAC) pode cursar com redução da fertilidade na mulher. Entretanto, nos casos em que ocorre gestação, os recém-nascidos das por- tadoras de hiperplasia adrenal congênita exibem risco de hiperandrogenismo, com todas as suas consequências. A presente revisão atualiza o tema, considerando também as necessidades da assistência a essas pacientes. A busca identificou 294 artigos na base de dados MEDLINE/PubMed de 1961 a março/2023, e os resultados mostraram que as portadoras de hiperplasia adrenal congênita exibem significativa redução da fertilidade. Nos casos de interesse de gestação, as portadoras de hiper- plasia adrenal congênita devem fazer um planejamento reprodutivo, envolvendo a fase antenatal, o acompanhamento pré-natal especializado, o parto e o aleitamento.

Congenital adrenal hyperplasia may lead to reduced male and female fertility. Mo- reover, when the pregnancy occurs, the newborns of patients with congenital adrenal hyperplasia are at risk of hyperandrogenism with all its consequences. This review updates the theme and emphasizes assistance needs. The search identified 294 ar- ticles in the MEDLINE/PubMed database from 1961 to March/2023, and the results showed that patients with congenital adrenal hyperplasia truly exhibit a significant reduction in fertility. In cases of interest in pregnancy, patients with congenital adre- nal hyperplasia should carry out reproductive planning, involving the antenatal pha- se, specialized prenatal care, till delivery and breastfeeding.

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Introducción: las enfermedades oncológicas son la causa de 9.5 millones de muertes en el mundo y la tercera causa de muerte en México. La aparición de heridas tumorales es una complicación de la progresión de la enfermedad oncológica con síntomas que repercuten en la calidad de vida de los pacientes. Objetivo: evaluar la percepción de calidad de vida de pacientes hospitalizados con diagnóstico primario de cáncer y herida tumoral en un hospital de tercer nivel de la Ciudad de México. Metodología: estudio descriptivo que incluyó a 57 pacientes hospitalizados con diagnóstico de cáncer primario y herida tumoral. La percepción de calidad de vida se evaluó con el cuestionario McGill Quality of Life Questionnaire (MQOL) con 4 dimensiones: de bienestar físico, psicológico, existencial y de apoyo social. La herida tumoral se estadificó con la escala Malignant Cutaneous Wound Stating System. La severidad de la enfermedad se midió con la escala APACHE II. El análisis se hizo con estadística descriptiva. Resultados: de 57 pacientes con edad entre 24 y 81 años de edad, predominó el cáncer de mama en 31.5% de mujeres y cáncer de testículo en 10.5% de hombres. La herida tumoral grado IV se presentó en 72% de los pacientes. La percepción de calidad de vida en general, que se midió con el Single ítem scale, fue buena y regular en 38.6 y 26.3%, respectivamente. Conclusiones: para la práctica de enfermería la evaluación de la calidad de vida en las personas con cáncer significa una diversidad de posibilidades para intervenir y promover el bienestar en la persona y la familia.

Introduction: Oncological diseases are the cause of 9.5 million deaths in the world and the third cause of death in Mexico. The appearance of tumor wounds is a complication of the oncological disease progression with symptoms that affect the quality of life of patients. Objective: To evaluate the perception of quality of life of hospitalized patients with a primary diagnosis of cancer and tumor wound in a tertiary care hospital in Mexico City. Methodology: Descriptive study that included 57 hospitalized patients diagnosed with primary cancer and tumor wound. The perception of quality of life was evaluated with the McGill Quality of Life Questionnaire with 4 dimensions: of physical, psychological, and existential well-being, as well as social support. The tumor wound was staged using the Malignant Cutaneous Wound Stating System scale. The severity of the disease was calculated with the APACHE II scale. The analysis was made with descriptive statistics. Results: Out of 57 patients aged 24 to 81 years, breast cancer predominated in 31.5% of women and testicular cancer in 10.5% of men. Grade IV tumor wound occurred in 72% of patients. The perception of quality of life in general, measured with the Single Item Scale, was good and regular in 38.6 and 26.3%, respectively. Conclusions: For nursing practice, the evaluation of the quality of life in people with cancer means a diversity of possibilities to intervene and promote the well-being of the person and the family.

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The purpose of this study was to evaluate the diagnostic performance of multiparametric ultrasound (mpUS; grayscale US, color Doppler US, strain elastography, and contrast-enhanced US) in the assessment of testicular lesions with negative tumoral markers. MpUS imaging data, patient age, serum tumor markers, scrotal pain, cryptorchidism, and related clinical information were retrospectively collected for patients who underwent mpUS examination between January 2013 and December 2019. Histologic results or follow-up examinations were used as the reference standard. In total, 83 lesions from 79 patients were included in the analysis. Fifty-six patients were finally diagnosed with benign tumors, and 23 patients were ultimately diagnosed with malignant tumors. Chi-square tests or Fisher's exact tests were used to assess the difference between the two groups. Stepwise multivariate logistic regression analysis showed that lesion diameter (odds ratio [OR] = 1.072, P = 0.005), vascularization on color Doppler US (OR = 4.066, P = 0.001), and hyperenhancement during the early phase (OR = 6.465, P = 0.047) were significant independent risk factors for malignancy; however, when compared with neoplastic lesions, pain (OR = 0.136, P < 0.001), absence of vascularization on color Doppler US (OR = 1.680, P = 0.042), and nonenhancement during the late phase (OR = 3.461, P = 0.031) were strongly associated with nonneoplastic lesions. MpUS features are useful for differentiating testicular lesions with negative tumoral markers and improving the preoperative diagnosis, which may avoid inappropriate radical orchiectomy.

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A series of chemotherapeutic drugs that induce DNA damage, such as cisplatin (DDP), are standard clinical treatments for ovarian cancer, testicular cancer, and other diseases that lack effective targeted drug therapy. Drug resistance is one of the main factors limiting their application. Sensitizers can overcome the drug resistance of tumor cells, thereby enhancing the antitumor activity of chemotherapeutic drugs. In this study, we aimed to identify marketable drugs that could be potential chemotherapy sensitizers and explore the underlying mechanisms. We found that the alcohol withdrawal drug disulfiram (DSF) could significantly enhance the antitumor activity of DDP. JC-1 staining, propidium iodide (PI) staining, and western blotting confirmed that the combination of DSF and DDP could enhance the apoptosis of tumor cells. Subsequent RNA sequencing combined with Gene Set Enrichment Analysis (GSEA) pathway enrichment analysis and cell biology studies such as immunofluorescence suggested an underlying mechanism: DSF makes cells more vulnerable to DNA damage by inhibiting the Fanconi anemia (FA) repair pathway, exerting a sensitizing effect to DNA damaging agents including platinum chemotherapy drugs. Thus, our study illustrated the potential mechanism of action of DSF in enhancing the antitumor effect of DDP. This might provide an effective and safe solution for combating DDP resistance in clinical treatment.

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Objective: To analyze the clinicopathologic characteristics and prognosis of testicular diffuse large B-cell lymphoma (DLBCL) . Methods: A retrospective analysis was performed on 68 patients with testicular DLBCL admitted to Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine from October 2001 to April 2020. The gene mutation profile was evaluated by targeted sequencing (55 lymphoma-related genes) , and prognostic factors were analyzed. Results: A total of 68 patients were included, of whom 45 (66.2% ) had primary testicular DLBCL and 23 (33.8% ) had secondary testicular DLBCL. The proportion of secondary testicular DLBCL patients with Ann Arbor stage Ⅲ-Ⅳ (P<0.001) , elevated LDH (P<0.001) , ECOG score ≥ 2 points (P=0.005) , and IPI score 3-5 points (P<0.001) is higher than that of primary testicular DLBCL patients. Sixty-two (91% ) patients received rituximab in combination with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP) -based first-line regimen, whereas 54 cases (79% ) underwent orchiectomy prior to chemotherapy. Patients with secondary testicular DLBCL had a lower estimated 5-year progression-free survival (PFS) rate (16.5% vs 68.1% , P<0.001) and 5-year overall survival (OS) rate (63.4% vs 74.9% , P=0.008) than those with primary testicular DLBCL, and their complete remission rate (57% vs 91% , P=0.003) was also lower than that of primary testicular DLBCL. The ECOG scores of ≥2 (PFS: P=0.018; OS: P<0.001) , Ann Arbor stages Ⅲ-Ⅳ (PFS: P<0.001; OS: P=0.018) , increased LDH levels (PFS: P=0.015; OS: P=0.006) , and multiple extra-nodal involvements (PFS: P<0.001; OS: P=0.013) were poor prognostic factors in testicular DLBCL. Targeted sequencing data in 20 patients with testicular DLBCL showed that the mutation frequencies of ≥20% were PIM1 (12 cases, 60% ) , MYD88 (11 cases, 55% ) , CD79B (9 cases, 45% ) , CREBBP (5 cases, 25% ) , KMT2D (5 cases, 25% ) , ATM (4 cases, 20% ) , and BTG2 (4 cases, 20% ) . The frequency of mutations in KMT2D in patients with secondary testicular DLBCL was higher than that in patients with primary testicular DLBCL (66.7% vs 7.1% , P=0.014) and was associated with a lower 5-year PFS rate in patients with testicular DLBCL (P=0.019) . Conclusion: Patients with secondary testicular DLBCL had worse PFS and OS than those with primary testicular DLBCL. The ECOG scores of ≥2, Ann Arbor stages Ⅲ-Ⅳ, increased LDH levels, and multiple extra-nodal involvements were poor prognostic factors in testicular DLBCL. PIM1, MYD88, CD79B, CREBBP, KMT2D, ATM, and BTG2 were commonly mutated genes in testicular DLBCL, and the prognosis of patients with KMT2D mutations was poor.

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Objective: To investigate the clinicopathological features and possible mechanisms of burned-out testicular germ cell tumors. Methods: The clinical and imaging data, histology and immunophenotypic characteristics of three cases of burned-out testicular germ cell tumors diagnosed at the Ruijin Hospital, Medical College of the Shanghai Jiaotong University, from 2016 to 2020 were retrospectively analyzed. The relevant literature was reviewed. Results: The mean age of the three patients was 32 years. Case 1 had an elevated preoperative alpha-fetoprotein level (810.18 μg/L) and underwent "radical pancreaticoduodenectomy and retroperitoneal lesion resection" for a retroperitoneal mass. Postoperative pathology showed embryonal carcinoma, which needed to exclude gonadal metastasis. Color Doppler ultrasound showed a solid mass of the right testis, with hypoechoic lesion and scattered calcification in some areas. Case 2 was a "right supraclavicular lymph node biopsy specimen." Chest X-ray showed multiple metastases in both lungs. The biopsy showed metastatic embryonic carcinoma and bilateral testicular color Doppler ultrasound revealed abnormal calcifications in the right testicle. Case 3 showed a cystic mass of the right testis with calcification and solid areas. All 3 patients underwent radical right orchiectomy. Grossly, borders of the testicular scar areas were well defined. Cross sectioning of the tumors showed a gray-brown cut surface and single focus or multiple foci of the tumor. The tumor maximum diameter was 0.6-1.5 cm. Microscopically, lymphocytes, plasma cells infiltration, tubular hyalinization, clustered vascular hyperplasia and hemosiderin laden macrophages were found in the scar. Atrophic and sclerotic seminiferous tubules, proliferation of clustered Leydig cells and small or coarse granular calcifications in seminiferous tubules were present around the scar. Seminoma and germ cell neoplasia in situ were seen in case 1, germ cell neoplasia in situ was seen in case 2 and germ cells with atypical hyperplasia were seen in case 3. Immunohistochemistry showed that embryonic carcinoma expressed SALL4, CKpan(AE1/AE3) and CD30, seminoma and germ cell tumor in situ expressed OCT3/4, SALL4 and CD117, and spermatogenic cells with atypical hyperplasia expressed CD99 and SALL4. The Ki-67 positive index was about 20%, while OCT3/4 and CD117 were both negative. Conclusions: Burned-out testicular germ cell tumors are rare. The possibility of gonad testicular metastasis should be considered first for extragonadal germ cell tumor. If fibrous scar is found in testis, it must be determined whether it is a burned-out testicular germ cell tumor. The burned-out mechanisms may be related to the microenvironment of tumor immune-mediated and local ischemic injury.

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Objective: To investigate the clinicopathological features, immunophenotype and prognosis of nuclear protein in testis (NUT) midline carcinoma. Methods: Twenty-four resection cases of NUT midline carcinoma diagnosed at the Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China from January 2018 to September 2022, were collected, and retrospectively analyzed for their clinicopathological characteristics. Relevant literature was reviewed. Results: All 24 cases of NUT midline carcinoma occurred in the chest or head and neck, including 14 men and 10 women, with a median age of 40 years. Histological examination showed that the tumors were poorly differentiated, with solid nested or sheet-like arrangement, small to medium-sized cells, sparse cytoplasm and coarse granular chromatin, including 5 cases with abrupt squamous epithelial differentiation. Immunohistochemistry showed that all 24 cases were positive for NUT protein, while 16 cases were p63 positive, 19 cases were p40 positive, 15 out of 18 cases were CK5/6 positive. Follow-up data were obtained for 21 patients (follow-up time range, 1-21 months), of which 11 survived, 10 died, and 3 were lost to follow-up. Conclusions: NUT midline carcinoma is a rare and highly aggressive malignancy with unique histological, immunophenotypic and molecular features. It has a poor prognosis.

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RESUMEN: los tumores testiculares son poco frecuentes en niños menores de 15 años y representan del 2 al 4% de todos los cánceres infantiles, la criptorquidia es el principal factor de riesgo para el desarrollo posterior de tumores de células germinales testiculares. Preescolar de 5 años de edad, con antecedente de criptorquidia izquierda sin tratamiento, desde hace 1 año presenta aumento progresivo de volumen en región inguinal izquierda la cual se extendía hasta la región escrotal izquierda, de consistencia pétrea, no doloroso a la palpación, sin adenomegalias, marcadores tumorales negativos, la ecografía testicular reporta: tumor quístico izquierdo, la tomografía de abdomen inferior reporta: tumor testicular izquierdo. se realizó orquiectomía radical izquierda y orquidopexia derecha, con evolución satisfactoria. se confirma el diagnostico de teratoma quístico maduro por biopsia e inmunohistoquímico. es importancia del diagnóstico y manejo precoz de la criptorquidia para evitar futuras neoplasias(AU)

SUMMARy testicular tumors are rare in children under 15 years of age and represent 2 to 4% of all childhood cancers, cryptorchidism is the main risk factor for the later development of testicular germ cell tumors. 5-year-old preschool boy, with a history of left cryptorchidism without treatment, for the last year he has presented a progressive increase in volume in the left inguinal which extended to the left scrotal region, of petrified consistency, not painful on palpation, without adenomegaly, negative tumor markers, testicular ultrasound reported: left cystic tumor, lower abdomen tomography reported: left testicular tumor. A left radical orchiectomy and right orchidopexy were performed, with satisfactory evolution. the diagnosis of mature cystic teratoma is confirmed by biopsy and immunohistochemistry. early diagnosis and management of cryptorchidism is important to avoid future neoplasms(AU)

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Androgen insensitivity syndrome(AIS)with bilateral testicular malignant transformation is very rare,and its diagnosis should be based on clinical manifestations,physical examination,serological findings,karyotype analysis,and pathological findings.This study reported a case of complete androgen insensitivity syndrome among Tibetan in Tibet.It took 17 years from the discovery of congenital absence of uterus to bilateral pelvic mass resection.Pathological examination confirmed that bilateral pelvic space occupying lesions were dysplastic testicular tissue with seminoma and sertoli cell adenoma-like nodules.This study summarized the clinicopathological features to deepen the understanding of the disease.

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Contrast-enhanced ultrasound (CEUS) is a new form of ultrasound (US) that can dynamically display microvessels in a highly sensitive manner. The purpose of this study was to investigate the efficacy of CEUS for characterizing testicular lesions in comparison with conventional US. Forty-seven patients with testicular lesions were enrolled. The histopathology results revealed that 31 cases were neoplastic (11 cases of seminomas, 8 nonseminomatous germ cell tumors, 8 lymphomas, 2 Leydig cell tumors, and 2 nonspecific tumors), and 16 cases were nonneoplastic (8 cases of infarctions, 3 epidermoid cysts, and 5 inflammation). The indicators of shallow lobulated morphology and cystic-solid echogenicity on conventional US were suggestive of germ cell tumors. More indicators on CEUS were found to be useful for characterizing testicular lesions. All the neoplastic lesions showed hyperenhancement on CEUS. Moreover, germ cell tumors presented with heterogeneous enhancement (73.7%, 14/19), a twisted blood vessel pattern, rapid wash-in and wash-out, and peripheral rim hyperenhancement signs. Lymphoma was characterized by nonbranching linear vessel patterns (87.5%, 7/8), rapid wash-in and slow wash-out. In nonneoplastic lesions, infarction and epidermoid cysts showed no enhancement, and abscesses were observed with marginal irregular enhancement. The sensitivity, specificity, and accuracy of CEUS for differentiating between neoplastic and nonneoplastic lesions were 100%, 93.8%, and 97.9%, respectively, and these values were higher than those for conventional US (90.3%, 62.5%, and 80.9%, respectively). CEUS can sensitively reflect the microvascular perfusion in testicular lesions and offers high accuracy for characterizing them.

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OBJECTIVE@#To investigate the inhibitory effect of RSL3 on the proliferation, invasion and migration of cisplatinresistant testicular cancer cells (I-10/DDP) and the effect of carbenoxolone on the activity of RSL3 against testicular cancer.@*METHODS@#MTT assay was used to evaluate the survival rate of I-10/DDP cells following treatment with RSL3 (1, 2, 4, 8, 16 or 32 μmol/L) alone or in combination with carbenoxolone (100 μmol/L) or after treatment with Fer-1 (2 μmol/L), RSL3 (4 μmol/L), RSL3+Fer-1, RSL3+carbenoxolone (100 μmol/L), or RSL3+Fer-1+carbenoxolone. Colony formation assay was used to assess the proliferation ability of the treated cells; wounding-healing assay and Transwell assay were used to assess the invasion and migration ability of the cells. The expression of GPX4 was detected using Western blotting, the levels of lipid ROS were detected using C11 BODIPY 581/591 fluorescent probe, and the levels of Fe2+ were determined with FerroOrange fluorescent probe.@*RESULTS@#RSL3 dose-dependently decreased the survival rate of I-10/DDP cells, and the combined treatment with 2, 4, or 8 μmol/L RSL3 with carbenoxolone, as compared with RSL3 treatment alone, resulted in significant reduction of the cell survival rate. The combination with carbenoxolone significantly enhanced the inhibitory effect of RSL3 on colony formation, wound healing rate (P=0.005), invasion and migration of the cells (P < 0.001). Fer-1 obviously attenuated the inhibitory effects of RSL3 alone and its combination with carbenoxolone on I-10/DDP cells (P < 0.01). RSL3 treatment significantly decreased GPX4 expression (P=0.001) and increased lipid ROS level (P=0.001) and Fe2+ level in the cells, and these effects were further enhanced by the combined treatment with carbenoxolone (P < 0.01).@*CONCLUSION@#Carbenoxolone enhances the inhibitory effect of RSL3 on the proliferation, invasion and migration of cisplatin-resistant testicular cancer cells by promoting RSL3-induced ferroptosis.

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Objetivos: relatar um caso raro de sarcoma fibromixoide de baixo grau (SFMBG) em uma localização incomum de modo a reforçar aspectos histopatológicos e imunoistoquímicos relevantes para o reconhecimento desta entidade e o adequado diagnóstico diferencial de massas paratesticulares. Relato de caso: homem de 20 anos, com massa escrotal à direita, cuja análise histopatológica demonstrou a presença de tecido fibroso com áreas mixoides e predominância de células fusiformes. A imunoistoquímica foi positiva para vimentina, com índice de Ki67 de 2%, e negativa para S100, CD-34, beta-catenina, desmina e miogenina. Conclusões: caso raro de SFMBG na região paratesticular que reforça a importância da histopatologia e da imunoistoquímica no diagnóstico desse tumor. Apesar da característica histológica benigna, o SFMBG apresenta altas taxas de recorrência e metástases, sendo essencial o seguimento do paciente.

Objectives: to report a rare case of low-grade fibromyxoid sarcoma (LGFMS) in an unusual location in order to reinforce histopathological and immunohistochemical aspects relevant to the recognition of this entity and the adequate differential diagnosis of paratesticular masses. Case report: 20-year-old man, with a right scrotal mass and histopathological analysis showing the presence of fibrous tissue with myxoid areas and a predominance of spindle cells. Immunohistochemistry was positive for vimentin, with a Ki67 index of 2%, and negative for S100, CD-34, beta-catenin, desmin and myogenin. Conclusions: rare case of LGFMS in the paratesticular region that reinforces the importance of histopathology and immunohistochemistry in the diagnosis of this tumor. Despite the benign histological characteristic, LGFMS has high rates of recurrence and metastasis, and patient follow-up is essential.

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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)