ABSTRACT
Bilateral testicular tumors are very rare in pediatric patients and only a few case reports have been reported. These patients have a high risk of sterility due to bilateral orchiectomy and subsequent gonadotoxic treatments. Therefore, if possible, testis-sparing surgery should be performed in patients with benign masses and testicular tissue preservation may be recommended in order to maintain fertility in later life. We present a 23 months old boy with synchronous bilateral testicular tumor managed with unilateral orchiectomy and testis-sparing surgery and testicular tissue cryopreservation performed to the controlateral side. We also review the literature on bilateral testis tumors in children.
Subject(s)
Cryopreservation/methods , Neoplasms, Germ Cell and Embryonal , Neoplasms, Multiple Primary , Orchiectomy/methods , Organ Sparing Treatments/methods , Teratoma , Testicular Neoplasms , Testis , Humans , Infant , Male , Neoplasms, Germ Cell and Embryonal/blood , Neoplasms, Germ Cell and Embryonal/pathology , Neoplasms, Germ Cell and Embryonal/surgery , Neoplasms, Multiple Primary/blood , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Teratoma/blood , Teratoma/pathology , Teratoma/surgery , Testicular Neoplasms/blood , Testicular Neoplasms/pathology , Testicular Neoplasms/surgery , Testis/diagnostic imaging , Testis/pathology , Testis/surgery , Tissue Preservation/methods , Treatment Outcome , Ultrasonography/methods , alpha-Fetoproteins/analysisABSTRACT
The aim of this study was to determine whether homocysteine (hcy) concentrations in embryo culture media correlate with pregnancy outcome in assisted reproductive technology (ART) cycles. Forty patients who underwent single embryo transfer at the infertility clinic of a tertiary care center were recruited for this case-control study. Spent embryo culture media from all patients were collected after single embryo transfer on day 3 (n = 40). Hcy concentrations in embryo culture media were analyzed by enzyme cycling method. Patients were grouped according to the diagnosis of a clinical pregnancy. Sixteen patients were pregnant while 24 patients failed to achieve conception. Mean Hcy levels in the culture media were significantly different between the groups (p < 0.003), as 4.58 ± 1.31 µmol/l in the non-pregnant group and 3.37 ± 0.92 µmol/l in the pregnant group. Receiver operator curve analysis for determining the diagnostic potential of Hcy for pregnancy revealed an area under the curve of 0.792 (confidence interval: 0.65-0.94; p < 0.05). A cut-off value of 3.53 µmol/l was determined with a sensitivity of 83.3%, and a specificity of 68.8%. Lower hcy levels were associated with a better chance of pregnancy and better embryo grades. Hcy may be introduced as an individual metabolomic profiling marker for embryos.
