Serous Borderline Ovarian Epithelial Type Tumors of Testis in A Young Man with Only Mass Resection: A Case Report.

Tumors of the ovarian epithelial type of testis are an infrequent entity. We report a case of borderline serous tumor in an 18-year-old male who presented with a right testicular mass, clinically suspicious of carcinoma. After right inguinal exploration, two pedunculated para-testicular masses were identified in the appendix of the right testis and epididymis. The histological features were as complex papillary structures lined by columnar cells with mild to moderate pleomorphism. Microscopically, features of borderline serous testicular tumors are identical to the morphology of the same tumors encountered in the ovarian counterparts. These tumors usually reveal papillae with fibrovascular cores lined by stratified cuboidal to columnar epithelium. This case highlights a need for clinicians and pathologists to be aware of this infrequent entity and improve the best patient management attitude. Serous epithelial tumors are common ovary tumors but are very rare entities in the testis. These tumors originate from the remnant of Mullerian ducts or Mullerian metaplasia of tunica vaginalis and are nonaggressive, even associated with extra ovarian spread, and have outstanding prognosis. A review of the literature has shown nearly fifty reported cases worldwide, and most of the cases occur in young to middle-aged adults.

the Short Abstinence May Have Paradoxical Effects On Sperms With Different Level Of DNA Integrity: A Prospective Study.

PURPOSE: To investigate the effect of short abstinence on sperm function tests and semen parameters. MATERIALS AND METHODS: This prospective study included 65 male patients with increased DNA injury in their ejaculated sperm and a history of recurrent pregnancy loss and/or assisted reproductive techniques failures. The effects of antioxidants medical therapy and short abstinence on semen quality were assessed (TUNEL test and CMA3 staining). RESULTS: Antioxidants have statistically significant effects on mean sperm concentration (untreated, 67.51 ± 44.40 million/ml, vs. treated, 56.09 ± 37.85 million/ml; P-value=0.005) and mean TUNEL score (untreated, 24.56% ± 9.49%, vs. treated, 20.64% ± 10.28%; P-value = 0.013). Moreover, a short abstinence period might have positive effects as shown on the TUNEL assay (20.64% ± 10.28 vs. 17.38% ± 8.59 ; P-value = 0.028) and CMA3 staining (47.79% ± 20.78, vs. short 41.92% ± 18.49; P-value = 0.019), when considering all study subjects. However, different results were obtained using more precise analysis based on a TUNEL cutoff score of 20%. The analysis showed that short abstinence might improve sperm DNA integrity in patients with TUNEL score > 20% (mean TUNEL score from 27.85% ± 8.32% to 19.14% ± 8.90% ; P-value =0.001%). However, it might have deleterious effects on sperm DNA integrity in patients with TUNEL score < 20% (mean TUNEL score from 11.89% ± 3.21% to 15.17% ± 7.79%; P-value = 0.045%) Conclusion: Our results showed that short abstinence may not be beneficial in all infertile males, and it should only be used in selected patients with abnormal DNA integrity.

Small Cell Carcinoma of Bladder; Still A Diagnostic and Therapeutic Challenge: Seven Years of Experience and Follow-up in A Referral Center.

PURPOSE: To report clinical, histopathological, and treatment features of small cell carcinoma of (SmccB) bladder during 7 years in a referral center. METHODS: The clinical, histopathological features, treatment modalities, and outcome of all patients with bladder SmccB treated between 2009 and 2016 who were managed in Hasheminejad Kidney Center (HKC) were retrospectively collected. RESULTS: Thirteen patients were diagnosed and managed with SmccB. The average age of patients was 64.92 years. For each patient, 8 markers were used for IHC staining on average. Neuroendocrine markers such as CD 56, Neuron Specific Enolase, Synaptophysin, and Chromogranin were found in a significant percentage of patients (69%, 38%, 54%, and 31% respectively). Patients were managed with TURBT alone (N=3), chemotherapy after TURBT (N=4), chemotherapy plus radical surgery (N=4) and radical surgery alone (N=2). The best clinical result was seen in chemotherapy received patients with or without radical surgery. The mean(SE) of survival rate in patients who received only chemotherapy alone was 42.4 (10.0) months, while in those who were managed with chemotherapy plus radical surgery it was 47.7 (10.1) months. CONCLUSION: In our center immunohistochemistry was needed for definitive diagnosis in 17/19 samples. Misdiagnosis happened in two samples without IHC request. We think that use of immunohistochemistry should be mandatory for diagnosis of SmccB to exclude misdiagnosis. Chemotherapy is the most important part of treatment and the addition of radical surgery can slightly improve patients' survival.