Young male patient with bilateral synchronous testicular germ cell tumour. Considerations for partial orchiectomy.

Bilateral synchronous testicular cancer is a rare disease and is usually associated with similar histological findings in each testicle. The standard therapy of bilateral testis cancer is generally considered to be inguinal orchiectomy. We present a case of synchronous bilateral testicular germ cell tumour, with different histology, initially treated with testis-sparing surgery. After pathology review, the margin of the partial orchiectomy was considered affected, and an inguinal orchiectomy was planned. Options for testis-sparing surgery are discussed.

Langerhans cell histiocytosis.

Langerhans cell histiocytosis (LCH) is a poorly understood proliferative disease, with different patterns of clinical presentation. Currently it is classified according to the number and type of system involved and the degree of organ dysfunction. The aetiology of the disease remains uncertain, and in some cases the disease is polyclonal, suggesting a reactive condition. Many cytokines have been implicated in the pathogenesis of LCH. Different therapeutic approaches can be considered depending on the affected organ, including surgery, radiotherapy and chemotherapy. Long-term organ dysfunction may remain, despite disease control and/or eradication, making indefinite supportive treatment mandatory. Here we present a literature review on all of the aspects of the disease, treatment approaches and existing protocols, and finally an adult clinical case.