Metastasis to the tunica vaginalis testis from a primary mucinous tumor of the cecum.

OBJECTIVES: We review the literature about secondary testicular tumors. METHODS: We present the case of a patient with a metastatic mucus-secreting testicular tumor who presented in the emergency room with symptoms of acute scrotum 10 months after surgery for a mixed tumor of the cecum. This type of tumor is rare, and the treatment of choice is orchiectomy; nevertheless, the prognosis of such metastasis remains poor. RESULTS: Because mucinous tumors can present late dissemination, long-term follow-up with assessment of the most common sites of metastasis is necessary. Our patient died 21 months after the initial diagnosis CONCLUSIONS: Testicular metastases and mucus-secreting intestinal tumor metastases are rare. These tumors occur in patients older than 60 years of age and young men. As in the case of primary tumors, the treatment is orchiectomy.

Median raphe cyst. Report of two cases and literature review.

OBJECTIVES: To report 2 cases of median raphe cysts, 1 in the penis and the other in the perineum. METHOD: Two cases of median raphe cyst are described; the first was treated by surgery and the second required no treatment. RESULTS: The surgical patient experienced no complications and was asymptomatic with no recurrence at 2 years. CONCLUSIONS: Median raphe cysts are a rare, benign condition of uncertain etiology. Treatment consists on simple excision.

[Bilateral synchronic testicular tumour of different histology]. / Tumor testicular bilateral sincrónico de distinta histología.

OBJECTIVE: To report one case of bilateral synchronic germ cell testicular tumour of different histology. METHODS/RESULTS: 37 year-old patient with left testicular tumor under study was found to have a contralateral synchronic testicular tumor on ultrasound. Bilateral inguinal orchiectomy was performed and pathology reported the presence of bilateral testicular tumours of different histological type. CONCLUSIONS: Around 75% of the cases of bilateral testicular tumours are metachronic, with only 10% presenting different histology. Histological type often correlates with the ultrasound findings, and the treatment of choice in patients with this type of oncological pathology is bilateral inguinal orchiectomy.

Obstructive uropathy secondary to ureteral herniation in a pediatric en bloc renal graft.

Ureteral herniation is a rare entity. We report the first case of extraperitoneal ureteral herniation in a pediatric en bloc renal graft causing obstructive uropathy. A 70-year-old, obese patient with an en bloc renal transplant was found to have ureterohydronephrosis in the right renal graft on magnetic resonance imaging. Nephrostomy with insertion of a double-J catheter confirmed the presence of a ureteral loop within the inguinal tract. Surgery confirmed herniation of the ureter through the internal inguinal ring, crossing over the spermatic cord. We performed release, resection, ureteral reimplantation and hernioplasty. Four months later, renal function was normal and urinary tract dilation had diminished. This case illustrates an unusual cause of obstructive uropathy in a transplanted kidney. Apart from obesity, two other factors may have contributed to its development: presence of a redundant ureter, and the fact that the ureter had been placed over, rather than under, the spermatic cord.