Testicular epidermoid cysts: a reevaluation.

BACKGROUND: Testicular epidermoid cysts (TECs) are rare benign testicular neoplasms. As TECs are rarely associated with germ cell tumours (GCTs), the understanding of biological behaviour and clinical management of TEC is unresolved. METHODS: We retrospectively searched the files of patients treated for testicular neoplasms and germ cell cancer in the time from 2000 to 2017. Those with TEC were subjected to closer review looking to clinical and histological features, and to results from imaging with ultrasonography (US), contrast enhanced sonography (CEUS) and magnetic resonance imaging (MRI). RESULTS: Among 589 patients undergoing surgery for testicular tumour, nine simple TECs were identified (1.5, 95% confidence intervals 0.53-2.50%). Median age was 26 years. Imaging revealed sharply demarcated roundish lesions with avascular central areas. Eight patients underwent testis-sparing excision with no recurrence ensuing. One had orchiectomy because of large size of the mass. Histologically, TECs consisted of cornifying squamous cell epithelium and no accompanying germ cell neoplasia in situ. Two additional cases (0.3% of all) required orchiectomy because these TECs were associated with ipsilateral GCT. CONCLUSIONS: TEC is usually a benign lesion that can safely be diagnosed with US, CEUS and MRI due to its roundish shape and its avascular centre. Histologically, this TEC corresponds to the prepubertal-type teratoma unrelated to germ cell neoplasia in situ of the 2016 WHO classification. The other subtype of TEC that is associated with invasive GCT represents a teratoma of postpubertal-type. From a clinical point of view it could be easier to differentiate between a "simple TEC" which is benign (prepubertal type) and a "complex TEC" which is malignant because of its association with invasive GCT.

[A new mathematical method for the radiological determination of total lung capacity]. / Ein neues Rechenverfahren zur radiologischen Ermittlung der totalen Lungenkapazität (TLC).

Various radiological methods for estimating lung volume depend on anatomical correlation with the volume of the thorax. It is not possible to derive general factors for correcting these methods and the accuracy and reliability can be improved only by introducing individual corrections. It must also be remembered that radiometric calculations of gas volume and lung capacity depend on the assumption that there is a fixed relationship between these. This, however, is untrue for a whole series of patho-physiological circumstances. Because of these problems, we describe our own radiometric method.

[The foveola pharyngea--demonstration in conventional tomography and computed tomography (author's transl)]. / Die Foveola pharyngea--Darstellung im konventionellen Tomogramm und in der Computertomographie.

The foveola pharyngea is a cavity on the underside of the clivus, located before the tuberculum pharyngeum and, as a lager pit it was detectable in approximately 1%, overall in approximately 4% of the personally examined x-rays (11/284) and computed tomograms (6/154) of the skull base. The canalis basilaris medianus inferior and canalis basilaris medianus bifurcatus almost always empties into one of the three forms of the foveola pharyngea (foveola pharyngea infundibuliformis posterior). The differential diagnosis to canalis basilaris medianus, canalis craniopharyngeus, suture sphenooccipitalis and bone destruction is discussed.

[Analysis and differential diagnosis of gastric impressions (author's transl)]. / Zur Analyse und Differentialdiagnostik der Magen-Impressionen.

Based on the vector principle conceived by Whalen pertaining to the spreading of intra abdominal space occupying lesions, the attempt was made to analyse impression effects of the gastric wall and to demonstrate their relevance for differential diagnosis. An examination technique (hypotensive double contrast technique), suitable for adequate assessment, applicable also to minor alterations, is being described.

[Rare malpositions of the colon (author's transl)]. / Seltene Fixationsanomalien des Colon. 3 Beobachtungen.

3 unusual cases of colon malposition are presented which were detected primarily radiologically. The clinical and diagnostic significance in adults is discussed. These rare anomalies can be explaned by embryology. Previous results presented in the same issue are discussed also.

[The value of early urographic films in the investigation of arterial hypertension (author's transl)]. / Der Wert des Frühurogramms bei der Abklärung einer arteriellen Hypertonie.

The value of early films during a urogram in the investigation of arterial hypertension was investigated (402 urograms on unselected hypertensives, with arteriographic examination in 80). The diagnostic accuracy in cases of proven unilateral reno-vascular disease was 58%, signs suggestive of renal artery stenosis were found in 6.5% of the total material. Possible causes of the low degree of accuracy are discussed.

Phenacetin abuse and chronic pyelonephritis.

A history of phenacetin abuse has been found almost three times more frequently among subjects diagnosed on clinical and functional grounds as suffering from chronic pyelonephritis than among those suffering from other renal diseases or among non-renal controls. The chronic pyelonephritis in subjects admitting phenacetin abuse has been usually characterized by a more frequent intense bacteriuria and leucocyturia, by a slightly more frequent haematuria, history of renal colic, presence of stones and more rapid downhill course of glomerular filtration rate than in subjects without phenacetin abuse. A sterile lesion also without any past evidence of infection was observed only in subjects with the heaviest analgesic abuse. The discontinuation of the abuse in 5 subjects led to an improvement of the renal function.

[Preoperative radiotherapy of bladder cancer]. / Die präoperative Strahlenbehandlung des Blasenkarzinoms

Based on the observation of 58 patients with carcinoma of the bladder the effect of preoperative irradiation is reported. After application of 3500 Rad in about four weeks the examination of the surgery preparations revealed histological absence of tumor cells in one third of the cases approximately. The irradiation technique used is described and also the effects and side-effects of synchronization induced by 5-fluorouracil in a part of the group. Consequences for the therapeutic proceeding with regard to the carcinoma of the bladder are discussed.