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Malignant mesothelioma of the tunica vaginalis is an extremely rare and aggressive tumor that is frequently encountered in elderly patients. The diagnosis of malignant mesothelioma of the tunica vaginalis poses a diagnostic challenge due to its infrequency and nonspecific clinical presentation. Histopathological examination and immunohistochemical staining are essential in differentiating this tumor from other para-testicular masses and establishing a definitive diagnosis. Early detection and comprehensive treatment planning are crucial for improving the prognosis and overall outcomes for patients with this rare malignancy. We present a report of malignant mesothelioma of the tunica vaginalis in a 78-year-old male patient with no history of asbestos exposure who presented with a large infiltrative left para-testicular mass. Histopathological examination revealed a biphasic proliferation composed of epithelioid and spindle cells with infiltrative features, foci of necrosis, and increased mitotic figures. Immunohistochemical staining exhibited positive staining for WT1, D2-40, and calretinin, supporting the mesothelial origin of the tumor. Notably, BerEP4 staining was negative, arguing against carcinoma. Immunostaining for keratin 5 was positive, supporting the mesothelial differentiation. The Ki67 proliferation index was high. The differential diagnosis included adenomatoid tumors, germ cell tumors, and pleomorphic sarcoma. We aim to discuss the clinical presentation, diagnostic approach, and therapeutic approaches of this rare entity. [ABSTRACT FROM AUTHOR]

Male genital tract ultrasound (MGT-US) represents an essential diagnostic tool in andrology. Scrotal US has shown a relevant impact on reproductive and general male health, assessing features related to reproductive health, scrotal pain, masses and trauma. Transrectal US (TRUS) has assumed growing relevance in infertility and pelvic pain assessment. We report here the standards in andrological US as derived from recent guidelines and evidence-based studies and analyze MGT-US abnormalities in relation to male reproductive and general health. [ABSTRACT FROM AUTHOR]

Objective: To develop an ultrasound-driven clinical deep learning radiomics (CDLR) model for stratifying the risk of testicular masses, aiming to guide individualized treatment and minimize unnecessary procedures. Methods: We retrospectively analyzed 275 patients with confirmed testicular lesions (January 2018 to April 2023) from two hospitals, split into training (158 cases), validation (68 cases), and external test cohorts (49 cases). Radiomics and deep learning (DL) features were extracted from preoperative ultrasound images. Following feature selection, we utilized logistic regression (LR) to establish a deep learning radiomics (DLR) model and subsequently derived its signature. Clinical data underwent univariate and multivariate LR analyses, forming the "clinic signature." By integrating the DLR and clinic signatures using multivariable LR, we formulated the CDLR nomogram for testicular mass risk stratification. The model’s efficacy was gauged using the area under the receiver operating characteristic curve (AUC), while its clinical utility was appraised with decision curve analysis(DCA). Additionally, we compared these models with two radiologists' assessments (5–8 years of practice). Results: The CDLR nomogram showcased exceptional precision in distinguishing testicular tumors from non-tumorous lesions, registering AUCs of 0.909 (internal validation) and 0.835 (external validation). It also excelled in discerning malignant from benign testicular masses, posting AUCs of 0.851 (internal validation) and 0.834 (external validation). Notably, CDLR surpassed the clinical model, standalone DLR, and the evaluations of the two radiologists. Conclusion: The CDLR nomogram offers a reliable tool for differentiating risks associated with testicular masses. It augments radiological diagnoses, facilitates personalized treatment approaches, and curtails unwarranted medical procedures. [ABSTRACT FROM AUTHOR]

Simple Summary: Testicular lesions (TLs) are challenging clinical or ultrasound findings. When large, hard palpable lumps, TL management is mainly clinical, requiring conventional color-Doppler ultrasound (CDUS) to confirm that they are solid, vascularized lesions suggesting malignancy. However, when their CDUS characteristics are uncertain or when nonpalpable, multiparametric US (mp-US) (i.e., the combination of CDUS and more recent US techniques such as contrast-enhanced US and sonoelastography) plays a key role in their characterization, aimed at differentiating benign from malignant TL. This is relevant, since TLs are frequent, testicular tumors are the most common malignancies in young men, and the accurate assessment of a TL is critical to define its correct management including testicular salvage and US follow-up or orchiectomy. In this scenario, this narrative and pictorial review reports a practical mp-US "identity card" and iconographic characterization of several benign and malignant TLs, useful to the physician in daily clinical practice. Background: Ultrasonography (US) represents the gold standard imaging method for the assessment of testicular lesions (TL). The gray-scale (GSUS) and color-Doppler (CDUS) ultrasound examination allow sonographers to investigate the size, margins, echotexture, and vascular features of TLs with the aim to differentiate benign from malignant lesions. Recently, the use of contrast-enhanced US (CEUS) and sonoelastography (SE) has led to further improvements in the differential diagnosis of TL. Although GSUS and CDUS are often sufficient to suggest the benign or malignant nature of the TL, CEUS can be decisive in the differential diagnosis of unclear findings, while SE can help to strengthen the diagnosis. The contemporary combination of GSUS, CDUS, CEUS, and SE has led to a new diagnostic paradigm named multiparametric US (mp-US), which is able to provide a more detailed characterization of TLs than single techniques alone. This narrative and pictorial review aimed to describe the mp-US appearance of several TLs. Methods: An extensive Medline search was performed to identify studies in the English language focusing on the mp-US evaluation of TLs. Results: A practical mp-US "identity card" and iconographic characterization of several benign and malignant TLs is provided herein. Conclusions: The mp-US characterization of TL reported herein can be useful in daily clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Numerous etiologies, categorised as Neoplastic and Non-Neoplastic lesions, can affect the testis. Non-neoplastic conditions are further broken down into important categories such as congenital anomaly, inflammation or infection, vascular disorders, and atrophy caused by various etiologies. Neoplastic lesions are far less common than non-neoplastic lesions, but their early detection is crucial for managing them and understanding age distribution. Objectives: Our study aims to analyze Histomorphological spectrum of various testicular specimens as well as to calculate age incidence of various testicular lesions. Material and Methods: This retrospective study of five years from January 2017 to December 2021 with total of 100 specimens conducted in department of pathology of jhalawar medical college. All orchidectomy specimens managed further and examined microscopically. Results: Overall, it was discovered that non-neoplastic lesions were more prevalent than neoplastic lesions (85% vs. 15%). The most frequent non-neoplastic lesions were torsion/infarction (38%), followed by both cryptorchidism (14%) and Non specific inflammatory lesions (14%). Seminoma (40%) is more frequent than embryonal carcinoma (26.67%) among neoplastic tumours, which is thought to be the second most frequent. Inflammatory lesions are substantially less common among younger age groups, according to our research. Conclusion: Comparing histopathogical evaluation to recently developed molecular techniques, we found it to be a very simple, logical, and effective instrument. It turns out to be quite useful for both identifying different testicular lesions and categorising their age occurrences.

The present study investigated the macroscopical and histological features of two spontaneous seminomas developed by zebrafish adults. Two wild-type male zebrafish of AB/TU strain aged 2 and 3 years, respectively, developed gross pathological signs consisting of asymmetrical swollen abdomens. In one fish, named fish 1, the testicular alteration is referred to as one testis (the right one), while in fish 2, both testes were altered in their size and shape. No signs of invasion were reported. The histological analysis revealed an extensive differentiation of germ cells in various developmental stages without any oocyte, and both lesions were compatible with spermatocytic and intratubular seminomas. The etiology and the pathogenesis of the reported lesions could be related to an intricate and interconnected network of intrinsic and extrinsic factors, including the housing condition, diet, genetic background, and operator training. [ABSTRACT FROM AUTHOR]

Background: Testicular lesions encompass a wide range of pathological conditions, including inflammatory, neoplastic, and developmental disorders. This study aims to provide an overview of the histopathological spectrum of testicular lesions observed at Amruth diagnostic laboratory. Methods: A retrospective analysis was conducted on testicular specimens received at Amruth diagnostic laboratory over a four-year period. Relevant clinical and pathological data were collected from the medical records, including age, presenting symptoms, and histopathological findings. The specimens were examined microscopically, and diagnosis was made based on established criteria. Results: A total of 200 testicular specimens were included in the study. The age of the patients ranged from 18 to 75 years, with a mean age of 42 years. The most common presenting symptom was testicular pain, reported in 65% of cases. The histopathological analysis revealed a diverse range of testicular lesions. Inflammatory conditions such as orchitis and epididymo-orchitis were observed in 20% of cases, followed by testicular tumors, including germ cell tumors (70%), sex cord-stromal tumors (12.5%), and metastatic tumors (7.5%). Additionally, non-neoplastic lesions like testicular atrophy, interstitial fibrosis, and vascular disorders were identified in 7.5% of cases. These findings provide important insights into the histopathological spectrum of testicular lesions in our study population. Conclusion: This study provides insights into the histopathological spectrum of testicular lesions encountered at Amruth diagnostic laboratory. The findings highlight the importance of a thorough histopathological evaluation in diagnosing and managing various testicular conditions. Understanding the diversity of testicular lesions can aid in appropriate treatment planning and counselling for patients with testicular pathologies. Further research and prospective studies are warranted to validate these findings and explore potential risk factors associated with specific testicular lesions. [ABSTRACT FROM AUTHOR]

The present study investigated the macroscopical and histological features of two spontaneous seminomas developed by zebrafish adults. Two wild-type male zebrafish of AB/TU strain aged 2 and 3 years, respectively, developed gross pathological signs consisting of asymmetrical swollen abdomens. In one fish, named fish 1, the testicular alteration is referred to as one testis (the right one), while in fish 2, both testes were altered in their size and shape. No signs of invasion were reported. The histological analysis revealed an extensive differentiation of germ cells in various developmental stages without any oocyte, and both lesions were compatible with spermatocytic and intratubular seminomas. The etiology and the pathogenesis of the reported lesions could be related to an intricate and interconnected network of intrinsic and extrinsic factors, including the housing condition, diet, genetic background, and operator training.

Background: The global distribution of testicular disorders differs conforming with differences in demographic denominators. The diagnostic dictum for these disorders customarily adheres to findings at clinical assessment, relevant imaging, and laboratory evaluation. Histopathological confirmation remains the ultimate for the diagnosis of testicular malignancies and many testicular dysfunctions. The epidemiological review of the histological outcomes among Kano populace, however, is deficient. Objective: The aim of the study was to analyse histological pattern of testicular lesions in Kano, Nigeria. Methodology: The study is a 14-year retrospective review of testicular specimens subjected to histology in Kano from January 2003 to December 2016. The variables obtained were the age of patients, laterality, and histological diagnoses. These were collated and analyzed; the findings were presented as mean, patients' age range, and laterality ratio with frequency tables. Results: Three hundred and forty-three testicular tissues were assessed. The nonneoplastic lesions were 79.2% with patients' age range of 3–90 years. Atrophies and maturation arrests formed 29.4% and 18.0%, respectively. Specimens from the right were more with a ratio of 1.6:1. Neoplastic lesions were 3.5% and patients' age range from 3 to 65 years. Seminomas were the predominant neoplastic lesion and constituted 66.7%. The right testes were more commonly affected and have a ratio of 1.4:1. Conclusion: This appraisal affirms that testicular lesions could be found across a wide age range and majorities are nonneoplastic. The findings in this study concur with the published African and Asian conclusions.

Abstract Aim of this survey is to review the few available literature data on pathophysiologic and clinical aspects of pubertal development in boys with McCune-Albright syndrome (MAS). On the basis of such analysis, we concluded that: 1) peripheral precocious puberty (PPP) is significantly more infrequent in boys than in girls; 2) the most common testicular abnormality at MAS presentation is macroorchidism, that may be either monolateral or bilateral; 3) macroorchidism is not always associated with clinical and biochemical evidence of PPP; 4) testicular microlothiasis is distinctly more frequent in boys with MAS than in those without MAS; 5) the available therapeutic schedules have to be adopted already at MAS presentation only in the cases with PPP.

The increased use of ultrasound in patients with urological and andrological symptoms has given an higher detection of intra-testicular nodules. Most of these lesions are hypoechoic and their interpretation is often equivocal. Recently, new ultrasound techniques have been developed alongside of B-mode and color-Doppler ultrasound. Although not completely standardized, contrast-enhanced ultrasound (CEUS) and tissue elastography (TE), added to traditional ultrasonography, can provide useful information about the correct interpretation of incidentally detected non-palpable testicular nodules. The purpose of this review article is to illustrate these new techniques in the patient management.

Objectives: The purpose of this study was to evaluate the differential diagnostic value of 18F-fluorodeoxy glucose positron emission tomography/computed tomography (18F-FDG PET/CT) for benign and malignant testicular lesions.Methods: The PET/CT scans of 53 patients with testicular lesions confirmed by biopsy or surgical pathology were retrospectively analyzed. There were 32 cases of malignant tumors and 21 cases of benign lesions. Differences in the maximum standardized uptake value (SUVmax) measurements and the SUVmax lesion/background ratios between benign and malignant lesions were analyzed. The diagnostic value of this PET/CT modality for the differential diagnosis of benign versus malignant testicular lesions was calculated.Results: The differences in the SUVmax measurements and the SUVmax lesion/background ratios between benign and malignant lesions were statistically significant (SUVmax: Z=-4.295, p=0.000; SUVmax lesion/background ratio: Z=-5.219, p=0.000); specifically, both of these indicators were higher in malignant lesions compared to benign lesions. An SUVmax of 3.75 was the optimal cutoff value to differentiate between benign and malignant testicular lesions. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this PET/CT modality in the differential diagnosis of benign versus malignant testicular lesions were 90.6%, 80.9%, 86.8%, 87.9%, and 85.0%, respectively.Conclusions: 18F-FDG PET/CT can accurately identify benign and malignant testicular lesions. [ABSTRACT FROM AUTHOR]

The increased use of ultrasound in patients with urological and andrological symptoms has given an higher detection of intra-testicular nodules. Most of these lesions are hypoechoic and their interpretation is often equivocal. Recently, new ultrasound techniques have been developed alongside of B-mode and color-Doppler ultrasound. Although not completely standardized, contrast-enhanced ultrasound (CEUS) and tissue elastography (TE), added to traditional ultrasonography, can provide useful information about the correct interpretation of incidentally detected non-palpable testicular nodules. The purpose of this review article is to illustrate these new techniques in the patient management. [ABSTRACT FROM AUTHOR]

Background: The global distribution of testicular disorders differs conforming with differences in demographic denominators. The diagnostic dictum for these disorders customarily adheres to findings at clinical assessment, relevant imaging, and laboratory evaluation. Histopathological confirmation remains the ultimate for the diagnosis of testicular malignancies and many testicular dysfunctions. The epidemiological review of the histological outcomes among Kano populace, however, is deficient., Objective: The aim of the study was to analyse histological pattern of testicular lesions in Kano, Nigeria., Methodology: The study is a 14-year retrospective review of testicular specimens subjected to histology in Kano from January 2003 to December 2016. The variables obtained were the age of patients, laterality, and histological diagnoses. These were collated and analyzed; the findings were presented as mean, patients' age range, and laterality ratio with frequency tables., Results: Three hundred and forty-three testicular tissues were assessed. The nonneoplastic lesions were 79.2% with patients' age range of 3-90 years. Atrophies and maturation arrests formed 29.4% and 18.0%, respectively. Specimens from the right were more with a ratio of 1.6:1. Neoplastic lesions were 3.5% and patients' age range from 3 to 65 years. Seminomas were the predominant neoplastic lesion and constituted 66.7%. The right testes were more commonly affected and have a ratio of 1.4:1., Conclusion: This appraisal affirms that testicular lesions could be found across a wide age range and majorities are nonneoplastic. The findings in this study concur with the published African and Asian conclusions., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Nigerian Journal of Surgery.)

Objective: To summarize the clinical characteristics of testicular torsion and explore the relationship between its incidence and temperature, the value of supplementary examinations, and the factors causing misdiagnosis and testicular lesions., Methods: We retrospectively analyzed the clinical data of the patients with testicular torsion diagnosed in 9 hospitals in Hunan Province from May 1, 2009 to November 1, 2018. The temperature at onset and WBC value after onset were analyzed. The misdiagnosis rate and testicular lesion rate in the first-visit hospitals were compared between the large general hospitals and local hospitals. The factors that affected the diagnosis and treatment of testicular torsion were analyzed., Results: A total of 274 cases were included in this study, and misdiagnoses occurred in 151 cases (61.9%). The initial diagnosis was made in large general hospitals in 59 cases; misdiagnosis occurred in 30.5% of the cases and the rate of testicular lesions was 57.6%. Of the 215 cases first diagnosed in local hospitals, only 82 cases were diagnosed correctly, and the misdiagnosis rate was as high as 61.9%; the rate of testicular lesion was 85.6% in these cases. There were significant differences in the misdiagnosis rate and testicular lesion rate between the two groups ( P < 0.05)., Conclusions: The first-visit misdiagnosis rate of testicular torsion is much lower and the probability of testicle preservation is significantly higher in large general hospitals than in the local hospitals, suggesting the importance of health education for testicular torsion, enhancing the awareness of this condition and training of the surgeons in primary hospitals.

From previous experiments it was concluded that failure of spermatogenic cells to differentiate after orchiopexy seems to be due to surgical trauma. Furthermore it appeared that in normally descended testes of naturally unilaterally cryptorchid pigs subjected to orchiopexy, the spermatogenic epithelium was poorly developed as compared with that of scrotal testes of unilaterally cryptorchid pigs that had not undergone the surgical procedure. Even simple inguinal surgery in unilaterally naturally cryptorchid piglets may already give rise to severe histological lesions in the spermatogenic epithelium of the normally descended contralateral testes at adulthood. On the other hand extirpation of the retained testis by laparotomy does not affect the spermatogenic epithelium in the contralateral scrotal testis. From these experiments it may be concluded that with regard to the prevention of sterility in unilaterally cryptorchid pigs it may be preferable to extirpate the retained testis rather than to perform an orchiopexy. [ABSTRACT FROM AUTHOR]