Ronald G. Frank

Primary carcinoid tumor of the testis.

Primary carcinoid tumors of the testis are exceedingly rare. Thirty-one primary tumors have been reported in the literature, none of which have been diagnosed preoperatively. We present a case report demonstrating the sonographic features of a testicular carcinoid which may contribute to an early preoperative diagnosis.

Histoplasmosis of the Penis

Histoplasmosis is a common cause of systemic mycosis in endemic areas of the United States. Genitourinary and cutaneous involvement with this dimorphous fungus is rare. We report a case of disseminated histoplasmosis associated with nonpainful ulcerative lesions of the glans and shaft of the penis.

Metastatic hypernephroma masquerading as acute cholecystitis.

Renal cell carcinoma can metastasize to multiple anatomic sites. The metastasis may simulate certain disease entities depending on the location and particular organ involved. It is important to recognize that these metastases can present many years after the primary tumor has been treated. We present a case in which a primary hypernephroma was surgically removed and subsequently 13 years later presented with metastatic disease to the gallbladder clinically simulating acute cholecystitis.

Torsion of an intraabdominal testis tumor presenting as an acute abdomen

Torsion of an intraabdominal testicular tumor is a rare preoperative diagnosis. An increased diagnostic yield is dependent on an expedient and comprehensive preoperative evaluation. This consists of a detailed past surgical history, a thorough physical examination, and close inspection of the preoperative abdominal films. An illustrated case report is presented.

Venous cavernous hemangioma of the testis

T images presented are from a 77-year-old man who was admitted to the hospital with a 1-year history of hoarseness. A recent workup revealed an advanced squamous cell carcinoma of the larynx (T3N2CM0). He was admitted to the hospital to begin his first course of neoadjuvant chemotherapy with 5-fluorouracil (5-FU) and cisplatinum. His admission genitourinary examination revealed a large solid-appearing mass of the left testicle. The patient claimed that the testicle had been enlarged for “50 years.” An ultrasound of the testis demonstrated a large inhomogeneous mass with multiple hypoechoic regions and calcific shadowing (Fig. 1). The serum beta-human chorionic gonadotropin and alfa-feto protein levels were normal. The patient underwent an inguinal exploration. The cord structures were normal. The left testicle was firm and irregularly enlarged. A left radical orchiectomy was performed. The bivalved gross specimen is seen in Figure 2. The microscopic evaluation demonstrates vascular channels consistent with a large cavernous hemangioma of the testis (Figs. 3A and B). Cavernous hemangiomas are benign vascular tumors. Only 25 cases of testicular hemangiomas have been cited previously in the literature.1 In the present case, it was believed that the mass was probably benign because it had been present for many years. The sonographic features were more suggestive of a malignant process. Thus a radical orchiectomy was performed. This lesion, while rare, should be included in the differential diagnosis of testicular masses.

Antenatal Sonographic Evidence of a Paratesticular Mass Representing Healed Meconium Peritonitis

Scrotal masses representing healed meconium peritonitis have been reported in the literature with increasing frequency. The first case of antenatal sonographic evidence of a paratesticular mass that was shown to represent healed meconium peritonitis at subsequent exploration is discussed in this report.

Imaging of retroperitoneal rhabdomyosarcoma mimicking hypernephroma

Malignant tumors that arise in the perinephric space often present a diagnostic dilemma. These retroperitoneal tumors may resemble renal carcinomas, extrahepatic lymphoma, metastatic disease, or tumors arising in other retroperitoneal organs. We present a case of a patient with a primary retroperitoneal rhabdomyosarcoma who had an extensive diagnostic workup prior to surgical intervention that was thought to be consistent with an aggressive renal cell carcinoma.

Human penile ossification: A case report and review of the literature

Human penile ossification is a rare event. Only a limited number of cases have appeared in the literature. Several reported cases have been related to local trauma and plastic induration of the penis. We report an additional case with a comprehensive review of case reports in the literature.

Sequential Bilateral Germ Cell Tumors of the Testis: Sonographic Evaluation

Testicular tumors are rare and account for less than 1% of all cancers in men. In 1% to 5% of cases, these tumors are bilateral. Sonography of the scrotum is important for the initial diagnosis and serial followup in the early diagnosis of a contralateral tumor. A case report of a man with sequential bilateral testicular tumors is presented with a review of the literature. Emphasis is placed on the importance of sonography in the evaluation of these tumors.