Stavros Ioannidis

Papillary cystadenoma of epididymis: Is there a need for further investigation in unilateral cases?

INTRODUCTION The presence of a mass in the epididymis is not a common entity. The papillary cystadenoma of epididymis is a benign tumor which may occur sporadically or as a characteristic of von Hippel-Lindau disease. PRESENTATION OF CASE We present a case of a 27-year-old man with a right scrotal mass who was treated with surgical excision. Histopathological examination revealed a clear cell epididymal papillary cystadenoma. A computed tomography scan that was performed later showed no other abnormality or any signs of von Hippel-Lindau disease. DISCUSSION In this report, a case of a young man suffering from this rare tumor is discussed, focusing on the need of further evaluation in order to determinate if it occurs as a feature of VHL disease or as a sporadic form. CONCLUSION In unilateral cases of papillary cystadenoma of epididymis such as our patients, literature advocates that no further examinations and expensive genetic testing is required.

Unilateral urinothorax can occur contralateral to the affected kidney

Abstract Urinothorax is a rare cause of transudative pleural effusion with biochemical characteristics of urine, usually secondary to obstructive uropathy. Urine usually moves into the pleural space from the retroperitoneal or peritoneal space via diaphragmatic lymphatics or an anatomical diaphragm defect. A total of approximately 70 cases have been previously described in the literature, and in the vast majority of cases urinothorax is unilateral and ipsilateral to the side of obstructive uropathy, trauma or malignancy. This report describes a rare case of unilateral urinothorax occurring contralateral to the side of obstruction.

Complications of Inflatable Penile Prostheses Implantation Classified according to the Modified Clavien System

Introduction. In patients with erectile dysfunction (ED), inflatable penile prosthesis (IPP) surgery is regarded as the gold standard treatment in medically refractory cases or where its conservative treatment options are contraindicated. Despite improvements in surgical technique and implanted materials, IPP surgery retains a substantial complication rate. The aim of the study was to record and grade the postoperative complications of IPP implantation according to a modified Clavien system. Methods. A total of 60 three-piece IPP implantations were performed between 2007 and 2013 by a single surgeon. The primary outcome was to stratify the early (first 30 days) complications into five categories using the modified Clavien-Dindo classification system. A secondary aim was to record the long-term adverse events and to identify possible factors related to complication occurrence. Results. Overall, there were 21 (35%) postoperative complications in 17 of 60 men (28.3%), with 15 adverse events occurring early after surgery. In terms of late complications, there were six (10%) major complications managed by either revision surgery or removal of the prosthesis. Conclusion. This study utilizes a validated morbidity scale thus overcoming problems of previous studies reporting IPP surgery complications. The modified Clavien classification system easily aids in assessing and comparing accurately patients’ postoperative complications, thus improving management and prevention.

Malignant Degeneration Within a Fibroepithelial Polyp of the Glans Penis: A Case Report and Literature Review

Introduction Fibroepithelial polyps (FEP) are benign mesodermal tumors that consist of a cone of fibrovascular stroma that emerges from the submucosa, covered by a layer of epithelium. Many synonyms have been used in the literature; among them, skin tags and acrochordons are the most frequently used. The FEPs are rarely formed in the glans penis, and their formation in this location is strongly associated with long-term condom catheter use. Hereby, we describe an additional case of an FEP of the glans penis associated with phimosis, and we report, for the first time, a malignant degeneration to squamous cell carcinoma (SCC).