Volume 10, Number 2Case ReviewLeydig Cell Hyperplasia Revealed by GynecomastiaCase ReviewMoulay Hassan FarihMohamed Fadl TaziSoufiane MellasMohamed Jamal El FassiLeydig cell tumors are rare and represent 1% to 3% of all tumors of the testis. Leydig cell tumors affect males at any age, but there are 2 peak periods of incidence: between 5 and 10 years and between 25 and 35 years. Their main clinical presentation is a testicular mass associated with endocrinal manifestations that are variable according to age and appearance of the tumor. Our patient, a 17-year-old adolescent, presented with an isolated and painless hypertrophy of the right mammary gland. Clinical examination found gynecomastia and no testicular mass. Hormonal levels and tumor markers were normal. Testicular sonography showed an ovular and homogeneous right intratesticular mass 6 mm in diameter. We treated the patient with an inguinal right orchidectomy. The anatomopathological study found a nodule of Leydig cell hyperplasia. The patient recovered without recurrence at 8-month follow-up. The patient opted for mammoplasty 2 months after his orchidectomy rather than wait for the spontaneous gradual regression of his gynecomastia, which requires at least 1 year. Leydig cell hyperplasia manifests in the adult by signs of hypogonadism, most frequently gynecomastia. Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it be subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually resolve favorably. [Rev Urol. 2008:10(2):164-167]FertilityTesticular tumorLeydig cell hyperplasiaNonseminomatous germ celltumorsGynecomastia
Volume 11, Number 4Case ReviewConcurrent Bilateral Renal Angiomyolipoma and Renal Cell Carcinoma in a Patient With Tuberous Sclerosis ComplexMohamed Fadl TaziSoufiane MellasMbarek DoublaliAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiRenal angiomyolipomas (AMLs) are often associated with tuberous sclerosis. These tumors are predominantly benign, although malignant forms do exist and are known to be associated with renal cell carcinoma. This case report describes a patient with tuberous sclerosis and massive bilateral AML. Total right nephrectomy was performed; histopathologic examination revealed the coexistence of AML and clear cell renal carcinoma in the same kidney. Because differentiation between renal cell carcinoma and AML with minimal or no fat component can be difficult, an accurate diagnosis is critical in the management of renal AML.[Rev Urol. 2009;11(4):216-218 doi: 10.3909/riu0436]© 2009 MedReviews®, LLCRenal cell carcinomaAngiomyolipomaTuberous sclerosis
Volume 12, Number 3Case ReviewRisk Factor Analysis and Management of Ureteral Double-J Stent ComplicationsCase ReviewMoulay Hassan FarihYounes AhallalAbdelhak KhalloukMohamed Jamal El FassiDouble-J ureteral stents are commonly used to manage urinary obstructions. Pain, bladder irritative symptoms, and fever are usually signs of early complications related to double-J stents; late complications are more troublesome. We review 4 cases that highlight a variety of late complications with double- J stents (encrustation, migration, and fragmentation). Following a review of the literature, guidelines are established for monitoring potential risk factors as well as management strategies for prevention of possible complications when using double-J stents. [Rev Urol. 2010;12(2/3):e147-e151 doi:10.3909/riu0447]Double-J stentExtracorporeal shock wave lithotripsyStent migrationFragmentationEncrustation
Volume 13, Number 4Case ReviewBenign Paratesticular Fibrous Pseudotumor With Malignant Clinical FeaturesMoulay Hassan FarihMohamed Fadl TaziElmehdi TaziAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiParatesticular tumors are rare intrascrotal masses that grow mainly in structures containing connective tissue around the testis, epididymis, or spermatic cord. We report here on a case of a 55-year-old man with a mass in the hemiscrotum that was found to be a paratesticular fibrous pseudotumor in the orchiectomy specimen pathologic examination. From this case report and literature review, a diagnostic and therapeutic strategy is demonstrated for the management of this uncommon lesion. [Rev Urol. 2011;13(4):e203-e205 doi: 10.3909/riu0509] © 2011 MedReviews®, LLCParatesticular fibrous pseudotumorEpididymisSpermatic cord
Volume 13, Number 3Case ReviewConcomitant Sertoli and Leydig Cell Tumor of the Testis: A Case ReportMoulay Hassan FarihMohamed Fadl TaziElmehdi TaziHinde ElfatemiMohcine BendahouAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiA rare intratubular gonadal stromal tumor was present in the testis of a 45-year-old man who was admitted to our hospital with the chief complaint of gradual enlargement of the left testis. Tumoral markers were negative and no extension was observed. The tumor comprised an intratubular mixture of two types of tumor cells with intercellular junctions: the predominant tumor cells were consistent with a Sertoli cell origin and cells comprising the minor population consistent with a Leydig cell origin. The patient is disease free after 6-month follow-up. The case is considered to be a testicular mixed tubular Sertoli-Leydig cell tumor. It highlights a rare type of primary tumor of the testis that features a good prognosis. [Rev Urol. 2011;13(3):173-175 doi:10.3909/riu0495] © 2011 MedReviews®, LLC
Volume 13, Number 2Case ReviewIdiopathic Scrotal Calcinosis: A Non-Elucidated Pathogenesis and Its Surgical TreatmentMoulay Hassan FarihOussama El YazamiMohamed Fadl TaziSoufiane MellasAbdelhak KhalloukMohamed Jamal El FassiScrotal calcinosis (SC) is a rare, benign entity defined as the presence of multiple calcified nodules within the scrotal skin. In most cases, there are no associated symptoms. We report the case of 27-year-old man with a massive SC. Treatment was surgical with complete excision of the affected part of the scrotum wall. Histopathologically, there was no epithelial lining around the calcified nodules and no cystic structure. Therefore, our case was considered idiopathic SC [Rev Urol. 2011;13(2):95-97 doi: 10.3909/riu0481] © 2011 MedReviews®, LLCTreatmentCalcinosisIdiopathicScrotumSurgery
Volume 13, Number 1Case ReviewAppendiceal Abscess Revealed by Right Renal Colic and HydronephrosisCase ReviewMoulay Hassan FarihAbdelhak KhalloukYounes AhallalMustapha AhsainiMohamed Jamal El FassiReported is the case of a patient who had an appendiceal abscess revealed by right renal colic with fever and general fatigue. The abdominal computed tomography scan showed hydronephrosis and an appendiceal abscess surrounding and compressing the ureter. The appendix contained a stercolith and was perforated. [Rev Urol. 2011;13(1):53-55 doi: 10.3909/riu0479]HydronephrosisRenal colicAppendicitisAbscess